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  • Question 1 - A 40 yr. old female presented with palmar xanthomas and tuberoeruptive xanthomas on...

    Correct

    • A 40 yr. old female presented with palmar xanthomas and tuberoeruptive xanthomas on her elbows and knees. Which of the following is the most probable diagnosis?

      Your Answer: Type III hyperlipoproteinaemia

      Explanation:

      Palmar xanthomas and tuberoeruptive xanthomas are found in type III hyperlipoproteinemia (dysbetalipoproteinemia,broad-beta disease, remnant removal disease)

    • This question is part of the following fields:

      • Cardiology
      7.4
      Seconds

  • Question 2 - Which of the following features of the jugular venous waveform indicates the closure...

    Incorrect

    • Which of the following features of the jugular venous waveform indicates the closure of the tricuspid valve?

      Your Answer: y descent

      Correct Answer: c wave

      Explanation:

      The a wave indicates atrial contraction. The c wave indicates ventricular contraction and resulting bulging of the tricuspid valve into the right atrium during isovolumetric systole. The v wave indicates venous filling. The x descent indicates the atrium relaxation and the movement of tricuspid valve downward. The y descent indicates the filling of the ventricle after the opening of the tricuspid valve.

    • This question is part of the following fields:

      • Cardiology
      7
      Seconds

  • Question 3 - A 70 yr. old male patient presented with increased difficulty in breathing during...

    Correct

    • A 70 yr. old male patient presented with increased difficulty in breathing during the last 4 months. He was diagnosed with mitral stenosis. On examination his BP was 120/80 mmHg and pulse rate was 68 bpm. There were bibasal crepitations on auscultation. He was on bisoprolol, frusemide and ISDN. From the given answers, what is the most likely indication of worsening of his mitral stenosis?

      Your Answer: Haemoptysis

      Explanation:

      Haemoptysis is a symptom which indicates the worsening of mitral stenosis. It occurs due to the rupture of pulmonary veins or the capillary system due to pulmonary venous hypertension. Elevated serum creatinine is seen in worsening aortic stenosis. Worsening of tricuspid regurgitation causes ascites and a pulsatile liver.

    • This question is part of the following fields:

      • Cardiology
      66.6
      Seconds

  • Question 4 - A 42 yr. old previously well woman presented with acute severe central chest...

    Correct

    • A 42 yr. old previously well woman presented with acute severe central chest pain for the past 2 hours. She has a family history of premature coronary artery disease. Her husband passed away recently due to prostate cancer. On examination her blood pressure was 130/80 mmHg and pulse rate was 80 bpm. Her ECG showed ST segment elevation and her troponin was slightly elevated. Emergency angiogram revealed slight wall irregularities with no luminal obstruction. Cardiovascular MR showed an apical ballooning of the myocardium resembling an octopus pot. Which of the following is the most likely cause for the ST segment elevation?

      Your Answer: Takotsubo cardiomyopathy

      Explanation:

      Causes for ST segment elevation other than myocardial infarction
      Natural variants
      -Early repolarization
      -Left ventricular hypertrophy and hypertrophic cardiomyopathy
      -Left bundle branch block
      Artefacts
      -Leads mispositioning
      -Electrical cardioversion
      Cardiovascular diseases
      -Pericarditis/ Myocarditis
      -Aortic dissection
      -Prinzmetal’s angina
      -Takotsubo Cardiomyopathy
      -Brugada Syndrome and arrhythmogenic right ventricular cardiomyopathy/dysplasia
      Pulmonary diseases
      -Pulmonary thromboembolism
      -Pneumothorax
      -Atelectasis and pulmonary metastases
      Gastrointestinal diseases
      -Acute pancreatitis
      -Acute cholecystitis
      Other conditions
      -Hyperkalaemia
      -Drug induced ST segment elevation (e.g. – clozapine)
      -Haemorrhagic cerebrovascular disease

      Coronary artery disease and myocardial infarction can be excluded with a negative angiogram and a slightly elevated troponin. Hypertrophic cardiomyopathy can be excluded with cardiovascular MR findings. Left ventricular aneurysm usually occurs following a myocardial infarction, but there is no positive history for that. The characteristic findings on cardiovascular MR confirms the diagnosis of Takotsubo cardiomyopathy.

    • This question is part of the following fields:

      • Cardiology
      26.7
      Seconds

  • Question 5 - A 35 yr. old female with systemic lupus erythematosus (SLE) was brought to...

    Correct

    • A 35 yr. old female with systemic lupus erythematosus (SLE) was brought to Casualty, complaining of chest pain and worsening difficulty in breathing for the past 36 hrs. On examination she was tachypnoeic, her BP was 85/65 mmHg and peripheral oxygen saturation was 98% on air. Her cardiac examination was normal but her jugular venous pressure was elevated. She didn't have ankle oedema. Her ECG showed sinus tachycardia and her CXR showed clear lung fields with a slightly enlarged heart. Which of the following is the most appropriate next step?

      Your Answer: Urgent transthoracic echocardiogram

      Explanation:

      Acute breathlessness in SLE can be due to a pericardial effusion or a pulmonary embolism. Normal peripheral oxygen saturation and normal ECG, make the diagnosis of pulmonary embolism less likely. To exclude pericardial effusion, an urgent transthoracic echocardiogram is needed.

    • This question is part of the following fields:

      • Cardiology
      37.8
      Seconds

  • Question 6 - A 28 yr. old primigravida in her 24th week of pregnancy came for...

    Correct

    • A 28 yr. old primigravida in her 24th week of pregnancy came for the routine follow up. She was asymptomatic at the time of examination. Her blood pressure was 152/92 mmHg and pulse rate was 90 bpm. Her blood pressure at the booking visit had been 132/80 mmHg. Her other examination findings were normal. Which of the following is the best method to use to treat her?

      Your Answer: Labetalol

      Explanation:

      Methyldopa is the drug of first choice for the control of mild to moderate hypertension in pregnancy. Labetalol is also considered as a first line drug for hypertension in pregnancy. Calcium channel blockers and hydralazine are considered as second line drugs. Beta-blockers (except labetalol), angiotensin receptor blockers, angiotensin-converting enzyme inhibitors and thiazides are not recommended.

    • This question is part of the following fields:

      • Cardiology
      16.5
      Seconds

  • Question 7 - A 65 yr. old woman was referred due to a pulse rate of...

    Correct

    • A 65 yr. old woman was referred due to a pulse rate of 40 bpm. Which of the following answers is associated with the least risk of asystole?

      Your Answer: Complete heart block with a narrow complex QRS

      Explanation:

      From the given answers, complete heart block with a narrow complex QRS complex is associated with the least risk of asystole. Transvenous pacing is indicated by the other given responses.

    • This question is part of the following fields:

      • Cardiology
      19.3
      Seconds

  • Question 8 - A 28 yr. old male was admitted with palpitations and chest discomfort for...

    Correct

    • A 28 yr. old male was admitted with palpitations and chest discomfort for the past 1 hour. On examination his pulse rate was 200 bpm and blood pressure was 80/50 mmHg. His ECG revealed narrow complex tachycardia with a heart rate of 200 bpm. Which of the following is the most appropriate management of this patient?

      Your Answer: Synchronised DC synchronised cardioversion

      Explanation:

      Narrow complex tachycardia with hypotension is a medical emergency. Immediate synchronized cardioversion is the ideal management.

    • This question is part of the following fields:

      • Cardiology
      98.5
      Seconds

  • Question 9 - A 70 yr. old man underwent temporary transvenous pacing. While in the coronary...

    Correct

    • A 70 yr. old man underwent temporary transvenous pacing. While in the coronary care unit he developed pre-syncope. His pulse rate was 30 bpm. His ECG showed pacing spikes which were not related to QRS complexes. What is the most appropriate action that can be taken?

      Your Answer: Increase the pacing voltage to a maximum

      Explanation:

      Pacemaker spikes on the ECG indicate that pacemaker is functioning. The most probable cause for this presentation is the change of the position of the tip of the pacing wire. Increasing the voltage will solve the problem. If it works, repositioning of the pacing wire should be done.

    • This question is part of the following fields:

      • Cardiology
      25.2
      Seconds

  • Question 10 - A 48 yr. old male presented with exertional angina for 2 weeks. He...

    Correct

    • A 48 yr. old male presented with exertional angina for 2 weeks. He has no significant past medical history or cardiac risk factors except a total cholesterol of 5.8 mmol/L. He has been already started on aspirin. Which of the following is the most suitable drug combination for him?

      Your Answer: B-blocker and statin

      Explanation:

      Beta blockers and calcium channel blockers have proven prognostic benefits. Nitrates don’t have any proven prognostic benefits. A statin is indicated for a patient with angina and cholesterol level of 5.5 to 8.5 to prevent risk of myocardial infarction. So the preferred combination from the given answers is beta blocker + statin.

    • This question is part of the following fields:

      • Cardiology
      28.1
      Seconds

  • Question 11 - A 85 yr. old male with a history of hypertension presented with a...

    Correct

    • A 85 yr. old male with a history of hypertension presented with a couple of pre-syncopal episodes. He describes these episodes as him having felt as if he was going to faint and he has had to sit down. There were no precipitating factors, associated chest pain or palpitations. He doesn't have chest pain, shortness of breath on exertion, orthopnoea or paroxysmal nocturnal dyspnoea. On examination he looked well. Blood pressure was 140/80 mmHg and pulse rate was 78 bpm which was irregular. His lungs were clear and heart sounds were normal. ECG showed sinus rhythm with occasional ventricular ectopic beats. Which of the following is an indication for permanent pacemaker implantation?

      Your Answer: Second-degree block associated with symptoms

      Explanation:

      Indications for permanent pacemaker implantation

      -Sinus node dysfunction
      -Acquired Atrioventricular(AV) block (Complete third-degree AV block with or without symptoms, Symptomatic second degree AV block, Mobitz type I and II, Exercise-induced second or third degree AV block in the absence of myocardial infarction, Mobitz II with widened QRS complex)
      -Chronic bifascicular block
      -After acute phase of myocardial infarction
      -Neurocardiogenic syncope and hypersensitive carotid sinus syndrome
      -Post cardiac transplantation
      -Hypertrophic cardiomyopathy
      -Pacing to detect and terminate tachycardia
      -Cardiac resynchronization therapy in patients with severe systolic heart failure
      -Patients with congenital heart disease

    • This question is part of the following fields:

      • Cardiology
      45.1
      Seconds

  • Question 12 - A 42 yr. old male patient who was on enalapril for hypertension presented...

    Correct

    • A 42 yr. old male patient who was on enalapril for hypertension presented with generalized body weakness. Investigations revealed hyperkalaemia. Which of the following can be expected in his ECG?

      Your Answer: Tall, tented T waves

      Explanation:

      In hyperkalaemia the ECG will show tall, tented T waves as well as small P waves and widened QRS complexes. 

    • This question is part of the following fields:

      • Cardiology
      15
      Seconds

  • Question 13 - A 55 yr. old female with a history of hypertension presented with severe...

    Correct

    • A 55 yr. old female with a history of hypertension presented with severe central chest pain for the past one hour, associated with sweating and vomiting. Her ECG showed ST elevation myocardial infarction, evident in leads V2-V4. Which of the following is an absolute contraindication for thrombolysis?

      Your Answer: Intracranial neoplasm

      Explanation:

      Absolute contraindications for fibrinolytic use in STEMI

      Prior intracranial haemorrhage (ICH)
      Known structural cerebral vascular lesion
      Known malignant intracranial neoplasm
      Ischemic stroke within 3 months
      Suspected aortic dissection
      Active bleeding or bleeding diathesis (excluding menses)
      Significant closed head trauma or facial trauma within 3 months
      Intracranial or intraspinal surgery within 2 months
      Severe uncontrolled hypertension (unresponsive to emergency therapy)
      For streptokinase, prior treatment within the previous 6 months

    • This question is part of the following fields:

      • Cardiology
      27
      Seconds

  • Question 14 - A 60 yr. old male presented with ventricular tachycardia which was successfully cardioverted....

    Incorrect

    • A 60 yr. old male presented with ventricular tachycardia which was successfully cardioverted. To check whether he had prolonged QT interval, which of the following is the most appropriate method to measure the QT interval in ECG?

      Your Answer: Time between the start of the Q wave and the start of the T wave

      Correct Answer: Time between the start of the Q wave and the end of the T wave

      Explanation:

      The QT interval is the time from the start of the Q wave to the end of the T wave. It represents the time taken for ventricular depolarisation and repolarisation. The QT interval should be measured in either lead II or V5-6.

    • This question is part of the following fields:

      • Cardiology
      24.1
      Seconds

  • Question 15 - A 9 year-old boy with central cyanosis underwent cardiac catheterization. His study results...

    Incorrect

    • A 9 year-old boy with central cyanosis underwent cardiac catheterization. His study results were given below:
      • Right atrium 7 mmHg  - Saturation 60 %
      • Right ventricle 110/6 mmHg  - Saturation 55 %
      • Pulmonary artery 20/5 mmHg - Saturation 55 %
      • Left atrium (mean) 9 mmHg - Saturation 98 %
      • Left ventricle 110/80 mmHg - Saturation 87 %
      • Aorta 110/80 mmHg - Saturation 76 %
      Which the following abnormalities are present in this patient?

      Your Answer: Ventricular septal defect

      Correct Answer: Tetralogy of Fallot

      Explanation:

      Based on the provided cardiac catheterization results, the following abnormalities are present in this patient:

      1. Central Cyanosis: The presence of central cyanosis indicates decreased oxygenation of the blood. This is likely due to an intracardiac shunt, causing unoxygenated blood to mix with oxygenated blood.
      2. Right-to-Left Shunt: The saturation readings in the right atrium (60%), right ventricle (55%), and pulmonary artery (55%) are all lower than the expected systemic saturation of 98%. This suggests a right-to-left shunt, allowing deoxygenated blood from the right side of the heart to enter the systemic circulation without passing through the lungs.
      3. Pulmonary Hypertension: The pulmonary artery pressure of 20/5 mmHg is elevated compared to normal values, indicating pulmonary hypertension. This could be secondary to increased pulmonary blood flow or resistance, often seen in the presence of a right-to-left shunt.
      4. Left-to-Right Shunt: Although not explicitly stated in the results, the elevated left atrial pressure (9 mmHg) suggests increased left-sided filling pressures. This could be due to increased blood flow from a left-to-right shunt, which commonly occurs in congenital heart defects.
      5. Normal Left Ventricular Pressure: The left ventricular pressure (110/80 mmHg) falls within normal limits, indicating that the left ventricle is not significantly affected by the shunting.

      Based on these findings, a likely diagnosis would be a congenital heart defect causing a right-to-left shunt, such as Tetralogy of Fallot or Eisenmenger syndrome, resulting in central cyanosis and pulmonary hypertension.

    • This question is part of the following fields:

      • Cardiology
      33
      Seconds

  • Question 16 - A 50 yr. old male presented with acute severe central chest pain and...

    Incorrect

    • A 50 yr. old male presented with acute severe central chest pain and acute ST elevation myocardial infarction was diagnosed. He was treated with streptokinase. 2 days later he was sweating excessively and he was found to be hypotensive. Which of the following cannot be considered as a reason for this presentation?

      Your Answer: Pulmonary embolus

      Correct Answer: Hypotensive effect of streptokinase

      Explanation:

      Hypotensive effect of streptokinase occurs during the streptokinase infusion which is usually transient. Acute mitral regurgitation due to rupture of papillary muscles, ventricular septal defects and reinfarctions (left or right) are known to cause hypotension after 24 hrs. Pulmonary embolism is less likely but cannot be excluded.

    • This question is part of the following fields:

      • Cardiology
      31.7
      Seconds

  • Question 17 - A 62 yr. old male presented with worsening breathlessness and fatiguability. On examination...

    Correct

    • A 62 yr. old male presented with worsening breathlessness and fatiguability. On examination there was bilateral ankle swelling and pulsatile liver. Auscultation revealed a pansystolic murmur best heard at the lower left sternal border. Which of the following is the most probable diagnosis?

      Your Answer: Tricuspid regurgitation

      Explanation:

      All the clinical features are suggestive of tricuspid regurgitation. The pansystolic murmur of mitral regurgitation is best heard at the apex.

    • This question is part of the following fields:

      • Cardiology
      42.8
      Seconds

  • Question 18 - A 60 yr. old female presented with difficulty in breathing. What is the...

    Correct

    • A 60 yr. old female presented with difficulty in breathing. What is the clinical sign that will indicate the presence of established pulmonary hypertension?

      Your Answer: Raised jugular venous pressure

      Explanation:

      A prominent A wave is observed in the jugular venous pulse and this indicates the presence of established pulmonary hypertension. In addition the pulmonic component of the second heart sound (P2) may be increased and the P2 may demonstrate fixed or paradoxical splitting. The signs of right ventricular failure include a high-pitched systolic murmur of tricuspid regurgitation, hepatomegaly, a pulsatile liver, ascites, and peripheral oedema.

    • This question is part of the following fields:

      • Cardiology
      163.7
      Seconds

  • Question 19 - A 50 yr. old male patient was started on amiodarone. Prior to commencement,...

    Correct

    • A 50 yr. old male patient was started on amiodarone. Prior to commencement, his blood urea and electrolytes were checked. What is the reason for doing this investigation before starting amiodarone?

      Your Answer: To detect hypokalaemia

      Explanation:

      Any antiarrhythmic drugs can potentially cause arrhythmias. Before starting amiodarone, any electrolyte imbalance including hypokalaemia, hypomagnesemia, or hypocalcaemia should be corrected to prevent any arrhythmias.

    • This question is part of the following fields:

      • Cardiology
      13.1
      Seconds

  • Question 20 - A 25 yr. old male presented with an episode of syncope. His examination...

    Incorrect

    • A 25 yr. old male presented with an episode of syncope. His examination findings were normal. He gave a history of sudden cardiac death of a close relative. His ECG showed incomplete right bundle-branch block and ST-segment elevations in the anterior precordial leads. What is the most probable diagnosis?

      Your Answer: Hypertrophic Cardiomyopathy

      Correct Answer: Brugada syndrome

      Explanation:

      Brugada syndrome is an autosomal dominant disorder characterized by sudden cardiac death. The positive family history and characteristic ECG findings are in favour of Brugada syndrome. Usually the physical findings are normal.

    • This question is part of the following fields:

      • Cardiology
      17.8
      Seconds

  • Question 21 - Which of the following describes the reason for the decline of the use...

    Correct

    • Which of the following describes the reason for the decline of the use of betablockers as antihypertensives in last few years?

      Your Answer: Less likely to prevent stroke + potential impairment of glucose tolerance

      Explanation:

      According to the latest research, beta blockers are associated with higher incidence of fatal and non-fatal strokes, all cardiovascular events, and cardiovascular mortality. New-onset diabetes also associates with beta blockers.

    • This question is part of the following fields:

      • Cardiology
      17.1
      Seconds

  • Question 22 - A 80 yr. old male was found on the floor. His blood pressure...

    Incorrect

    • A 80 yr. old male was found on the floor. His blood pressure was 100/60 mmHg. His core temperature was 31ºC. His FBC and serum electrolytes were within normal limits. Which of the following would be found in his ECG?

      Your Answer: U waves

      Correct Answer: Long QT interval

      Explanation:

      Hypothermia is defined as a core body temperature of < 35 °C.
      Hypothermia may produce the following ECG changes:
      -Bradyarrhythmia
      -Osborne Waves (= J waves)
      -Prolonged PR, QRS and QT intervals
      -Shivering artefact
      -Ventricular ectopics
      -Cardiac arrest due to VT, VF or asystole

    • This question is part of the following fields:

      • Cardiology
      9.1
      Seconds

  • Question 23 - A 60 yr. old previously well male was admitted with a suspected pulmonary...

    Correct

    • A 60 yr. old previously well male was admitted with a suspected pulmonary embolism. On examination his BP was 130/80 mmHg and pulse rate was 88 bpm. His CXR was normal. He was treated with low molecular weight heparin. Which of the following is the most appropriate initial lung investigation for this patient?

      Your Answer: Computed tomographic pulmonary angiography

      Explanation:

      Computed tomographic pulmonary angiography (CTPA) is the standard investigative tool, used for diagnosing a pulmonary embolism. Pulmonary angiography is indicated if CTPA is not available.

    • This question is part of the following fields:

      • Cardiology
      16.7
      Seconds

  • Question 24 - A 25 yr. old previously well female, in her 10th week of pregnancy...

    Correct

    • A 25 yr. old previously well female, in her 10th week of pregnancy presented with a left sided painful calf swelling. An ultrasound scan revealed deep venous thrombosis (DVT) of her left leg. Which of the following is the most appropriate management of this patient?

      Your Answer: Initiate and then continue treatment with heparin until delivery

      Explanation:

      Warfarin is contraindicated during pregnancy due to its teratogenic effects. She should be given heparin throughout her pregnancy. It can be converted to warfarin if necessary after the delivery.

    • This question is part of the following fields:

      • Cardiology
      22.7
      Seconds

  • Question 25 - A 65 yr. old male with a history of smoking and alcohol was...

    Correct

    • A 65 yr. old male with a history of smoking and alcohol was admitted with an ST elevation myocardial infarction. He was obese and lives a sedentary lifestyle. What is the non-pharmacological intervention which will be most helpful to reduce future ischaemic events?

      Your Answer: Stopping smoking

      Explanation:

      Stopping smoking is the single most effective non-pharmacological intervention which will reduce future ischaemic events. But the rest of the responses are also important interventions with regards to reducing future ischaemic events.

    • This question is part of the following fields:

      • Cardiology
      11.5
      Seconds

  • Question 26 - A 30 yr. old male patient presented with palpitations that occur randomly at...

    Incorrect

    • A 30 yr. old male patient presented with palpitations that occur randomly at rest. There have however been episodes of fast palpitations and dizziness on exertion. On examination there was a systolic murmur at the apex as well as a prominent apex beat and the chest was clear. Which of the following is LEAST likely to suggest a diagnosis of hypertrophic cardiomyopathy?

      Your Answer: A septum of 1.7 cm on echocardiography

      Correct Answer: A history of hypertension for 10 years

      Explanation:

      Hypertrophic cardiomyopathy is an autosomal dominant condition. Patients present with sudden cardiac death, dyspnoea, syncope and presyncope, angina, palpitations, orthopnoea and paroxysmal nocturnal dyspnoea, Congestive heart failure and dizziness. Physical findings include double or triple apical impulse, prominent a wave in the JVP, an ejection systolic crescendo-decrescendo murmur and a holosystolic murmur at the apex and axilla of mitral regurgitation.
      ECG shows ST-T wave abnormalities and LVH, axis deviation (right or left), conduction abnormalities (P-R prolongation, bundle-branch block), sinus bradycardia with ectopic atrial rhythm, atrial enlargement, abnormal and prominent Q wave in the anterior precordial and lateral limb leads.
      2D echocardiography shows abnormal systolic anterior leaflet motion of the mitral valve, LVH, left atrial enlargement, small ventricular chamber size, septal hypertrophy with septal-to-free wall ratio greater than 1.4:1, mitral valve prolapse and mitral regurgitation, decreased midaortic flow, partial systolic closure of the aortic valve in midsystole

    • This question is part of the following fields:

      • Cardiology
      27.7
      Seconds

  • Question 27 - A 28 yr. old primigravida in her 24th week of pregnancy presented with...

    Correct

    • A 28 yr. old primigravida in her 24th week of pregnancy presented with a history of palpitations, which are fast and regular. She doesn't complain of any episodes of collapse. On examination she was well, pulse rate was 102 bpm, which was regular and her blood pressure was 110/70 mmHg. Her JVP was not elevated. Heart sounds were normal. ECH showed sinus tachycardia. Which of the following can be expected because of the  physiological changes which occur in the boy during pregnancy?

      Your Answer: Tachycardia

      Explanation:

      The cardiovascular alterations which occur during pregnancy are for the optimal growth and development of the foetus and help to protect the mother from the risks of delivery, such as haemorrhage. The changes are characterized by an increased vascular volume, cardiac output, and heart rate, with a marked fall in vascular resistance and reduction in blood pressure.

    • This question is part of the following fields:

      • Cardiology
      17.3
      Seconds

  • Question 28 - A 50 yr. old male with a history of type II diabetes mellitus...

    Incorrect

    • A 50 yr. old male with a history of type II diabetes mellitus and hypertension presented with exertional dyspnoea and chest pain for 2 weeks. On examination his blood pressure was 145/80 mmHg. On auscultation reversed splitting of the second heart sound and bibasal crepitations were detected. What would be the most likely finding on his ECG?

      Your Answer: P pulmonale

      Correct Answer: Left bundle branch block

      Explanation:

      When closure of the pulmonary valve occurs before the aortic valve, reversed splitting occurs. The causes of reversed splitting are aortic stenosis, hypertrophic cardiomyopathy, left bundle branch block (LBBB), and a ventricular pacemaker.

    • This question is part of the following fields:

      • Cardiology
      15.3
      Seconds

  • Question 29 - From the following responses, what is the commonest cardiovascular abnormality associated with Marfan's...

    Incorrect

    • From the following responses, what is the commonest cardiovascular abnormality associated with Marfan's syndrome of an adult?

      Your Answer: Aortic dissection

      Correct Answer: Aortic root dilatation

      Explanation:

      The main cardiovascular manifestations associated with Marfan’s syndrome are aortic dilatation and mitral valve prolapse.

    • This question is part of the following fields:

      • Cardiology
      5.5
      Seconds

  • Question 30 - A 65 yr. old man with hypertension presented with sudden onset right arm...

    Incorrect

    • A 65 yr. old man with hypertension presented with sudden onset right arm weakness which resolved after 10 hrs. He has had 2 similar episodes during the last 6 weeks. On examination his blood pressure was 140/80 mmHg and pulse rate was 88 bpm. His ECG showed atrial fibrillation and the CT scan of his brain was normal. Which of the following is the most appropriate management for this patient?

      Your Answer: Aspirin

      Correct Answer: Warfarin

      Explanation:

      CHA₂DS₂-VASc score is used for atrial fibrillation stroke risk calculation.
      Congestive heart failure – 1 point
      Hypertension – 1 point
      Age ≥75 years – 2 points
      Diabetes mellitus – 1 point
      Stroke/Transient Ischemic Attack/Thromboembolic event – 2 points
      Vascular disease (prior MI, PAD, or aortic plaque) – 1 point
      Age 65 to 74 years – 1 point
      Sex category (i.e., female sex) – 1 point
      Score of 2 or more is considered as high risk and anticoagulation is indicated. This patient’s score is 4, so he needs life-long warfarin to prevent a stroke.

    • This question is part of the following fields:

      • Cardiology
      9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiology (20/30) 67%
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