21- Which of the following concerning congenital heart disease is correct?
1) ASD is the commonest malformation at birth
2) congenital complete heart block is usually associated with Anti-Ro antibodies in the mother
3) Ebstein's anomaly is associated with maternal exposure to lithium carbonate
4) Hypoplastic left heart syndrome is characterised by a large, dilated left ventricle
5) Osteogenesis imperfecta is associated with aortic stenosis
Answer-3
22- Which of the following regarding the anatomy of the heart is true?
1) The aortic valve is tricuspid.
2) The ascending aorta is entirely outside the pericardial sac.
3) The left atrial appendage is identified readily by transthoracic echocardiography.
4) The pulmonary trunk lies anterior to the ascending aorta.
5) The right atrium is posterior to the left atrium.
Answer-1
23- A patient presents with atrial fibrillation and later they revert to sinus rhythm. Under which of the following circumstances is the patient more likely to remain in sinus rhythm?
1) age > 75 years old
2) been commenced on warfarin
3) left atrium size > 6 cm on ECHO
4) short history of AF
5) ventricular rate on presentation of 130 bpm
Answer-4
24- A 68-year-old man has been very ill for months following the onset of chronic liver disease with hepatitis C infection. He experiences a sudden loss of consciousness and then exhibits paraplegia on the right. A cerebral angiogram reveals lack of perfusion in the left middle cerebral artery istribution. The most likely cardiac lesion to be associated with this finding is?
1) Acute rheumatic fever
2) Left atrial myxoma
3) Libman-Sacks endocarditis
4) Non-bacterial thrombotic endocarditis
5) Paradoxical thromboembolus
Answer-4
25- A 65 year old man presents with severe central crushing chest pain. ECG shows evidence of an inferior myocardial infarction. He receives TPA, Heparin and Aspirin. Four hours after initial presentation, he starts feeling dizzy and breathless. His pulse is 40 bpm regular, BP 80/50. Heart sounds are soft and chest clear to auscultation. ECG shows 2:1 AV block with T wave inversion inferiorly. IV atropine was administered but had no effect. What is the next most important treatment?
1) IV Dopamine.
2) IV Isoprenaline.
3) Insert a permanent pacemaker.
4) Insert a temporary pacemaker.
5) Monitor his progress.
Answer-4
26- A 70-year-old male is referred by his GP for management of recently diagnosed congestive heart failure. The patient has a history of poorly controlled hypertension. Over the last three months he has been aware of deteriorating shortness of breath, fatigue, and orthopnea. Over the last month he had been commenced on Digoxin (62.5 micrograms daily), Frusemide (80 mg daily), and amiloride 10 mg. On examination he has a pulse of 96 bpm regular, a blood pressure of 132/88 mmHg. His JVP was not raised, he had some scattered bibasal crackles on auscultation with a displaced apex beat in the anterior axillary line, 6th intercostal space. Auscultation of the heart revealed no murmurs and he had peripheral oedema to the mid tibia. Investigations showed: electrolytes normal serum urea concentration 17 mmol/l (NR 2-8 mmol/l) creatinine 175 micromol/l (NR 55-110) Serum digoxin 0.7 ng/mL {therapeutic: 1.0-2.0} One month previously his urea had been 11 mmol/l and creatinine 110
micromol/l. An ECG reveals left ventricular hypertrophy and Chest X-ray shows cardiomegaly and calcified aorta. What is the most appropriate next step in management?
1) Add an ACE inhibitor to the current regimen
2) Add atenolol at a dose of 25mg daily
3) Increase digoxin to 0.25 mg daily
4) Increase frusemide to 80 mg twice daily
5) Maintain on current therapy.
Answer-1
27- A 14-year-old boy presents with hypertension. Which of the following statements concerning hypertension in the young is true?
1) Sodium nitroprusside is useful for the long-term treatment of severe cases.
2) Headache is the usual presenting feature.
3) It is defined as systolic blood pressure above the 99th centile for age.
4) Abnormalities are frequently seen on DMSA scan.
5) Aortic coarctation is the commonest secondary cause.
Answer-4
28- A 23 year old male presents with a deep vein thrombosis. He has no past medical history but his mother has suffered from deep vein thromboses. Which of the following is likely to be found on haematological assessment?
1) Factor V Leiden mutation
2) Protein S deficiency
3) Protein C deficiency
4) Antithrombin deficiency
5) Lupus anticoagulant
Answer-4
29- In a normal heart, the oxygen saturation of a sample of blood taken from a catheter in the pulmonary capillary wedge position should be equal to a sample from which of the following?
1) coronary sinus
2) femoral artery
3) pulmonary artery
4) right atrium
5) right ventricle
Answer-2
30 -A 60-year-old man with a past history of controlled hypertension presents with acute onset weakness of his left arm, that resolved over 12 hours. He had suffered two similar episodes over the last three months. Examination reveals a blood pressure of 132/82 mmHg and he is in atrial fibrillation with a ventricular rate of 85 per minute. CT brain scan is normal.
What is the most appropriate management?
1) amiodarone
2) aspirin
3) digoxin
4) dipyridamole
5) warfarin
Answer-5
More Questions & Answers:-
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1) ASD is the commonest malformation at birth
2) congenital complete heart block is usually associated with Anti-Ro antibodies in the mother
3) Ebstein's anomaly is associated with maternal exposure to lithium carbonate
4) Hypoplastic left heart syndrome is characterised by a large, dilated left ventricle
5) Osteogenesis imperfecta is associated with aortic stenosis
Answer-3
22- Which of the following regarding the anatomy of the heart is true?
1) The aortic valve is tricuspid.
2) The ascending aorta is entirely outside the pericardial sac.
3) The left atrial appendage is identified readily by transthoracic echocardiography.
4) The pulmonary trunk lies anterior to the ascending aorta.
5) The right atrium is posterior to the left atrium.
Answer-1
23- A patient presents with atrial fibrillation and later they revert to sinus rhythm. Under which of the following circumstances is the patient more likely to remain in sinus rhythm?
1) age > 75 years old
2) been commenced on warfarin
3) left atrium size > 6 cm on ECHO
4) short history of AF
5) ventricular rate on presentation of 130 bpm
Answer-4
24- A 68-year-old man has been very ill for months following the onset of chronic liver disease with hepatitis C infection. He experiences a sudden loss of consciousness and then exhibits paraplegia on the right. A cerebral angiogram reveals lack of perfusion in the left middle cerebral artery istribution. The most likely cardiac lesion to be associated with this finding is?
1) Acute rheumatic fever
2) Left atrial myxoma
3) Libman-Sacks endocarditis
4) Non-bacterial thrombotic endocarditis
5) Paradoxical thromboembolus
Answer-4
25- A 65 year old man presents with severe central crushing chest pain. ECG shows evidence of an inferior myocardial infarction. He receives TPA, Heparin and Aspirin. Four hours after initial presentation, he starts feeling dizzy and breathless. His pulse is 40 bpm regular, BP 80/50. Heart sounds are soft and chest clear to auscultation. ECG shows 2:1 AV block with T wave inversion inferiorly. IV atropine was administered but had no effect. What is the next most important treatment?
1) IV Dopamine.
2) IV Isoprenaline.
3) Insert a permanent pacemaker.
4) Insert a temporary pacemaker.
5) Monitor his progress.
Answer-4
26- A 70-year-old male is referred by his GP for management of recently diagnosed congestive heart failure. The patient has a history of poorly controlled hypertension. Over the last three months he has been aware of deteriorating shortness of breath, fatigue, and orthopnea. Over the last month he had been commenced on Digoxin (62.5 micrograms daily), Frusemide (80 mg daily), and amiloride 10 mg. On examination he has a pulse of 96 bpm regular, a blood pressure of 132/88 mmHg. His JVP was not raised, he had some scattered bibasal crackles on auscultation with a displaced apex beat in the anterior axillary line, 6th intercostal space. Auscultation of the heart revealed no murmurs and he had peripheral oedema to the mid tibia. Investigations showed: electrolytes normal serum urea concentration 17 mmol/l (NR 2-8 mmol/l) creatinine 175 micromol/l (NR 55-110) Serum digoxin 0.7 ng/mL {therapeutic: 1.0-2.0} One month previously his urea had been 11 mmol/l and creatinine 110
micromol/l. An ECG reveals left ventricular hypertrophy and Chest X-ray shows cardiomegaly and calcified aorta. What is the most appropriate next step in management?
1) Add an ACE inhibitor to the current regimen
2) Add atenolol at a dose of 25mg daily
3) Increase digoxin to 0.25 mg daily
4) Increase frusemide to 80 mg twice daily
5) Maintain on current therapy.
Answer-1
27- A 14-year-old boy presents with hypertension. Which of the following statements concerning hypertension in the young is true?
1) Sodium nitroprusside is useful for the long-term treatment of severe cases.
2) Headache is the usual presenting feature.
3) It is defined as systolic blood pressure above the 99th centile for age.
4) Abnormalities are frequently seen on DMSA scan.
5) Aortic coarctation is the commonest secondary cause.
Answer-4
28- A 23 year old male presents with a deep vein thrombosis. He has no past medical history but his mother has suffered from deep vein thromboses. Which of the following is likely to be found on haematological assessment?
1) Factor V Leiden mutation
2) Protein S deficiency
3) Protein C deficiency
4) Antithrombin deficiency
5) Lupus anticoagulant
Answer-4
29- In a normal heart, the oxygen saturation of a sample of blood taken from a catheter in the pulmonary capillary wedge position should be equal to a sample from which of the following?
1) coronary sinus
2) femoral artery
3) pulmonary artery
4) right atrium
5) right ventricle
Answer-2
30 -A 60-year-old man with a past history of controlled hypertension presents with acute onset weakness of his left arm, that resolved over 12 hours. He had suffered two similar episodes over the last three months. Examination reveals a blood pressure of 132/82 mmHg and he is in atrial fibrillation with a ventricular rate of 85 per minute. CT brain scan is normal.
What is the most appropriate management?
1) amiodarone
2) aspirin
3) digoxin
4) dipyridamole
5) warfarin
Answer-5
More Questions & Answers:-
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