11- A 17 year old girl was found collapsed and drowsy. Her 12-lead ECG showed a sinus tachycardia of 120 beats per minute with a corrected QT interval of 500 ms (normal <470). Which of the following is the most likely cause of her presentation?
1) Amphetamine
2) Diphenhydramine
3) Glue sniffing
4) Methadone
5) Methanol
Answer-2
Many drugs can cause a prolonged QT interval. more
12- A randomised double-blind placebo controlled study of a cholesterollowering drug for the primary prevention of coronary heart disease was conducted. It had a five-year follow up period.
The results showed an absolute risk of myocardial infarction in the group-receiving placebo during was 10 per cent. The relative risk of those given the cholesterol lowering medication was 0.8 What number of patients will need to be treated with the drug for five years to prevent one myocardial infarction?
1) 20
2) 40
3) 50
4) 80
5) 100
Answer-3
13- Which ONE of the following is true regarding acute pulmonary embolism?
1) a normal ECG excludes the diagnosis
2) embolectomy is more effective than thrombolysis in improving survival
3) Heparin is as effective as thrombolytic therapy
4) the presence of hypoxaemia is an indication for thrombolysis
5) thrombolysis administered through a peripheral vein is as effective as through a pulmonary artery catheter
Answer-5
14- A 70-year-old woman has a history of dyspnoea and palpitations for six months. An ECG at that time showed atrial fibrillation. She was given digoxin, diuretics and aspirin. She now presents with two short-lived episodes of altered sensation in the left face, left arm and leg. There is poor coordination of the left hand. ECHO was normal as was a CT head scan.
What is the most appropriate next step in management?
1) anticoagulation
2) carotid endarterectomy
3) clopidogrel
4) corticosteroid treatment
5) no action
Answer-1
15- A 21 year old man with Hypertrophic Cardiomyopathy presents in clinic with dizzy spells but has not had any syncopal episodes. Which of the following, if present, would be indicate an increased risk of sudden cardiac death?
1) Asymmetric septal hypertrophy with maximum wall thickness of 2.1 cm
2) Blood Pressure drop of 20mmHg during peak exercise tolerance testing
3) Left Ventricular Outflow Tract Gradient of 80 mmHg
4) Systolic Anterior Movement of the mitral valve on echocardiography
5) Worsening exertional angina
Answer-2
16- Whilst attending the cardiology clinic, the staff nurse measures the blood pressure of a 61-year-old man, and finds that it is 183/100 mmHg sitting and 190/105 standing. He has a heart rate of 81/minute, with an irregularly irregular rhythm. On auscultation of the heart, there are no murmurs, but he has bibasilar crackles on chest examination. Which of the following pathological findings is most likely to be present?
1) Left ventricular hypertrophy
2) Left atrial myxoma
3) Occlusive coronary atherosclerosis
4) Cor pulmonale
5) Mitral regurgitation
Answer-1
17- A 24-year-old woman develops infective endocarditis involving the aortic valve. She receives a porcine bioprosthesis because of her desire to have children and not to take anticoagulant medication. After ten years, she must have this prosthetic valve replaced. Which of the following pathologic findings in the bioprosthesis has most likely led to the need for replacement?
1) Calcification with stenosis
2) Dehiscence
3) Infective endocarditis
4) Strut failure
5) Thrombosis
Answer-1
The bioprosthesis has the advantage of not requiring anticoagulation, but it does not wear well with time, and typically must be replaced within 5 to 10 years
18- A randomised, double-blind, placebo controlled trial of a cholesterol lowering drug in the primary prevention of coronary heart disease is reported. 1000 subjects are treated with the active drug, and 1000 are given placebo. They are followed up over a five year period and 100 individuals in the placebo group and 80 in the treatment group suffer a myocardial infarction. What is the annual percentage risk of myocardial infarction in the group treated with placebo?
1) 0.5%
2) 2%
3) 5%
4) 8%
5) 10%
Answer-2
19- A 25-year-old previously healthy woman has worsening fatigue with dyspnoea, palpitations, and fever over the past one week. Her vital signs on admission to the hospital show Temperature 38.9°C Respiratory rate 30/min Pulse 105 bpm and BP 95/65 mmHg. Her heart rate is irregular.
An ECG shows diffuse ST-T segment changes. A Chest X-ray shows mild cardiomegaly. An echocardiogram shows slight mitral and tricuspid regurgitation but no valvular vegetations. Her troponin I is 12 ng/mL. She recovers over the next two weeks with no apparent sequelae. Which of the following laboratory test findings best explains the underlying etiology for these events?
1) ANCA titer of 1:80
2) Anti-streptolysin O titer of 1:512
3) Blood culture positive for Streptococcus, viridans group
4) Coxsackie B serologic titer of 1:160
5) Total serum cholesterol of 9.6 mmol/l
Answer-4
20- A 74-year-old man presented with acute pain, pallor and absent pulses in his right leg. Investigations revealed an embolus in his femoral artery. What is the most likely source of this embolus?
1) marantic endocarditis
2) paradoxical emboli
3) rheumatic endocardial vegetations
4) right ventricular thrombi
5) thrombi from an atheromatous aorta
Answer-5
More Questions & Answers:-
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Page10
1) Amphetamine
2) Diphenhydramine
3) Glue sniffing
4) Methadone
5) Methanol
Answer-2
Many drugs can cause a prolonged QT interval. more
12- A randomised double-blind placebo controlled study of a cholesterollowering drug for the primary prevention of coronary heart disease was conducted. It had a five-year follow up period.
The results showed an absolute risk of myocardial infarction in the group-receiving placebo during was 10 per cent. The relative risk of those given the cholesterol lowering medication was 0.8 What number of patients will need to be treated with the drug for five years to prevent one myocardial infarction?
1) 20
2) 40
3) 50
4) 80
5) 100
Answer-3
13- Which ONE of the following is true regarding acute pulmonary embolism?
1) a normal ECG excludes the diagnosis
2) embolectomy is more effective than thrombolysis in improving survival
3) Heparin is as effective as thrombolytic therapy
4) the presence of hypoxaemia is an indication for thrombolysis
5) thrombolysis administered through a peripheral vein is as effective as through a pulmonary artery catheter
Answer-5
14- A 70-year-old woman has a history of dyspnoea and palpitations for six months. An ECG at that time showed atrial fibrillation. She was given digoxin, diuretics and aspirin. She now presents with two short-lived episodes of altered sensation in the left face, left arm and leg. There is poor coordination of the left hand. ECHO was normal as was a CT head scan.
What is the most appropriate next step in management?
1) anticoagulation
2) carotid endarterectomy
3) clopidogrel
4) corticosteroid treatment
5) no action
Answer-1
15- A 21 year old man with Hypertrophic Cardiomyopathy presents in clinic with dizzy spells but has not had any syncopal episodes. Which of the following, if present, would be indicate an increased risk of sudden cardiac death?
1) Asymmetric septal hypertrophy with maximum wall thickness of 2.1 cm
2) Blood Pressure drop of 20mmHg during peak exercise tolerance testing
3) Left Ventricular Outflow Tract Gradient of 80 mmHg
4) Systolic Anterior Movement of the mitral valve on echocardiography
5) Worsening exertional angina
Answer-2
16- Whilst attending the cardiology clinic, the staff nurse measures the blood pressure of a 61-year-old man, and finds that it is 183/100 mmHg sitting and 190/105 standing. He has a heart rate of 81/minute, with an irregularly irregular rhythm. On auscultation of the heart, there are no murmurs, but he has bibasilar crackles on chest examination. Which of the following pathological findings is most likely to be present?
1) Left ventricular hypertrophy
2) Left atrial myxoma
3) Occlusive coronary atherosclerosis
4) Cor pulmonale
5) Mitral regurgitation
Answer-1
17- A 24-year-old woman develops infective endocarditis involving the aortic valve. She receives a porcine bioprosthesis because of her desire to have children and not to take anticoagulant medication. After ten years, she must have this prosthetic valve replaced. Which of the following pathologic findings in the bioprosthesis has most likely led to the need for replacement?
1) Calcification with stenosis
2) Dehiscence
3) Infective endocarditis
4) Strut failure
5) Thrombosis
Answer-1
The bioprosthesis has the advantage of not requiring anticoagulation, but it does not wear well with time, and typically must be replaced within 5 to 10 years
18- A randomised, double-blind, placebo controlled trial of a cholesterol lowering drug in the primary prevention of coronary heart disease is reported. 1000 subjects are treated with the active drug, and 1000 are given placebo. They are followed up over a five year period and 100 individuals in the placebo group and 80 in the treatment group suffer a myocardial infarction. What is the annual percentage risk of myocardial infarction in the group treated with placebo?
1) 0.5%
2) 2%
3) 5%
4) 8%
5) 10%
Answer-2
19- A 25-year-old previously healthy woman has worsening fatigue with dyspnoea, palpitations, and fever over the past one week. Her vital signs on admission to the hospital show Temperature 38.9°C Respiratory rate 30/min Pulse 105 bpm and BP 95/65 mmHg. Her heart rate is irregular.
An ECG shows diffuse ST-T segment changes. A Chest X-ray shows mild cardiomegaly. An echocardiogram shows slight mitral and tricuspid regurgitation but no valvular vegetations. Her troponin I is 12 ng/mL. She recovers over the next two weeks with no apparent sequelae. Which of the following laboratory test findings best explains the underlying etiology for these events?
1) ANCA titer of 1:80
2) Anti-streptolysin O titer of 1:512
3) Blood culture positive for Streptococcus, viridans group
4) Coxsackie B serologic titer of 1:160
5) Total serum cholesterol of 9.6 mmol/l
Answer-4
20- A 74-year-old man presented with acute pain, pallor and absent pulses in his right leg. Investigations revealed an embolus in his femoral artery. What is the most likely source of this embolus?
1) marantic endocarditis
2) paradoxical emboli
3) rheumatic endocardial vegetations
4) right ventricular thrombi
5) thrombi from an atheromatous aorta
Answer-5
More Questions & Answers:-
Page1 Page2 Page3 Page4 Page5 Page6 Page7 Page8 Page9
Page10
12- The NNT is the inverse of the absolute risk reduction (ARR). The ARR is the absolute difference in the rates of events between a given activity or treatment relative to a control activity or treatment, ie control event rate (CER) minus the experimental event rate (EER), or ARR = CER - EER.
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