71- A 14 year old boy presents with fever. Which of the following might contribute to a diagnosis of rheumatic fever?
1) The finding of target lesions on the hands.
2) The finding of tender nodules in the fingertips.
3) A prolonged PR interval on ECG.
4) A CRP of 10.
5) Positive Romberg's sign.
Answer-3
72- A 40-year-old man attending a routing screening has a blood pressure of 166/100 mmHg. Two weeks later his blood pressure was 150/90 mmHg. He does not smoke. He drinks 35 units alcohol / week. His body mass index (BMI) is 30 kg/m2 (20 - 25). What is the best management strategy?
1) amlodipine
2) atenolol
3) bendrofluazide
4) enalapril
5) lifestyle advice
Answer-5
73- A 19-year-old woman is found to have a cardiac murmur characterized by a mid-systolic click. An echocardiogram reveals mitral insufficiency with upward displacement of one leaflet. There is also aortic root dilation to 4 cm. She has a dislocated right ocular crystalline lens. She dies suddenly and unexpectedly. The medical examiner finds a prolapsed mitral valve with elongation, thinning, and rupture of chordae tendineae. A mutation involving which of the following genes is most likely have be present in this patient?
1) Beta-myosin
2) CFTR
3) FGFR
4) Fibrillin
5) Spectrin
Answer-4
74- A 51 year old businessman complains of dyspnoea on exertion. He recently returned from a business trip to the USA. He has distant heart sounds on auscultation of the chest. A chest radiograph reveals that there is a thin rim of calcification surrounding the cardiac outline. Which of the following conditions is most likely responsible for these findings?
1) Uraemia
2) Tuberculosis
3) Group B coxsackie virus
4) Sarcoidosis
5) Metastatic carcinoma
Answer-2
75- A 60-year-old woman is admitted with sudden onset of chest pain and is diagnosed with an acute myocardial infarction. Her acute illness is complicated by low blood pressure and poor tissue perfusion for several days. Her serum lactate becomes elevated. Her serum urea and creatinine are noted to be increasing.
Day 1 Day 2 Day 3
urea (mmol/L) 8 22 30
creatinine (µmol/L) 116 140 200
Granular and hyaline casts are present on microscopic urinalysis. The renal lesion that is most likely to be present in this situation is?
1) Acute tubular necrosis
2) Minimal change disease
3) Nodular glomeruloscerosis
4) Pyelonephritis
5) Renal vein thrombosis
Answer-1
Ischaemia, typically in hypotensive hospitalized patients, is the most frequent antecedent to acute tubular necrosis. Blood pressure should be maintained in
cardiogenic shock with fluids and / or inotropic agents.
76- A 45 year old male type 1 diabetic with a number of complex diabetic gastrointestinal complications is noted to have a PR interval of 0.18s, a QRS duration of 0.1s and a QT interval of 0.48s on routine ECG. Which of the following drugs may be responsible?
1) Cisapride
2) Octreotide
3) Co-trimoxazole
4) Domperidone
5) Cimetidine
Answer-1
Cisapride has been withdrawn due to the problem of prolonged QT interval and torsades de pointe. Prolonged QT is defined as greater than 0.45s. Other agents
include amitriptyline and pheonthiazines yet metoclopramide and dompaeridone are not associated.
77- You are asked to see a patient in the Intensive Care Unit who is short of breath and tachycardic to rule out a cardiac cause of her symptoms. A right heart catheter reveals that the mixed venous O2 saturation is 70%; the pulmonary capillary wedge O2 saturation is 97%. The haemoglobin is normal and the patient is afebrile. You are able to state which of the following?
1) her cardiac output is decreased
2) her cardiac output is normal
3) her heart is normal
4) she has high-output failure
5) she is in shock due to a non-cardiac cause
Answer-2
78- A 59-year-old man who was active all his life develops sudden severe anterior chest pain that radiates to his back. Within minutes, he is unconscious. He has a history of hypertension, but a recent treadmill test had revealed no evidence of cardiac disease.
Which of the following do you suspect?
1) Acute viral myocarditis
2) Group A streptococcal infection
3) Pulmonary embolus
4) Right middle cerebral artery embolus
5) Tear in the aortic intima
Answer-5
79- Concerning complete atrioventricular septal defects which of the following statements is true?
1) are seen frequently in patients with trisomy 21
2) frequently have aortic valve insufficiency
3) have a normal mitral valve structure
4) include a coronary sinus atrial septal defect
5) include a perimembranous ventricular septal defect
Answer-1
80- 21 year-old woman has a history of palpitations and light headedness. ECG shows short PR interval and inferior Q waves. Her symptoms improve with atenolol 25 mg/day but she has had two short episodes of similar symptoms in the previous 24 hours. What is the longterm management of choice?
1) Anticoagulation.
2) Oral amiodarone.
3) Oral digoxin.
4) Increase the dose of atenolol.
5) Radiofrequency ablation.
Answer-5
WPW can be associated with negative delta waves in II, III and aVF. The longterm management of choice is ablation of the accessory pathway.
More Questions & Answers:-
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1) The finding of target lesions on the hands.
2) The finding of tender nodules in the fingertips.
3) A prolonged PR interval on ECG.
4) A CRP of 10.
5) Positive Romberg's sign.
Answer-3
72- A 40-year-old man attending a routing screening has a blood pressure of 166/100 mmHg. Two weeks later his blood pressure was 150/90 mmHg. He does not smoke. He drinks 35 units alcohol / week. His body mass index (BMI) is 30 kg/m2 (20 - 25). What is the best management strategy?
1) amlodipine
2) atenolol
3) bendrofluazide
4) enalapril
5) lifestyle advice
Answer-5
73- A 19-year-old woman is found to have a cardiac murmur characterized by a mid-systolic click. An echocardiogram reveals mitral insufficiency with upward displacement of one leaflet. There is also aortic root dilation to 4 cm. She has a dislocated right ocular crystalline lens. She dies suddenly and unexpectedly. The medical examiner finds a prolapsed mitral valve with elongation, thinning, and rupture of chordae tendineae. A mutation involving which of the following genes is most likely have be present in this patient?
1) Beta-myosin
2) CFTR
3) FGFR
4) Fibrillin
5) Spectrin
Answer-4
74- A 51 year old businessman complains of dyspnoea on exertion. He recently returned from a business trip to the USA. He has distant heart sounds on auscultation of the chest. A chest radiograph reveals that there is a thin rim of calcification surrounding the cardiac outline. Which of the following conditions is most likely responsible for these findings?
1) Uraemia
2) Tuberculosis
3) Group B coxsackie virus
4) Sarcoidosis
5) Metastatic carcinoma
Answer-2
75- A 60-year-old woman is admitted with sudden onset of chest pain and is diagnosed with an acute myocardial infarction. Her acute illness is complicated by low blood pressure and poor tissue perfusion for several days. Her serum lactate becomes elevated. Her serum urea and creatinine are noted to be increasing.
Day 1 Day 2 Day 3
urea (mmol/L) 8 22 30
creatinine (µmol/L) 116 140 200
Granular and hyaline casts are present on microscopic urinalysis. The renal lesion that is most likely to be present in this situation is?
1) Acute tubular necrosis
2) Minimal change disease
3) Nodular glomeruloscerosis
4) Pyelonephritis
5) Renal vein thrombosis
Answer-1
Ischaemia, typically in hypotensive hospitalized patients, is the most frequent antecedent to acute tubular necrosis. Blood pressure should be maintained in
cardiogenic shock with fluids and / or inotropic agents.
76- A 45 year old male type 1 diabetic with a number of complex diabetic gastrointestinal complications is noted to have a PR interval of 0.18s, a QRS duration of 0.1s and a QT interval of 0.48s on routine ECG. Which of the following drugs may be responsible?
1) Cisapride
2) Octreotide
3) Co-trimoxazole
4) Domperidone
5) Cimetidine
Answer-1
Cisapride has been withdrawn due to the problem of prolonged QT interval and torsades de pointe. Prolonged QT is defined as greater than 0.45s. Other agents
include amitriptyline and pheonthiazines yet metoclopramide and dompaeridone are not associated.
77- You are asked to see a patient in the Intensive Care Unit who is short of breath and tachycardic to rule out a cardiac cause of her symptoms. A right heart catheter reveals that the mixed venous O2 saturation is 70%; the pulmonary capillary wedge O2 saturation is 97%. The haemoglobin is normal and the patient is afebrile. You are able to state which of the following?
1) her cardiac output is decreased
2) her cardiac output is normal
3) her heart is normal
4) she has high-output failure
5) she is in shock due to a non-cardiac cause
Answer-2
78- A 59-year-old man who was active all his life develops sudden severe anterior chest pain that radiates to his back. Within minutes, he is unconscious. He has a history of hypertension, but a recent treadmill test had revealed no evidence of cardiac disease.
Which of the following do you suspect?
1) Acute viral myocarditis
2) Group A streptococcal infection
3) Pulmonary embolus
4) Right middle cerebral artery embolus
5) Tear in the aortic intima
Answer-5
79- Concerning complete atrioventricular septal defects which of the following statements is true?
1) are seen frequently in patients with trisomy 21
2) frequently have aortic valve insufficiency
3) have a normal mitral valve structure
4) include a coronary sinus atrial septal defect
5) include a perimembranous ventricular septal defect
Answer-1
80- 21 year-old woman has a history of palpitations and light headedness. ECG shows short PR interval and inferior Q waves. Her symptoms improve with atenolol 25 mg/day but she has had two short episodes of similar symptoms in the previous 24 hours. What is the longterm management of choice?
1) Anticoagulation.
2) Oral amiodarone.
3) Oral digoxin.
4) Increase the dose of atenolol.
5) Radiofrequency ablation.
Answer-5
WPW can be associated with negative delta waves in II, III and aVF. The longterm management of choice is ablation of the accessory pathway.
More Questions & Answers:-
Page1 Page2 Page3 Page4 Page5 Page6 Page7 Page8 Page9
Page10
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