Cardiology

Question 1

What are the features of aortic regurgitation

Answer 1

• early diastolic murmur: intensity of the murmur is increased by the handgrip manoeuvre
• collapsing pulse
• wide pulse pressure
• Quincke’s sign (nailbed pulsation)
• De Musset’s sign (head bobbing)

Question 2

What murmur is Marfan’s associated with

Answer 2

Aortic regurgitation

Question 3

What are ECG changes due to Digoxin therapy

Answer 3

‘Scooped’ ST depression in leads II, III, aVF, v5 and v6
‘reverse tick sign’

Question 4

When should anticoagulation be started in a patient with AF and an cute ischemic stroke

Answer 4

2 weeks after stroke

Question 5

What are first line drugs used to prevent angina attacks

Answer 5

Beta-blocker or CCB

Question 6

Rate control for AF

Answer 6

Beta Blockers - Contraindicated in asthma
CCBs (e.g Diltiazem)
Digoxin

Question 7

Rhythm control AF

Answer 7

Beta-blockers
Dronedarone (2nd line in pts following cardioversion)
Amiodarone - particularly if co-existing HF

Question 8

What is Bisferiens pulse and what is it indicative of

Answer 8

Features: 2 systolic upstrokes
Associated with mixed aortic valve disease

Question 9

ECG changes in hypothermia

Answer 9

Bradycardia
J waves
Prolonged PR/ QT/ QRS intervals

Question 10

What are the classical features of cardiac tamponade

Answer 10

Beck’s Triad
- hypotension
- raised JVP
- muffled heart sounds

Question 11

What ECG changes are seen in cardiac tamponade

Answer 11

Tachycardia
electrical alterans

Question 12

What condition is besferiens pulse associated with

Answer 12

HOCM

Question 13

How is Torsades de pointes managed

Answer 13

IV magnesium sulphate

Question 14

What are some causes of torsades de pointes

Answer 14

Erythromycin
electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia
myocarditis
hypothermia
subarachnoid haemorrhage

Question 15

What are features of Wellen syndrome

Answer 15

biphasic or deep T wave inversion in V2-3
minimal ST elevation
no Q waves

Question 16

What are features of takayasu’s arteritis

Answer 16

systemic features of a vasculitis e.g. malaise, headache
unequal blood pressure in the upper limbs
carotid bruit and tenderness
absent or weak peripheral pulses
upper and lower limb claudication on exertion
aortic regurgitation (around 20%)

Question 17

What can takayasu arteritis be associated with

Answer 17

Renal artery stenosis

Question 18

How is takayasu arteritis managed

Answer 18

Steroids

Question 19

Define Buerger’s disease and it’s features

Answer 19

Buerger’s disease (also known as thromboangiitis obliterans) is a small and medium vessel vasculitis that is strongly associated with smoking.

Features
extremity ischaemia
intermittent claudication
ischaemic ulcers
superficial thrombophlebitis
Raynaud’s phenomenon

Question 20

When should beta blockers be stopped during acute HF

Answer 20

Beta-blockers should only be stopped in acute heart failure if the patient has heart rate < 50/min, second or third degree AV block, or shock