cardiology

Question 1

Jerky pulse, mid systolic murmur - what is the dx?

Answer 1

HOCM

Question 2

Common complication of MR?

Answer 2

Atrial flutter or fibrillation

Question 3

Prophylaxis for SVT in pregnancy?

Answer 3

Metoprolol

Question 4

HOCM: defective mutation is beta or alpha myosin?

Answer 4

β-myosin heavy chain

Question 5

Strep or staph - which is better prognosis in IE?

Answer 5

Streptococcal infection

Question 6

Pansystolic murmur worse on inspiration, associated with WPW syndrome?

Answer 6

Ebstein’s anomaly

Question 7

What parameter is essential to monitor when giving Mg?

Answer 7

RR

Question 8

a wave, cannon a, c wave, v wave, x descent, y descent interpretation?

Answer 8

a wave - atrial contraction
cannon a - atrial contraction against closed tricuspid valve
c wave - closure of tricuspid valve
v wave - passiVe filling of blood in atrium against closed tricuspid valve
x descent - fall in atrial pressure during ventricular systole
y descent - opening of tricuspid valve

Question 9

Mechanism of hypokalemia?

Answer 9

Increased delivery of sodium to the distal part of the distal convoluted tubule

Question 10

Drug class of dabigatran and bivalirudin?

Answer 10

Direct thrombin inhibitor

Question 11

Mechanism of furosemide?

Answer 11

Inhibits the Na-K-Cl cotransporter in the thick ASCENDING LIMB of the loop of Henle

Question 12

Mechanism of indapamide?

Answer 12

Inhibiting the sodium-chloride symporter (NCC) in the DCT

Question 13

Eplerenone

Answer 13

Blocking aldosterone-mediated sodium reabsorption and potassium secretion at the level of COLLECTING DUCTS

Question 14

Palpitations, pre-syncope and ECG findings of T wave inversion and epsilon waves in V1-V3?

Answer 14

Arrhythmogenic right ventricular cardiomyopathy (ARVD)

Question 15

Which drugs can be used to promote duct closure in PDA?

Answer 15

Ibuprofen/indomethacin

Question 16

Most important test to confirm PH?

Answer 16

Cardiac catheterisation

Question 17

Common causes of endocarditis?

Answer 17

Staph aureus, staph epidermis (if <2 months post valve surgery)

Question 18

What enhances and reduces effect of adenosine?

Answer 18

E - dipyridamole R - aminophylline

Question 19

ST depression on exercise stress testing despite normal coronary arteries?

Answer 19

Cardiac syndrome X

Question 20

Swan-Ganz catheter measures pressure in which heart chamber?

Answer 20

Left atrium

Question 21

CHB following an MI - which artery?

Answer 21

Right coronary artery

Question 22

TiMe

Answer 22

Tricuspid regurg - louder on inspiration
Mitral regurg - louder on expiration

Question 23

Treatment for PAD?

Answer 23

1 - smoking cessation and exercise 2 - 80mg atorva, clopidogrel 3 - surgical/endovascular revasc 4 - naftidrofuryl (5HT2 antag)

Question 24

Drainage of coronary sinus?

Answer 24

RA

Question 25

Right ventricle fibro fatty infiltrate?

Answer 25

Arrhythmogenic right ventricular cardiomyopathy

Question 26

ASD murmur?

Answer 26

Ejection systolic - louder on inspiration

Question 27

Is murmur in AR high pitched or low pitched? MS murmur?

Answer 27

High pitched and MS is low pitched

Question 28

# Anjali Had Lovely Salmon Sandwiches Causes of restrictive cardiomyopathy?

Answer 28

Amyloidosis, haemochromatosis, Loffler's syndrome, sarcoidosis, scleroderma

Question 29

Amiodarone mechanism of action?

Answer 29

Blocks potassium channels

Question 30

Treatment for severe MS? Commissurotomy or valve replacement?

Answer 30

Percutaneous mitral commissurotomy

Question 31

After successful cardioversion how long should anticoag continue for? 1 week or 4 weeks?

Answer 31

4 weeks

Question 32

Definiton of Eisenmenger's Syndrome? Reversal of left to right shunt or right to left shunt?

Answer 32

Reversal of left to right shunt

Question 33

When to give four-factor prothrombin complex concentrate in context of warfarin therapy?

Answer 33

Emergency surgery

Question 34

When to give 5 mg vitamin K IV in context of warfarin therapy?

Answer 34

6-8 hours till surgery

Question 35

What guides surgery for AS? Symptoms or aortic valve gradient?

Answer 35

Symptoms

Question 36

What is downsloping ST depression associated with?

Answer 36

Cardiac syndrome x

Question 37

Convex ST elevation in V1-V3 with a partial right bundle branch block pattern?

Answer 37

Brugada

Question 38

Harsh systolic murmur that increases on Valsalva manoeuvre, LVH?

Answer 38

HOCM

Question 39

T wave inversions in the right precordial leads and epsilon waves?

Answer 39

Arrhythmogenic right ventricular cardiomyopathy (arvc)

Question 40

Bicuspid aortic valve association?

Answer 40

Coarctation of aorta

Question 41

Drug to avoid in HOCM?

Answer 41

Ramipril

Question 42

Mechanism of hypokalaemia due to thiazides?

Answer 42

Increased delivery of sodium to the distal part of the distal convoluted tubule

Question 43

Presentation of rheum fever? Organism in rheumatic fever?

Answer 43

Pyrexia, arthralgia - Strep pyogenes

Question 44

Mechanism of action of bivalirudin in acute coronary syndrome?

Answer 44

Reversible direct thrombin inhibitor

Question 45

Long QT syndrome usually due to?

Answer 45

Loss-of-function/blockage of K+ channels

Question 46

Atrial myxoma commonest site?

Answer 46

Left atrium

Question 47

If high-risk of failure of cardioversion (previous failure), offer electrical cardioversion after at least 4 weeks treatment with which drug?

Answer 47

Amiodarone

Question 48

ECG shows irregular broad complex monomorphic tachycardia with a stable axis?

Answer 48

Amiodarone

Question 49

Fonda mechanism of action?

Answer 49

Activates antithrombin III

Question 50

Left parasternal heave in which heart pathology?

Answer 50

Tricuspid regurg

Question 51

Familial hypertriglyceridaemia association? Familial hypercholesterolaemia association?

Answer 51

Tri - eruptive xanthoma Chlo - tendon xanthoma

Question 52

COPD and different P wave morphologies?

Answer 52

Verapamil

Question 53

Can PDA cause hypertension?

Answer 53

No