Cardiology

Question 1

Which anti-hypertensive/AF med should be stopped in HF?

Answer 1

CCBs

Question 2

At what point do both micro and macroscropic changes become visible in cardiac tissue post MI?

Answer 2

12-24 hours post occlusion

Question 3

Which artery supplies the left atrium?

Answer 3

Left circumflex artery

Question 4

Which artery supplies the left ventricle?

Answer 4

Left marginal artery - branch of circumflex

Question 5

Which cardiac defect is associated with turner’s syndrome?

Answer 5

Co-arctation of the aorta

Question 6

Main 3 problems associated with Kartagener’s syndrome

Answer 6

Dextrocardia, bronchiectasis and infertility - last 2 due to ineffective cilia

Question 7

Which cardiac defects are associated with Marfan’s syndrome?

Answer 7

Aortic root dilatation (causes aortic regurg), mitral valve prolapse and mitral regurg. Risk aortic dissection

Question 8

Which cardiac defects are associated with congenital rubella syndrome?

Answer 8

PDA, ASD and pulmonary stenosis

Question 9

What pulmonary artery systolic pressure is indicative of pulmonary hypertension?

Answer 9

> 30mmHg

Question 10

Presentation of dilated cardiomyopathy

Answer 10

Left bundle branch block and right axis deviation - can present weeks to months post partum

Question 11

Presentation of HOCM

Answer 11

Exertional syncope/pre-syncope. ECG shows LVH or asymmetrical septal hypertrophy

Question 12

Cause of wolf-parkinson white

Answer 12

Abnormal congenital accessory pathway (bundle of Kent) bypassing AVN with episodes of tachyarrythmia. Allows a re-entry circuit

Question 13

ECG signs of WPW

Answer 13

SHortened PR interval, Delta wave (slow upstroke of initial portion of the QRS complex) and QRS prolongation. ST segment and T wave are often in the opposite direction to the QRS complex. Can be exacerbated by valsalva manouvre.

Question 14

Treatment for WPW

Answer 14

Only definitively treat when high risk of sudden cardiac death - radiofrequency catheter ablation. If low risk can offer pharmacological management for the tachyarrythmias,

Question 15

What is wenkebache phenomenom?

Answer 15

2nd degree mobitz type 1 heart block - PR progressively gets longer until it drops a beat

Question 16

Features of Marfan’s

Answer 16

Pectus excavatum, ectopic lentis, pes planus, high arched palate, recurrent pneumothorax, aortic root dilation, mitral prolapse and positive wrist and thumb signs

Question 17

When would you hear VSD murmur?

Answer 17

Pan-systolic

Question 18

What type of pacemaker mode is used in patients with chronic AF causing bradycardia?

Answer 18

VVI mode

Question 19

What is pulsus paradoxus?

Answer 19

A decrease in SBP of >10mmHg upon inspiration - in pericarditis or pericardial effusion it is a sign of impending tamponade and circulatory collapse

Question 20

If patient develops bundle branch block post MI, which vessel is most likely affected?

Answer 20

LAD

Question 21

Treatment for symptomatic mobitz type 2 heart block?

Answer 21

Permanent pacing as can develop to complete heart block

Question 22

Likely cause of large JVP V-wave

Answer 22

Tricuspid regurgitation

Question 23

Features of tricuspid regurgitation

Answer 23

JVP v-wave, peripheral oedema, right ventiricular failure, Pan-systolic murmur, paradoxical splitting of second heart sound, pulsatile liver, tender hepatomegaly, ascites and right atrial hypertrophy

Question 24

What is dressler sydrome?

Answer 24

A complication of transmural MI, weeks after initial infarct. Causes mild fever and pleuritic chest pain (exacerbated by lying down/relieved by sitting forward). Friction rub may be heard.

Question 25

What does an opening snap in early diastole indicate?

Answer 25

Severe mitral stenosis

Question 26

Which organism is most likely to cause rheumatic fever?

Answer 26

Group a strep aka strep pyogenes

Question 27

What is kussmaul’s sign?

Answer 27

Distension od the jugular veins during inspiration whilst sitting up

Question 28

Machinery like murmur in bady which is loud systolic extending into diastole

Answer 28

PDA