Cardiology

Question 1

ECG unstable angina

Answer 1

ST depression and T wave inversion

Question 2

Ix suspected stable angina

Answer 2

Exercise ECG

Question 3

CHADSVASC

Answer 3

CHADSVASC (max score 9)

(1) Congestive heart failure
(1) HTN
(2) Age (65-74 = 1, >75 = 2)
(1) Diabetes mellitus
(2) Stroke/TIA/VTE
(1) Vascular disease
(1) (Female)

Question 4

HASBLED

Answer 4

HTN
Abnormal liver
Abnormal renal
Stroke
Bleeding
Labile INRs
Elderly (>65)
Drugs
Alcohol

Question 5

Cannon waves

Answer 5

Complete heart block

Question 6

Treatment complete heart block

Answer 6

Pacemaker

Question 7

Murmur in rheumatic fever

Answer 7

Diastolic at L sternal edge

Question 8

Ix suspected carotid artery stenosis

Answer 8

Carotid doppler USS

Question 9

When is carotid endarterectomy appropriate treatment?

Answer 9

> 70% stenosis

Anterior circulation TIA

Question 10

What do deep (>2mm) Q waves suggest?

Answer 10

Pathological Q waves = Previous MI (ischaemia tissue)

NSTEMI

Question 11

Loud first heart sound

Answer 11

Mitral stenosis

Question 12

Early diastolic murmur at L sternal edge

Answer 12

Aortic regurg

Question 13

Third heart sound

Answer 13

CCF - rapid ventricular filling

Question 14

Fourth heart sounds

Answer 14

Atrial contraction against stiffened L ventricle (associated with systemic HTN)

Question 15

Tapping apex

Answer 15

Mitral stenosis

Question 16

Opening snap

Answer 16

Mitral stenosis

Question 17

Soft pan-systolic murmur

Answer 17

Tricuspid regurgitation

Question 18

Laterally displaced apex beat

Answer 18

Mitral regurg

Question 19

3 common causes acute mitral regurg

Answer 19

Mitral valve prolapse
IE
RhF

Question 20

Common causes chronic mitral regurg

Answer 20

Ischaemia,

LV dilatation

Question 21

Signs/symptoms mitral regurg

Answer 21

Dyspnoea,
Orthopnoea, PND 
AF, palpitations 
Fatigue 
Cool extremities 
Oedema 

Loud pan systolic murmur
Laterally displaced apex
AF

Question 22

Commonest cause tricuspid regurg

Answer 22

IE (IVDU)

Question 23

Cause acute aortic regurg

Answer 23

Pulmonary congestion

Question 24

Causes chronic aortic regurg

Answer 24

LV dilatation/hypertrophy

Question 25

Type of LVH in aortic regurg vs aortic stenosis?

Answer 25

AR - eccentric | AS - concentric

Question 26

Mid systolic click, soft late systolic murmur at the apex

Answer 26

Mitral valve prolapse --> MR

Question 27

First line for LVF

Answer 27

ACEi | BB

Question 28

Reversible causes cardiac arrest

Answer 28

Hypovolaemia Hypothermia Hypoxia Hypo/hyperkalaemia Tension pneumothorax Thromboembolism Tamponade Toxins

Question 29

Mx for peri-arrest bradycardia

Answer 29

Atropine

Question 30

Contraindications to adenosine in arrhythmias

Answer 30

Asthmatics (causes bronchospasm)

Question 31

Manoeuvres for AS murmur

Answer 31

Sit forwards, Expiration Radiates to carotids

Question 32

Manoeuvres for MR murmur

Answer 32

Radiates to axilla Lean to LHS Loudest at apex

Question 33

Commonest cause mitral stenosis

Answer 33

RhF in childhood

Question 34

Increased O2 sats between RA and RV

Answer 34

VSD

Question 35

New systolic murmur post MI (+signs of shock)

Answer 35

? VSD

Question 36

Immediate investigations following MI

Answer 36

Cardiac enzymes CXR ECG +routine bloods

Question 37

Ix suspected post MI VSD

Answer 37

ECG CXR Echo