Cardiovascular

Question 1

Ejection systolic murmur + BP difference in arms + radio-femoral delay

Answer 1

Aortic coarctation

Question 2

Rib notching on CXR

Answer 2

Aortic coarctation

Question 3

Slow rising pulse + heaving apex beat

Answer 3

Aortic stenosis

Question 4

Atrial plop in early diastole

Answer 4

Atrial myxoma

Question 5

Increased JVP + hypotension + muffled heart sounds

Answer 5

Cardiac tamponade

Question 6

Kussmaul’s sign (paradoxical rise in JVP with inspiration)

Answer 6

Constrictive pericarditis (and cardiac tamponade)

Question 7

Prominent x descent + absent y descent

Answer 7

Cardiac tamponade

Question 8

Prominent x and y descents

Answer 8

Constrictive pericarditis

Question 9

Reverse tick, sloping ST depression + T wave inversion

Answer 9

Digoxin effect

Question 10

Machinery murmur

Answer 10

Patent ductus arteriosus

Question 11

Chest pain + fever + pericardial effusion + high ESR weeks/months after AMI

Answer 11

Pericarditis

Question 12

Brisk/jerky pulse

Answer 12

HOCM

Question 13

Aschoff nodules

Answer 13

Rheumatic fever

Question 14

Cannon ‘a’ waves

Answer 14

3rd degree heart block

Question 15

Large ‘v’ waves

Answer 15

Tricuspid regurgitation

Question 16

Young female with palpitations

Answer 16

SVT

Question 17

Palpitations + dizziness in young female with eating disorder or alcoholic

Answer 17

Torsades de pointes

Question 18

Ejection systolic murmur + fixed S2 splitting

Answer 18

Atrial septal defect

Question 19

Pansystolic murmur over lower left sternal edge

Answer 19

Ventricular septal defect

Question 20

Chest pain + dyspnoea + anuria + limb pain/pallor + paraplegia

Answer 20

Aortic dissection

Question 21

Distortion of aortic knuckle + mediastinal widening on CXR

Answer 21

Aortic dissection

Question 22

Stroke after infective endocarditis

Answer 22

Mycotic aneurysm

Question 23

Double heart border on CXR

Answer 23

Mitral stenosis

Question 24

Double apical impulse

Answer 24

HOCM

Question 25

Polyarthritis + carditis + rash + chorea after throat infection

Answer 25

Rheumatic fever

Question 26

Leg aching after prolonged standing

Answer 26

Varicose veins/chronic venous insufficiency

Question 27

Haemosiderin deposition

Answer 27

Varicose veins/chronic venous insufficiency

Question 28

Corona phlebectatica

Answer 28

Varicose veins/chronic venous insufficiency

Question 29

Lipodermatosclerosis

Answer 29

Chronic venous insufficiency

Question 30

Atrophie blanche

Answer 30

Chronic venous insufficiency

Question 31

S4 heart sound + soft S2

Answer 31

Aortic stenosis

Question 32

S3 heart sound + soft S1 + displaced apex beat

Answer 32

Mitral regurgitation

Question 33

Increased pulse pressure + displaced apex beat

Answer 33

Aortic regurgitation

Question 34

Opening snap + mid-diastolic rumble

Answer 34

Mitral stenosis

Question 35

Tapping apex beat

Answer 35

Mitral stenosis

Question 36

Right heart failure + displaced apex beat in alcoholic

Answer 36

Alcoholic cardiomyopathy

Question 37

Collapsing pulse

Answer 37

Aortic regurgitation

Question 38

Loud S1

Answer 38

Mitral stenosis

Question 39

Opening snap

Answer 39

Mitral stenosis

Question 40

Bifid P wave + RVH + RAD

Answer 40

Mitral stenosis

Question 41

Narrow pulse pressure

Answer 41

Aortic stenosis

Question 42

ST depression + dominant R waves in V1-3

Answer 42

Posterior STEMI

Question 43

Pansystolic murmur over left sternal edge

Answer 43

Tricuspid regurgitation

Question 44

Haemosiderin-laden cells in alveoli in CHF

Answer 44

Macrophages

Question 45

Systolic murmur 2-8 days after AMI

Answer 45

Ventricular septal defect

Question 46

Plateau pulse

Answer 46

Aortic stenosis

Question 47

Fixed raised JVP

Answer 47

SVC obstruction

Question 48

Erythema marginatum (erythematous rings on trunk)

Answer 48

Rheumatic fever

Question 49

Dilated ventricles with global hypokinesis on echo

Answer 49

Dilated cardiomyopathy

Question 50

Arrhythmia after repeated vomiting

Answer 50

Torsades de pointes (due to hypokalaemia)

Question 51

Rash on face + murmur

Answer 51

Mitral stenosis (malar flush)

Question 52

SVT refractory to vagal manoeuvres and adenosine

Answer 52

Atrial tachycardia

Question 53

Jaundice after infective endocarditis

Answer 53

Traumatic haemolysis

Question 54

Collapse in patient on antihypertensives

Answer 54

Postural hypotension