cardiovascular

Question 1

previous MI takes atorvastatin, which cell type is primarily targeted by this drug?

Answer 1

hepatocyte

Question 2

an increase in sympathetic outflow is a key compenent of the physiological response to heart failure, what is the main way that this response results in an increase in pre-load?

Answer 2

increases renin secretion

Question 3

a 41 y/o man dies suddenly at work. the post mortem report describes >90% luminal narrowing of the left main coronary artery due to rupture of an atherosclerotic plaque. which cell is initially involved with excess lipid uptake in the vessel wall?

Answer 3

macrophage

Question 4

systolic pressure = 125
diastolic = 85
left ventricular end-diastolic vol = 130 mL
LVESV = 65mL
right atrial pressure 2 mmHg
left atrial pressure 4 mmHg
what is the best estimate of the MAP?

Answer 4

98

Question 5

ischaemic heart disease and right-sided cardiac failure presents with bilateral leg oedema. what has led to his oedema

Answer 5

increased venuole hydrostatic pressure

Question 6

describe the mechanism of action of GTN

Answer 6

arginine is converted into a neurotransmitter that activates guanylate cyclase

Question 7

what is the most important predisposing risk factor for atherosclerosis

Answer 7

cigarette smoking

Question 8

most likely infectious pathogen for IV drug users presenting with breathlessness, fever, pulse 100, regular rhythm, BP 100/60, raised JVP with predominant V waves, pansystolic murmur at left sternal edge on inspiration

Answer 8

staphylococcus aureus

Question 9

swollen leg, bed bound, overweight and smoker, warm/swollen/tender left calf. what is the single most important investigation to make the diagnosis

Answer 9

doppler ultrasound scan of proximal leg vein

Question 10

what chronic heart failure medication gives an intractable cough?

Answer 10

lisinopril

Question 11

what causes severe narrowing of the anterior descending branch of the left coronary artery

Answer 11

atheroma

Question 12

what is the first line treatment for ambulatory BP average of 164/102

Answer 12

amlodipine

Question 13

what nerve is most likely stimulated by blowing into a syringe to terminate the arrhythmia

Answer 13

vagus

Question 14

what is the most appropriate initial management for superficial femoral artery stenosis and an ankle brachial pressure index of 0.84

Answer 14

structured exercise programme

Question 15

where would you detect mitral regurgitation on auscultation

Answer 15

5th left ICS

Question 16

what ulcer is most likely to give cool peripheries with reduced distal pulses

Answer 16

arterial

Question 17

what other cardiac abnormality is linked to aortic stenosis

Answer 17

left ventricular hypertrophy

Question 18

what medication is antiplatelet

Answer 18

ticagrelor

Question 19

what is the most likely diagnosis for old women SOB lying down, no wheeze or oedema

Answer 19

left sided heart failure

Question 20

which medication is a treatment for heart failure

Answer 20

lisinopril

Question 21

what is part of the baroreceptor response to decreased blood volume

Answer 21

an increase in sympathetic output to blood vessels

Question 22

how do you treat intermittent claudication

Answer 22

do as much physical exercise as possible