MCQ's Flashcards
- Which of the following signs is most commonly associated with Left heart failure
a. Ankle oedema
b. Crackles at the lung bases
c. Irregularly irregular pulse
d. Hepatic enlargement
e. Hypotension
b. Crackles at the lung bases
- John 50 yo welder - calls for a check-up for an insurance policy. OE truncal obesity and his BP in 170/100 mmHg. You find he has a low HDL, elevated triglycerides and slightly raised liver transaminases - his most likely diagnosis is
a. Cushing’s disease
b. Phaeochromocytoma
c. Metabolic syndrome
d. Goodpastures syndrome
e. Nelson’s syndrome
c. Metabolic syndrome
- 40 yo housewife presents for follow-up after being diagnosed with hypertension. At her check-up 180/100 mmHg - not been taking her medications - Framingham study - she is at most risk of developing:
a. Right sided cardiac failure
b. PVD
c. Sudden cardiac death
d. Metabolic syndrome
Stroke
Stroke
- Jane is 32 and delivered a baby 3 days ago after an uneventful pregnancy. She has worsening SOB, ankel welling and is feeling very tired. No chest pain, CXR shows an enlarged heart. What is most likely diagnosis?
a. Dilated cardiomyopathy
b. Restrictive cardiomyopathy
c. Infective endocarditis
d. Hypertrophic cardiomyopathy
Myocardial infarction
a. Dilated cardiomyopathy
- Alcohol
- Acromegaly
- SLE
- Essential hypertension
- Sleep apnoea
- Renal artery stenosis
- Hyperparathyroidism
- Hyperthyroidism
- Cushing’s syndrome
- Polycystic kidneys
- Benign intracranial hypertension
B. 32 female OCP - ringing in ears and mild headache over last 2 months - 151/92 - trying to lose weight (obesity is a risk factor for benign intracranial hypertension) -
C. 56 man feeling tired all the time 1 episode of falling asleep driving during day. Trying to lose weight and exercise - 155/89 -
D. 62 lady - chronic severe asthma - severe exacerbations - 158/93 -
E. 66 lady - fit and healthy - 140-144/88-94 -
65 lady rash over her face which worsens in sunlight - notices lethargy and joint pains - 158/93 -
A. 58 yo old man history of 2 MI over last 2 years - now pains in both legs when he walks 25 metres. BP always normal, today 160/98 - 6
B. 32 female OCP - ringing in ears and mild headache over last 2 months - 151/92 - trying to lose weight (obesity is a risk factor for benign intracranial hypertension) - 11
C. 56 man feeling tired all the time 1 episode of falling asleep driving during day. Trying to lose weight and exercise - 155/89 - 5
D. 62 lady - chronic severe asthma - severe exacerbations - 158/93 - 9
E. 66 lady - fit and healthy - 140-144/88-94 - 4
65 lady rash over her face which worsens in sunlight - notices lethargy and joint pains - 158/93 - 3
- List 4 causes of bilateral ankle oedema
Drugs - NSAIDS, Nifedipine, amlodipine, fludcortisone
Heart failure
Chronic venous insufficiency - raised venous pressure
Hypoalbuminaemia - renal and liver failure
Pelvic mass
Lymphatic congestion
56 yo Aboriginal - worsening ankle oedema. RF Hx, ankle swelling several years ago - now palpitations
OE irregularly irregular pulse 100, BP 148/90, bilateral pitting ankle oedema - murmur is illustrated - low pitched and best heard at apex
Most likely cause in this man?
Right sided heart failure
56 yo Aboriginal - worsening ankle oedema. RF Hx, ankle swelling several years ago - now palpitations
OE irregularly irregular pulse 100, BP 148/90, bilateral pitting ankle oedema - murmur is illustrated - low pitched and best heard at apex
Most likely diagnosis
Heart failure - right sided due to mitral stenosis from RF - RHD
3 signs of right sided cardiac failure
Elevated JVP, hepatosplenomegaly, peripheral pitting oedema
3 other signs expect to find of RHCF
Mitral stenosis murmur, crackles in lung base, irregularly irregular pulse, displaced apex beat, S3 and S4, parasternal heave, Dyskinetic apex beat.
