Cardiology practice questions

Question 1

What scoring system is used to grade the severity of symptoms in patients with heart failure

Answer 1

New York heart associated classification

Question 2

Which medications are used for supraventricular tachycardia (2)

Answer 2

IV verapamil
IV adenosine

Question 3

Which pathologies are most associated with new left bundle branch block on an ECG (2)

Answer 3

STEMI
Hypertension

Question 4

Which scoring system is used to asses risk of stroke in patients with atrial fibrillation

Answer 4

CHA2DS2-VASc

Question 5

Which heater pathology is associated with an early diastolic soft murmur

Answer 5

aortic regurgitation

Question 6

Which medication is used for prevention of stroke in patients with atrial fibrillation at increased risk

Answer 6

apixaban

Question 7

What is an alternative lipid modification therapy used if patients are intolerant of statins

Answer 7

ezetimibe

Question 8

Which medication is used for rate control in atrial fibrillation

Answer 8

bisoprolol (a beta blocker)

Question 9

What ECG appearance is associated with pericarditis

Answer 9

saddle-shaped ST elevation and PR depression

Question 10

What pathology is frothy pink sputum associated with

Answer 10

heart failure

Question 11

What is the first line anti-hypertensive treatment in patients of African/Caribbean ethnicity

Answer 11

amlodipine

Question 12

What is the first line antihypertensive treatment for diabetic patients

Answer 12

ramipril

Question 13

What are the signs of aortic regurgitation (2)

Answer 13

Collapsing pulse
Progressive shortness of breath, esp on exertion

Question 14

If a patient presents with acute onset chest pain, sweating, and a feeling of dread with new left bundle branch block on their ECG, what is the likely diagnosis

Answer 14

STEMI

Question 15

What medication is used to treat unstable bradycardia

Answer 15

IV atropine

Question 16

What medication is used as primary prevention of cardiovascular disease

Answer 16

Astrovastatin

Question 17

What is the first-line antihypertensive medication for diabetic patients of African/Caribbean ethnicity

Answer 17

candesartan

Question 18

If a patient presents with sudden onset, severe, tearing chest pain in the anterior chest what is the likely diagnosis

Answer 18

Aortic dissection

Question 19

If someone presents with low fever and sharp anterior chest pain which worsens with breathing and improves leaning forwards, what is the likely diagnosis

Answer 19

pericarditis

Question 20

What is the likely diagnosis if a patient presents with breathless on exertion and waking at night gasping for breath

Answer 20

heart failure

Question 21

Mechanism of action of nitrates

Answer 21

release of NO in smooth muscle
Activation of guanylate cyclase
GTP to cGMP
Smooth muscle relaxation

Question 22

ECG findings of atrial flutter (2)

Answer 22

sawtooth pattern
Narrow complex tachycardia

Question 23

Where does the superior mesenteric artery leave the aorta

Answer 23

L1

Question 24

Where is the posterior tibial pulse found

Answer 24

Behind and below the medial ankle

Question 25

what drugs can cause hyponatraemia

Answer 25

Thiazides

Question 26

What heart condition is sarcoidosis associated with

Answer 26

dilated cardiomyopathy

Question 27

What ECG changes suggest left bundle branch block (2)

Answer 27

prolonged QRS complex Dominant S wave in V1

Question 28

What causes LBBB

Answer 28

Damage of left bundle branch and the associated Purkinje fibres

Question 29

How does sympathetic stimulation increase heart rate

Answer 29

Increasing the conduction velocity of the atrioventricular node

Question 30

What conditions would infarction of the sino-atrial node and atrioventricular node present with (2)

Answer 30

bradycardia Heart block

Question 31

What ECG feature suggests hypokalaemia

Answer 31

U waves

Question 32

What is there a high risk of in the first 24 hours after an MI

Answer 32

Ventricular arrhythmia Heart failure Cardiogenic shock

Question 33

What is the mechanism of action of amiodarone + the effects (2)

Answer 33

Blocks potassium channels Prolongs repolarisation Prolongs action potential duration

Question 34

When is B type natriuretic peptide release

Answer 34

in response to ventricular strain eg increased ventricular filling pressure

Question 35

What does decreased intracellular calcium cause

Answer 35

Relaxation of vascular smooth muscle (vasodilation and hypotension)

Question 36

What can long QT syndrome lead to

Answer 36

Torsades de pointes (a type of polymorphic ventricular tachycardia)

Question 37

What protein restores resting potential

Answer 37

Na+/K+ ATPase

Question 38

Why is concurrent use of trimethoprim and ACE inhibitors dangerous

Answer 38

can cause life-threatening hyperkalaemia

Question 39

What happens to cardiac output in postural hypotension

Answer 39

Falls upon standing up

Question 40

What condition can potassium channel activators be indicated for

Answer 40

Angina

Question 41

What is the characteristic ECG sign of myocardial ischaemia

Answer 41

ST segment depression on exercise

Question 42

Where is the diastolic murmur of aortic regurgitation best heard

Answer 42

Left lower sternal border (With patient sitting up)

Question 43

what are the symptoms of aortic regurgitation (2)

Answer 43

Shortness of breath Dizzy spells

Question 44

What pathology are tall tented T waves and flattened P waves associated with

Answer 44

hyperkalaemia

Question 45

What type of arrhythmia is cardioversion indicated for

Answer 45

Ventricular fibrillation (if the patient is pulseless)

Question 46

What improves mortality rates in patients with heart failure

Answer 46

Ramipril

Question 47

Example of an ARB

Answer 47

Losartan

Question 48

What type of drug is hyponatraemia a side effect of

Answer 48

Thiazide diuretics

Question 49

Where is the angiotensin converting enzyme produced

Answer 49

lungs

Question 50

Function of the foramen ovalis

Answer 50

Allows blood to move from the right atrium to the left atrium

Question 51

Function of the ductus arteriosus

Answer 51

Allows blood to bypass pulmonary circulation Connects aorta and pulmonary trunk

Question 52

In what direction does HbF shift the oxygen dissociation curve

Answer 52

Left

Question 53

What hormone acts on beta 1 receptors in the sino atrial node

Answer 53

Noradrenaline

Question 54

Features of supraventricular tachycardia (2)

Answer 54

High heart rate Narrow QRS complexes