Cardiovascular Medicine

Question 1

What are the branches of the external carotid artery?

Answer 1

Use the mnemonic:

‘Some Angry Lady Figured out PMS’

Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal

Question 2

What is are the ECG signs of hyperkalaemia?

Answer 2

• Wide QRS complexes
• Small or absent P waves
• Tall-tended T waves
• Sinusoidal pattern

Question 3

What is the correct surface landmark for locating the femoral artery?

Answer 3

Midway between the ASIS and the pubic symphysis (also known as the mid-inguinal point)

Question 4

What is the relationship between protease inhibitors and warfarin?

Answer 4

Protease inhibitors are strong inhibitors of the CYP3A4 system and is therefore likely to interfere with warfarin metabolism

Question 5

What murmur does aortic regurgitation cause?

Answer 5

Early diastolic

Question 6

What murmur does aortic stenosis cause?

Answer 6

Ejection systolic murmur

Question 7

What murmur do atrial septal defects cause?

Answer 7

Ejection systolic murmur

Question 8

What murmur does mitral regurgitation cause?

Answer 8

Pansystolic murmur

Question 9

What murmur does tricuspid regurgitation cause?

Answer 9

Pansystolic murmur

Question 10

What is cor pulmonale?

Answer 10

Right-sided heart failure secondary to long-standing COPD

Question 11

What causes cor pulmonale?

Answer 11

Chronic hypoxia from COPD, subsequent vasoconstriction in pulmonary vasculature causing pulmonary hypertension and then right-sided heart failure

Question 12

What are common signs of cor pulmonale?

Answer 12

• Engorged neck veins
• Loud P2
• Lower-extremity oedema
• Hepatomegaly

Question 13

What is the definition of first degree heart block?

Answer 13

A delay, without interruption, in conduction from atria to ventricles (PR interval) of >200ms (five small squares)

Question 14

What is marked first degree heart block?

Answer 14

PR interval > 300 ms

Question 15

What is second degree heart block type one also known as?

Answer 15

Mobitz type I, Wenckebach

Question 16

What is the definition of second degree heart block type 1?

Answer 16

Progressive prolongation of the PR interval culminating in a non-conductive P wave (absence of QRS)

Question 17

What is second degree heart block type 2 also known as?

Answer 17

Mobitz type II, Hay block

Question 18

What is the definition of second degree heart block type 2?

Answer 18

Intermittent non-conductive P waves (loss of QRS) without progressive prolongation of the PR interval

Question 19

What is the cause of second degree heart block type 2?

Answer 19

Failure of conduction at the level of the His-Purkinje system (below the AV node)

Question 20

What is the cause of second degree heart block type 1?

Answer 20

A reversible conduction block at the level of the AV node

Question 21

What is high grade AV block?

Answer 21

A form of second degree heart block with a P:QRS ratio of 3:1 or higher producing an extremely low ventricular rate

Question 22

What is complete heart block?

Answer 22

A complete absence of AV conduction with no supraventricular impulses conducted to the ventricles which leads to severe bradycardia

Question 23

What are the ECG signs of complete heart block

Answer 23

Complete P wave dissociation from QRS complexes with independent arterial and ventricular rates

Question 24

What is ezetimibe?

Answer 24

A cholesterol-lowering drug

Question 25

What is perindopril?

Answer 25

An ACE-inhibitor

Question 26

When is stenting indicated in carotid artery stenosis?

Answer 26

- >70% in asymptomatic patients - >50% ipsilateral in symptomatic patients - Bilateral stenosis

Question 27

What type of MI is most likely to cause complete heart block?

Answer 27

Inferior STEMI

Question 28

What artery is occluded in 80% of inferior STEMIs?

Answer 28

Right coronary

Question 29

Which arteries supply the lateral wall of the left ventricle?

Answer 29

Left anterior descending and left circumflex

Question 30

When do cholesterol emboli typically present?

Answer 30

After arterial manipulation such as surgery, stent placement or cardiac catheterisation

Question 31

What are thrash toes?

Answer 31

Also known as blue toes they are darkened toes caused by blockages to the small vessels of the foot

Question 32

What are the key diagnostic features of renal artery stenosis?

Answer 32

- Severe, refractory hypertension - Kidney dysfunction - Hx of coronary artery disease/peripheral vascular disease - Abdominal bruid - 'flash' pulmonary oedema

Question 33

What is giant cell arteritis?

Answer 33

Granulomatous vasculitis of large and medium sized arteries primarily branches of the external carotid

Question 34

What is the most common serious complication of giant cell arteritis?

Answer 34

Irreversible blindness as a result of optic nerve ischaemia

Question 35

What is giant cell arteritis also known as?

Answer 35

Temporal arteritis