Meeran Book Cardio

Question 1

What are the signs of Digoxin poisoning?

Answer 1

• Yellow rings around light
• Bradycardia/ tachycardia and palpitations
• Nausea
• Anorexia

Question 2

What is the most probably cause of AF in a young person?

Answer 2

Hyperthyroidism

Question 3

Which valve is most likely associated with AF?

Answer 3

Mitral valve pathology

Question 4

What are the organisms associated with infectious endocarditis?

Answer 4

• Staph aureus (most commonly and associated with IVDU)
• Strep viridans (dental work)

Question 5

What is the definitive diagnostic tool for infective endocarditis?

Answer 5

Blood cultures, three performed within 24 hours 2 hrs apart

Question 6

What are the adverse effects of amiodarone?

Answer 6

• Pulmonary fibrosis
• Liver damage
• Peripheral neuropathy
• Abnormal thyroid function

Question 7

What is the most common cause of resistance to hypertensive therapy?

Answer 7

Failure to take medication correctly

Question 8

What is the first sign seen on x-ray of left sided heart failure?

Answer 8

Pulmonary oedema–> pleural effusion

Question 9

What is the pulse pressure like in aortic stenosis?

Answer 9

Narrow pulse pressure

Question 10

What is the CHADS VaSc score?

Answer 10

• Congestive heart failure (1)
• Hypertension (1)
• Age
  
  • >= 75 (2)
  • >= 65 (1)
• Diabetes mellitus (1)
• Stroke/ TIA previously (2)
• Vascular disease (1)
• Sex
  
  • Female (1)

0= no management required

1= aspirin/ warfarin

2= warfarin

Question 11

What are the signs of ischaemia on ECG?

Answer 11

• ST depression
• T wave inversion

Question 12

Why are troponin levels not the most indicitive test for MI at patient presentation?

Answer 12

Because troponin levels take 10-12 hours to come back

Question 13

What is the murmur heard with mitral prolapse?

Answer 13

Barlow syndrome, mid-systolic click with late systolic murmur

Question 14

What is a Carey Coombs murmur?

Answer 14

A murmur associated with Rheumatic fever and a thickened mitral valve, a short mid-diastolic murmur at the apex

Question 15

What should be given to a patient at presentation with ?MI who is allergic to aspirin?

Answer 15

Clopidogrel

Question 16

What is the normal range for a PR interval?

Answer 16

3-5 small squares (0.12-0.2s)

Question 17

What is the normal range for a QRS complex?

Answer 17

1.5-2.5 small squares (0.06-0.1s)

Question 18

What is the normal QT interval range?

Answer 18

9-11 small squares (0.36-0.44s)

Question 19

What is the normal P wave range?

Answer 19

2-3 small squares (0.08-0.12s)

Question 20

What is the first line management of a patient with AF at presentation within 48 hours?

Answer 20

DC cardioversion

Question 21

What is Dressler’s syndrome?

Answer 21

An autoimmune pericarditis that occurs weeks after an MI

Question 22

What is the most likely complication of a small, asymptomatic VSD?

Answer 22

Endocarditis, due to stasis of blood potentially causing infection

Question 23

What is the first line imaging for polycystic kidney disease?

Answer 23

USS KUB

Question 24

What is the inheritance pattern of polycystic kidney disease?

Answer 24

Autosomal dominant

Question 25

What is the pulse pressure like in aortic regurgitation?

Answer 25

Wide pulse pressure

Question 26

What is the presentation on Prinzmetal angina?

Answer 26

Variant angina, occurs usually when the individual is at rest between midnight and the early hours of the morning

Question 27

Which medication is contraindicated in Prinzmetal angina?

Answer 27

Beta blockers, as they can induce vasospasm

Question 28

What is the pharmacological management of HOCM?

Answer 28

1. Beta blockers 2. Verapamil (NDH Ca channel blockers)