Cardiac Pathology :)

Question 1 of 47

1

ACE inhibitors work by:

Select one of the following:

Blocking the sympathetic effect of noradrenaline on blood vessels.
Preventing the conversion of angiotensin I to angiotensin II.
Blocking angiotensin II receptors
Rapid degradation of angiotensin II.

Explanation

Question 2 of 47

1

A 53-year-old man complains of erection difficulty. He recently had some transient angina and was given some medications.
His symptoms started soon after the consultation. Which drug is likely to be causing his symptoms?

Select one of the following:

Nifedipine
Ramipril
Labetalol
Spironolactone
Bendroflumethiazide

Explanation

Question 3 of 47

1

Click on the orange point and write the correct answer.

An older man arrives at ED with swollen lips. Not anaphylactic shock. His regular prescriptions are nifedipine, simvastatin, warfarin, lansoprazole and Ramipril. Which is causing this angioedema?

Explanation

Question 4 of 47

1

A 65-year-old man presents with central crushing angina for the first time. He is transferred immediately to the closest cardiac unit to undergo a primary percutaneous coronary intervention. There is thrombosis of the left circumflex artery only. Angioplasty is carried out and a drug-eluding stent is inserted.

What are the most likely changes to have occurred on ECG during admission?

Select one of the following:

ST elevation in leads V1–4
ST elevation in leads V1–6
ST elevation in leads I, aVL, V5, V6
ST elevation in leads II, III and aVF

Explanation

Question 5 of 47

1

The ECG shows an antero-lateral STEMI. Which coronary artery is most likely to have been occluded?

Select one of the following:

Left Circumflex artery
Left anterior descending artery
Right main coronary artery.
Right posterior descending artery
Left main coronary artery

Explanation

Question 6 of 47

1

Which of the following will be observed in a patient that has mitral regurgitation

Select one of the following:

Diastolic murmur, 5th intercostal space, left midclavicular line
Diastolic murmur, 4th intercostal space, left midclavicular line
Diastolic murmur, apex of the heart
Systolic murmur, apex of the heart.
Systolic murmur, 2nd intercostal space, right sternal border.

Explanation

Question 7 of 47

1

A murmur is heard just to the left of the sternum in the 2nd intercostal space during systole, what kind of murmur do you suspect?

Select one of the following:

Aortic Stenosis
Aortic regurgitation
Pulmonary stenosis
Pulmonary regurgitation
mitral stenosis

Explanation

Question 8 of 47

1

A 25-year-old woman with known mitral valve prolapse develops a low-grade fever, malaise and night sweats after a couple of weeks of a major dental procedure. Examination reveals tender vasculitic lesions on the finger pulps and microscopic haematuria. Which is the most appropriate initial step in management?

Select one of the following:

Give antibiotics
Chest X-ray.
Give NSAIDs
Sputum sample
Get blood cultures

Explanation

Question 9 of 47

1

A middle aged female has central retrosternal angina. The pain is worse lying flat and when she takes a deep breath. It is relieved by sitting up, and leaning forward. An ECG is performed as below. What is the most likely diagnosis?

Select one of the following:

The ECG
Acute STEMI
Endocarditis
NSTEMI
Pulmonary embolism
Pericarditis

Explanation

Question 10 of 47

1

Click on the orange point and write the correct answer.

A 54 years old man presents to the emergency department with chest pain which does not go away with GTN spray. He sits down and the pain persists and he begins to feel an ache in his arm, and feels extremely sweaty. An ECG is performed.

Explanation

Question 11 of 47

1

At ED, an elderly woman with Type 2 diabetes mellitus, Hypertension and BMI of 33.6 was admitted to your department via ambulance after experiencing an episode of central crushing chest pain that radiated to her left arm. It came on while she was watching TV and has not been relieved despite rest and GTN spray.
Vital signs: RR: 35; BP:105/62; SpO2:90%; Temperature: 37.0oC
Based on the ECG, what is the most appropriate initial management for this?

Select one of the following:

The ECG
IV morphine, GTN, aspirin
Percutaneous coronary intervention (PCI)
Arrange a CTPA
Coronary artery bypass graft (CABG)
IV morphine, 15L high flow O2, GTN, aspirin

Explanation

Question 12 of 47

1

Fill the blank spaces to complete the text.

A is an extra or unusual sound heard during a heartbeat.

Explanation

Question 13 of 47

1

Fill the blank spaces to complete the text.

Murmurs can either be (S1) or (S2).

Valvular murmurs: 2 main reasons
: Valve is too narrow for the blood to pass through.

(Incompetence): Valve does fully shut so there is backflow

Explanation

Question 14 of 47

1

Click on each orange point and write the correct answer.

Fill in the Table.

Explanation

Question 15 of 47

1

Non-valvular murmurs also exist.

Select one of the following:

True
False

Explanation

Question 16 of 47

1

Click on each orange point and write the correct answer.

Label the different valves.

Explanation

Question 17 of 47

1

Fill the blank spaces to complete the text.

of the aortic valves (due to naturally ) mainly causes .

The most common cause of is rheumatic heart disease due to the bacteria of group Streptococcus.

Explanation

Question 18 of 47

1

What is the correct ordering of the heart layers?

Select one of the following:

fibrous pericardium, parietal serous pericardium, pericardial cavity, pericardial fluid, visceral serous pericardium, epicardial fat, myocardium, endocardium
fibrous pericardium, epicardial fat, visceral serous pericardium, pericardial cavity, pericardial fluid, parietal serous pericardium, myocardium, endocardium
fibrous pericardium, parietal serous pericardium, visceral serous pericardium, pericardial cavity, pericardial fluid, epicardial fat, emyocardium, endocardium
epicardial fat, fibrous pericardium, parietal serous pericardium, visceral serous pericardium, pericardial cavity, pericardial fluid,endocardium, myocardium

Explanation

Question 19 of 47

1

What is true regarding endocarditits?

Select one or more of the following:

Inflammation of the endocardium
common cause: Staph Aureus
common cause: Strep viridans
New murmur
Fever
Splinter Hemorrhage
Janeway lesions and Osler nodes
Diagnosis: Echocardiograms and electrocardiograms
Diagnosis: Blood culture and echocardiograms
Manage: antibiotics and NSAIDS

Explanation

Question 20 of 47

1

What is true regarding pericarditits?

Select one or more of the following:

inflammation of pericardium
Common cause: Coxsackie B virus
Chest pain which feels better when sitting forward
Auscultation: pericardial friction rub audible
Widespread saddle shaped ST-elevation on ECG = diagnosis
1-2 weeks course of NSAIDs
complication: cardiac tamponade
Auscultation: crackles
Chest pain better from lying down
dispersed ST-elevation on ECG leads = diagnosis

Explanation

Question 21 of 47

1

Click on each orange point and write the correct answer.

What are these clinical symptoms?

Explanation

Question 22 of 47

1

Fill the blank spaces to complete the text.

angina is due to problems in blood supply. It comes about at or , like walking.

Explanation

Question 23 of 47

1

Fill the blank spaces to complete the text.

Stable angina is due to . It is a chest tightness or heaviness, which is relieved by . It may radiate to one or both , the neck, jaw or .

Explanation

Question 24 of 47

1

Fill the blank spaces to complete the text.

GRAB to treat stable angina:

spray for symptomatic relief

Factor modification like stop smoking and reduced cholesterol

reduces mortality by 34% (fact)

to reduce symptoms unless contraindicated

Explanation

Question 25 of 47

1

Fill the blank spaces to complete the text.

Unstable angina, NSTEMI and STEMI are a group of conditions that occur due to decreased blood flow in the arteries, leading to heart muscle . This is known as .

Explanation

Question 26 of 47

1

How does ACS (acute coronary syndrome) present?

Select one of the following:

Angina pectoris pain
noticeable sweating
tachypneia
nausea
vomiting
progresses--> radiating pain

Explanation

Question 27 of 47

1

Click on each orange point and write the correct answer.

Which is NSTEMI and which is STEMI?

Explanation

Question 28 of 47

1

Fill the blank spaces to complete the text.

Acute management of ACS: MONA

IV
Oxygen (if Sats < 94%)

Explanation

Question 29 of 47

1

Fill the blank spaces to complete the text.

Secondary management of ACS is :

STEMI
therapy--> PCI ( intervention)

If this cannot be achieved within hours of diagnosis or PCI is not available, therapy such as streptokinase is to be done.

Explanation

Question 30 of 47

1

Fill the blank spaces to complete the text.

Secondary prevention of myocardial infarction: AAABC

(antiplatelet)
inhibitor

Beta-blocker
(antiplatelet)

Explanation

Question 31 of 47

1

Click on the orange point and write the correct answer.

What morphology is shown below? (2 words)

Explanation

Question 32 of 47

1

Which leads are lateral?

Select one or more of the following:

AVF
AVL
AVR
II
I
III
V1 and V2
V3 and V4
V5
V6

Explanation

Question 33 of 47

1

Which leads are anterior?

Select one or more of the following:

AVF
AVR
AVL
lead I
lead II
lead III
V1 AND V2
V3 AND V4
V5
V6

Explanation

Question 34 of 47

1

Which of these leads is not inferior?

Select one of the following:

II
III
AVF
I

Explanation

Question 35 of 47

1

Click on each orange point and write the correct answer.

Fill in what each abbreviation in the table stands for.

Explanation

Question 36 of 47

1

Which of these could result from severe or untreated hypertension?

Select one or more of the following:

stroke
MI
blindness
renal failure
pulmonary disease
aneurysms
ovarian cancer

Explanation

Question 37 of 47

1

What are side effects of ACE inhibitors?

Select one or more of the following:

Dry cough
Angioedema
Hypotension
Hyperkalemia
Hypercalcemia
Hypoglycemia

Explanation

Question 38 of 47

1

Hydrochlorothiazide and Metolazone are examples of thiazide-like diuretics.

Select one of the following:

True
False

Explanation

Question 39 of 47

1

Fill the blank spaces to complete the text.

end in “sartan” e.g.

They're given if side effects of ACE inhibitors are experienced.

Explanation

Question 40 of 47

1

Fill the blank spaces to complete the text.

Beta blockers reduce the by reducing heart rate and force of contraction (hence the ).

They end in -lol like .

Explanation

Question 41 of 47

1

What is true regarding beta blocker side effects?

Select one or more of the following:

bronchoconstriction
bradycardia
heart failure
hypotension
AV nodal conduction block
polyuria
renal failure
dehyrdation
vertigo

Explanation

Question 42 of 47

1

Fill the blank spaces to complete the text.

If the patien is younger than 8o years, treatment for stage hypertension is given if:
damage
disease (or significant risk of developing it)
Renal disease

Explanation

Question 43 of 47

1

NSTE-ACS refers to Unstable Angina and NSTEMI.

Select one of the following:

True
False

Explanation

Question 44 of 47

1

Fill the blank spaces to complete the text.

Cardiac markers: I/T

They are the most specific/sensitive tests for .

Explanation

Question 45 of 47

1

Click on each orange point and write the correct answer.

Fill in the diagram. (ABREVIATIONS WHERE APPROPRIATE)

Explanation

Question 46 of 47

1

WHICH are side-effects of calcium channel blockers?

Select one or more of the following:

peripheral edema
flushing
headache
severe hypotension
angina
hidrosis
miosis

	Created by Plymouth Med about 6 years ago

Courtesy of Dayo's Maturity 1 teach. Content credited to him.

Cardiac Pathology :)

Question 1 of 47

ACE inhibitors work by:

Select one of the following:

Explanation

Question 2 of 47

A 53-year-old man complains of erection difficulty. He recently had some transient angina and was given some medications. His symptoms started soon after the consultation. Which drug is likely to be causing his symptoms?

Select one of the following:

Explanation

Question 3 of 47

Click on the orange point and write the correct answer.

An older man arrives at ED with swollen lips. Not anaphylactic shock. His regular prescriptions are nifedipine, simvastatin, warfarin, lansoprazole and Ramipril. Which is causing this angioedema?

Explanation

Question 4 of 47

Select one of the following:

Explanation

Question 5 of 47

The ECG shows an antero-lateral STEMI. Which coronary artery is most likely to have been occluded?

Select one of the following:

Explanation

Question 6 of 47

Which of the following will be observed in a patient that has mitral regurgitation

Select one of the following:

Explanation

Question 7 of 47

A murmur is heard just to the left of the sternum in the 2nd intercostal space during systole, what kind of murmur do you suspect?

Select one of the following:

Explanation

Question 8 of 47

Select one of the following:

Explanation

Question 9 of 47

A middle aged female has central retrosternal angina. The pain is worse lying flat and when she takes a deep breath. It is relieved by sitting up, and leaning forward. An ECG is performed as below. What is the most likely diagnosis?

Select one of the following:

Explanation

Question 10 of 47

Click on the orange point and write the correct answer.

A 54 years old man presents to the emergency department with chest pain which does not go away with GTN spray. He sits down and the pain persists and he begins to feel an ache in his arm, and feels extremely sweaty. An ECG is performed.

Explanation

Question 11 of 47

Select one of the following:

Explanation

Question 12 of 47

Fill the blank spaces to complete the text.

A is an extra or unusual sound heard during a heartbeat.

Explanation

Question 13 of 47

Fill the blank spaces to complete the text.

Murmurs can either be (S1) or (S2). Valvular murmurs: 2 main reasons : Valve is too narrow for the blood to pass through. (Incompetence): Valve does fully shut so there is backflow

Explanation

Question 14 of 47

Click on each orange point and write the correct answer.

Fill in the Table.

Explanation

Question 15 of 47

Non-valvular murmurs also exist.

Select one of the following:

Explanation

Question 16 of 47

Click on each orange point and write the correct answer.

Label the different valves.

Explanation

Question 17 of 47

Fill the blank spaces to complete the text.

of the aortic valves (due to naturally ) mainly causes . The most common cause of is rheumatic heart disease due to the bacteria of group Streptococcus.

Explanation

Question 18 of 47

What is the correct ordering of the heart layers?

Select one of the following:

Explanation

Question 19 of 47

What is true regarding endocarditits?

Select one or more of the following:

Explanation

Question 20 of 47

What is true regarding pericarditits?

Select one or more of the following:

Explanation

Question 21 of 47

A 53-year-old man complains of erection difficulty. He recently had some transient angina and was given some medications.
His symptoms started soon after the consultation. Which drug is likely to be causing his symptoms?

Murmurs can either be (S1) or (S2).

Valvular murmurs: 2 main reasons
: Valve is too narrow for the blood to pass through.

(Incompetence): Valve does fully shut so there is backflow

of the aortic valves (due to naturally ) mainly causes .

The most common cause of is rheumatic heart disease due to the bacteria of group Streptococcus.

GRAB to treat stable angina:

spray for symptomatic relief

Factor modification like stop smoking and reduced cholesterol

reduces mortality by 34% (fact)

to reduce symptoms unless contraindicated

Acute management of ACS: MONA

IV
Oxygen (if Sats < 94%)

Secondary management of ACS is :

STEMI
therapy--> PCI ( intervention)

If this cannot be achieved within hours of diagnosis or PCI is not available, therapy such as streptokinase is to be done.

Secondary prevention of myocardial infarction: AAABC

(antiplatelet)
inhibitor

Beta-blocker
(antiplatelet)