Cardiology Quiz | Cardiology Objective Type Questions and Answers

21 A previously well 27-year-old woman presents with a history of transient ischaemic attack affecting her right side and speech. She had returned to the United Kingdom from a holiday in New Zealand two days previously. On examination there was nothing abnormal to find. An ECG, chest X-ray, CT brain scan and routine haematology and biochemistry were all normal. What is the most likely underlying abnormality?

22 Which of the following infections is least likely to cause myocarditis?

23 Which of the following is a recognised feature of abetalipoproteinaemia?

24 A 44-year-old man has had no major medical problems throughout his life, except for arthritis pain involving all extremities for the past couple of years. He has had worsening orthopnoea and ankle oedema in the past six months. He is afebrile. There is no chest pain. A chest X-ray shows cardiomegaly with both enlarged left and right heart borders, along with pulmonary oedema. Laboratory test findings include sodium 139 mmol/L, potassium 4.3 mmol/L, urea 7 mmol/L creatinine 95 µmol/L, and glucose 8.6 mmol/L. Which of the following additional laboratory test findings is he most likely to have?

25 A 56 year old male with left ventricular systolic dysfunction was dyspnoeic on climbing stairs but not at rest. The patient was commenced on ramipril and frusemide. Which one of the following drugs would improve the patient's prognosis?

26 A 30-year-old man presents with a history of transient loss of consciousness and palpitations. His ECG shows ventricular tachycardia. Which of the following treatments should be avoided?

27 Primary prevention trials for the treatment of hypercholesterolaemia reveal a reduction in all cause mortality following treatment with which of the following?

28 Which of the following concerning the use of intravenous bicarbonate in cardiorespiratory arrest is correct?

29 A 55-year-old woman was found to have ++ glycosuria and had a maternal history of Type II diabetes mellitus. She was a smoker of 20 cigarettes per day. Examination reveals no specific abnormalities apart from a BMI of 30. Blood pressure was 132/88 mmHg. Investigations reveal: serum creatinine 80 µmol/L (60 – 110) plasma glucose (fasting) 11.3 mmol/L (3.0 – 6.0) total serum cholesterol 5.5 mmol/L (<5.2) HDL cholesterol 1.4 mmol/L (>1.55) What is most likely to improve her life expectancy?

30 In a patient presenting with aortic stenosis, which of the following findings would be most helpful in establishing a diagnosis of congenital bicuspid valve as the etiology?

31 A 60-year-old man with a past history of controlled hypertension presents with acute onset weakness of his left arm, that resolved over 12 hours. He had suffered two similar episodes over the last three months. Examination reveals a blood pressure of 132/82 mmHg and he is in atrial fibrillation with a ventricular rate of 85 per minute. CT brain scan is normal. What is the most appropriate management?

32 In a normal heart, the oxygen saturation of a sample of blood taken from a catheter in the pulmonary capillary wedge position should be equal to a sample from which of the following?

33 A 23 year old male presents with a deep vein thrombosis. He has no past medical history but his mother has suffered from deep vein thromboses. Which of the following is likely to be found on haematological assessment?

34 A 14-year-old boy presents with hypertension. Which of the following statements concerning hypertension in the young is true?

35 A 70-year-old male is referred by his GP for management of recently diagnosed congestive heart failure. The patient has a history of poorly controlled hypertension. Over the last three months he has been aware of deteriorating shortness of breath, fatigue, and orthopnea. Over the last month he had been commenced on Digoxin (62.5 micrograms daily), Frusemide (80 mg daily), and amiloride 10 mg. On examination he has a pulse of 96 bpm regular, a blood pressure of 132/88 mmHg. His JVP was not raised, he had some scattered bibasal crackles on auscultation with a displaced apex beat in the anterior axillary line, 6th intercostal space. Auscultation of the heart revealed no murmurs and he had peripheral oedema to the mid tibia. Investigations showed: electrolytes normal serum urea concentration 17 mmol/l (NR 2-8 mmol/l) creatinine 175 micromol/l (NR 55-110) Serum digoxin 0.7 ng/mL {therapeutic: 1.0-2.0} One month previously his urea had been 11 mmol/l and creatinine 110 micromol/l. An ECG reveals left ventricular hypertrophy and Chest X-ray shows cardiomegaly and calcified aorta. What is the most appropriate next step in management?

36 A 65 year old man presents with severe central crushing chest pain. ECG shows evidence of an inferior myocardial infarction. He receives TPA, Heparin and Aspirin. Four hours after initial presentation, he starts feeling dizzy and breathless. His pulse is 40 bpm regular, BP 80/50. Heart sounds are soft and chest clear to auscultation. ECG shows 2:1 AV block with T wave inversion inferiorly. IV atropine was administered but had no effect. What is the next most important treatment?

37 A 68-year-old man has been very ill for months following the onset of chronic liver disease with hepatitis C infection. He experiences a sudden loss of consciousness and then exhibits paraplegia on the right. A cerebral angiogram reveals lack of perfusion in the left middle cerebral artery istribution. The most likely cardiac lesion to be associated with this finding is?

38 A patient presents with atrial fibrillation and later they revert to sinus rhythm. Under which of the following circumstances is the patient more likely to remain in sinus rhythm?

39 Which of the following regarding the anatomy of the heart is true?

40 A 68 year old woman was admitted to hospital with evidence of biventricular cardiac failure. On examination her pulse was 100 beats per minute (sinus rhythm), and her blood pressure was 140/60 mmHg. She had haemorrhages in both fundi. Her condition improved after intravenous diuretics. Investigations revealed: haemoglobin 5.6 g/dl (11.5 – 16.5) haematocrit 0.19 (0.36 – 0.47) MCV 118 fl (80 – 96) MCH 33.0 pg (28 – 32) WCC 3.4 x 109/L (4 – 11) platelet count 95 x 109/L (150 – 400) What is the next most appropriate step in management?