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Cardiology Quiz | Cardiology Short Questions and Answers

Questions
41 A 74-year-old man has had increasingly severe, throbbing headaches for several months, centered on the right. There is a palpable tender cord-like area over his right temple. His heart rate is regular with no murmurs, gallops, or rubs. Pulses are equal and full in all extremities, BP is 110/85 mmHg. A biopsy of this lesion is obtained, and histologic examination reveals a muscular artery with lumenal narrowing and medial inflammation with lymphocytes, macrophages, and occasional giant cells. He improves with a course of high-dose corticosteroid therapy. Which of the following laboratory test findings is most likely to be present with this disease?
A Anti-double stranded DNA titer of 1:1024
B Erythrocyte sedimentation rate of 110 mm/hr
C HDL cholesterol of 0.6 mmol/L
D pANCA titer of 1:160

Answer: Erythrocyte sedimentation rate of 110 mm/hr
42 A 26-year-old man is noted to have cyanosis of the lower limbs and clubbing of the toes but not the fingers. Which of the following statements is true?
A He has Eisenmenger's syndrome.
B He has coarctation of the aorta.
C He is likely to have a loud continuous 'machinery' murmur below the left clavicle.
D He is likely to need urgent surgery.

Answer: He has Eisenmenger's syndrome.
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43 Which of the following is true regarding mitral stenosis?
A it is tolerated well in pregnancy
B there is characteristically a low wedge pressure
C in AF, the opening snap disappears
D The opening snap is not heard when the mitral valve is heavily calcified

Answer: The opening snap is not heard when the mitral valve is heavily calcified
44 A 54 year old man presents with central crushing chest pain. Examination is normal. 12-lead ECG shows ST segment elevation in leads II, III, aVF and ST depression in V1, V2 and V3. Which coronary artery is occluded?
A Circumflex
B Left Anterior Descending
C Left Main Stem
D Right Coronary Artery

Answer: Right Coronary Artery
45 Which of the following is true regarding the coronary circulation?
A Adenosine is the most important mediator of metabolic vasodilation.
B Coronary blood flow is independent of myocardial oxygen consumption due to autoregulation.
C Coronary blood flow within a normal range of blood pressure is primarily determined by perfusion pressure.
D Increased myocardial O2 demand is met primarily by increasing O2 extraction.

Answer: Adenosine is the most important mediator of metabolic vasodilation.
46 A 17-year-old woman loses consciousness while out jogging one afternoon, as she has done for many years. She is taken to Accident and Emergency, where a chest X-ray, CT brain scan, FBC, and biochemistry are all normal. Over the next year, she develops mild dyspnea and fatigue. There are several episodes of pre-syncope. After another syncopal episode, she is referred to a cardiologist who orders and ECG that shows changes of left ventricular hypertrophy and broad Q waves. An echocardiogram reveals left ventricular and septal hypertrophy, small left ventricle, and reduced septal excursion. The septum has a "ground glass" appearance. She then dies suddenly and unexpectedly. The microscopic appearance of the septum with trichrome stain reveals myofiber disarray. Which of the following conditions is she most likely to have had?
A Diabetes mellitus
B Hypertrophic cardiomyopathy
C Rheumatic heart disease
D Systemic lupus erythematosus

Answer: Hypertrophic cardiomyopathy
47 A 78 year old female is referred by her GP with high blood pressure. Over the last three months her blood pressure is noted to be around 180/80 mmHg. She has a body mass index of 25.5kg/m2, is a nonsmoker. There are no features to suggest a secondary cause for her hypertension. Which of the following is the most appropriate treatment for her blood pressure?
A Alpha-Blocker
B Angiotensin Converting Enzyme (ACE) Inhibitor
C Angiotensin Blocker
D Calcium channel blocker

Answer: Calcium channel blocker
48 A 55 year old man presents with gynaecomastia while receiving treatment for Heart failure. Which of the following drugs is most likely to be the cause of his gynaecomastia
A Omeprazole
B Frusemide
C Carvedilol
D Amiloride

Answer: Omeprazole
49 In the diagnosis of rheumatic fever, which of the following may be helpful?
A A generalised macular-papular rash.
B ASO titre of less than 1:200.
C Polyarthritis.
D Staphylococcus aureus grown on throat culture.

Answer: Polyarthritis.
50 An elderly man with a history of asthma, congestive heart failure, and peptic ulcer disease is admitted with bronchospasm and rapid atrial fibrillation. He recieves frequent nebulised salbutamol and IV digoxin loading, his regular medications are continued. 24 hours after admission his serum potassium is noted to be 2.8 mmol/l. Which of his medications is most likely to have caused this abnormality.
A Digoxin
B ACE inhibitor
C Salbutamol
D Ranitidine

Answer: Salbutamol
51 A 65-year-old woman, a heavy smoker for many years, has had worsening dyspnoea for the past 5 years, without a significant cough. A chest X-ray shows increased lung size along with flattening of the diaphragms, consistent with emphysema. Over the next several years she develops worsening peripheral oedema. BP 115/70 mmHg. Which of the following cardiac findings is most likely to be present?
A Right ventricular hypertrophy
B Constrictive pericarditis
C Left ventricular aneurysm
D Non-bacterial thrombotic endocarditis

Answer: Right ventricular hypertrophy
52 A 70 year old male was receiving amiodarone 200 mg daily for intermittent atrial fibrillation. However, he was aware of tiredness and lethargy. He appeared clinically euthyroid with no palpable goitre. Investigations revealed: Serum free T4 23pmol/L (9-26) Serum total T3 0.8 nmol/L (0.9-2.8) Serum TSH 8.2 mU/L (<5) Which of the following statements would explain these results?
A Abnormal thyroxine binding globulin
B Amiodarone-induced hypothyroidism
C Spontaneous hypothyroidism
D TSH secreting pituitary adenoma

Answer: Amiodarone-induced hypothyroidism
53 Which of the following antiarrhythmic drugs may be used in the treatment of long QT syndrome?
A Amiodarone
B Atenolol
C Flecainide
D Propofanone

Answer: Atenolol
54 A 55-year-old woman has had worsening shortness of breath for several years. She now has to sleep sitting up on two pillows. She has difficulty swallowing. There is no history of chest pain. She is afebrile. Recently, she suffered a stroke with left hemiparesis. A chest X-ray reveals a near-normal left ventricular size with a prominent left atrial border. Which of the following conditions is most likely to account for these findings?
A Aortic coarctation
B Cardiomyopathy
C Essential hypertension
D Mitral valve stenosis

Answer: Mitral valve stenosis
55 A 60 year old man had a myocardial infarction 6 weeks ago. He is taking aspirin 75 mg/day and metoprolol 50mg 2/day. During a routine follow-up Exercise Test he has a 20 beat run of non-sustained VT. He achieved stage 4 of the Bruce protocol and 92 % of his target heart rate. The non-sustained VT occurred halfway through Stage 2. ST segments were normal during the study. What is the definitive investigation?
A Coronary angiography.
B Echocardiogram.
C Electrophysiological study.
D Thallium exercise scan.

Answer: Electrophysiological study.
56 A 57-year-old man develops deep venous thrombosis during a hospitalization for prostatectomy. He exhibits decreased mental status with right hemiplegia, and a CT scan of the head suggests an acute cerebral infarction in the distribution of the left middle cerebral artery. A chest X-ray reveals cardiac enlargement and prominence of the main pulmonary arteries that suggests pulmonary hypertension. His serum troponin I is <0.4 ng/mL. Which of the following lesions is most likely to be present on echocardiography?
A Coarctation of the aorta
B Dextrocardia
C Pulmonary stenosis
D Ventricular septal defect

Answer: Ventricular septal defect
57 A 35 year old woman presented with a history of intermittent lightheadedness. Clinical examination and 12-lead ECG were normal. Which of the following, if present on a 24 hour Holter ECG tracing, would be the most clinically important?
A Atrial premature beats.
B Profound sleep-associated bradycardia.
C Supraventricular tachycardia.
D Transient Mobitz type 1 atrioventricular block.

Answer: Supraventricular tachycardia.
58 A 52 year old sales representative is admitted with an inferior myocardial infarction. He receives thrombolysis and makes an uneventful recovery. He is discharged on atenolol, aspirin and orvastatin. He enquires how long after his MI must he wait before he is able to drive?
A One week
B Two weeks
C Four weeks
D Three months

Answer: Four weeks
59 Which of the following may be responsible for a hypokalaemic hypertension ?
A Non-classical congenital adrenal hyperplasia
B Barter's syndrome
C Diabetic nephropathy
D Liddle's syndrome

Answer: Liddle's syndrome
60 Which of the following compounds has a vasodilating effect?
A Antidiuretic hormone
B Calcitonin
C Endothelin
D Renin

Answer: Calcitonin

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