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  1. 1. CardiologyA 50 year old woman presents with left arm and legweakness of 5 hours duration. She is known to have AF. Sheis hypertensive but her AF is rate controlled with a HR of 80.Neurological exam confirms 4/5 weakness but there is nilelse remarkable, bloods are normal and CT head shows noevidence of haemorrhage. As there is no evidence ofhaemorrhage on CT, what anti platelet or anticoagulant are?yo going to prescribe:Select the best answerIV HeparinWarfarin to be commenced covered by LMWHThrombolysisAspirinNoneQuestion category: CardiologyA 50 year old woman presents with left arm and legweakness of 5 hours duration. She is known to have AF. Sheis hypertensive but her AF is rate controlled with a HR of 80.Neurological exam confirms 4/5 weakness but there is nilelse remarkable, bloods are normal and CT head shows noevidence of haemorrhage. As there is no evidence ofhaemorrhage on CT, what anti platelet or anticoagulant are?yo going to prescribe:Select the best answerAspirinNoneWarfarin to be commenced covered by LMWHThrombolysisIV Heparinestion category: CardiologyA 23 year old female has been referred to the cardiologyclinic. She has been increasingly shortness of breath and
  2. 2. can barely climb stair without becoming short of breath. Sheis found to be hypertensive. An ECHO revealed right atrialhypertrophy and raised right atrial pressure. Cardiaccatheterisation was performed and revealed a higher thannormal oxygen saturation in the right atrium and ventricle.?What is the most likely diagnosis:Select the best answer(Atrial Septal Defect (Ostium primum(Atrial Septal Defect (Ostium secundumPulmonary HypertensionVentricular septal defectPatent ductus arteriosus Anatomy?Regarding the renal artery, which is correct:Select the best answerThey arise from the abdominal artery above the superiormesenteric arteryThe aorta passes through the diaphragm at the level of theeleventh thoracic vertebraThe gonadal arteries arise above the origin of the renalarteryThe right renal artery is longer than the leftThe suprarenal artery arises from the renal arteryCardiologyA 60 year old who is on Lithium for bipolar disorder is foundto be hypertensive by her GP is to be commenced on antihypertensive therapy. What anti hypertensive would you?prescribe to limit the risk of lithium toxicity:Select the best answerBendroflumethiazideLosartanAmlodipine
  3. 3. AtenololAtenolol is the safest option. Thiazides with lithium lead tosalt and water retention and increase lithium concentration.Ramipril and losartan can lead to increased Lithiumconcentration and thus toxicity. Amlodipine can also increase.the concentrationRamiprilAnatomyIn regards to the coronary arteries, which of the following is:correct:Select the best answerThe posterior interventricular artery is a branch of thecircumflex arteryThe anterior interventricular artery arises above the leftposterior aortic cuspThe circumflex artery is a branch of the right coronary arteryThere is a lot of cross over circulation between the right andleft coronary arteriesThe anterior interventricular artery predominantly suppliesthe left ventricleCardiologyA 70 year old female has a past medical history ofhypertension. she has had 2 syncopal episodes and wasfound to have an ejection systolic murmur and bibasalcrackles and a blood pressure of 165/115 mmHg. An ECHOwas arranged and revealed aortic stenosis. Cardiaccatheterisation revealed a gradient of 50mmHg across theaortic valve. Which is the most contributory to your decision?for referral for valve replacement
  4. 4. :Select the best answerPresence of symptomsThe symptomology is the most important factor in decisionfor replacement. Although the gradient across the valve isnearly severe before replacement is recommended thereshould normally be evidence of symptoms. If patients are toounfit to undergo surgery (note age is not a factor if thepatient is fit and healthy) then balloon valvuloplasty can be.utilisedLeft Ventricular HypertrophyAge of patientEvidence of heart failureGradientAnatomyBleeding from a posterior gastric ulcer arise from which?vessel:Select the best answerSplenic arteryThe splenic artery lies along the upper borderof the pancreas, which is directly posterior to the stomach.The left and right gastro omental arteries supply the superiorand inferior portion of the greater curvature of the stomachrespectively. The fundus is supplied by the short gastric andthe inferior pancreaticoduodenal artery supplies the second.part of the duodenumInferior pancreaticoduodenal arteryRight gastro omental arteryLeft gastro omental arteryshort gastric artery
  5. 5. CardiologyAn 20 year old student is brought to A and E following acollapse in an a night club. There was no suspicion of illicitdrug use. He has had 3 collapse episodes previously. Hehad regained consciousness after a few minutes. There is nilof note on examination with BP and HR within normalparameters. However, an ECG shows a QT interval of 0.56.Which ion channel is likely to be defective and have caused?these signs and symptoms:Select the best answerPotassiumThe majority of cases of Long QT syndrome arecaused by defects in potassium channels, LQT1 and 2,which leads to prolonged depolarisation due to decrease inpotassium outflow. Other causes are defect in sodiumchannel, LQT3 and mutation in LQT8 leading to calcium.channels defects but these account for a smaller numberSodiumChlorideMagnesiumCalciumCardiologyA 23 year old female who has history of a cardiac conditionwants to start a family with her husband and has beenreferred to the cardiology clinic for advice. What condition is?an absolute contra indication to pregnancy:Select the best answerASDA)Primary pulmonary hypertensionPulmonary hypertensionis the only absolute contraindication as it can rapidlydeteriorate during pregnancy. MVP and bicuspid aortic valveshould be monitored. PFO and ASD are not.contraindications
  6. 6. B)Bicuspid aortic valveC)PFOD)Mitral valve prolapseCalciumCardiologyA 40 year old man with new onset AF and no evidence ofstructural heart disease on ECHO, was commenced onwarfarin and has an INR of 2.5. He is then successfullycardioverted 6 weeks later. How long after successful?cardioversion should the warfarin be continued:Select the best answerCurrent recommendations are to continue for 4 weeks postcardioversion due to the high relapse rate in the first fewweeks following cardioversionweeks4months 3IndefinitedStop Immediatelymonths6RheumatologyA 52 year old woman with previous history of IBS presentswith general aches and pains all over with stiffness in herhands and wrist, not worse at any time of the day. She hasbeen unable to sleep because of the pain and is veryfatigued. She is also suffering from band like headaches. Onexamination there are multiple tender spots over her hipsand back. Blood results including auto antibodies are?normal. What is the most likely diagnosis:Select the best answerA)IBSFibromyalgia syndromeFibromyalgia is the most likelydiagnosis. It leads to generalised musculoskeletal pain,
  7. 7. stiffness, tenderness, sleep disturbance and easy fatigability.It usually affects woman from 30 to 60 years of age.Diagnostic criteria are set out but the ACR and include ;widespread pain for 3 months; pain on palpation of certaintrigger point e.g. greater trochanter, second rib, occiput;There is nil of note on examination and all blood.investigations are normalB)Rheumatoid ArthritisC)Chronic fatigue syndromeD)Depression

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