Curriculum Quiz: Cardiology

A patient presents with a broad complex tachycardia. Which one of the following is not an indication for immediate cardioversion?

Which one of the following statements about cardiac markers is the most appropriate?

Which one of the following would be an unusual ECG finding early after a heart transplant?

A 65-year-old man presents with an episode of chest pain which has lasted approximately 2 hours. He describes it as retrosternal and burning in nature. It radiated to his left arm. He is a smoker and has hypertension but is otherwise well.

Which one of the following would not increase his likelihood of having an acute myocardial infarction?

Examine the ECG below. What is the ECG diagnosis?

A 65-year-old man presents with sudden thoracic pain and is suspected of having an acute aortic dissection.

Which of the following is the most common predisposing factor for this disease?

Regarding endocarditis, which one of the following statements is correct?

A 36-year-old man presents to the emergency department with acute chest pain. Which of the following features of his clinical history would most strongly suggest that he has an acute coronary syndrome?

A 55-year-old lady attends the ED having collapsed with a GCS of 6/15. You suspect she has a subarachnoid haemorrhage (SAH). Her ECG shows ST segment elevation.

Which one of these statements is True?

A 72-year-old man presents with ischaemic chest pain of three hours’ duration. He has a past history of hypertension and hypercholesterolaemia. On examination he is haemodynamically stable and his chest pain is resolving with opiate analgesia, GTN, and aspirin. His standard 12 lead ECG shows ST segment depression in the anterior chest leads. Troponin assay is awaited.

With the information given, which of the following statements is most appropriate?

A 68-year-old woman attends the emergency department (ED) complaining of thoracic pain.

Which of the following is the most common presenting symptom of acute aortic dissection?

With respect to acute myocarditis, which one of the following statements is correct?

A 54-year-old man presents with sudden onset retrosternal chest pain radiating through to the back. He has a history of hypertension for which he takes atenolol but is otherwise well. On examination, he is in pain, has a pulse of 105 and a blood pressure of 185/105. He has an early diastolic murmur and his chest is clear. His ECG reveals ST segment elevation in the inferior leads and his CXR reveals a widened mediastinum.

Which of the following statements is most appropriate?

Which one of the following characterises paroxysmal atrial fibrillation (AF)?

An eight month pregnant Asian 27-year-old woman presents with breathlessness and palpitations.

Which of the following heart valve disorders is most likely to be the cause of her symptoms?

Which of the following statements, concerning management of low risk chest pain, is correct?

If a patient with a device set to a lower rate limit (LRL) of 50 bpm is in normal (unpaced) sinus rhythm at 47 bpm, which one of the following is the most likely explanation?

A 45-year-old woman presents with dizziness, chest pain and palpitations. She is previously well. She has a tachycardia of 200.

You are unsure if she has a supraventricular or ventricular tachycardia (VT). Which one of the following is most indicative that the tachycardia may be supraventricular?

Which one of the following is the commonest cause of acute pericarditis?

Which one of the following is the most common presenting symptom of pulmonary hypertension?

A 50-year-old heavy smoker is brought in complaining of severe increased shortness of breath and a non-productive cough. Pulse 112, BP 105/62, RR 24, SaO2 89% on room air, temperature 36.9o. Looking at the chest x-ray, which one of the following statements is true?

Click on the x-ray to enlarge.

A 67-year-old lady presents with collapse and marked respiratory distress; she is pale, tachypnoeic, tachycardic and has a reduced conscious level. She is known to have ischaemic heart disease and has presented previously with acute pulmonary oedema.

Which one of the following investigations will be most helpful in confirming this diagnosis?

Which of the following is the most common cause of a regular broad complex tachycardia (BCT)?

Which of the following regarding Brugada syndrome is true? (Select all that apply)

A 64-year-old suffered an out of hospital cardiac arrest post-MI. Following defibrillation, they now have a pulse but their non-invasive blood pressure is 60/30.

Which of the following options is your first management step?

Which of the following statements regarding patients in cardiac arrest is false?

A 72-year-old patient presents with difficulty in breathing. He has a background of lung cancer with liver metastases. He is lethargic and finds it very difficult to speak. He has a long-term chest drain in place on the left. His initial observations are respiratory rate of 32, heart rate of 125, blood pressure of 75/40 and temperature of 36.8o C. His chest x-ray shows cardiomegaly and a small pleural effusion on the left side. His POCUS shows:

Image courtesy of Francisco Norman thepocusatlas.com

How would you manage this patient?

In patients with a left-to-right shunt, which of the following is a correct statement?

A 74-year-old lady with known ischaemic heart disease and cardiac failure presents to the ED with a history of syncope. Which one of the following is true of syncope in the presence of cardiac failure?

The LVAD is restarted and the patient is conscious. His ECG shows Ventricular tachycardia. What is your main priority now?