Cardiology MCQs

CARDIOLOGY MCQS  HF ADD TO INVEST.  urine analysis   Na+….&  s. Na due to water retention.  DIGITALIS TOXICITY

 add: hallucinations & acute confusional state.

 DIGITALIS

 sagging(saucering)of S-T segment

 DIGITALIS TOXICITY

 BIGEMINI(1:1)

HTN causes sclerosis in Kidney / Valves / vs.  1ST LINE OF TTT IN HTN (V. IMP.)  search for the secondary cause & TTT.  HTN  the M/C cause of stroke in EGYPT.(v.imp neuro MCQ…repeated)  ACE  used in unilateral RAS…never the bilateral  DIRUETICS  combined with most anti-hpertensives.

BBS ARE # IN: 1) Bronchial asthma. 2) Sexual dysfunction. 3) PVD  can use carvedilol  use CCBs as an alternative in 1,2 & 3) 4) DM  use ACEI 5) in elderly. 6) Pregnancy.



METHYL DOPA  best in pregnancy. (repeated MCQ & last year grand finale)

WHAT'S THE CEREBRAL AUTO-REGULATION??  BP   the endothelium of intracranial vss  release NO  VD  BP. But in case of  BP  damage of the endothelium  no release of NO.

DD OF HTN ENCEPHALOPATHY??? (V. IMP.) 

of DELIRIUM.



2ry causes of HTN.

ISHD: 

ACETYL-CHOLINE  VC in case of atheroma. (MCQ)



ATHEROMA >70%   the blood flow during ex.



TEITZ $

 costochondritis & tender chest wall(DD of chest pain)(MCQ)



CK-MB

 >6 TIMES IN MI



LDH

 the last to fall back to normal



TROPONINS

 the most specific



MYOGLOBINS

 earliest to rise.

*VENTRICULAR ANEURYSM 

DOUBLE APEX

ARRYTHMIA: 

AVN IS SUPPLIED BY

 right coronary



ANNULUS FIBROSUS

 has the same role AVN  physiological delay



ATRIAL FLUTTER

 after the carotid sinus massage  rate to the 1/2..e.g:150…75.



A. FLUTTER??

 right atrial macro-entry. (MCQ)



WPW

 palpitation for years



COMPLETE HB

 constant P-P but variable P-R



TTT OF ARRHYTHMIA & EPILEPSY  MONOTHERAPY IS BETTER THAN COMBINATION THERAPY…why??? coz anti-arrhythmic drugs are arrhythmogenic themselves



VERAPAMIL  constipation

AMIODARONE: 

add to uses  WPW



can potentiate effect of WARFARIN???



causes of photosensitivity.

ADENOSINE:  1st line of TTT in SVT…BUT DOESN"T PREVENT IT(MCQ)

VENTRICULAR INHIBITED PACEMAKER (LANGE) 

Functions only when ventricular rate falls below normal-



QRS can be detected

REMEMBER: 

 Q-T interval  recurrent episodes of V. Tach.



DC shock is of choice in TTT of V-Tach with HF

IEC: 

INDICATIONS OF SURGERY???(MCQ)



INFECTED PROSTHETIC VALVE



ALLERGY to drugs



LEGIONELLA – CLAMYDIA - COXIELLA….are diagnosed by serology & special culture media & PCR



ACQUIRED VSD

PERICARDIAL EFFUSION  ECG changes are found in all leads(in contrast to MI)

PULMONARY EMBOLISM: 

INVESTIGATIONS  M/C finding in ECG  sinus tachycardia(MCQ)



INVERTED T in ant leads



SI QIII TIII(LATE & RARE)(S1,Q3,T3)



CT WITH CONTRAST  nephropathy.



NO HEMOPTYSIS OR PLEURITIC CHEST PAIN IN MASSIVE PULMONARY EMBOLISM (in contrast to pulmonary infarction)

# TO THE THROMBOLYTICS OR ANTICOAGULANTS… WHAT ARE THE ALTERNATIVES IN….? 

MI  PTCA



Pulmonary infarction  filter inserted in IVC above the renal veins

DISSECTING AORTIC ANEURYSM: 

ETIOLOGY: 1) Coarcutation. (hypertension) 2) pregnancy 3) calcific AS 4) syphilitic aortitis



ADD TO C/P  acute paraplegia-pleural effusion



ADD TO DD  perforated PU



INVESTIGATION OF CHOICE  CT(MCQ)



ADD TO TTT  1st line (according to the presentation) + analgesics

TRICUSPID ATRESIA??? 

Small RV.



Peripheral cyanosis since birth. (MCQ)



Pulmonary cyanosis



Shunts.

IN PREGNANCY (P.108) 

 COP by 30-50%(MCQ)



TTT of HTN   -methyl-dopa.

REMEMBER (MCQ) : IN CARCINOID 

ENDOTHELIAL PLAQUES ON VALVES.

HYPERLIPIDEMIA: 

CHYLOMICRONS  apo B48-A1-A2-C-E



VLDL  apo B100



LDL  apo B100



HDL  is the source of apo C2-E

 TYPE II  Xanthomas on extensors-hyper B-lipoproteinemia  ADD TO CAUSES OF 2RY HYPERLIPIDEMIA  HRT & OCP…increasing TAG & HDL

HYPO-LIPIDIMIC DRUGS?? 

 LDL & CHOLESTEROL  statines – resins.



 TAG  fibrates – niacin - omega 3 – ezetamides.



IF BOTH ARE HIGH COMBINE BUT…avoid combining statines & fibrates  RHABDOMYOLYSIS

CAUSES of RAYNAUD'S??(MCQ) 1) BBS 2)

CRYOGLOBULINEMIA

3) SCLERODERMA 4)

VIBRATION TRAUMA????

SHOCK 

WEDGE PRESSURE=  VENOUS RETURN

ADRENALINE in 1) BRONCHIAL ASTHMA

 SC

2) CARDIAC ARREST

 IV or intracardiac

3) ANAPHYLACTIC SHOCK

 IM

ADD TO EMERGENCIES P.134: 1) Dissecting aortic aneurysm. 2) unstable angina. 3) MI.