12690425
Descrição
Quiz por Plymouth Med, atualizado more than 1 year ago
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Criado por Plymouth Med
mais de 6 anos atrás
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|
Questão 1
Questão
ACE inhibitors work by:
Responda
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Blocking the sympathetic effect of noradrenaline on blood vessels.
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Preventing the conversion of angiotensin I to angiotensin II.
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Blocking angiotensin II receptors
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Rapid degradation of angiotensin II.
Questão 2
Questão
A 53-year-old man complains of erection difficulty. He recently had some transient angina and was given some medications.
His symptoms started soon after the consultation. Which drug is likely to be causing his symptoms?
Responda
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Nifedipine
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Ramipril
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Labetalol
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Spironolactone
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Bendroflumethiazide
Questão 3
Questão
An older man arrives at ED with swollen lips. Not anaphylactic shock. His regular prescriptions are nifedipine, simvastatin, warfarin, lansoprazole and Ramipril. Which is causing this angioedema?
Responda
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Ramipril
Questão 4
Questão
A 65-year-old man presents with central crushing angina for the first time. He is transferred immediately to the closest cardiac unit to undergo a primary percutaneous coronary intervention. There is thrombosis of the left circumflex artery only. Angioplasty is carried out and a drug-eluding stent is inserted.
What are the most likely changes to have occurred on ECG during admission?
Responda
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ST elevation in leads V1–4
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ST elevation in leads V1–6
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ST elevation in leads I, aVL, V5, V6
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ST elevation in leads II, III and aVF
Questão 5
Questão
The ECG shows an antero-lateral STEMI. Which coronary artery is most likely to have been occluded?
Responda
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Left Circumflex artery
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Left anterior descending artery
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Right main coronary artery.
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Right posterior descending artery
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Left main coronary artery
Questão 6
Questão
Which of the following will be observed in a patient that has mitral regurgitation
Responda
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Diastolic murmur, 5th intercostal space, left midclavicular line
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Diastolic murmur, 4th intercostal space, left midclavicular line
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Diastolic murmur, apex of the heart
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Systolic murmur, apex of the heart.
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Systolic murmur, 2nd intercostal space, right sternal border.
Questão 7
Questão
A murmur is heard just to the left of the sternum in the 2nd intercostal space during systole, what kind of murmur do you suspect?
Responda
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Aortic Stenosis
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Aortic regurgitation
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Pulmonary stenosis
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Pulmonary regurgitation
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mitral stenosis
Questão 8
Questão
A 25-year-old woman with known mitral valve prolapse develops a low-grade fever, malaise and night sweats after a couple of weeks of a major dental procedure. Examination reveals tender vasculitic lesions on the finger pulps and microscopic haematuria. Which is the most appropriate initial step in management?
Responda
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Give antibiotics
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Chest X-ray.
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Give NSAIDs
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Sputum sample
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Get blood cultures
Questão 9
Questão
A middle aged female has central retrosternal angina. The pain is worse lying flat and when she takes a deep breath. It is relieved by sitting up, and leaning forward. An ECG is performed as below. What is the most likely diagnosis?
Responda
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The ECG
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Acute STEMI
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Endocarditis
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NSTEMI
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Pulmonary embolism
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Pericarditis
Questão 10
Questão
A 54 years old man presents to the emergency department with chest pain which does not go away with GTN spray. He sits down and the pain persists and he begins to feel an ache in his arm, and feels extremely sweaty. An ECG is performed.
Responda
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antero-lateral STEMI
Questão 11
Questão
At ED, an elderly woman with Type 2 diabetes mellitus, Hypertension and BMI of 33.6 was admitted to your department via ambulance after experiencing an episode of central crushing chest pain that radiated to her left arm. It came on while she was watching TV and has not been relieved despite rest and GTN spray.
Vital signs: RR: 35; BP:105/62; SpO2:90%; Temperature: 37.0oC
Based on the ECG, what is the most appropriate initial management for this?
Responda
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The ECG
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IV morphine, GTN, aspirin
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Percutaneous coronary intervention (PCI)
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Arrange a CTPA
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Coronary artery bypass graft (CABG)
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IV morphine, 15L high flow O2, GTN, aspirin
Questão 12
Questão
A [blank_start]heart[blank_end] [blank_start]murmur[blank_end] is an extra or unusual sound heard during a heartbeat.
Responda
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heart
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murmur
Questão 13
Questão
Murmurs can either be [blank_start]systolic[blank_end] (S1) or [blank_start]diastolic[blank_end] (S2).
Valvular murmurs: 2 main reasons
[blank_start]Stenosis[blank_end]: Valve is too narrow for the blood to pass through.
[blank_start]Regurgitation[blank_end] (Incompetence): Valve does fully shut so there is backflow
Responda
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Stenosis
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Regurgitation
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systolic
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diastolic
Questão 14
Responda
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diastole
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diastole
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diastole
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systole
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systole
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systole
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systole
Questão 15
Questão
Non-valvular murmurs also exist.
Responda
- True
- False
Questão 16
Questão
Label the different valves.
Responda
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Aortic
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Pulmonary
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tricuspid
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mitral
Questão 17
Questão
[blank_start]Calcification[blank_end] of the aortic valves (due to naturally [blank_start]aging[blank_end]) mainly causes [blank_start]aortic[blank_end] [blank_start]stenosis[blank_end].
The most common cause of [blank_start]mitral[blank_end] [blank_start]stenosis[blank_end] is rheumatic heart disease due to the bacteria of group [blank_start]A[blank_end] Streptococcus.
Responda
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Calcification
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aortic
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stenosis
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aging
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stenosis
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mitral
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A
Questão 18
Questão
What is the correct ordering of the heart layers?
Responda
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fibrous pericardium, parietal serous pericardium, pericardial cavity, pericardial fluid, visceral serous pericardium, epicardial fat, myocardium, endocardium
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fibrous pericardium, epicardial fat, visceral serous pericardium, pericardial cavity, pericardial fluid, parietal serous pericardium, myocardium, endocardium
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fibrous pericardium, parietal serous pericardium, visceral serous pericardium, pericardial cavity, pericardial fluid, epicardial fat, emyocardium, endocardium
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epicardial fat, fibrous pericardium, parietal serous pericardium, visceral serous pericardium, pericardial cavity, pericardial fluid,endocardium, myocardium
Questão 19
Questão
What is true regarding endocarditits?
Responda
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Inflammation of the endocardium
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common cause: Staph Aureus
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common cause: Strep viridans
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New murmur
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Fever
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Splinter Hemorrhage
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Janeway lesions and Osler nodes
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Diagnosis: Echocardiograms and electrocardiograms
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Diagnosis: Blood culture and echocardiograms
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Manage: antibiotics and NSAIDS
Questão 20
Questão
What is true regarding pericarditits?
Responda
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inflammation of pericardium
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Common cause: Coxsackie B virus
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Chest pain which feels better when sitting forward
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Auscultation: pericardial friction rub audible
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Widespread saddle shaped ST-elevation on ECG = diagnosis
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1-2 weeks course of NSAIDs
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complication: cardiac tamponade
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Auscultation: crackles
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Chest pain better from lying down
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dispersed ST-elevation on ECG leads = diagnosis
Questão 21
Questão
What are these clinical symptoms?
Responda
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osler nodes
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splinter hemorrhages
Questão 22
Questão
[blank_start]Unstable[blank_end] angina is due to problems in blood supply. It comes about at [blank_start]rest[blank_end] or [blank_start]minimal[blank_end] [blank_start]exertion[blank_end], like walking.
Responda
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Unstable
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rest
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minimal
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exertion
Questão 23
Questão
Stable angina is due to [blank_start]myocardial[blank_end] [blank_start]ischemia[blank_end]. It is a [blank_start]central[blank_end] chest tightness or heaviness, which is relieved by [blank_start]rest[blank_end]. It may radiate to one or both [blank_start]arms[blank_end], the neck, jaw or [blank_start]teeth[blank_end].
Responda
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myocardial
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ischemia
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central
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rest
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arms
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teeth
Questão 24
Questão
GRAB to treat stable angina:
[blank_start]Glycerol[blank_end] [blank_start]Trinitrate[blank_end] spray for symptomatic relief
[blank_start]Risk[blank_end] Factor modification like stop smoking and reduced cholesterol
[blank_start]Aspirin[blank_end] reduces mortality by 34% (fact)
[blank_start]Beta[blank_end] [blank_start]blockers[blank_end] to reduce symptoms unless contraindicated
Responda
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Glycerol
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Trinitrate
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Risk
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Aspirin
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blockers
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Beta
Questão 25
Questão
Unstable angina, NSTEMI and STEMI are a group of conditions that occur due to decreased blood flow in the [blank_start]coronary[blank_end] arteries, leading to heart muscle [blank_start]ischemia[blank_end]. This is known as [blank_start]acute[blank_end] [blank_start]coronary[blank_end] [blank_start]syndrome[blank_end].
Responda
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coronary
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ischemia
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acute
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coronary
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syndrome
Questão 26
Questão
How does ACS (acute coronary syndrome) present?
Responda
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Angina pectoris pain
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noticeable sweating
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tachypneia
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nausea
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vomiting
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progresses--> radiating pain
Questão 27
Questão
Which is NSTEMI and which is STEMI?
Responda
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STEMI
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NSTEMI
Questão 28
Questão
Acute management of ACS: MONA
IV [blank_start]Morphine[blank_end]
Oxygen (if Sats < 94%)
[blank_start]Nitrates[blank_end]
[blank_start]Aspirin[blank_end]
Responda
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Morphine
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Nitrates
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Aspirin
Questão 29
Questão
Secondary management of ACS is [blank_start]revascularization[blank_end]:
STEMI
[blank_start]reperfusion[blank_end] therapy--> [blank_start]primary[blank_end] PCI ([blank_start]percutaneous[blank_end] [blank_start]coronary[blank_end] intervention)
If this cannot be achieved within [blank_start]2[blank_end] hours of diagnosis or PCI is not available, [blank_start]thrombolytic[blank_end] therapy such as streptokinase is to be done.
Responda
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revascularization
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reperfusion
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percutaneous
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coronary
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primary
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2
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thrombolytic
Questão 30
Questão
Secondary prevention of myocardial infarction: AAABC
[blank_start]Aspirin[blank_end] (antiplatelet)
[blank_start]ACE[blank_end] inhibitor
[blank_start]Atorvastatin[blank_end]
Beta-blocker
[blank_start]Clopridogrel[blank_end] (antiplatelet)
Responda
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Clopridogrel
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Atorvastatin
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ACE
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Aspirin
Questão 31
Questão
What morphology is shown below? (2 words)
Responda
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ST elevation
Questão 32
Questão
Which leads are lateral?
Responda
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AVF
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AVL
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AVR
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II
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I
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III
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V1 and V2
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V3 and V4
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V5
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V6
Questão 33
Questão
Which leads are anterior?
Responda
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AVF
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AVR
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AVL
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lead I
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lead II
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lead III
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V1 AND V2
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V3 AND V4
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V5
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V6
Questão 34
Questão
Which of these leads is not inferior?
Responda
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II
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III
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AVF
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I
Questão 35
Questão
Fill in what each abbreviation in the table stands for.
Responda
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left anterior descending
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left main coronary artery
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right coronary artery
Questão 36
Questão
Which of these could result from severe or untreated hypertension?
Responda
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stroke
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MI
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blindness
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renal failure
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pulmonary disease
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aneurysms
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ovarian cancer
Questão 37
Questão
What are side effects of ACE inhibitors?
Responda
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Dry cough
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Angioedema
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Hypotension
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Hyperkalemia
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Hypercalcemia
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Hypoglycemia
Questão 38
Questão
Hydrochlorothiazide and Metolazone are examples of thiazide-like diuretics.
Responda
- True
- False
Questão 39
Questão
[blank_start]Angiotenisin[blank_end] [blank_start]Receptor[blank_end] [blank_start]Blockers[blank_end] end in “sartan” e.g. [blank_start]Losartan[blank_end]
They're given if side effects of ACE inhibitors are experienced.
Responda
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Angiotenisin
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Receptor
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Blockers
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Losartan
Questão 40
Questão
Beta blockers reduce the [blank_start]cardiac[blank_end] [blank_start]output[blank_end] by reducing heart rate and force of contraction (hence the [blank_start]stroke[blank_end] [blank_start]volume[blank_end]).
They end in -lol like [blank_start]metoprolol[blank_end].
Responda
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metoprolol
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cardiac
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output
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stroke
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volume
Questão 41
Questão
What is true regarding beta blocker side effects?
Responda
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bronchoconstriction
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bradycardia
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heart failure
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hypotension
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AV nodal conduction block
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polyuria
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renal failure
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dehyrdation
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vertigo
Questão 42
Questão
If the patien is younger than 8o years, treatment for stage [blank_start]1[blank_end] hypertension is given if:
[blank_start]End[blank_end] [blank_start]organ[blank_end] damage
[blank_start]Cardiovascular[blank_end] disease (or significant risk of developing it)
Renal disease
[blank_start]Diabetes[blank_end]
Responda
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1
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organ
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End
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Cardiovascular
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Diabetes
Questão 43
Questão
NSTE-ACS refers to Unstable Angina and NSTEMI.
Responda
- True
- False
Questão 44
Questão
Cardiac markers: [blank_start]Troponin[blank_end] I/T
They are the most specific/sensitive tests for [blank_start]MI[blank_end].
Responda
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Troponin
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myocardial infarction
Questão 45
Questão
Fill in the diagram. (ABREVIATIONS WHERE APPROPRIATE)
Responda
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STEMI
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NSTEACS
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NSTEMI
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unstable angina
Questão 46
Questão
WHICH are side-effects of calcium channel blockers?
Responda
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peripheral edema
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flushing
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headache
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severe hypotension
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angina
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hidrosis
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miosis
Questão 47
Questão
CCBs used to treat hypertension end in –dipine such as [blank_start]nifedipine[blank_end]
Responda
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nifedipine
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