Saturday, February 3, 2024 CVS TEST: 1

A man brought into the ED after being stabbed in the chest. Chest is bilaterally clear with
muffled heart sounds. BP is 60/nil. Pulse is 120bpm. JVP raised. What is the most likely dx?

 Pulmonary embolism
 Cardiac tamponade
 Pericardial effusion
 Hemothorax
 Pneumothorax

A man with prosthetic heart valve underwent hemicolectomy and after some days complains of
left hypochondriac pain, fever and has a systolic murmur. What is the next inv to ascertain the
cause of HF?

 CT scan
 Blood culture
 ECG
 MRI
 Radioactive thyroid scan

A 4yo girl is found to have bounding pulse and continuous machinery murmur. What is the most
probable dx?

 TOF
 ASD
 VSD
 PDA

A 12yo child with episodes of sudden bluish discoloration and brief loss of consciousness.
Exam: clubbing, central cyanosis, systolic thrill with systolic ejection murmur in 2nd left ICS.
What is the most probable dx?

 TOF
 ASD
 VSD
 PDA

A 60yo diabetic complains of pain in thigh and gluteal region on walking up the stairs for the
last 6 months. She is a heavy smoker and has ischemic heart disease. What is the most
appropriate dx?

 Thromboangitis Obliterans
 Sciatica
 DVT
 Atherosclerosis
 Embolus
Saturday, February 3, 2024 CVS TEST: 1

A 50yo man has a stab wound to his left anterior chest at the level of the 4th ICS. He has a BP
80mmHg, pulse=130bpm. His neck veins are dilated and his heart sounds are faint. His trachea
is central. What is the most appropriate dx?

 Cardiac tamponade
 Diaphragmatic rupture
 Fractured ribs
 Tension pneumothorax
 Traumatic rupture of aorta

A 28yo man with complains of headache and nose bleeds also has pain in the lower limbs on
exertion. Exam: radio-femoral delay, cold legs with weak pulse and mild systolic murmur with
normal S1S2. What is the most probable dx?

 TOF
 ASD
 VSD
 PDA
 CoA

A 40yo man collapsed at home and died. The GPs report says he suffered from T2DM and
BMI=35. What is the most likely cause of death?

 MI
 DM
 HF

An 18yo man complains of fatigue and dyspnea, he has left parasternal heave and systolic thrill
with a harsh pan-systolic murmur at left parasternal edge. What is the most probable dx?

 TOF
 ASD
 VSD
 PDA
 TGA

A 50yo smoker and heavy drinker presents with complaints of racing heart. A 24h ECG comes
out normal. What is your next step in management?

 ECHO
 Reassure
 Stress test
 none

A 60yo pt who has had a MI a week back presents with dyspnea and pericardial rub. ECG
shows ST elevation. CXR: loss of margin at costo-vertebral angle. What is the single most likely
cause?

 Cardiac tamponade
 Mitral regurg.
 Dressler’s syndrome
Saturday, February 3, 2024 CVS TEST: 1

 Atrial fib
 Emboli

A 57yo woman who is suffering from HTN, presented to the hospital with complaints of
recurrent falls when trying to get out of bed or getting up from sitting. She is on some anti-HTN
therapy with no other med problems. What is the cause of her fall?

 CCB
 Vertibrobasiliar insufficiency
 Thiazide
 Hypoglycemia
 Infection

A 28yo shipyard worker was admitted for pain in calf while at work which has been increasing
over the last 3m. There is no hx of HTN or DM but he is a smoker. Exam: loss of posterior tibial
and dorsalis pedis pulsation along with a non-healing ulcer at the base of the right 1st MTP joint.
What is the most probably dx?

 Thromboangitis obliterans
 Sciatica
 DVT
 Baker’s cyst
 Embolus

ECG of an 80yo pt of ICH shows saw-tooth like waves, QRS complex of 80ms duration,
ventricular rate=150/min and regular R-R interval. What is the most probable dx?

 Atrial fib
 Atrial flutter
 SVT
 Mobitz type1 second degree heart block
 Sinus tachycardia

A 45yo man who is diabetic and HTN but poorly compliant has chronic SOB, develops severe
SOB and chest pain. Pain is sharp, increased by breathing and relieved by sitting forward. What
is the single most appropriate dx?

 MI
 Pericarditis
 Lung cancer
 Good pastures syndrome
 Progressive massive fibrosis

54 year old man is admitted to the emergency department with a 15 minute history of
crushing Central chest pain which on of the following rises first following infarction ?

 AST
 Troponin I
 CK
 CKMB
 Myoglobin
Saturday, February 3, 2024 CVS TEST: 1

A 62 year old man is admitted with to the cardiology ward with infective endocarditis
blood cultures grow streptococcus Bovis what is the most appropriate investigation
given the blood culture findings?

 Small bowel meal

 Bronchoscopy
 Cystoscopy
 Gastroscopy
 colonoscopy

2 day old baby girl is noted to become cyanotic wHILST feeding and crying a diagnosis
of congenital heart disease is suspected what is the most likely Cause?

 Transposition of the great arteries

 Coarctation of the aorta
 Patent ductus arteriosis
 Tetralogy of fallot
 Ventricular septal defect

A 17 year old female presents with recurrent attacks of collapse these episodes typically
occur without warning and have occurred whilst she was running for a bus there is no
significant past medical history and the only family history of note is that her father died
suddenly when he was 38 years old what is the likely cause?

 Vasovagal attacks
 Anxiety
 Epilepsy
 Cardiogenic syncope
 Malingering

A 59 year old female is admitted to the emergency department word of 30 minute history
of central chest pain radiating to her left arm and ECG shows start elevation in Leads 2 3
AvF which coronary artery is the most likely to be affected?

 Right coronary
 Left anterior descending
 Left men stem
 Left circumflex
 Anterior interventricular

A 55 year old presents to the emergency department with shortness of breath since the
morning last month he was admitted following an inferior mark Myocardial infraction he
was started on aspirin atorvastatin lisinopril and bisoprolol an echo performed following
the myocardial infraction showed normal left ventricular function he is still a smoker
despite repeated attempts to give up examination today reveals by basil crackles whilst
the chest X-ray shows upper lobe diversion and Perihilar shadowing the ECG and
cardiac enzymes are normal what is the most likely cause of his breathlessness?

 infective endocarditis
 Pheochromocytoma
 fibromuscular dysplasia
Saturday, February 3, 2024 CVS TEST: 1

 Renal artery stenosis

 Anterior myocardial infarction

And 18 year old female who is known to have turners syndrome is referred to cardiology
as she has the murmur on examination soft ejection systolic murmur is heard what is the
most likely cause of this finding?

 Coarctation of the aorta

 ventricular septal defect
 pulmonary stenosis
 supravalvular aortic stenosis
 Bicuspid aortic valve

Which one of the following treatments have not been shown to improve mortality in
patients with chronic heart failure?

 Beta blockers
 Spironolactone
 Furesmide
 Nitrates and hydralazine
 EnalApril

Six weeks after having a prosthetic heart valve patient develops infective endocarditis
what is the most likely Causative Organism?

 Streptococcus viridans
 Staphylococcus epidermidis
 Staphylococcus aureus
 Streptococcus bovis
 One of the HACEK group

A 60 year old man presents with increasing shortness of breath on exertion during the
examination third heart sound is heard examination of the respiratory system is
unremarkable which one of the following is most consistent with this finding?

 Dilated cardiomyopathy
 Hypertrophic obstructive cardiomyopathy
 Atrial fibrillation
 Mitral stenosis
 Normal variant

36 year old woman presents for a routine antenatal review she is now 15 weeks pregnant
her blood pressure and clinic is 154 by 94 millimeter mercury this is confirmed with
ambulatory blood pressure monitoring on reviewing the notes it appears her blood
pressure four weeks ago was 146 by 88 a urine dipstick shows protein positive and
nothing else there is no significant past medical history of note what is the most likely
diagnosis?

 Preeclampsia
 Pregnancy induced hypertension
 white coat hypertension
Saturday, February 3, 2024 CVS TEST: 1

 normal physiological change

 Pre-existing hypertension

A 52 old female with unknown history of systemic sclerosis presents with for annual
review to the rheumatology clinic which one of the following symptoms is most
characteristic in patients who have developed pulmonary arterial hypertension?

 Exertional Dyspnea
 Paroxysmal nocturnal dyspnea
 Cough
 Early morning Dyspnea
 Orthopnea

A 42-year-old woman has type 2 diabetes mellitus and hypertension. She has recently
been started on a new antihypertensive medication and has noticed that her blood
glucose control Is not as good as It was before. Which of the following drugs Is
responsible for the symptoms of this patient?

 Amlodipine
 Atenolol
 Thiazide diuretics
 Lisinopril
 Verapamil

The absolute contraindication to thrombolytic therapy is:

 INR> 2.5
 Recent head trauma
 Suspected aortic dissection
 Known bleeding disorder
 Pregnancy

The following is the character of the pulse in Aortic Regurgitation:

 Slow rising pulse

 Pulsus alternans
 Pulsus paradoxus
 Collapsing pulse
 Pulsus biseferiens