Welcome to your #Internal_Medicine#Cardiology#MRCP_QBank
A 60 year man who is type 2 diabetic is admitted with chest pain. His ECGs show inferior ST elevation of 1 mm in 2 leads. He is thrombolysed with steptokinase. His BM measurement is 15, and has missed his gliclazide dose today. What is the best management?
A 55 year old patient presented with breathlessness and ankle oedema. The blood pressure is 135/80 mmHg. On examination, her JVP rises with inspiration. She has a soft systolic murmur and a third heart sound. Blood tests reveal a Hb 10.5 g/dl, WCC 7.5 x 109/L, Platelets 150 x 109/L, sodium 136 mmol/l, potassium 3.5 mmol/l, creatinine 140 µmol/l, urea 6 µmol/l. ECG shows poor R wave progression. An echocardiogram shows no pericardial effusion, the ventricles are stiff and systolic function is mildly impaired. Which of the following is the likely diagnosis?
A 40 year old patient had a mitral valve replacement for mitral stenosis 1 month ago. She presents with fevers, lethargy and rigor. Her blood tests reveal Hb 9.5 g/dl, WCC 13 x 109/L, platelets 500 x 109/L, sodium 136 mmol/l, potassium 4.2 mmol/l, ESR 90 mm/hr, CRP 180 mg/l. She also has 2 splinter haemorrhages and 2+ of blood on urine dipstick. 3 sets of blood cultures are taken. Which of the following organisms is most likely to be grown in the blood cultures?
A 65 year old lady has ischaemic cardiomyopathy and symptoms of breathlessness walking up one flight of steps. Her breath sounds are clear. Chest X ray shows cardiomegaly and clear lung fields. She is currently on frusemide 40mg bd and perindopril 4 mg at night. What medication should be added?
A 55 year old man has progressive shortness of breath and ankle oedema. He has come from Africa originally and gives a history of probably tuberculosis many years ago. On examination, he has a blood pressure of 105/55 mmHg, raised JVP +6 cm with a rapid y descent and significant ankle oedema. What is the likely diagnosis?
A 75 year old man has become progressively more breathless. On examination he has a displaced cardiac apex and a third heart sound. Chest XR confirms cardiomegaly. An echocardiogram shows Left ventricle size of 6.5 cm (
A 50 year old man has suffered an uncomplicated myocardial infarct 3 days ago and at the moment he has no problems. He is a tourist and wishes to travel back home as soon as possible. How soon after an uncomplicated myocardial infarct may a patient travel by flight safely?
A 65 year old man has an angioplasty to the left anterior descending artery. In considering medical therapy, which of the following reduces restenosis rates following angioplasty?
A 50 year old man presents with palpitations. His ECG shows AV dissociation. Which of the following conditions is most likely to cause AV dissociation on an ECG?
A 60 year old man has palpitations. An admission ECG shows QTc prolongation of 0.48 s. Which of the following conditions might be associated?
A 45 year old man has chest pain walking up hills. Which of the following investigations is the best for risk stratification of angina?
A 65 year old man has palpitations. He has a broad complex tachycardia on the ECG. In a broad complex tachycardia. Which of the following would be the strongest indication towards a diagnosis of VT?
