Cardiology FRACGP AKT- Dr SAM 50-115

A 76-year-old man suddenly collapsed and died. At post mortem exam, a retroperitoneal

hematoma due to ruptured aortic aneurysm was noted. What is the most likely underlying cause of the aortic aneurysm?

A 33-year-old male came to the hospital with complaint of occasional left sided chest pain that lasts <30mins, following exercise, which relieves upon taking rest. What is the most probable

diagnosis?

An 82-year-old male suddenly becomes unconscious and fell down. He recovered completely within minutes. What is the best investigation you do to diagnose the case?

A 56-year-old man presents to the emergency department with chest pain. The following ECG was taken. What is the most likely diagnosis?

 

A man comes to the emergency department with history of pulsatile swelling in the abdomen, he has history of hypertension and on examination: pulse 120bpm, BP 70/40mmHg. He is restless and in shock. What emergency management should be done on priority basis?

A 72-year-old man presents to the ED (emergency department) with chest pain. The following ECG was taken. What is the most likely diagnosis?

A patient underwent hip surgery. Later he presents with SOB (shortness of breath) and chest pain. What is the diagnosis?

The body of a 65-year-old man who was treated for TB and bronchitis was seen at autopsy. His legs were swollen and his liver showed signs of a transudate fluid. What was the likely cause of the transudate?

A woman presents with history of falls, becomes pale and clumsy. She is hypertensive and takes atenolol, Bendroflumethiazide and amlodipine. What investigation is needed?

A 52-year-old man with history of ant MI 3 weeks ago developed sudden onset of dyspnoea. Examination: BP 100/60mmHg, pulse 100bpm, SaO2 88%, chest bilateral crackles. Which investigation would you do to find the underlying cause?

A 74-year-old lady called an ambulance for an acute chest pain. She has a history of diabetes mellitus and hypertension, and is a heavy smoker. Paramedics mentioned that she was overweight and recently immobile because of a hip pain. She collapsed and died in the

ambulance. What is the most likely cause of death?

A 48-year-old man has continuous ant chest pain which is worse on inspiration and has temp of 36.5C since 4 weeks after a MI. His ESR=45mm/h. What is the single most likely explanation for the abnormal investigation?

A patient diagnosed with DVT is taking warfarin. What is his cut off INR limit?

A 70-year-old woman with longstanding anxiety is seen in the OPD. She complains of her heart skipping a beat quite often. This particularly occurs when she is trying to get to sleep. The palpitations are never sustained. What is the most likely rhythm disturbance?

A 29-year-old man was involved in an RTA (road traffic accident). He presents with distended neck veins; clear breath sounds and a trachea which is in the midline. His RR (respiratory rate) 34bpm, BP=60/0mmHg. What is the most likely diagnosis?

A 52-year-old man underwent a hemicolectomy. After a few days he complains of left ventricular pain and fever. ECHO has been done and shows a systolic murmur. What is the next appropriate investigation?

A 63-year-old man has been brought to the hospital after collapsing during a wedding. Ambulance is called and his ECG is given below below. What is the most likely diagnosis?

A 56-year-old man who is hypertensive recently underwent a change in medicines. 2 days later he developed wheezing. Which drug is likely the cause of this?

A hypertensive patient on Bendroflumethiazide 2.5mg/d has come for his routine check-up. Examination: BP 145/85mmHg. Lab investigation: K+ 5.9, Na+ 137. What is the most appropriate management for this patient?

A 57-year-old man having hypertension is on oral anti-hypertensive. However, he is finding it difficult to mobilize as he feels dizzy whenever he tries to get up. What is the most appropriate investigation for him?

After surgery a patient’s left leg has become swollen and tender. The diameter of the calf has increased and passive movements cause pain. What is the most probable diagnosis?

A 50-year-old female had swelling in her ankles. She is a known alcoholic. Now she presented with breathlessness and palpitations. What is the most likely cause of her condition?

a. Ventricular tachycardia

b. SVT

c. A-flutter

e. Ventricular-ectopic

Alcohol abuse is a known risk factor for developing atrial fibrillation.

A Fib can lead to palpitations, irregular heart rhythms, and is associated with a risk of heart failure, which can result in symptoms like breathlessness and ankle swelling due to fluid retention.

A 42-year-old lady had corrective surgery for cyanotic congenital heart disease at the age of 3y, after a palliative operation during infancy. There is a no parasternal impulse and an early diastolic murmur. What is the most probable diagnosis?

What is the most likely diagnosis based on this ECG?

Patient presents with pain and swelling in left leg and thigh up to the level of inguinal ligament. Where is the level of occlusion?

A 65-year-old man presents with dyspnoea 3 day after an MI. On auscultation he has a

pan systolic murmur at the apex radiating to the axilla. What is the most likely diagnosis?

A 63-year-old man presented with sudden onset of severe dyspnoea, orthopnoea, raised JVP and bilateral basal crackles 3 day after an episode of MI. A diagnosis of acute congestive cardiac failure was made and IV furosemide was started for this patient. What electrolyte abnormality is expected?

A 70-year-old hypertensive of British decent on thiazide diuretics needs a 2nd drug to control his BP. Which one of the following is the best choice for him?

A 62-year-old man has slow palpitations Practice nurse does an ECG. ECG is given below. What is the most likely diagnosis?

A 70-year-old woman is admitted with diarrhea, vomiting and dehydration. Examination shows yellow visual halos in her eyes, ECG shows bradycardia. She has a history of chronic atrial fibrillation. Which drug causes the above-mentioned side effects?

A white English man with a past history of MI is a known hypertensive and diabetic. He is

currently on aspirin, statin and metformin. What would you add to the treatment?

A 51-year-old man had a MI a few days ago. He developed breathlessness. On examination a pan systolic murmur is heard. What can be the cause of this symptom?

A 72-year-old man presents to the emergency department with chest pain. You decide to and ECG. It is given below. What is the most likely diagnosis?

A 28-year-old man presents with a 2 hours history of rapid palpitations. He feels a little light headed but is otherwise well. Examination: pulse 170bpm and regular, BP 100/68mmHg. He has had 2 similar episodes in the past. You do an ECG and ECG is given below

A 45-year-old man is admitted to emergency department with excruciating pain in the right leg. Examination: limb is pale and dorsalis pedis and posterior tibial pulses are absent. Pulse=88bpm, irregular and he has a pan systolic murmur at apex. What is the most probable diagnosis?

A 58-year-old man suddenly becomes shocked several days after suffering an acute anterior Myocardial infarction. His CXR shows a large globular-shaped heart and clear lung fields. What is the single most likely explanation for the abnormal investigation?

A branch of the dominant coronary artery that supplies the inferior portion of the septum. What is the single most appropriate option?

The artery that supplies the anterior right ventricular wall. What is the single most appropriate option?

After an MI, a man presents with pan systolic murmur which is radiating to the axilla. What is the diagnosis?

A 59-year-old patient has been diagnosed with hypertension. His BP has been >160/90mmHg on 3 separate occasions. His biochemical profile is as follows: Na+=145mmol/l, K+=6.2mmol/l, creatinine=112umol/l, urea=5.7mmol/l. What is the most appropriate anti-hypertensive drug for him?

A 46-year-old man with tachycardia has the following ECG. What is the most likely diagnosis?

A 55-year-old patient presents with complains of abdominal pain that radiates to the back. While talking to you he collapses. An expansile abdominal mass is felt on examination. BP is 70/45 mm Hg and pulse is 88 beats/ min. What is the single most likely diagnosis?

A new born baby is brought with pan systolic murmur at sternal border but the baby is not cyanosed. What is the diagnosis?

A 55-year-old man is having slow growing ascites. When we tap the peritoneal fluid, the protein is are elevated and it is clear and yellow. What could be the origin for ascites?

A 50-year-old man came to the hospital a few months after he had a MI. Systemic examination is unremarkable apart from a new pan-systolic murmur. What is the most appropriate investigation of choice?

A man after MI presented with sudden breathlessness and dyspnoea. Examination:

scattered pan systolic murmur all over the precordium. What is the next investigation that will lead to diagnosis?

A man is brought to the emergency department after he was stabbed in the chest. Chest is clear bilaterally with muffled heart sounds. B 60/0mmHg, pulse 120bpm, JVP is raised. What is the most probable diagnosis?

A 68-year-old man on treatment for an irregular heart beat comes to the emergency

department. He has palpitations for the last 3 hours. Examination: pulse regular, 154bpm.

Carotid sinus massage settled his pulse down to 80bpm. ECG is given below. What is the most likely rhythm

disturbance?

A 76-year-old man is in the CCU 2 days after an acute MI. He tells you that he had an

episode of rapid pounding in the chest lasting for about 2minutes. He remains conscious

throughout. What is the most likely rhythm?

A 70-year-old lady on Raloxifene for osteoporosis has recently flown from UK to Australia. She now presents with severe chest pain, SOB and suddenly collapsed in the emergency department. What is the single most appropriate diagnosis?

A 54-year-old man comes with sudden onset of palpitations and breathlessness. His

heart rate is 164bpm. ECG is given below. What is the single most appropriate treatment in the acute phase?

A 72-year-old woman who is taking loop diuretics for left ventricular failure. She now is

suffering from palpitations and muscle weakness. What is the electrolyte imbalance found?

A patient came to the hospital with a complaint of severe chest pain lasting for >1 hour. Following ECG test, patient revealed to have ST depression. He was already on aspirin. What is the most specific treatment for this patient?

The ECG of a 65-year-old shows absent P waves, narrow QRS complex, ventricular rate of 120bpm and irregular R-R interval. What is the most probable diagnosis?

80-year-old patient of IHD (ischemic heart disease) presents to you with palpitations. You do an ECG. ECG is given below

What is the most probable diagnosis?

A 70-year-old man presents with a punched-out ulcer between his toes. He is a heavy

drinker and smoker. Exam: ulcer is yellow and the foot turns red when dangling off the bed.

What is the single most likely diagnosis?

A 65-year-old woman complains of a painful discharging ulcer above her ankle on the

inner side of her left lower leg. Exam: the base of the ulcer is red and covered by a yellow

fibrous tissue. The border is irregular. The skin is tight. What is the single most likely diagnosis?

A 55-year-old woman suffered from an acute MI 5 days ago. While she was in the

hospital the patient developed features of pulmonary oedema and heart failure. What is the most probable cause of her present condition?

A 70-year-old man presents with acutely painful, pale paralysed and pulseless left leg. He is noted to have atrial fibrillation. What is the most probable diagnosis?

A 60-year-old man has had increasing pain in both buttocks, thighs and calves on walking for three months. He has also recently developed impotence. Femoral and distal pulses are absent in both limbs. What is the SINGLE most likely site of arterial obstruction?

A patient presents with irregularly irregular pulse of 162bpm. ECG shows atrial fibrillation. What drug is most useful initially?

Which finding, on clinical examination of the pulse, suggests a diagnosis of hypertrophic obstructive cardiomyopathy (HOCM)?

For the following type of surgery what is the most likely agent that may cause postoperative infection — aorto-iliofemoral reconstruction with a Dacron vascular prosthesis?

Which one of the following electrocardiographic changes is found in hypercalcaemia?