Your-Doctor
Multiple Choice Questions (MCQ)


Quiz Categories Click to expand

Category: Cardiology--->Heart Failure
Page: 4

Question 16# Print Question

A 73-year-old man well known to the ED with alcohol excess presented with acute pulmonary oedema requiring CPAP. His presenting ECG demonstrated sinus rhythm with a broad left bundle branch block with QRS duration of 73 ms. A subsequent coronary angiogram demonstrates the following:

  • LMS normal
  • LAD 50% mid vessel stenosis
  • LCx 60% distal stenosis
  • RCA recessive vessel, 75% proximal disease

A subsequent echocardiogram demonstrated a left ventricular diastolic dimension of 7 cm. There is global impairment of left ventricular systolic function with EF estimated at 30%. There was severe mitral regurgitation due to annular dilatation. He was successfully commenced on ramipril and bisoprolol.

What is the most appropriate management at this stage?

A. Referral for CRT-D
B. Referral for revascularization
C. Commence warfarin therapy for a dilated left ventricle
D. Commence spironalactone
E. Advise abstinence from alcohol and repeat echocardiogram at 6 weeks


Question 17# Print Question

A 74-year-old patient presents to hospital with a VF arrest. She is successfully resuscitated and a subsequent ECG demonstrates a clear-cut anterior myocardial infarction with >2 mm ST elevation in leads V2–V6. Coronary angiography demonstrates a suboccluded proximal LAD, with a small unobstructed circumflex artery and a 70% stenosis in the proximal RCA. She undergoes successful coronary intervention to her proximal LAD and has an uncomplicated recovery from her infarct. Her echocardiogram demonstrates akinesia of the apex, but an overall EF estimated at 35–40%. She is established on dual anti-platelet therapy, ramipril, bisoprolol, and a statin.

What other therapy should she have?

A. Spironalactone
B. Epleronone
C. ICD insertion
D. CRT insertion
E. PCI to her RCA


Question 18# Print Question

A 45-year-old patient with a known diagnosis of AL amyloid presents to cardiology outpatient clinic. He is under the haematologists receiving chemotherapy for myeloma.

Which one of the following statements is true when there is cardiac involvement with amyloid?

A. ACE inhibitor therapy is the cornerstone of treatment with cardiac involvement
B. In endstage disease, cardiac transplantation in AL amyloid is relatively contraindicated
C. Beta-blockers are used routinely
D. With adjunctive chemotherapy, the prognosis for AL amyloid is good
E. Diuretics should not be used because of profound hypotension


Question 19# Print Question

A 50-year-old man with sarcoidosis is referred to the outpatient clinic from the respiratory clinic. Which one of the following features would suggest cardiac involvement?

A. First-degree heart block
B. Dilated cardiomyopathy
C. Echo features suggestive of ARVC
D. D E/A reversal on mitral inflow Doppler with an elevated E/E' on tissue Doppler imaging
E. All of the above


Question 20# Print Question

You are asked to review a 65-year-old man with known pulmonary fibrosis who has been admitted under the chest physicians with an infection. He is not responding to broad-spectrum antibiotic therapy. He is a lifelong smoker. His 12-lead ECG demonstrates first-degree AV block with complete RBBB and a normal QRS axis. His CXR is of poor quality but could be consistent with fluid overload. Echocardiography demonstrates thinning of the septum and apex with overall moderate impairment of systolic function.

Which one of the following investigations is least likely to help with the underlying diagnosis?

A. Cardiac catheterization
B. BNP
C. Serum ACE
D. High-resolution CT chest
E. Exercise ECG




Category: Cardiology--->Heart Failure
Page: 4 of 14