Your-Doctor Multiple Choice Questions (MCQ)

Category: Cardiology--->Ischaemic heart disease
Page: 5

Question 21#Print Question

You are asked to review a 32-year-old smoker in the ED. He has presented with an hour of ongoing chest pain. The pain is described as left-sided and sharp but not focal. There is no postural change and no change with inspiration. He appears clinically well. The emergency team are concerned because he has anterior ST elevation and show you his ECG

What do you recommend?

a. Activation of the primary angioplasty team
b. Await troponin tests and give analgesia
c. Non-steroidal anti-inflammatory analgesia
d. Urgent bedside echo to rule out a regional wall motion abnormality
e. CT pulmonary angiogram

Question 22#Print Question

Which of the following should not be used as a procedural antiacoagulant for primary angioplasty?

a. Unfractionated heparin (± GP 2b/3a)
b. Enoxaparin (± GP 2b/3a)
c. Fondaparinux
d. Bivalarudin
e. Bivalarudin + GP 2b/3a

Question 23#Print Question

You review a patient in the CCU who was admitted earlier with a large anterior myocardial infarction treated with primary angioplasty. He has no bystander disease but the presentation was late. The echocardiogram shows severe LV impairment. There is pulmonary oedema which you have been treating with furosemide boluses and continuous positive airway pressure non-invasive ventilation. Blood pressure is now 85/50 mmHg and urine output in the last hour is 10 mL. Oxygen saturations are maintained at 94% with high-flow oxygen. He remains alert.

What treatment should you consider next? 

a. Call an anaesthetist to consider ventilation
b. Start a dopamine infusion
c. Give a fluid challenge
d. Start a nitrate infusion
e. Start a furosemide infusion

Question 24#Print Question

A 45-year-old diabetic man is admitted directly to the catheterization laboratory with chest pain and ST elevation. He had elective angioplasty a week previously for stable angina. He received drug-eluting stents and is taking aspirin and clopidogrel. The relevant angiographic image is shown

What is the diagnosis?

a. Acute stent thrombosis of the right coronary artery
b. Acute stent thrombosis of the left anterior descending artery
c. Acute stent thrombosis of the circumflex artery
d. Acute stent thrombosis of a saphenous vein graft
e. Catheter-induced coronary dissection

Question 25#Print Question

You are completing the discharge summary for a patient who has undergone primary angioplasty with a bare metal stent for an anterior myocardial infarction. The pharmacist questions you regarding the duration of antiplatelets.

What do you advise? 

a. Dual antiplatelets for 12 months and then aspirin long term
b. Ticagrelor for 1 month and aspirin long term
c. Aspirin for 1 month and ticagrelor long term
d. Ticagrelor alone is adequate long term
e. Dual antiplatelets long term

Category: Cardiology--->Ischaemic heart disease
Page: 5 of 5