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FRACP PAST PAPERS - CARDIOVASCULAR - page 15 / 17

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58.

What are the pathological and haemodynamic consequences of chronic compensated mitral regurgitation

A.

decreased pulmonary blood flow

B.

decreased pulmonary vascular resistance

C.

increased LVEDV

D.

increased sarcomere length

E.

increased LV mass

59.

Concerning cyanotic congenital heart disease

A.

almost always presents shortly after birth

B.

associated with tachypnoea at rest

C.

associated with gout in children

D.

associated with increased risk of embolic stroke

E.

improves with intermittent positive pressure ventilation

60.

Which of the following increases coronary thrombosis in a previously atherosclerotic coronary tree

A.

von Willebrand factor deficiency

B.

anti thrombin III deficiency

C.

homocysteinuria

D.

decreased apolipoprotein (a)

E.

decreased HDL in men

61.

60yr old male with broad regular tachycardia in RBBB pattern and no evident p waves, rate 200/min and BP 90/70, dyspnoeic and dizzy. No response to CSM. Given IV lignocaine bolus and 30 mins of lignocaine infusion 4mg/min with no effect. The next best management would be (one answer)

A.

IV digoxin

B.

IV verapamil

C.

more IV lignocaine

D.

wait another 15 min

E.

elective cardioversion with sedation

62.

20 yr old thin tall male with sudden onset of severe chest pain. JVP 4cm, HS dual with diastolic murmur at LSE. Carotids normal, BP 120/70, ECG shows 2mm ST elevation in leads II and III with no Q waves. Best management would be (one answer)

A.

IV streptokinase

B.

IV heparin

C.

await cardiac enzyme results

D.

transthoracic echo

E.

CT thorax

63.

Echo shown  ?MVP ?HOCM Young female with dyspnoea on exertion. Which of the following is/are true?

A.

increased risk of sudden death

B.

SBE prophylaxis is required

C.

calcium channel blockers improve survival

D.

beta-blockers are contraindicated

E.

vasodilators improve symptoms

64.

ECG shown with ST elevation ( 2 saddle shaped) in I, aVL, II, III and aVF, V3-6. Rate 100/min BP 170/110.  46 yr old male with crushing chest pain for 2 hours. No other clinical abnormalities - no murmurs or rubs. The best initial treatment would be (one answer)

A.

aspirin

B.

IV streptokinase

C.

IV atenolol

D.

IV heparin

E.

IV nitroprusside

65.

The haemodynamic significance of SVT is affected by

A.

QT interval

B.

P wave morphology

C.

P-QRS dissociation (relationship of P to QRS)

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