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FRACP PAST PAPERS - CARDIOVASCULAR - page 7 / 17

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What would be the best test?

A.

CT adrenals

B.

Renal angiogram

C.

Renal IVP

D.

Renal scintiscan

E.

3.

A 23 year old obese male (weight 150% normal).  ?Cleft palate repair and rheumatic fever at age of 8.  Now a 2 year history of exertional dyspnoea.  Right heart catheterization given:

IVC77% - O2 sat.

SVC 74% - O2 sat.

RA76% - O2 sat.

RV79% - O2 sat.

PA 79% - O2 sat.

A.

Lose weight

B.

Close ASD

C.

Close VSD

D.

Penicillin prophylaxis

E.

Diuretics

4.

25 year old female pregnant 4 months. Presents with dyspnoea, AF, CHF.  Echo shows mitral valve area of  0.6 cm2.  Increased pulmonary pressures, calcification minor, mild MR only, mobile anterior mitral valve leaflet.  Next best step after management of AF:

A.

therapeutic abortion

B.

bed rest and medical management until after delivery

C.

open mitral valve commissurotomy

D.

mitral valve replacement

E.

mitral valve balloon valvuloplasty

5.

Chest x-ray with pericardial calcification:

A.

CV wave in JVP

B.

RA and PCW pressures equal

C.

Increased PCW pressures with inspiration

D.

RV pressure more in systole

E.

RV & LV pressures equal in systole

6.

50 year old female, increased SOB. Exam - CHF, AF, L systolic murmur, BP 150/100. Echo enlarged LV, concentric hypertrophy, decreased LV function, narrowing of aortic valve with peak gradient 45mmHg. Given digoxin and diuretics and stabilized. After echo findings what do you do next?

A.

continue current therapy

B.

ACE inhibitor

C.

aortic balloon valvuloplasty

D.

aortic valve replacement

E.

cardiac transplant.

7.

16 year old school boy, murmur since age 2, asymptomatic.  Brought for a checkup. O/E: systolic murmur lower LSE, L thrill, BP, pulse, splitting normal. Murmur ?change in Valsalva?

A.

HOCM

B.

MVP

C.

congenital pulmonary stenosis

D.

ASD

E.

VSD

8.

18 year old IV drug user shown a Roth spot on picture of fundus. Presents with fever. Most likely organism:

A.

Klebsiella

B.

Staph. aureus

C.

Acinetobacter

D.

Strep. bovis

E.

Pseudomonas

9.

75 year old man with ventricular demand pacemaker, experiences palpitations, no dizziness. ECG - tachycardia, 150/min, p waves present. Cause of palpitations:

A.

AF

B.

Atrial flutter

C.

VT

D.

Pacemaker induced tachycardia

E.

AVN RT

10.

Elderly woman on Digoxin and Frusemide. 2 weeks ago added Captopril & NSAID. Now nauseated. Digoxin level 2.8, Creatinine 0.14 - 0.3. Next step:

A.

stop everything and recheck Dig. level

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