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FRACP PAST PAPERS - CARDIOVASCULAR - page 9 / 17

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b.IV heparin and atenolol

c.IV GTN

d.

atenolol

e.

await CK

9.

Young female with MS in 1st trimester of pregnancy.  Which is the best predictor of response to pregnancy:

a.pre-pregnancy symptoms

b.apex beat displacement

c.valve area on echocardiogram

d.length of the murmur

10.

24 yo female presents with three episodes of collapse in the last four months during which she is totally unconscious.  Her mother died suddenly in swimming pool, her grandfather in MVA.  Examination unremarkable.  ECG is shown - inc QT.  Which of the following is most likely to stop further attacks:

a.phenytoin

b.inderal

c.amiodarone

d.sotalol

11.

Pathogenetic mechanisms of myocardial reperfusion injury  —  following ischaemia in animal experiments include:                   

  A.  excessive cytosolic calcium.                                   

  B.  precipitation of intracellular adenosine.                                                                                       

  C.  upset of the osmotic - hydrostatic pressure balance across the capillary wall.                                         

  D.  formation of oxygen free radicals.                             

  E.  adherence of neutrophils preventing flow through capillaries.

12.

Which of the following statements concerning coronary artery disease risk factors and their management is/are correct?

A.

In the normal range of serum cholesterol (4.0 - 5.5 mmol/l)the likelihood of developing clinical manifestations of coronary heart disease increases with the serum cholesterol level.                                                                      

B.

Decreased HDL is an independent risk factor for coronary artery disease in men.

C.

Lowering serum cholesterol by clofibrate results in an increased risk of cholelithiasis.

D.

Lowering serum cholesterol by reducing dietary fat results in an increased risk of colonic cancer.

E.

The level of risk of coronary heart disease in smokers is related to the number of cigarettes smoked.                     

13.

With regard to beta 1 receptor agonist inotropic agents:

A.

Their effects are mediated through cyclic AMP.

B.

The relationship between developed tension in the myocardium and cytosolic calcium concentration remains unaltered.

C.

They have a negative inotropic action in the presence of severe limitation of coronary blood flow.

D.

Their inotropic effects are additive with Digoxin.

E.

Their myocardial receptor number is normal in heart failure.

14.

Concerning supraventricular tachycardia (SVT):

A.

SVT is due to re-entry in about 30% of patients

B.

Approximately 30% of accessory atrio-ventricular connections responsible for SVT do not produce delta waves during sinus rhythm.

C.

Frequently recurrent SVT results in reduced left ventricular function.

D.

Greater than 80% of patients with disabling SVT have a surgically curable lesion

E.

SVT may produce angina and ST segment depression in the absence of atheromatous coronary artery disease.

15.

Regarding cardiology formulae:

A.

vascular resistance is inversely related to the cardiac output.

B.

ejection fraction is calculated by dividing end diastolic   volume into stroke volume.                                     

C.

area of a stenotic valve is inversely related to the square   root of the  pressure gradient.

D.

blood flow is inversely related to the difference in arterial  and venous oxygen content.

E.

Cardiac index is calculated by dividing cardiac output by body surface area                                              

16.

A reduced effect of a standard dose of oral digoxin may be  encountered in which of the following clinical settings?

   A. Renal failure.

   B. Hyperthyroidism.

   C. Concomitant cholestyramine administration.       

   D. Concomitant quinidine administration.            

   E.  Hypercalcaemia

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