Manual 100 Questions in Cardiology

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She reports blacking out for a few seconds after feeling light headed when getting up from her chair. She denies chest pain, palpitations or short of breath.

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It is the first time this has happened, but she does often get light headed on standing. Her medication history is aspirin 75mg OD, bisoprolol 2. Other than a few cuts and scrapes, her examination is grossly normal. Her ECG and blood tests including cardiac enzymes are all grossly normal, other than slightly low sodium. What is the most likely cause of her collapse? Postural hypotension, most likely secondary to antihypertensives. Paroxysmal fast AF.

Syncope due to severe aortic stenosis. Posterior circulation stroke. It started an hour ago and has got progressively worse. He has never had a pain like this before. He has a past medical history of hypertension and takes amlodipine and for it. He smokes 30 cigarettes a day and has a 70pack year history. What is the most likely diagnosis?

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He is sweaty and nauseous. The pain has not responded to repeated doses of his own GTN. Otherwise his examination is grossly normal. Trop T is elevated at Treatment dose enoxaparin 1. GTN infusion. Busco Pan is a 55 year old man who presented to his GP with a productive cough.

He is also short of breath on minimal exertion. He is wheezy on examination and his tympanic temperature is 38 degrees Celsius. On percussion there is some dullness in the left basal lung field, alongside bronchial breath sounds in the same region. He is started on amoxicillin for suspected community acquired pneumonia and goes home. An initial ECG performed by paramedics showed Torsade de Pointes and he was admitted to the coronary care unit for cardiac monitoring and further management.

He has a history of poorly controlled asthma, requiring daily oral glucocorticoid therapy.

Furthermore, he has AF and is anticoagulated on rivaroxaban. He was diagnosed with schizophrenia 12 years ago is currently on haloperidol to control his symptoms, though he occasionally acts erratically. Which of the following is most likely to be associated with torsade de pointes? He is clearly uncomfortable and he gestures to his chest as if to suggest pain.

He has a history of imprisonment for the supply for opiates. On examination, he is visibly sweaty. He has some painful nodules on his hands. There are no dark streaks beneath the fingernails.

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Examination of the retina is completely unremarkable. He has some bruising and track marks in his antecubital fossa. He is currently slightly confused but manages to suggest that he passed some blood in his urine when he last visited the toilet. His tympanic temperature is T waves are present and uninverted. There is unconvincing evidence of ST depression or elevation in any contiguous leads. Granulomatosis with polyangiitis.

Hand Foot and Mouth Disease. Infective Endocarditis.

Myocardial Infarction. Secondary Syphilis. A 14 year old girl presents to her GP with a productive cough and a fever. A man stands up to clear the dishes after dinner. He feels a sharp, tearing sensation in the epigastric region of his abdomen, toward his back. He immediately collapses to the floor. His skin is pale, cool, and diaphoretic.


Pedal pulses are absent. You should. She reports a history of hypertension, ulcers, angina, and atherosclerosis. Her pain is a 7 on a 1—10 scale. She self-administered three of her prescribed nitroglycerin tablets, without effect. You should first. A year-old male presents supine in bed, alert, and complaining of lightheadedness, difficulty breathing, and heavy chest pressure that radiates to his arms.

You auscultate crackles in both lung fields. A year-old female is supine in bed with difficulty breathing and substernal chest pressure. She is alert and breathing 26 times per minute, with crackles auscultated bilaterally. Accessory muscle use is evident. An year-old male had a syncopal episode while standing during church service.

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Bystanders assisted him to the ground, where he presents awake, confused, and short of breath. He is breathing 18 times per minute; his lung sounds are clear.

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Which of the following series of actions would be most appropriate? A Sit the patient upright and assist him to a gurney, administer oxygen, and perform a full physical examination. B Move the patient to a cooler spot within the church; loosen his clothing and fan him to promote cooling. C Keep the patient supine and transfer him to the gurney, administer oxygen, and move toward the ambulance.