AMC MCQ Cardiovascular Medicine 3

Question 1

A 72-year-old man with heart failure presents with worsening dyspnoea, orthopnoea and bilateral basal crepitations. Which investigation best confirms decompensated heart failure?

Accepted Answer

B-type natriuretic peptide

Answer

Elevated BNP or NT-proBNP supports a diagnosis of decompensated heart failure.

Question 2

Which class of drug is first-line for symptomatic relief of pulmonary congestion in acute heart failure?

Accepted Answer

Intravenous loop diuretic

Answer

IV loop diuretics such as frusemide relieve pulmonary congestion in acute decompensated heart failure.

Question 3

A patient with HFrEF is already on an ACE inhibitor and beta-blocker but remains symptomatic with an ejection fraction of 30%. Which agent reduces mortality next?

Accepted Answer

Spironolactone

Answer

A mineralocorticoid receptor antagonist like spironolactone reduces mortality in symptomatic HFrEF.

Question 4

Which examination finding most specifically indicates elevated right atrial pressure in heart failure?

Accepted Answer

Raised jugular venous pressure

Answer

A raised JVP directly reflects elevated right atrial pressure and is a specific sign of congestion.

Question 5

A patient on an ACE inhibitor develops a persistent dry cough. What is the most appropriate substitute?

Accepted Answer

Angiotensin receptor blocker

Answer

An ARB provides similar benefit without the bradykinin-mediated cough of ACE inhibitors.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Cardiovascular Medicine 3