MRCP Part 1 Cardiology and Respiratory

Question 1

A 62-year-old man presents with acute chest pain. His ECG shows ST elevation in leads II, III, and aVF with reciprocal changes in I and aVL. Which coronary artery is most likely occluded?

Accepted Answer

Right coronary artery

Answer

Left anterior descending artery

Answer

Left circumflex artery

Answer

Left main stem

Question 2

A patient with heart failure has the following spirometry: FEV1 2.8L (predicted 3.5L), FVC 3.2L (predicted 4.2L), FEV1/FVC ratio 87.5%. What pattern does this show?

Accepted Answer

Restrictive pattern

Answer

Obstructive pattern

Answer

Mixed obstructive and restrictive

Answer

Normal spirometry

Question 3

Which valvular lesion classically produces an early diastolic murmur best heard at the left sternal edge with the patient sitting forward?

Accepted Answer

Aortic regurgitation

Answer

Mitral stenosis

Answer

Pulmonary stenosis

Answer

Tricuspid regurgitation

Question 4

A 70-year-old woman with atrial fibrillation has a CHA2DS2-VASc score of 4. According to NICE guidelines, what is the recommended anticoagulation strategy?

Accepted Answer

Direct oral anticoagulant (DOAC)

Answer

Aspirin alone

Answer

Aspirin plus clopidogrel

Answer

No anticoagulation required

Question 5

A patient presents with pleuritic chest pain, haemoptysis, and breathlessness. D-dimer is elevated and CTPA shows a filling defect in the right lower lobe pulmonary artery. What is the most appropriate initial treatment?

Accepted Answer

Low molecular weight heparin and arrange DOAC

Answer

Intravenous thrombolysis with alteplase

Answer

Inferior vena cava filter

Answer

Oral warfarin alone

Question 6

In which condition would you expect to find bilateral hilar lymphadenopathy on chest X-ray with a raised serum ACE level?

Accepted Answer

Sarcoidosis

Answer

Tuberculosis

Answer

Small cell lung cancer

Answer

Lymphoma