MRCP Part 1 Cardiology

Question 1

A 60-year-old man presents with central chest pain radiating to the jaw, diaphoresis, and an ECG showing ST elevation in leads II, III, and aVF. 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

Which drug class is absolutely contraindicated in acute decompensated heart failure with cardiogenic shock?

Accepted Answer

Beta-blockers

Answer

Loop diuretics

Answer

Vasopressors

Answer

Angiotensin-converting enzyme inhibitors

Question 3

A 45-year-old woman has recurrent palpitations. A 24-hour Holter shows intermittent delta waves and short PR interval. What is the diagnosis?

Accepted Answer

Wolff-Parkinson-White syndrome

Answer

Lown-Ganong-Levine syndrome

Answer

Complete heart block

Answer

Brugada syndrome

Question 4

What is the mechanism of action of digoxin in atrial fibrillation?

Accepted Answer

Blocks sodium-potassium ATPase, increasing vagal tone and slowing AV node conduction

Answer

Direct cardioversion to sinus rhythm

Answer

Blocks beta-adrenergic receptors at the AV node

Answer

Prolongs the action potential in atrial tissue

Question 5

In a patient with HOCM, which intervention is most likely to worsen outflow tract obstruction?

Accepted Answer

Valsalva manoeuvre

Answer

Beta-blockers

Answer

Squatting

Answer

Exercise in a supine position

Question 6

Which ECG finding is most specific for hyperkalaemia?

Accepted Answer

Peaked T waves

Answer

Prolonged QTc

Answer

Shortened PR interval

Answer

U waves