Cardiology Flashcards
6 cards from real MRCP PART 1 practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Cardiology flashcards as text
A 30-year-old woman with a history of recurrent deep vein thrombosis and livedo reticularis has a prolonged APTT that does not correct on mixing. What diagnosis should be suspected?
Answer: Antiphospholipid syndrome
Antiphospholipid syndrome (APS) presents with thrombosis (arterial or venous), recurrent miscarriages, and livedo reticularis. The APTT is paradoxically prolonged in vitro (due to lupus anticoagulant interfering with phospholipid-dependent clotting assays) but the patient is prothrombotic. Failure to correct on mixing confirms an inhibitor.
What is the most appropriate management for a haemodynamically stable patient with AF of known duration less than 48 hours?
Answer: Rhythm or rate control after anticoagulation initiation, with cardioversion if appropriate
For AF of less than 48 hours duration, cardioversion (chemical or electrical) can be considered without prolonged anticoagulation, though DOAC or LMWH should be started before cardioversion and continued for at least 4 weeks after. Rate control is an alternative for stable patients.
Which valve lesion produces a mid-diastolic rumbling murmur best heard at the apex with the bell in the left lateral position?
Answer: Mitral stenosis
Mitral stenosis produces a low-pitched, mid-diastolic rumbling murmur, heard best at the apex with the bell of the stethoscope, with the patient in the left lateral position. It is often preceded by an opening snap and is accentuated by exercise.
A patient with known IHD develops sudden-onset severe chest pain tearing to the back, unequal blood pressures in both arms, and a widened mediastinum on CXR. What is the diagnosis?
Answer: Type A aortic dissection
The triad of tearing chest/back pain, unequal arm blood pressures, and widened mediastinum is classic for aortic dissection. Type A involves the ascending aorta and is a surgical emergency. CT aortogram is the investigation of choice if the patient is haemodynamically stable.
What is the most common cause of complete heart block in the UK?
Answer: Degenerative fibrosis (Lenègre/Lev disease)
The most common cause of complete heart block in adults is idiopathic degenerative fibrosis of the conduction system (Lenègre's or Lev's disease), occurring with age. Inferior MI affecting the RCA is a recognised but less common cause.
Which investigation is the gold standard for diagnosing coronary artery disease?
Answer: Invasive coronary angiography
Invasive coronary angiography (cardiac catheterisation) remains the gold standard for diagnosing coronary artery disease, as it provides real-time visualisation of coronary anatomy, allows assessment of stenosis severity, and permits simultaneous intervention (PCI).