CA prep

A 56-year-old man with a history of hypertension presents to the Emergency Department with shortness of breath and chest pain. Initial ECG shows ischaemia in leads V2 to V5. He is taken to the cardiac catheterization lab and an angiogram showed complete occlusion of the proximal left anterior descending artery. Which of the following primary ECG findings help in the diagnosis of ischaemia in this patient?

• Q-wave

• ST depression

• T wave inversion

• ST elevation

1.      A 42-year old obese man visits the cardiology clinic with chief complaints of chest tightness and dyspnoea on exertion for the past one week. the symptoms usually disappear on rest. There is no evidence of previous myocardial infarction. The resting ECG is normal. Which of the following changes can be seen during exercise ECG of this patient?

• Presence of U waves

• Depression of ST segment

• Prolonged QT interval

• Elevation of ST segment

1.      A 45-year-old man faints and loses consciousness suddenly. While he is being resuscitated, his heart rate is found to be 45 bpm. He is given atropine to treat his condition, following which his heart rate increase to 88 bpm. Which is the likely effect on this drug on the action potentials of a pacemaker cell in the SA node of this man to increase his heart rate?

• Prolongation of phase 2

• Hyperpolarisation of phase 0

• Rapid depolarisation of phase 4

• Unchanged phase 3

A 19-year-old man with the left main coronary artery (LMCA) arising from the right aortic sinus presents with recurrent episodes of syncope. Between which structures would the course of LMCA be compressed to cause this symptom?

• Aorta and pulmonary artery

• Pulmonary artery and right auricle

• Pulmonary artery and superior vena cava

• Aorta and right auricle

55 years old come to ED with bradycardia. Angiography found blood insufficiency in SA node. What artery is blocked?

• Left anterior artery

• Left coronary artery

• Right coronary artery

• Right marginal artery

A 53-year-old man is treated for hypertension. Recently he consulted a physician with complaints of incomplete urinary evacuation and another anti-hypertensive drug was added to his prescription. After two days, he reports with complaints of dizziness and faint while getting from the bed. Which drug is most likely added to for this patient?

• Prazosin

• Hydralazine

• Propanolol

• Nifedipine

A 35-year-old man is struck by a car. An emergency physician who is passing by evaluates his condition. The man has several lacerations, most of which are still bleeding. He is unconscious, and his breathing is becoming rapid and shallow. The emergency physician thinks that patient will soon enter hypovolaemic shock. If this occurs, what other findings/changes would be expected in this patient?

• Increased total peripheral resistance

• Increased urine output

• Increased cardiac output

• Increased JVP

A 20-year-old man presents with a low-grade fever for 3 weeks. On examination, he is febrile, tachycardic and tachypnoeic. His blood pressure is 100/80mmHG. Needle tracks are seen in his left antecubital fossa. There are splinter haemorrhages under his fingernails and tender haemorrhagic nodules are seen on his palms and soles. A heart murmur is heard on auscultation. A tender spleen is just palpable. Which of the following microorganisms is most likely to be cultured from this patient’s blood?

•     Staphylococcus aureus

• Streptococcus viridians

• Escherichia coli

• Mycobacterium tuberculosis

1.      A 76-year-old man who has had a previous myocardial infarction presents with acute decompensated heart failure. He also complains of a productive cough with pink frothy sputum and is dyspnoeic. There was pedal pitting oedema and raised JVP. On chest examination, third heart sound and rales were heard at both lung bases. Which change best describes the pathophysiology involved in the presentation in this man?

• Increased negativity of pulmonary interstitial pressure

• Increased hydrostatic pressure

• Decreased plasma oncotic pressure

• Lymphatic obstruction

A 50-year-old man visits the clinic for a routine health check-up. His lipid profile shows the following result. The attending physician prescribes a lipid-lowering drug in view of his lipid profile. What drug is prescribed

• Fibrates

• Statins

• Cholestyramine

• Ezetimibe