Multiple Choice Questions on Cardiology | Objective Questions Cardiology | MCQ
1 >>A patient is diagnosed with long QT syndrome and has beencommenced on beta-blockers with no symptoms and a QTcof 470 ms. No genetic testing has been performed. She has a7-year-old daughter and asks about the risks for her child.What is it appropriate to tell her? ?
- (A) The patient should be considered for genetic testing
- (B) The patient’s daughter should be considered for genetic testing
- (C) An ICD is likely to be the safest option
- (D) If her daughter has a normal ECG she can be reassured that she does not have long QT syndrome
2 >>A 61-year-old with a history of a myocardial infarction 2 yearsago with a known ejection fraction of 25% presents to A&E witha 2 hour history of mild palpitations. He is otherwise fit and well.His ECG monitoring shows a regular broad complex tachycardiaat a rate of 170 bpm which self-terminated before a 12-leadECG was performed. His U&Es are normal. The patient’s bloodpressure was 130/90 mmHg during the tachycardia and he wasnot unduly distressed. He is transferred to CCU where a 12-leadECG shows LBBB with a QRS duration of 100 ms. ?
- (A) He needs an ICD
- (B) He needs an urgent revascularization
- (C) He needs an EP study
- (D) He tolerated his tachycardia well; therefore it is likely to be an SVT with aberrancy
3 >>A patient with previous myocardial infarction, an ejection fractionof 25%, and a QRS duration of 140 ms, but no history of cardiacarrest, is seen in clinic and an ICD is recommended. She isconcerned about driving.What is it appropriate to tell her? ?
- (A) A. She will need to stop driving for 6 months
- (B) B. She will need to stop driving for 1 month
- (C) C. If she has an appropriate shock she will need to stop driving for 6 months
- (D) E. B and C
4 >>Which one of the following features is least suggestive that abroad complex tachycardia is ventricular in origin (VT)? ?
- (A) P waves seen ‘walking through the tachycardia’
- (B) The QRS duration shortens as the patient goes from sinus rhythm to tachycardia
- (C) Capture beats
- (D) A right bundle branch block pattern with a small R wave and a large R’ wave(i.e. rsR’) in V1
5 >>A 37-year-old man presents to A&E with pneumonia and atemperature of 39°C. He has no chest pain but a routine ECG isperformed and is shown in Figure 1.1. ?
- (A) He should be referred for primary angioplasty
- (B) His temperature may have exacerbated his ECG changes
- (C) He should be treated with ajmaline
- (D) He needs an ICD
6 >>Which one of the following would not be considered a high-riskmarker for sudden cardiac death in hypertrophic cardiomyopathy? ?
- (A) Family history of sudden cardiac death
- (B) Non-sustained VT on cardiac monitoring
- (C) LV septal thickness of 2.3cm
- (D) Drop in blood pressure on ETT
7 >>A 26-year-old patient presents to A&E with the rhythm stripshown in Figure 1.2. He is complaining of palpitations and chestpain. His blood pressure is 80/60 mmHg.What should the initial management be? ?
- (A) IV adenosine
- (B) IV amiodarone
- (C) IV beta-blocker
- (D) Urgent cardioversion
Cardiology Objective Questions | Cardiology Quiz
8 >>The ECG shown in Figure 1.2 is diagnostic of which one of thefollowing rhythms? ?
- (A) AF with aberrancy
- (B) AF with pre-excitation
- (C) VT
- (D) AVNT-orthodromic
9 >>Which one of these drugs does not prolong the QT interval? ?
- (A) Amiodarone
- (B) Erythromycin
- (C) Carbemazpine
- (D) Clozapine
10 >>What does the the box plot in Figure 1.3 show? ?
- (A) An inappropriate shock for AF
- (B) Inappropriate ATP for AF
- (C) Appropriate shock for VT
- (D) Appropriate ATP for VT
11 >>With regard to ARVC: ?
- (A) The diagnosis can be confirmed on the basis of MRI findings alone
- (B) All patients with a confirmed diagnosis will need an ICD
- (C) It is normally autosomal dominant
- (D) Genetic tests are positive in most cases
12 >>A 57-year-old patient with a history of dilated cardiomyopathyand an ejection fraction of 20% is admitted to hospital after apresyncopal episode. His ECG on arrival shows monomorphic VTwith a rate of 180 bpm and his BP is 70/50 mmHg. He receivesurgent cardioversion and his QRS complexes are narrow onreturn to sinus rhythm. He is normally NYHA class III and is onmaximum medication for HF. ?
- (A) According to NICE criteria he does not qualify for an ICD as his aetiology is not IHD
- (B) He should receive a biventricular ICD
- (C) He should receive a standard ICD
- (D) He should be commenced on oral amiodarone
Cardiology Objective Questions | Cardiology Quiz
13 >>An asymptomatic 32-year-old man has the ECG shown in Figure 1.4performed as part of a routine work medical examination. ?
- (A) This ECG shows right bundle branch block
- (B) He is asymptomatic and can be reassured without further investigation
- (C) He should have a 5 day monitor and as long as there are no significant arrhythmias orchanges in the QRS complexes he can be reassured and discharged
- (D) He should proceed to an EP study
14 >>What is the rhythm shown in Figure 1.5? ?
- (A) AF with pre-existing RBBB
- (B) AVNRT with aberrancy
- (C) VT-likely to arise from the left ventricle
- (D) VT-likely to arise from the right ventricle
15 >>A patient with a secondary prevention ICD in situ experienced ashock from his device. The download is shown in Figure 1.6. It isa single-chamber device and the top trace is from the RV tip toRV ring and the lower trace is from the generator can to the RVshock coil. ?
- (A) He has had an appropriate shock for VF
- (B) He has had VF appropriately terminated with ATP
- (C) He has had VT appropriately terminated with ATP
- (D) He has had an inappropriate shock
16 >>A 65-year-old diabetic man with a previous history of myocardialinfarction 3 years ago (no intervention required) is found to haveatrial fibrillation. His LVEF is 55% and he has no cardiovascular symptoms. What would you advise him with regard to the best thromboprophylaxis? ?
- (A) High-dose aspirin
- (B) Warfarin
- (C) Aspirin and warfarin
- (D) Aspirin or warfarin
17 >>A 25-year-old man presents to the ED with a broad complex tachycardia that is irregularly irregular. The patient is haemodynamically uncompromised. An anaesthetist is not available to assist with immediate DC cardioversion.What is the best initial treatment option? ?
- (A) IV adenosine
- (B) IV flecainide
- (C) Oral beta-blocker
- (D) IV beta-blocker
18 >>A 60-year-old man attends clinic because of hypertension. His BP in clinic is 170/90 mmHg and his echocardiogram shows mild LVH and mild LA dilatation. He is not diabetic and has no other medical history of note. Which one of the following medications is most effective in preventing AF? ?
- (A) ACE inhibitors
- (B) Beta-blockers
- (C) Calcium-channel antagonists
- (D) Diuretics
19 >>A 62-year-old woman attends clinic following an ED attendance 6 weeks previously with a one-week history of palpitations. She was diagnosed with AF at the time and commenced on aspirin and a beta-blocker. Her echocardiogram showed no significant abnormalities and her ECG in clinic today confirms atrial fibrillation with a ventricular rate of 70 bpm. She continues to get occasional palpitations and would like to be considered for cardioversion. What do you advise? ?
- (A) She needs to be warfarinized for at least 48 hours pre-cardioversion
- (B) Anticoagulation should be continued after successful cardioversion for at least 4 weeks
- (C) If a TOE rules out atrial thrombus, no anticoagulation is required post-procedure
- (D) Anticoagulation is not required prior to chemical cardioversion
20 >>A 75-year-old diabetic woman with a history of previous MI and an LVEF of 35% has been on amiodarone for paroxysmal AF for several years. On examination she is breathless at rest and has signs of congestive cardiac failure. She has heard about dronedarone and is wondering whether she can have it instead of amiodarone. What do you advise her about dronedarone? ?
- (A) It is more effective than amiodarone in maintaining sinus rhythm
- (B) It has no effect on heart (ventricular) rate during AF episodes
- (C) It is contraindicated in NYHA class IV heart failure patients
- (D) It is suitable for her as she is diabetic and aged over 70