1. Cardiology
A 50 year old woman presents with left arm and leg
weakness of 5 hours duration. She is known to have AF. She
is hypertensive but her AF is rate controlled with a HR of 80.
Neurological exam confirms 4/5 weakness but there is nil
else remarkable, bloods are normal and CT head shows no
evidence of haemorrhage. As there is no evidence of
haemorrhage on CT, what anti platelet or anticoagulant are
?yo going to prescribe
:Select the best answer
IV Heparin
Warfarin to be commenced covered by LMWH
Thrombolysis
Aspirin
None
Question category: Cardiology
A 50 year old woman presents with left arm and leg
weakness of 5 hours duration. She is known to have AF. She
is hypertensive but her AF is rate controlled with a HR of 80.
Neurological exam confirms 4/5 weakness but there is nil
else remarkable, bloods are normal and CT head shows no
evidence of haemorrhage. As there is no evidence of
haemorrhage on CT, what anti platelet or anticoagulant are
?yo going to prescribe
:Select the best answer
Aspirin
None
Warfarin to be commenced covered by LMWH
Thrombolysis
IV Heparin
estion category: Cardiology
A 23 year old female has been referred to the cardiology
clinic. She has been increasingly shortness of breath and

2. can barely climb stair without becoming short of breath. She
is found to be hypertensive. An ECHO revealed right atrial
hypertrophy and raised right atrial pressure. Cardiac
catheterisation was performed and revealed a higher than
normal oxygen saturation in the right atrium and ventricle.
?What is the most likely diagnosis
:Select the best answer
(Atrial Septal Defect (Ostium primum
(Atrial Septal Defect (Ostium secundum
Pulmonary Hypertension
Ventricular septal defect
Patent ductus arteriosus Anatomy
?Regarding the renal artery, which is correct
:Select the best answer
They arise from the abdominal artery above the superior
mesenteric artery
The aorta passes through the diaphragm at the level of the
eleventh thoracic vertebra
The gonadal arteries arise above the origin of the renal
artery
The right renal artery is longer than the left
The suprarenal artery arises from the renal arteryCardiology
A 60 year old who is on Lithium for bipolar disorder is found
to be hypertensive by her GP is to be commenced on anti
hypertensive therapy. What anti hypertensive would you
?prescribe to limit the risk of lithium toxicity
:Select the best answer
Bendroflumethiazide
Losartan
Amlodipine

3. Atenolol
Atenolol is the safest option. Thiazides with lithium lead to
salt and water retention and increase lithium concentration.
Ramipril and losartan can lead to increased Lithium
concentration and thus toxicity. Amlodipine can also increase
.the concentration
Ramipril
Anatomy
In regards to the coronary arteries, which of the following is
:correct
:Select the best answer
The posterior interventricular artery is a branch of the
circumflex artery
The anterior interventricular artery arises above the left
posterior aortic cusp
The circumflex artery is a branch of the right coronary artery
There is a lot of cross over circulation between the right and
left coronary arteries
The anterior interventricular artery predominantly supplies
the left ventricle
Cardiology
A 70 year old female has a past medical history of
hypertension. she has had 2 syncopal episodes and was
found to have an ejection systolic murmur and bibasal
crackles and a blood pressure of 165/115 mmHg. An ECHO
was arranged and revealed aortic stenosis. Cardiac
catheterisation revealed a gradient of 50mmHg across the
aortic valve. Which is the most contributory to your decision
?for referral for valve replacement

4. :Select the best answer
Presence of symptoms
The symptomology is the most important factor in decision
for replacement. Although the gradient across the valve is
nearly severe before replacement is recommended there
should normally be evidence of symptoms. If patients are too
unfit to undergo surgery (note age is not a factor if the
patient is fit and healthy) then balloon valvuloplasty can be
.utilised
Left Ventricular Hypertrophy
Age of patient
Evidence of heart failure
Gradient
Anatomy
Bleeding from a posterior gastric ulcer arise from which
?vessel
:Select the best answer
Splenic arteryThe splenic artery lies along the upper border
of the pancreas, which is directly posterior to the stomach.
The left and right gastro omental arteries supply the superior
and inferior portion of the greater curvature of the stomach
respectively. The fundus is supplied by the short gastric and
the inferior pancreaticoduodenal artery supplies the second
.part of the duodenum
Inferior pancreaticoduodenal artery
Right gastro omental artery
Left gastro omental artery
short gastric artery

5. Cardiology
An 20 year old student is brought to A and E following a
collapse in an a night club. There was no suspicion of illicit
drug use. He has had 3 collapse episodes previously. He
had regained consciousness after a few minutes. There is nil
of note on examination with BP and HR within normal
parameters. However, an ECG shows a QT interval of 0.56.
Which ion channel is likely to be defective and have caused
?these signs and symptoms
:Select the best answer
PotassiumThe majority of cases of Long QT syndrome are
caused by defects in potassium channels, LQT1 and 2,
which leads to prolonged depolarisation due to decrease in
potassium outflow. Other causes are defect in sodium
channel, LQT3 and mutation in LQT8 leading to calcium
.channels defects but these account for a smaller number
Sodium
Chloride
Magnesium
Calcium
Cardiology
A 23 year old female who has history of a cardiac condition
wants to start a family with her husband and has been
referred to the cardiology clinic for advice. What condition is
?an absolute contra indication to pregnancy
:Select the best answer
ASD
A)Primary pulmonary hypertensionPulmonary hypertension
is the only absolute contraindication as it can rapidly
deteriorate during pregnancy. MVP and bicuspid aortic valve
should be monitored. PFO and ASD are not
.contraindications

6. B)Bicuspid aortic valve
C)PFO
D)Mitral valve prolapseCalcium
Cardiology
A 40 year old man with new onset AF and no evidence of
structural heart disease on ECHO, was commenced on
warfarin and has an INR of 2.5. He is then successfully
cardioverted 6 weeks later. How long after successful
?cardioversion should the warfarin be continued
:Select the best answer
Current recommendations are to continue for 4 weeks post
cardioversion due to the high relapse rate in the first few
weeks following cardioversion
weeks4
months 3
Indefinited
Stop Immediately
months6
Rheumatology
A 52 year old woman with previous history of IBS presents
with general aches and pains all over with stiffness in her
hands and wrist, not worse at any time of the day. She has
been unable to sleep because of the pain and is very
fatigued. She is also suffering from band like headaches. On
examination there are multiple tender spots over her hips
and back. Blood results including auto antibodies are
?normal. What is the most likely diagnosis
:Select the best answer
A)IBS
Fibromyalgia syndromeFibromyalgia is the most likely
diagnosis. It leads to generalised musculoskeletal pain,

7. stiffness, tenderness, sleep disturbance and easy fatigability.
It usually affects woman from 30 to 60 years of age.
Diagnostic criteria are set out but the ACR and include ;
widespread pain for 3 months; pain on palpation of certain
trigger point e.g. greater trochanter, second rib, occiput;
There is nil of note on examination and all blood
.investigations are normal
B)Rheumatoid Arthritis
C)Chronic fatigue syndrome
D)Depression