Forwarded from iNternal-MeDicine MCQs and Cases
Which of the following is a modifiable risk factor for coronary heart disease?
Anonymous Quiz
2%
A. Increasing chronological age
6%
B. Male biological sex
83%
C. Systemic arterial hypertension
9%
D. Family history of premature coronary disease
0%
E. Inherited genetic predisposition
Forwarded from iNternal-MeDicine MCQs and Cases
Q903. A 57-year-old man presents with predictable retrosternal chest pressure during brisk walking, relieved by rest. He has hypertension and dyslipidaemia. Cardiovascular examination reveals normal heart sounds, no murmurs, normal peripheral pulses, and no signs of heart failure. His resting ECG is also normal.
Forwarded from iNternal-MeDicine MCQs and Cases
Which statement is correct?
Anonymous Quiz
0%
A. Normal auscultation excludes coronary artery disease.
6%
B. A normal resting ECG excludes myocardial ischaemia.
14%
C. Stable angina requires an abnormal cardiac examination.
3%
D. Normal peripheral pulses exclude coronary stenosis.
77%
E. Normal examination findings do not exclude chronic coronary disease.
Forwarded from iNternal-MeDicine MCQs and Cases
Q906. A 67-year-old woman previously experienced predictable exertional chest discomfort that resolved with rest. Over the previous 48 hours, the episodes have become more frequent and prolonged, including chest pressure while sitting. There is no fever or pleuritic pain.
Forwarded from iNternal-MeDicine MCQs and Cases
Which feature most strongly raises concern for acute coronary syndrome rather than stable angina?
Anonymous Quiz
0%
A. A consistent exertional trigger over several months
3%
B. Prompt relief after stopping familiar exercise
0%
C. Unchanged symptom severity during the previous year
93%
D. New, prolonged, increasingly frequent discomfort occurring at rest
3%
E. Predictable discomfort only during heavy physical activity
Forwarded from iNternal-MeDicine MCQs and Cases
Q913. A 72-year-old man with diabetes mellitus and chronic kidney disease undergoes coronary angiography using iodinated contrast medium. During subsequent monitoring, his serum creatinine rises significantly. Other major causes of acute kidney injury are excluded.
Forwarded from iNternal-MeDicine MCQs and Cases
Which complication is recognised following coronary angiography, particularly in patients with pre-existing renal impairment?
Anonymous Quiz
0%
A. Acute bacterial myocarditis
0%
B. Primary adrenal insufficiency
89%
C. Contrast-associated acute kidney injury
9%
D. Acute rheumatic carditis
3%
E. Pulmonary valve thrombosis
Forwarded from iNternal-MeDicine MCQs and Cases
Q914. A 62-year-old man presents to the emergency department with severe central chest pressure radiating to his left arm. The pain began 30 minutes ago and is associated with diaphoresis and nausea. His blood pressure is 128/78 mmHg, pulse is 96/min, and oxygen saturation is 97% on room air.
Forwarded from iNternal-MeDicine MCQs and Cases
Which investigation should be obtained and interpreted immediately, ideally within 10 minutes of arrival?
Anonymous Quiz
73%
A. Twelve-lead electrocardiogram
5%
B. Exercise treadmill testing
7%
C. Elective coronary CT angiography
2%
D. Stress myocardial perfusion imaging
14%
E. Routine transthoracic echocardiography before ECG
Forwarded from iNternal-MeDicine MCQs and Cases
Q923. A 70-year-old man has disabling exertional angina despite optimised medical treatment. Coronary angiography demonstrates 80% stenosis of the left main coronary artery, 60% stenosis of the proximal left anterior descending artery and 70% stenosis of a major obtuse marginal branch. His left ventricular ejection fraction is 45%. He is considered suitable for cardiac surgery, and the coronary anatomy is amenable to complete surgical revascularisation.
Forwarded from iNternal-MeDicine MCQs and Cases
Which treatment is generally preferred to improve symptoms and long-term outcomes?
Anonymous Quiz
55%
A. Coronary artery bypass grafting
10%
B. Continued medical therapy without revascularisation assessment
10%
C. Transmyocardial laser revascularisation
10%
D. Enhanced external counterpulsation as definitive treatment
15%
E. Percutaneous intervention without anatomical or Heart Team assessment
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و High yelid points
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بسعر رمزي يتواصل على الخاص
@Ducktor47
Forwarded from iNternal-MeDicine MCQs and Cases
Q1109. A 22-year-old man presents with severe chest pain and tachycardia following cocaine exposure. ECG shows sinus tachycardia without persistent ST elevation. His initial troponin is normal, but the symptoms began only 30 minutes ago. Which statement is most appropriate?
A. A negative initial troponin definitively excludes acute myocardial infarction.
B. Routine fibrinolysis is indicated solely because cocaine was used.
C. Immediate discharge is appropriate whenever the first ECG is nondiagnostic.
D. A normal initial ECG proves there is no myocardial ischaemia.
E. Acute coronary syndrome remains possible and requires appropriate monitored evaluation and serial testing.
A. A negative initial troponin definitively excludes acute myocardial infarction.
B. Routine fibrinolysis is indicated solely because cocaine was used.
C. Immediate discharge is appropriate whenever the first ECG is nondiagnostic.
D. A normal initial ECG proves there is no myocardial ischaemia.
E. Acute coronary syndrome remains possible and requires appropriate monitored evaluation and serial testing.
Forwarded from iNternal-MeDicine MCQs and Cases
❤1
A 68-year-old woman with type 2 diabetes mellitus and hypertension presents with intermittent central chest heaviness at rest over the preceding four hours, with the longest episode lasting 30 minutes. She is now pain-free. Her pulse is 84 beats/min, blood pressure is 146/86 mmHg, and oxygen saturation is 96% on room air. There are no clinical signs of heart failure. ECG demonstrates 2 mm horizontal ST-segment depression in leads V4–V6 and T-wave inversion in leads I and aVL. High-sensitivity troponin T is 86 ng/L on arrival and rises to 310 ng/L three hours later (upper reference limit 14 ng/L). Her creatinine is 82 µmol/L, and she has received aspirin 300 mg.