DM / DNB Cardiology Entrance Mock Test 5
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.
If loading fails, click here to try again
Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test.
Start
Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 5.
You scored %%SCORE%% out of %%TOTAL%%.
Your performance...
Source: Cardiophile MD - January 20, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 4
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.
If loading fails, click here to try again
Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test.
Start
Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 4.
You scored %%SCORE%% out of %%TOTAL%%.
Your performan...
Source: Cardiophile MD - January 18, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Reverse pulsus paradoxus
is an expiratory fall in pulse volume, the opposite of pulsus paradoxus. The classical causes of reverse pulsus paradoxus described are [1]:
Isorhythmic atrioventricular (AV) dissociation
Hypertrophic obstructive cardiomyopathy
Intermittent positive pressure ventilation
During intermittent positive pressure ventilation the swings in intrathoracic pressure is opposite to that of normal breathing. Hence the inspiratory blood pressure is higher than the expiratory blood pressure [2].
In case of isorhythmic AV dissociation, inspiratory increase in sinus rate results in sinus rhythm dominating over AV dissociation. In sinus ...
Source: Cardiophile MD - December 19, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Diastolic pulsus alternans
Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as the alternation of mitral inflow velocities. In one case it was due dilated cardiomyopathy and pulmonary embolism [1]. Another report was in severe heart failure [2]. Alternation in ventricular diastolic function can be documented both by Doppler echo and Tissue Doppler imaging [3].
Earlier description of diastolic pulsus alternans was alternation in the left ventricular diastolic pressures, as in a case of hypertrophic cardiomyopathy [4].
Reference
Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P. “Like a sound and its ...
Source: Cardiophile MD - December 18, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Situations in which SVT can be dangerous
Situations in which supraventricular tachycardia (SVT) can be dangerous:
Usually SVT is an arrhythmia which is well tolerated and patients seldom go into hemodynamic compromise with SVT. But in certain situations, SVT can be dangerous, if it is associated with:
Hypertrophic cardiomyopathy
Acute coronary syndrome (ACS) – increased myocardial oxygen demand worsens ACS
Inoperable severe coronary artery disease – increased myocardial oxygen demand worsens ischemia
SVT requiring high dose antiarrhythmic agent for suppression – severe bradycardia can occur after termination of SVT (Source: Cardiophile MD)
Source: Cardiophile MD - December 11, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs
M-Mode echocardiography
(Time-motion mode) was one of the earliest tools of the echocardiographer. M-Mode gives an ice-pick view of the heart. The vertical axis gives the distance of each point from the transducer while horizontal axis gives the time period. M-Mode gives high resolution in the time axis so that it is easy to time various events in the cardiac cycle, especially if a synchronized ECG tracing is displayed along with it. One of the commonest sites of imaging is the parasternal region. As we sweep from base to apex, the initial section imaged will have the aorta anteriorly and left atrium posteriorly. The next set of images is taken ...
Source: Cardiophile MD - December 5, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Echocardiogram Library Echocardiography anatomical M-Mode Source Type: blogs
Giant T wave inversion
Brief Review
ECG showing deep T wave inversion in anterior wall myocardial infarction
(Click on the image for an enlarged view)
Giant T wave inversion can be broad and deep or just deep T inversions. A depth of T wave of 10 mm or above is generally considered as deep T inversion [1]. Giant T wave inversions with depth of 35 mm have also been described in literature [2]. Deep T inversions without gross increase in width can occur in ischemia and hypertrophic cardiomyopathy. In a study involving 864 patients with hypertrophic cardiomyopathy, 15% had giant T wave inversion [3]. While giant T inversions occurred in about one ...
Source: Cardiophile MD - November 18, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology ECG Library deep T inversion giant T inversion Large T wave inversion Source Type: blogs
Immediate care in sport – time for a change
How confident would you be if you are taken out of your emergency room and transported to be pitchside caring for a critically injured athlete? Your only medical equipment is strapped to your waist in a small bag; you have a physio with you, there are no other Doctors, no nurses and no little red button to press for help. There are twenty thousand people watching you at the ground and you are live on the sports channel with a further million people watching on…
Time critical limb injury
The days of finding a local Doctor who happens to be nearby or a relative of the players to “cover a game” are over. Medical...
Source: Life in the Fast Lane - September 8, 2015 Category: Emergency Medicine Authors: Fraser Brims Tags: Sports Medicine ICIR ICIS Immediate care Pitchside sport medicine Trauma Source Type: blogs
Research and Reviews in the Fastlane 089
This study found that athletes with pathologic TWI (except those in aVR, III, V1) were likely to have underlying cardiac pathology (45% of patients). Hypertrophic cardiomyopathy was the most common finding (81% of cardiac pathology). These authors recommend that all athletes with pathologic TWI be referred for further cardiac testing.
Recommeded by Anand Swaminathan
The R&R iconoclastic sneak peek icon key
The list of contributors
The R&R ARCHIVE
R&R Hall of famer You simply MUST READ this!
R&R Hot stuff! Everyone’s going to be talking about this
R&R Landmark paper A paper that ...
Source: Life in the Fast Lane - July 1, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: R&R in the FASTLANE critical care Education Emergency Medicine Intensive Care recommendations research and reviews Source Type: blogs
WHO classification of maternal cardiovascular risk – Cardiology MCQ
WHO maternal cardiovascular risk class for pregnancy in asymptomatic severe left ventricular outflow tract obstruction (LVOTO) with hypertrophic cardiomyopathy (HCM):
a) Class I
b) Class II
c) Class III
d) Class IV
Correct answer: c) Class III
Class III indicates significantly increased risk of maternal mortality or severe morbidity. In case class III risk is noted in those with asymptomatic severe LVOTO or symptoms or arrhythmias despite optimal medical treatment or with moderate left ventricular systolic dysfunction.
Class I is no detectable risk of maternal mortality and no or mild risk of morbidity. This class does not...
Source: Cardiophile MD - May 29, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Most common arrhythmia in HCM – Cardiology MCQ
Most common arrhythmia in hypertrophic cardiomyopathy (HCM):
a) Ventricular tachycardia
b) Ventricular fibrillation
c) Atrial tachycardia
d) Atrial fibrillation
Correct answer: d) Atrial fibrillation
Atrial fibrillation is also the most common sustained arrhythmia in general population. Onset of atrial fibrillation causes decompensation of cardiac status in HCM because the stiff ventricle is dependant on atrial transport function for diastolic filling.
The post Most common arrhythmia in HCM – Cardiology MCQ appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - May 26, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ ECG / Electrophysiology Source Type: blogs
Hypotension and pulmonary edema in HOCM – Cardiology MCQ
Hypotension and pulmonary edema in severe hypertrophic obstructive cardiomyopathy (HOCM) is treated with:
a) Dobutamine
b) Nitroglycerine
c) Metoprolol and noradrenaline
d) All of the above
Correct answer: c) Metoprolol and noradrenaline
Treatment with inotropes and vasodilators may be life threatening in those cases of severe HOCM presenting with hypotension and pulmonary edema. Instead betablockers and vasoconstrictors like phenylephrine or noradrenaline should be used to improve the hemodynamic status in HOCM.
The post Hypotension and pulmonary edema in HOCM – Cardiology MCQ appeared first on Cardiophile MD. (S...
Source: Cardiophile MD - May 25, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Ventricular septal myectomy for HOCM – Cardiology MCQ
Ventricular septal myectomy for relieving left ventricular outflow tract (LVOT) obstruction in hypertrophic obstructive cardiomyopathy (HOCM) is known as:
a) Maron procedure
b) Morrow procedure
c) Braunwald procedure
d) Cox procedure
Correct answer: b) Morrow procedure
Ventricular septal myectomy is useful in abolishing the LVOT gradient in up to ninety percent of the cases. It also reduces the mitral regurgitation due to systolic anterior movement (SAM) of anterior mitral leaflet. There is long term improvement in exercise capacity in up to eighty percent, with long term survival similar to the general population. More i...
Source: Cardiophile MD - May 24, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Indication for coronary angiography in HCM – Cardiology MCQ
Class I indication for coronary angiography in hypertrophic cardiomyopathy (HCM) as per 2014 ESC (European Society of Cardiology) guidelines:
a) Adult survivors of cardiac arrest
b) Sustained ventricular tachyarrhythmia
c) Severe stable angina
d) All of the above
Correct answer: d) All of the above
Additional class IIa recommendations would be in those with intermediate pre-test probability of coronary artery disease and in those above forty years of age prior to septal reduction therapy.
The post Indication for coronary angiography in HCM – Cardiology MCQ appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - May 24, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Echocardiographic view to measure LV thickness in HCM – Cardiology MCQ
Recommended view for measuring left ventricular (LV) thickness by echocardiography in hypertrophic cardiomyopathy (HCM):
a) Parasternal long axis view by 2D
b) Parasternal long axis view by M-Mode
c) Short axis by 2D
d) None of the above
Correct answer: c) Short axis by 2D
As per the ESC (European Society of Cardiology) 2014 guidelines, short axis 2 dimensional (2D) measurements of all LV segments from base to apex is recommended to measure the maximum thickness of the left ventricular wall in hypertrophic cardiomyopathy. LV maximum thickness is a factor used for risk stratification with a cut off value of 30 millimeters....
Source: Cardiophile MD - May 22, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Echocardiography Source Type: blogs
