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DM / DNB Cardiology Entrance Mock Test 13
In this study, cangrelor was discontinued 1-6 hours prior to surgery, while aspirin was continued throughout the perioperative period. Bridging with cangrelor did not increase major bleeds prior to surgery, though minor bleeds, mostly ecchymosis at venipuncture site, was higher. P2Y12 assay documented sufficient platelet inhibition corresponding to levels required for anti thrombotic effect [1]. Cangrelor is awaiting approval and more large scale trials regarding the use of bridging are needed. Reference 1. Angiolillo DJ et al; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing ...
Source: Cardiophile MD - February 7, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 7
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 7. You scored %%SCORE%% out of %%TOTAL%%. Your performan...
Source: Cardiophile MD - January 23, 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 1
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 This mock test has only 10 questions. Future tests will have more questions depending the user response. 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 complete...
Source: Cardiophile MD - January 15, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Dangerous arrhythmia with WPW syndrome – Cardiology MCQ
Dreaded arrhythmia in association with WPW syndrome (Wolff-Parkinson-White syndrome) is: 1. Orthodromic atrioventricular re-entrant tachycardia (Orthodromic AVRT) 2. Antidromic atrioventricular re-entrant tachycardia (Antidromic AVRT) 3. Atrial fibrillation 4. Atrial flutter Correct answer: 3. Atrial fibrillation Orthodromic AVRT is the commonest arrhythmia in WPW syndrome, while atrial flutter is not an arrhythmia usually associated with WPW syndrome. In orthodromic AVRT, the signal passes down the normal atrioventricular conduction system and back from the ventricle to the atrium by the accessory pathway. Hence the QRS i...
Source: Cardiophile MD - November 16, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance atrial fibrillation irregular wide QRS tachycardia Wolff-Parkinson-White syndrome Source Type: blogs

Cardiology MCQ: Familial WPW syndrome
Gene responsible for familial WPW syndrome: a) KCNJ5 b) HERG c) PRKAG2 d) None of the above Correct Answer: c) PRKAG2 WPW syndrome is characterized by short PR interval, delta wave due to ventricular pre-excitation and consequent arrhythmias. About three percent of WPW syndrome can have a familial occurrence [ Vidaillet HJ, et al. Familial occurrence of accessory atrioventricular pathways (preexcitation syndrome). N Engl J Med 1987;317:65-9]. These familial cases have an autosomal dominant mode of inheritance and the genes responsible were first identified by Gallob MH and associates [Gollob MH et al. Identification of a g...
Source: Cardiophile MD - November 30, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Axis: Bold As Love
Axis determination is one of the most common ECG topics that I see junior doctors (and some senior doctors!) struggling with. Hopefully this tutorial will clear things up… ECG Axis Determination The diagram below illustrates the relationship between QRS axis and the frontal leads of the ECG. Image reproduced from Chung Normal Axis = QRS axis between -30 and +90 degrees. Left Axis Deviation = QRS axis less than -30 degrees. Right Axis Deviation = QRS axis greater than +90 degrees. Extreme Axis Deviation = QRS axis between -90 and 180 degrees (AKA “Northwest Axis”). There are several complem...
Source: Life in the Fast Lane - October 20, 2014 Category: Emergency Medicine Authors: Edward Burns Tags: Cardiology ECG Emergency Medicine axis deviation EKG LAD rad Source Type: blogs

Pacemaker Panic #2
ECG Exigency 016 A 68-year old woman presents by ambulance to the Emergency Department. Per the ambulance crew, she was brought from home after experiencing 7 out of 10 chest discomfort and weakness. She has a history of hypertension that is well controlled with furosemide, and has a pacemaker because her “heart used to go funny.” The ambulance crew are basic life support only, so the patient has received 324mg of aspirin, and oxygen by nasal cannula. Upon arrival she is seated upright on the stretcher breathing rapidly, with the following vitals: heart rate 107, blood pressure 180/110, respirations 20 and slightly lab...
Source: Life in the Fast Lane - September 19, 2014 Category: Emergency Medicine Authors: Mat Goebel Tags: Cardiology Clinical Case ECG Education Emergency Medicine EKG failure hyperkalaemia hyperkalemia pacemaker pacer pacing ppm Source Type: blogs

Structural heart diseases associated with WPW syndrome
Structural heart diseases associated with WPW (Wolff-Parkinson-White Syndrome) syndrome Ebstein’s anomaly, hypertrophic cardiomyopathy, mitral valve prolapse (Source: Cardiophile MD)
Source: Cardiophile MD - July 28, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Ebstein's anomaly Hypertrophic cardiomyopathy mitral valve prolapse Structural heart diseases associated with WPW syndrome Wolff-Parkinson-White syndrome Source Type: blogs

Can atrial fibrillation cause ventricular fibrillation?
Atrial fibrillation is the commonest sustained arrhythmia. In which situation is atrial fibrillation likely to cause ventricular fibrillation? 1. When associated with hyperthyroidism 2. When associated with hypothyroidism 3. When associated with WPW syndrome 4. When associated with mitral stenosis Correct answer: 3. When associated with WPW syndrome In Wolff-Parkinson-White (WPW) syndrome, atrial fibrillation gets conducted to the ventricles both through the normal atrioventricular (AV) conduction system and the accessory pathway. The normal AV conduction system has decremental properties and the refractory period increa...
Source: Cardiophile MD - April 21, 2014 Category: Cardiology Authors: Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Take Me Out to the Ballgame
A 31-year-old man presented to the ED with syncope. He was previously healthy, takes no medications, and had run a marathon the day before. He was riding the light rail home from a baseball game when he developed vague 4/10 epigastric abdominal pain associated with nausea and diaphoresis. He remembers feeling lightheaded and flushed before momentarily passing out. His wife said he became quite pale immediately beforehand. He did not have any headache, chest pain, or shortness of breath before or after the syncopal episode. He has a significant family history of premature coronary artery disease. He had normal vital signs ...
Source: Spontaneous Circulation - October 11, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Take Me Out to the Ballgame
A 31-year-old man presented to the ED with syncope. He was previously healthy, takes no medications, and had run a marathon the day before. He was riding the light rail home from a baseball game when he developed vague 4/10 epigastric abdominal pain associated with nausea and diaphoresis. He remembers feeling lightheaded and flushed before momentarily passing out. His wife said he became quite pale immediately beforehand. He did not have any headache, chest pain, or shortness of breath before or after the syncopal episode. He has a significant family history of premature coronary artery disease. He had normal vital signs...
Source: Spontaneous Circulation - October 11, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Wide Complex Tachycardia
An otherwise healthy woman in her 20's presented with tachycardia. She had experienced palpitations and called 911. Prehospital rhythm strips were at a rate of at least 200 (unavailable) and the medics gave adenosine at both 6 mg and 12 mg with no effect. She was very stable with no CP, SOB, hypotension or evidence of shock.Here is the initial ED ECG:What is the diagnosis (this is pathognomonic)? See below. (Notice that the computer incorrectly read ***Acute MI***)1. The rhythm is irregularly irregular, therefore it is atrial fibrillation2. The complexes are wide (so one might think of atrial f...
Source: Dr. Smith's ECG Blog - March 23, 2013 Category: Cardiology Authors: Steve Smith Source Type: blogs

USMLE Questions – Characteristic Disease Findings
The United States Medical Licensing Examination (USMLE) is designed to emphasize knowledge of clinical scenarios and clinical pearls, even on Step I. Listed below are some commonly encountered disease findings and characteristics. Feature Disease 45, X chromosome Turner’s syndrome 5-HIAA increased in urine Carcinoid syndrome Aganglionic rectum Hirschsrpung’s disease Apple-core sign on barium enema Colon cancer Arched back (opisthotonos) Tetanus Argyll-Robertson pupil Syphilis Ash leaf on forehead Tuberous sclerosis Auer rods Acute myelogenous leukemia Austin Flint murmur Aortic regurgitation...
Source: Inside Surgery - January 18, 2013 Category: Surgeons Authors: Editor Tags: Surgpedia USMLE diseases findings VMA water hammer pulse Source Type: blogs