Notes in BPT QC

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Published	02/05/2025	What is the mechanism of action of midodrine, as used in the treatment of orthostatic hypotension?A. Alpha1-agonistB. Alpha2-agonistC. Beta1- agonistD…
Published	02/19/2025	A patient presents with worsening exertional dyspnoea. The transthoracic echo shows elevated pulmonary pressures with normal LV size and systolic func…
Published	02/05/2025	Which sign is suggestive of aortic root abscess in endocarditis? A. J point depression B. PR prolongation C. ST elevation D. T wav…
Published	02/05/2025	What serum marker is increased with commencement of angiotensin receptor neprilysin inhibitors (ARNI)?A. BNPB. NT-proBNPC. ADHD. Aldosterone
Published	02/05/2025	A 65 year old male has stable angina. Coronary angiogram demonstrates an 80% mid-LAD lesion and a 90% mid-RCA lesion. The next most appropriate manage…
Published	02/05/2025	Which of the following can cause electrical alternans?A. Acute rheumatic feverB. Pericardial effusionC. Takotsubo cardiomyopathyD. Cardiac amyloidosis
Published	02/05/2025	What best describes the relationship between blood pressure and cardiovascular risk?A. ExponentialB. LinearC. U curveD. J curve
Published	02/05/2025	What drug is most likely to cause rebound hypertension when stopped abruptly after chronic use?A. ClonidineB. PrazosinC. MetoprololD. Hydralazine&nbsp…
Published	02/05/2025	Non-invasive ventilation is employed in patients with acute cardiogenic pulmonary oedema. By what mechanism does NIV lead to cardiovascular improvemen…
Published	02/05/2025	A 54 year old man presents with worsening exertional dyspnoea and is found to have pulmonary hypertension with RVSP 76 mmHg (< 33mmHg) on echocardi…
Published	02/05/2025	Ebstein's Anomaly commonly affects which valve?A. PulmonaryB. TricuspidC. AorticD. Mitral
Published	02/05/2025	A 54 year old man has severe aortic regurgitation on echocardiogram. He has no cardiac symptoms. What feature in echocardiography would be the stronge…
Published	02/05/2025	A 17 year old boy presents with group A streptococcal positive acute rheumatic fever, with arthritis, pericarditis and prolonged PR. What is the short…
Published	02/05/2025	A 72 year old man with a history of AF and is known to be a fast CYP2D6 metaboliser with a history of previous codeine toxicity. Which rate control ag…
Published	02/05/2025	A 76 year old male presents with 24 hour history of chest pain. His ECG shows an evolving anterior MI. The next day he has a new diastolic murmur. An …
Published	02/05/2025	What is the most sensitive indicator of cardiac function?A. COB. SVC. SV:COD. SV: EDVE. Ventricular EDV
Published	02/05/2025	What is the main benefit of drug eluting stents vs bare metal stents?A. Reduces risk of early stent stenosisB. Reduces mortalityC. More appropriate fo…
Published	02/05/2025	In patients with non-ST elevated myocardial infarction, all of the following are associated with high risk. Which of the following is at greatest risk…
Published	02/05/2025	An asymptomatic 60 year old man is undergoing an insurance physical. As part of this, he is required to perform an exercise stress test. He manages 9 …
Published	02/05/2025	A 58 year old woman presents with chest pain, BP 80/50 in a rural setting. Her ECG demonstrates an inferior STEMI with complete heart block with a hea…
Published	02/05/2025	Which of the following is the strongest indication for the implantation of a biventricular pacemaker/defibrillator in a patient with heart failure who…
Published	02/05/2025	60 year old lady develops severe central chest pain with radiation to the right arm whilst at a funeral. ECG show left axis deviation, T wave inversio…
Published	02/05/2025	What is the best management for L main CAD?A. CABGB. Optimal medical managementC. PCI + drug eluting stentD. PCI + bare metal stentE. CABG + PCI
Published	02/05/2025	78 year old man presents with new-onset atrial fibrillation. He has a past history of hypertension and diabetes. He has a normal echocardiogram. Which…
Published	02/07/2025	A 83 year old man presents for investigation of chest pain which has been occurring for several weeks. The pain is not associated with any radiation o…
Published	02/07/2025	An 82 year old female with chronic renal impairment (eGFR 30), obesity and COPD presents with shortness of breath. Her plasma BNP is 922 (normal 125).…
Published	02/05/2025	An 80 year old female presents following a syncopal event. Heart rhythm monitoring shows slow AF with a ventricular response rate of 50 bpm. She had p…
Published	02/05/2025	The greatest benefit of cardiac resynchronization therapy over standard implantable cardioverter defibrillator (ICD) in patients with long QRS duratio…
Published	02/05/2025	Which of the following would be the most common symptom in someone presenting with acute myocarditis?A. Chest painB. SyncopeC. FeverD. PalpitationsE. …
Published	02/05/2025	Which area of myocardium is most vulnerable to necrosis with exposure to ischemia?A. Sub-epicardiumB. PerivascularC. PericardiumD. Mid-myocardiumE. Su…
Published	02/05/2025	Cardiovascular risk factor assessment tables are used to assess an individual's cardiovascular risk. Which risk factor contributes the most to cardiov…
Published	02/05/2025	What is the most characteristic ECG finding which differentiates between wide QRS and VT?A. AV dissociationB. QRS > 140C. Bizarre ECG changes neith…
Published	02/05/2025	What is the most common pathogen to cause prosthetic valve endocarditis?A. Coagulase negative staphB. EnterococcusC. HACEKD. Staph aureusE. Strep viri…
Published	02/05/2025	Which blood pressure monitoring correlates best with end-stage organ failure?A. Ambulatory BP monitoringB. Exercise BP monitoringC. Clinic BP monitori…
Published	02/05/2025	What is the best indication for CABG over PCI in multi-vessel disease?A. DiabetesB. Normal LVEFC. AgeD. Previous CABGE. Renal impairment
Published	02/05/2025	Which NSAID has the lowest association with cardiovascular disease?A. IbuprofenB. DiclofenacC. NaproxenD. CelecoxibE. Meloxicam
Published	02/05/2025	What is the most common mechanism for typical atrial flutter?A. Ectopic atrial focusB. Intra-atrial macro re-entry circuitC. Macro re-entry around myo…
Published	02/05/2025	What investigation is most useful in predicting symptomatic response to cardiac resynchronization therapy?A. Cardiac MRIB. EchoC. Coronary angiogramD.…
Published	02/05/2025	An 80 year old female presents diaphoretic and distressed with new onset sternal chest pain radiating through to the back. She has a past history of h…
Published	02/05/2025	An 80 year old female presents diaphoretic and distress with new onset sternal chest pain radiating through to the back. She has a past history of hyp…
Published	02/05/2025	A 70 year old man presents for advice regarding hyperlipidemia. In the recent past he has trialed diet modification and exercise. He has a past histor…
Published	02/05/2025	A 72 year old female presents with syncope. She has a past history of CABG (8 years ago), paroxysmal AF with rapid ventricular rate, hypertension and …
Published	02/05/2025	A middle age gentleman presents with chest pain, a raised JVP and an S3 gallop. The chest is clear to auscultation, however he is hypotensive. The ECG…
Published	02/05/2025	A 42 year old male collapses and has a cardiac arrest in the shopping center. There has been no preceding chest pain, palpitations. His rhythm strip s…
Published	02/05/2025	In general, what is the greatest disadvantage of coronary stenting to CABG?A. High rates of revascularizationB. Post-procedural stroke riskC. Long ter…
Published	02/05/2025	A 70 year old man is in intensive care following admission with a myocardial infarct. He becomes unwell, hypotensive (70/50) and has a decreased level…
Published	02/05/2025	A 68 year old male presents with daily angina despite medical therapy (aspirin, metoprolol, ramipril, nitrate, PRN GTN). He has previously had stable …
Published	02/05/2025	In adults who have had tetralogy of Fallot defects corrected successfully during childhood, what is the most common pathology?A. Aortic stenosisB. Eis…
Published	02/05/2025	Troponin I and Troponin T are preferred for the diagnosis of myocardial infarction because they:A. Are more sensitive than CKMBB. Are the most specifi…
Published	02/05/2025	Cardiovascular risk tables are used to estimate risk of cardiovascular events. Which variable has the greatest impact on absolute risk of cardiovascul…
Published	02/05/2025	Which of the following ECG changes is most characteristic of VTA. AV dissociationB. Bizarre QRS morphology not resembling RBBB/LBBBC. QRS duration &gt…
Published	02/19/2025	Which valve defect is most commonly associated with infective endocarditis?A. Mitral stenosisB. Mitral valve prolapseC. Aortic stenosisD. Tricuspid re…
Published	02/05/2025	Which of the following agent has the greatest effect on the left ventricular function in a patient with congestive heart failure?A. ACEIB. Beta blocke…
Published	02/05/2025	A 50 year old man with a history of heart failure but normal renal function was commenced on digoxin. How long after the first dose of digoxin should …
Published	02/07/2025	A 30 year old man presents with tricyclic antidepressant overdose. His ECG reveals broad QRS complexes (QRS 140ms). Which of the following is most imp…
Published	02/05/2025	A patient presents with shortness of breath and oedema. His jugular venous pressure is raised and a parasternal heave is present. His chest is clear. …
Published	02/05/2025	Patient had an out of hospital VF arrest, was defibrillated and continued CPR with no change in rhythm. He was given two doses of adrenaline. Which of…
Published	02/05/2025	What is the most important factor in determining the success of thrombolysis?A. Male genderB. Location of the coronary occlusionC. Fibrin specificity …
Published	02/05/2025	An 83 year old woman has heart failure with and LVEF of 38%. She has an implantable cardiac defibrillator and is on enalapril 10mg daily, carvedilol 2…
Published	02/05/2025	A 70 year old man with a permanent pacemaker for complete heart block presents with syncope. Which of the following will cause electromagnetic interfe…
Published	02/05/2025	Cardiovascular treatment trials often report composite end points of "major adverse cardiac events". Of these events which is the most subject to bias…
Published	02/19/2025	A 30 year old lady presented to you with persistent high blood pressure. She takes the contraceptive pill and amlodipine. No other significant medical…
Published	02/05/2025	Which drug is most likely to maintain sinus rhythm following direct current cardioversion for atrial fibrillation?A. MetoprololB. DigoxinC. SotalolD. …
Published	02/05/2025	In a 79 year old man with a blood pressure of 170/90, according to current evidence, what is the most effective and most cost-effective antihypertensi…
Published	02/05/2025	A 59 year old lady with stable coronary disease presents to her doctor for review. She has been on ramipril, atorvastatin and aspirin for 5 years. She…
Published	02/05/2025	A patient with congestive cardiac failure with an ejection fraction of 35% is referred for medical optimization. He is already on stable B-blocker the…
Published	02/05/2025	Following an anterior STEMI what is the most likely mechanism for developing shock?A. LV pump failureB. Cardiac tamponadeC. Papillary muscle ruptureD.…
Published	02/19/2025	What is the most likely cause of out of hospital cardiac arrest for a 45 year old man?A. Arrhythmogenic right ventricular dysplasiaB. Long QT syndrome…
Published	02/05/2025	What is the most likely cardiovascular complication in a patient following successful stenting of a coronary artery with a drug eluting stent?A. Late …
Published	02/05/2025	Acute rheumatic fever is a non-suppurative complication of group A streptococcus infection. Which of the following ECG changes can be used to support …
Published	02/05/2025	A 70 year old gentleman presents with CCF and LVEF of 30%. He has a history of paroxysmal AF. What is the most appropriate treatment for his atrial fi…
Published	02/05/2025	A 35 year old lady presents with a 6-9 month history of dyspnoea on climbing stairs. She has been on the oral contraceptive pill for 10 years. On exam…
Published	02/05/2025	A patient with hypertrophic cardiomyopathy presents with cardiogenic shock. His observations are:HR 105/min, sinus rhythmBP 85/60mmHgSpO2 92% on 6L vi…
Published	02/07/2025	Patients with suspected angina may be investigated with non-invasive anatomical tests (CT angiography) or functional tests (exercise ECG, stress echoc…
Published	02/05/2025	Regarding cardioversion for patients with atrial fibrillation, which of the following statements is most correct?A. Amiodarone is contraindicated in p…
Published	02/05/2025	Which form of dilated cardiomyopathy has the best prognosis for recovery with medical therapy?A. Chemotherapy induced cardiomyopathyB. HIV induced car…
Published	02/05/2025	Which of the following is the strongest indication for the implantation of a biventricular pacemaker defibrillator in a patient with heart failure who…
Published	02/05/2025	In a patient with significant left main coronary artery stenosis, what is the best treatment option?A. CABGB. Medical treatmentC. Bare metal stentD. D…
Published	02/05/2025	An 83 year old male presents for investigation of chest pain which has been ocurring for several weeks. The pain is not associated with any radiation …
Published	02/05/2025	An 82 year old female with chronic renal impairment (estimated GFR 30), obesity and COPD presents with shortness of breath. Her plasma BNP is 922 (nor…
Published	02/07/2025	An 80 year old female presents following a syncopal event. Heart rhythm monitoring shows slow AF with a ventricular response rate of 50 bpm. She had p…
Published	02/05/2025	Increased release of which of the following hormones is most likely to increase food intake?A. AdoponectinB. GhrelinC. Glucagon-like peptide 1 (GLP1)D…
Published	02/05/2025	Which of the following best explains early morning low testosterone levels in non-diabetic obese males?A. Low physical activityB. Low sex hormone bind…
Published	02/05/2025	Which of the following 100g contains the highest calories?A. 60% alcoholB. Animal proteinC. CarbohydratesD. Poly-saturated fatE. Soft drink
Published	02/05/2025	Which is the most common side effect of high dose prednisone?A. DepressionB. ManiaC. PsychosisD. InsomniaE. Delirium
Published	02/05/2025	What is the main reason for tight BSL control in a woman with gestational diabetes?A. Reduce congenital malformationB. Reduce miscarriage ratesC. Redu…
Published	02/05/2025	Which of the following would give the greatest level when measured at midnight in comparison to 8am level?A. AdrenalineB. CortisolC. InsulinD. Growth …
Published	02/05/2025	Patient has pan-hypopituitarism and is currently on thyroxine 100mcg daily, prednisone 5mg daily and testosterone replacement. The addition of which o…
Published	02/05/2025	An 81 year old woman presents with new and ongoing seizures and confusion. She was recently discharge following an admission with Herpes Zoster, treat…
Published	02/19/2025	A 38 year old woman is found to have an 8mm pituitary adenoma on MRI brain while being investigated for the cause of chronic headaches. Pituitary func…
Published	02/05/2025	A 48 year old type 2 diabetic man, diet controlled, obese, with fasting BSL at home ranging 9-12, with post prandial 6-11. What is the most likely cau…
Published	02/05/2025	What is the reason for measuring thyroid stimulating antibodies in the third trimester of pregnant in a woman with Graves Disease?A. To check whether …
Published	02/05/2025	A 42 year old man with type 1 diabetes for 20 years, nephropathy, presents with recent onset trouble using his fingers with thickening of the tendons …
Published	02/09/2025	What predisposes someone to greater risk of developing type 1 diabetes mellitus?A. Father with type 1 diabetesB. Mother with type 1 diabetesC. Autoimm…
Published	02/05/2025	A 72 year old man presents with hypotension, lethargy and decreased libido. Examination reveals reduced facial and body hair, bilaterally small firm t…
Published	02/05/2025	In diabetic ketoacidosis, what is the mechanism of hyponatremia?A. Syndrome of inappropriate anti-diuretic hormone secretionB. Extrarenal sodium loss …
Published	02/05/2025	The best clinical explanation for the glucose lowering effect of exanetide (GLP-1 analogue) is?A. Delayed gastric emptyingB. Increased glucagon secret…
Published	02/05/2025	A 55 year old male with 12 year history of T2DM complains of pain in his feet. It is worse at night. He describes it as a burning sensation. He can't …
Published	02/19/2025	Osteonecrosis of the jaw is a rare disorder of bisphosphonates. What is the greatest risk factor for ONJ?A. Advanced ageB. Mode of delivery (IV vs PO)…
Published	02/05/2025	A 32 year old woman presents with headache and a BP of 220/120. The following investigations were performed:Urine- Cortisol 74 (10 - 55)- Adrenaline 8…
Published	02/05/2025	A 43-year-old alcoholic man is found to have anemia. His blood film shows numerous spur cells and moderate thrombocytopenia. Which of the followi…
Published	02/05/2025	A 54 year old woman presents with a lump in her neck, increasing size over 3 weeks. Examination reveals a diffuse enlarged thyroid and a prominent 2cm…
Published	02/09/2025	A 25 year old male comes to see you because he is concerned about his infertility. He is 1.8m tall and weights 70kg. He has no facial hair, but has ax…
Published	02/05/2025	A 38 year old lady presents to ED with her first episode of diabetic ketoacidosis with a pH of 7.20 and BSL 25. There are no known precipitating facto…
Published	02/05/2025	In a normal person, which of the following is most likely to cause a decrease in circulating growth hormone concentration?A. Slow wave sleepB. Hypergl…
Published	02/05/2025	Glucagon-like peptide-1, secreted post-prandially by the L cells in the intestine, increases which of the following?A. Gastric emptyingB. Body weightC…
Published	02/05/2025	Which of the following hormones is likely to be at its highest level during the luteal phase compared with any other time of the menstrual cycle?A. Lu…
Published	02/09/2025	In the average person, which of the following accounts for the greatest amount of daily energy expenditure?A. Fat mass metabolismB. Basal metabolic pr…
Published	02/05/2025	A 31 year old women presents with absence of menstrual periods since stopping the oral contraceptive pill five months ago. She has the following inves…
Published	02/05/2025	Which of the following most frequently causes hypoglycemia in patients with diabetes?A. PioglitazoneB. GlibenclamideC. MetforminD. AcarboseE. Sitaglip…
Published	02/05/2025	A 52 year old mane with type 2 diabetes has been non-specifically unwell for a week. He underwent a resection of a craniopharyngioma nine months ago. …
Published	02/05/2025	A 60 year old male presents with central weight gain, hypertension and diabetes. He has a history of asthma treated with inhaled corticosteroids. He d…
Published	02/05/2025	A 35 year old woman with type 1 diabetes since age 14 is reviewed. She reports three episodes of hypoglycemia with levels <3.0 mmol/L during the ni…
Published	02/05/2025	Which of the following agents is most likely to induce weight loss when used to treat type 2 diabetes mellitus?A. AcarboseB. Glargine insulinC. Glimep…
Published	02/05/2025	Which of the following drug classes is most likely to lead to the onset of type 2 diabetes?A. Atypical anti-psychotic drugsB. Beta blockersC. Thiazide…
Published	02/05/2025	A 65 year old man presents with a history of paroxysmal atrial tachycardia who has been treated with amiodarone for 5 years, he presents with worsenin…
Published	02/19/2025	A 43 year old woman presents with a six month history of hypertension which has been difficult to control. She is now taking three agents for her bloo…
Published	02/05/2025	Which of the following counter-regulatory factors is released earliest in response to hypoglycemia?A. AdrenalineB. CortisolC. NoradrenalineD. Growth h…
Published	02/05/2025	Which of the following has the greatest effect on peak bone mass?A. Pubertal ageB. Childhood calcium intakeC. Genetic factorD. Childhood physical acti…
Published	02/05/2025	A 16 year old male presents with short stature. Which of the following findings is most suggestive of growth hormone deficiency?A. Reduced growth velo…
Published	02/05/2025	A patient presenting to the Emergency Department is thought to have acute intermittent porphyria. Which of the following is most suggestive of an alte…
Published	02/05/2025	In a patient with Type 2 diabetes, which of the following co-existing clinical situations is the strongest contraindication to the use of a thiazolidi…
Published	02/09/2025	A 65 year old woman with longstanding rheumatoid arthritis and osteoporosis presents with a mid-thoracic crush fracture, She has a history of two prev…
Published	02/19/2025	In patients with Type 1 diabetes mellitus, the greatest benefit in using a long-acting insulin analogue is in reducing which of the following?A. Diabe…
Published	02/07/2025	A 25 year old has adrenocorticotrophic hormone dependent Cushing's Syndrome. He has a normal MRI scan of the pituitary fossa. Which of the following i…
Published	02/05/2025	A 51 year old man presents with unstable angina. His mother died at age 58 years as a result of a myocardial infarction and his 48 year old brother, w…
Published	02/05/2025	In the Western population, body mass index (BMI) has significantly increased over the past 40 years in all age groups. Most of this is accounted for b…
Published	02/05/2025	In women with Graves Disease, which of the following is associated with an increased relative risk of developing Grave's ophthalmopathy?A. PregnancyB.…
Published	02/19/2025	A 58 year old smoker presents with a new diagnosis of hypertension. His BP has been difficult to control with levels of 190/110 despite amlodipine 10m…
Published	02/05/2025	A patient with pan-hypopituitarism is on quarterly testosterone injection, daily 100mcg thyroxine, prednisone 5mg daily, desmopressin 200mcg BD. Addit…
Published	02/05/2025	The primary mechanism by which parathyroid hormone increases serum calcium is by:A. Decreased renal tubular reabsorption of calciumB. Decreased renal …
Published	02/05/2025	A 28 year old presents to her GP for a routine check up. Results of her thyroid function tests are shown:T4 29.6 (mildly raised)TSH 1.2 (within normal…
Published	02/05/2025	A 55 year old woman presents to her GP with a history of recurrent headaches. Her GP requests a CT brain which demonstrates a 6mm round pituitary mass…
Published	02/09/2025	A 67 year old lady presented with fatigue, lethargy and pre-tibial pitting oedema. She had a history of Hashimotoʼs hypothyroidism, on 300mcg thyroxin…
Published	02/05/2025	You are asked to review a middle-aged gentleman who has recently been gaining weight despite being on maximal biguanide and sulphonylurea for his Type…
Published	02/05/2025	A 60 year old woman presents with lethargy and polyuria.Results of her investigations are as follows:Ca2+ 2.86 [2.20 – 2.55]PTH 20 pmol/L [1.3 – 7.6]P…
Published	02/05/2025	A 70 year old man presents to your diabetes clinic. You discover that his EtOH drinking is high risk. What is the most appropriate next step?A. Conduc…
Published	02/05/2025	A 30 year old lady with Type 1 Diabetes Mellitus is currently on 10 units of short acting insulin with meals and 30 units of long acting insulin at ni…
Published	02/05/2025	Which factor is the strongest indication for surgery in native valve bacterial endocarditis?A. Intravenous drug use and valve endocarditisB. Mobile ve…
Published	02/05/2025	A 54 year old man presents with sudden onset palpitations and is found to be in atrial fibrillation. The decision is made to attempt pharmacological c…
Published	02/05/2025	An 86 year old patient is admitted to hospital with a chest infection. She has chronic atrial fibrillation with previous cardioembolic left middle cer…
Published	02/05/2025	By which mechanism does dobutamine predominately increase cardiac output?A. Activation of cell surface dopamine receptorsB. Inhibitions of alpha-adren…
Published	02/05/2025	Which of the following is a relative contraindication to the use of adenosine in supraventricular tachycardia?A. Child-Pugh C cirrhosisB. End-stage ch…
Published	02/05/2025	Cardiac relaxation is an active process. Which protein is the major component of active cardiac relaxation?A. ActinB. RelaxinC. TelethoninD. TitinE. T…
Published	02/05/2025	A 47-year-old female is found to be hypertensive on a 24 hour ambulatory blood pressure monitor with an average systolic pressure of 145. She has a ba…
Published	02/05/2025	Which of the following conditions is most associated with silent myocardial infarction due to atherosclerosis?A. HypertriglyceridemiaB. SmokingC. Obes…
Published	02/05/2025	An 86-year-old man is diagnosed with Atrial Fibrillation. Which of the following represents the strongest contra-indication to the use of Dabigatran?A…
Published	02/05/2025	Many of the risk factors for atherosclerosis are also risk factors for Abdominal Aortic Aneurysms. Which of these risk factors confers the greatest ri…
Published	02/05/2025	What is the JVP waveform is seen in Complete Heart Block?A. Cannon waves B. Prominent a wavesC. Steep y descentD. Slow X descentE. Peaked c waves
Published	02/05/2025	Impaired movement of which of the following ions is implicated in torsades de pointes?A. SodiumB. PotassiumC. ChlorideD. CalciumE. Magnesium
Published	02/05/2025	Which of the following is a substrate for neprilysin, the neutral endopeptidase?A. AngiotensinogenB. AldosteroneC. ReninD. BradykininE. Kallikrein
Published	02/05/2025	Which of the following is most suggestive of diastolic heart failure on transthoracic echocardiography?A. Reduced fractional shorteningB. E/A ratio of…
Published	02/05/2025	61yo male presents with haematemesis of 100ml. He had an NSTEMI 2 weeks ago and 3 bare metal stents were inserted. His discharge meds were aspirin, cl…
Published	02/05/2025	A 45-year-old man has recurrent syncope when standing for long periods and when seeing noxious stimuli like blood. What is an indication for cardiac p…
Published	02/05/2025	A 76 year old man presented to ED with central tearing chest pain. Aortic dissection was confirmed on CT. His BP was 164/70 and his HR was 68. What is…
Published	02/05/2025	A 50 year old man with a history of mild hypertension on a beta blocker presents with new onset angina, with his chest pain responding to aspirin. He …
Published	02/05/2025	An otherwise well 82 year old female is investigated for an incidental heart murmur. She describes symptoms of dyspnoea only on marked exertion. A tra…
Published	02/05/2025	Intracellular sodium movement is responsible for which part of the cardiac action potential A. Phase 0B. Phase 1C. Phase 2D. Phase 3E. Phase 4
Published	02/05/2025	In heart failure, what significant alteration changes the cardio myocytes excitation-contraction function that impairs myocytes contractility?A. Cardi…
Published	02/05/2025	What is the most common cause of abnormally large U waves on ECG? A. AcidosisB. HypothermiaC. Myocardial IschaemiaD. HypokalaemiaE. Left Ventricu…
Published	02/05/2025	Which of the following is most suggestive of a non-cardiogenic cause of pulmonary oedema?A. Normal left ventricular function on echocardiogramB. Norma…
Published	02/05/2025	Atrial fibrillation is caused by multiple micro re-entrant pathways. These arise adjacent to which structure?A. AV nodeB. Carotid sinusC. Pulmonary ve…
Published	02/05/2025	A 78 year old man with chronic AF is admitted with urosepsis. His BP is 140/80 and heart rate is 150. What is the most appropriate management of his A…
Published	02/05/2025	When delivering shocks to perform electrical cardioversion the synchronization function is used to shock appropriately. At which part of the ECG is th…
Published	02/05/2025	What is the most common long-term complication of successful surgical repair of Tetralogy of Fallot?A. Pulmonary incompetenceB. Tricuspid regurgitatio…
Published	02/05/2025	What occurs patho-physiologically during vasovagal syncope?A. Increased parasympathetic, increased sympathetic toneB. Decreased parasympathetic, decre…
Published	02/05/2025	56 year old male presents with chest pain. He has long standing angina that settles with aspirin. His last stress test was positive at high workload. …
Published	02/05/2025	An 80 year old woman with known chronic heart failure presents with acute decompensated heart failure. She has a background of osteoporosis, chronic p…
Published	02/05/2025	Which of these changes is associated with normal aging?A. reduced resting stroke volumeB. reduced resting ejection fractionC. increased resting heart …
Published	02/05/2025	During cardiac catheterisation several measurements of LV systolic function are made. These are often influenced by preload and afterload. Which one o…
Published	02/05/2025	Patients with atrial fibrillation are at increased risk of stroke. Of the following, which feature carries the highest risk?A. HypertensionB. Congesti…
Published	02/05/2025	A 60 year old gentleman who has a heavy smoking history presents with weight loss andconfusion. CT chest reveals a left lower lobe lesion with mediast…
Published	02/05/2025	Abnormalities in which one of the following genes or proteins is most closely associated with the development of drug resistance during chemother…
Published	02/05/2025	A 75 year-old man with non-small cell lung cancer and mild chronic renal failure (his serumcreatinine is usually 0.15 mmol/L [0.06-0.12]) is recoverin…
Published	02/05/2025	22-year-old man is evaluated post resection of a stage I nonseminomatous testicular germ cell tumour with no vascular invasion (low risk). The mo…
Published	02/05/2025	A patient with metastatic adenocarcinoma of unknown primary involving liver and bone presents with back pain, urinary incontinence and altered sensati…
Published	02/05/2025	A 23 year old man is found to have elevated plasma metanephrins (5x the upper limit of normal) and a unilateral 4cm adrenal mass upon investigation fo…
Published	02/05/2025	A 38 year old woman treated for advanced melanoma with pembrolizumab (anti-PD1 antibody) presents with new onset fatigue, generalized weakness, diarrh…
Published	02/05/2025	A patient has been diagnosed with Glioblastoma Multiforme and has had debulking surgery performed. What is the next best management step to improve su…
Published	02/19/2025	55 yr old female with a history of node positive cancer, managed with resection and chemotherapy. She is found to have a liver lesion a few years late…
Published	02/09/2025	A few hours after completing the Auckland marathon a 24 year old is taken to the Emergency Department by her concerned partner on account of increasin…
Published	02/05/2025	What is the most common form of thyroid cancer?A. MedullaryB. FollicularC. PapillaryD. AnaplasticE. Squamous Cell
Published	02/05/2025	A 64 year old woman with treated hypertension was found to have a right adrenal lesion by CT imaging when investigating for cholelithiasis 2 years pre…
Published	02/05/2025	A 22 year old university student was diagnosed with type 1 diabetes 12 years ago and treated with multiple daily injections of insulin (basal insulin …
Published	02/05/2025	What is the most common presenting symptom of pituitary apoplexy?A. DiplopiaB. HeadacheC. Neck stiffnessD. VertigoE. Visual loss
Published	02/05/2025	To diagnose type 2 diabetes mellitus in an asymptomatic patient, the patient must fulfil two diagnostic criteria, measured on separate days. What is t…
Published	02/05/2025	An 86 year old lady with hypertension, type 2 diabetes and osteoporosis is found to have mild primary hyperparathyroidism. Her usual medications are m…
Published	02/19/2025	The pharmacokinetic properties of which analogue insulin are largely determined by binding to and dissociation from serum albumin?A. Aspart (Novorapid…
Published	02/05/2025	Patients should be considered for investigation for secondary causes of osteoporosis if their Z score is less than -2.0. Assuming normal distribution …
Published	02/05/2025	In addition to glucagon, which hormones counterregulatory hypoglycaemia?A. Adrenaline, cortisol, growth hormoneB.  Adrenocorticotrophic hormone (…
Published	02/05/2025	An elderly lady presents to ED and is found to be hyponatraemic. She is on each of the following medications. Which of the following is the most likel…
Published	02/05/2025	A 25-year-old pregnant woman presents to the emergency department 12 weeks into her pregnancy with nausea, vomiting, a fine tremor and a HR of 115. Th…
Published	02/05/2025	Which form of insulin has the longest half-life?A. Glargine (Optisulin/Lantus)B. Aspart (Novorapid/Novolog)C. Lispro (Humalog)D. Isophane (Protophane)…
Published	02/05/2025	A 46-year-old woman with known Addison's disease presents with fever, flank pain and dysuria. Her HR is 102bpm and BP is 120/84 mm Hg. She is admitted…
Published	02/05/2025	A 60-year-old female presents with an eight-month history of headaches, galactorrhea and amenorrhoea. She is hypotensive. You are suspecting pituitary…
Published	02/05/2025	A 75-year-old woman with back pain has a DEXA scan to investigate for osteoporosis. The T score results are shown below:- Lumbar + 0.5- Radial - 2.6- …
Published	02/05/2025	A 36-year-old female presents with several months of amenorrhea. She is slightly overweight but not tanned. She is clinically euthyroid with no eviden…
Published	02/05/2025	Which of the following is most associated with Carbimazole?A. Aseptic MeningitisB. AgranulocytosisC. Interstitial NephritisD. Sensorineural hearing lo…
Published	02/05/2025	Within the pancreatic beta islet cell, the sulphonylurea class of medications act upon which of the following?A. AMP kinase enzymeB. ATP sensitive pot…
Published	02/05/2025	Insulin is stored in vesicles within the pancreatic beta cell which is then released in response to rising blood glucose. In which molecular form is i…
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