MRCP Cardiology MCQs

Brennan Stephen

• Publisher: CRC Press
• Year: 2018
• ISBN:
  9781315357836
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Cardiology is a large and critical branch of internal medicine, and as such covers a vast amount of the knowledge tested in Membership of the Royal Colleges of Physicians (MRCP) exams. This study guide contains 150 multiple choice questions (MCQs), each with various numbers of stem answers. The questions cover a wide range of both cardiology and cardiovascular pharmacology and encompass both basic anatomy and physiology of the heart, through to advanced topics such as evidence-based medicine. The questions are supplemented at the back of the book with explanatory answers to aid further revision and study.

SECTION 1

Cardiovascular pharmacology

Cardiac glycosides

Q1 Digoxin:

a Shortens the PR interval

b Should be stopped prior to elective DC cardioversion

c May cause atrial fibrillation

d May cause false-positive results on exercise testing

e Can only be administered orally

Q2 Digoxin toxicity:

a May cause ventricular fibrillation

b May cause ventricular tachycardia

c May cause atrial fibrillation

d May be precipitated by hypokalaemia

e May be precipitated by hypercalcaemia

Q3 Digoxin:

a Acts by inhibiting the enzyme H/K-ATPase

b Has a positive chronotropic effect

c Has a negative inotropic effect

d In high doses, increases the sympathetic outflow from the central nervous system

e Peak serum concentrations occur in 20–30 minutes

Q4 Digoxin:

a Reduces mortality in cardiac failure

b May be used as a second-line agent in WPW syndrome

c Withdrawal of digoxin from patients with chronic heart failure may be associated with cardiac decompensation

d Toxicity treated with Digibind may result in hyperkalaemia

e Toxicity does not occur if the plasma concentration levels are in the correct therapeutic range

Q5 Digoxin toxicity may be precipitated by:

a A creatinine level of 180 mmol/L

b A potassium level of 6.2 mmol/L

c Co-administration of verapamil

d Co-administration of warfarin

e Acute lobar pneumonia

Q6 Which of the following occur following regular digoxin medication?

a Increased force and rate of contraction

b Decreased heart rate

c Increased automaticity

d a and b

e All of the above

Q7 Digoxin causes which of the following ECG changes?

a T-wave flattening

b Prolonged PR interval

c Shortened QT interval

d Tenting of the T-wave

Q8 Digoxin causes which of the following physiological effects?

a Decreasing aldosterone levels

b Direct renal vasodilation

c Inhibiting ADH levels

d Increasing cardiac output

Diuretics

Q9 Frusemide:

a Is a short-acting thiazide diuretic

b Typically causes hypercalcaemia

c May precipitate digoxin toxicity

d Acts on the descending limb of the Loop of Henle

e May cause glucose intolerance

Q10 Thiazide diuretics cause the following electrolyte disturbances:

a Hypoglycaemia

b Hyponatraemia

c Hypokalaemia

d Hypocalcaemia

e Hypouricaemia

Q11 The cardiotoxic effects of digoxin are enhanced in the presence of:

a Hyperkalaemia

b Hypercalcaemia

c Alkalosis

d Hypokalaemia

e Hyperchloraemia

Q12 Metolazone:

a Is only active by the IV route

b Is an orally active loop diuretic

c Acts synergistically with frusemide

d Is contraindicated in renal failure

e Is licenced for acute pulmonary oedema

Q13 Bendrofluazide:

a Is initially started at 5 mg daily in the management of hypertension

b Is a long-acting loop diuretic

c Tends to cause hyponatraemia, hypocalcaemia, and hyperuricaemia

d Male impotence is a rare side effect

e May be given as an IV bolus in acute pulmonary oedema

Q14 Spironolactone:

a Is a long-acting thiazide diuretic

b May cause hyperkalaemia

c Is a first-line agent for essential hypertension

d Is used in the treatment of Conn’s syndrome

e Has no role in the management of ascites secondary to alcoholic cirrhosis

Beta-adrenoceptor blocking drugs

Q15 Propranolol is contraindicated in the presence of:

a Complete heart block

b Peripheral vascular disease

c Diabetes mellitus

d Atrial fibrillation

e Asthma

Q16 Cardioselective beta-blockers are contraindicated in: a Asthma

a Diabetes mellitus

b Male erectile impotence

c Peripheral vascular disease

d Migraines

Q17 The rationale for giving atenolol with nicardipine in treating hypertension is ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Preface
• About the author
• Acknowledgement
• SECTION 1 Cardiovascular pharmacology
• SECTION 2 Cardiology
• Index