Beruflich Dokumente
Kultur Dokumente
Exam Revision
Work Smart
Scores
Community
Work Hard
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
j
k
l
m
n
Hyperthyroidism
i
j
k
l
m
n
j
k
l
m
n
Peripheral neuropathy
i
j
k
l
m
n
j
k
l
m
n
Hepatitis
j
k
l
m
n
i
j
k
l
m
n
Hypothyroidism
i
j
k
l
m
n
j
k
l
m
n
Photosensitivity
Correct
Correct
Correct
Correct
Amiodarone is a potent anti-arrhythmic useful in all forms of dysrhythmias. Caution is required in renal
impairment and there is a risk of thyroid dysfunction with accumulation of iodine. It enhances the effects of
Warfarin and increased Digoxin, Phenytoin and Cyclosporin levels. There is an increased risk of bradycardia
and AV block and myocardial depression with betablockers and calcium channel blockers. Toxicity is increased
if hypokalaemia occurs with diuretics. Reversible corneal microdeposits, optic neuritis, peripheral neuropathy
Score:
Total Answered:
and myopathy, bradycardia and conduction disturbances, phototoxicity, and rarely a persistent slate grey
discolouration, hypo and hyperthyroidism, diffuse pulmonary alveolitis in pneumonitis and fibrosis, disturbed
liver function tests, jaundice, hepatitis and cirrhosis are all reported.
Copyright 2002 Dr Colin Melville
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
An 18 month old girl presents with stridor at 1 am. She has had a cold for 48 hours, with low-grade fever, but
went to bed as usual at 7.30pm. She awoke 4 hours later crying and distressed, with a barking cough.
What is the most likely diagnosis?
(Please select 1 option)
j
k
l
m
n
Allergic rhinitis
j
k
l
m
n
Asthma
j
k
l
m
n
Croup
i
j
k
l
m
n
Gastroesophageal reflux
j
k
l
m
n
Sinusitis
Classical history of viral croup. Most of these episodes are one-off and settle rapidly without treatment or with
dexamethasone orally.
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
He requires a diuretic
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Correct
Correct
Incorrect answer selected
Correct
Score:
Total Answered:
Ventricular septal defects cause shunting of oxygenated blood from the left ventricle to the right.
Cyanosis is a later occurrence - following the development of Eisenmenger's syndrome, that is, shunt reversal.
Tag Question
Remove Tag
Cyanotic congenital heart disease requires surgical correction of vascular or shunt anomalies.
Remove question
The differential diagnosis of cyanosis and congestive cardiac failure in neonates includes
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
Which one of the following is/are true of sudden infant death syndrome?
True / False
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
It is the commonest cause of death in infants aged 1-2 months in this country.
selected
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
There is a tenfold increased risk of sudden infant death to siblings of children with SIDS.
Correct
Correct
Incorrect answer
Correct
Correct
Score:
There is a twice normal risk of SIDS in siblings and low birth weight/premature infants.
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
A 10-year-old boy is referred with heart murmur. He has collapsed on one occasion after energetic sport, but
recovered quickly and has otherwise been well. Full term normal delivery with no neonatal complications.
Immunisations up to date. There is no FH/SH of note.
On examination he is well and on the 75% for height and weight. Respiratory rate is 15/min and pulse 85/min
and blood pressure is 100/60 mmHg. Pulse volume is low, but equal in all 4 limbs. He has a carotid thrill and 3/6
ejection systolic murmur best heard at the upper sternum and conducted into the neck. No liver is palpable.
What is the most likely diagnosis?
(Please select 1 option)
j
k
l
m
n
Aortic coarctation
i
j
k
l
m
n
Aortic stenosis
j
k
l
m
n
Score:
j
k
l
m
n
Total Answered:
j
k
l
m
n
Simple faint
Correct
The history of collapse, plateau pulses and characteristic murmur all point to aortic stenosis as the diagnosis. This
Tag Question
requires detailed assessment with echocardiography, ECG and Chest X-ray. It may be amenable to balloon valvuloplasty,
which may help delay the need for surgery until he is fully grown. Valve replacement is usually required in symptomatic
Remove Tag
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
A 9-year-old girl presents with throat discomfort and cough, particularly during the daytime. She has been well
over the winter, with symptoms worsening in the Spring. Full term normal delivery with no neonatal
complications. Immunisations up to date. There is no FH/SH of note.
On examination she is apyrexial and well. She is constantly clearing her throat, and has a clear nasal
discharge. She has no cervical lymphadenopathy. Her throat is minimally injected, and ear examination is
normal.
Select themost likely diagnosis?
(Please select 1 option)
i
j
k
l
m
n
Asthma
j
k
l
m
n
Foreign body
j
k
l
m
n
Infectious mononucleosis
Score:
j
k
l
m
n
Paratonsillar abscess
Total Answered:
j
k
l
m
n
Postnasal drip
The history is of nasal discharge and cough, worse since Spring. This points to allergens rather than infection
Tag Question
as the underlying cause. A postnasal drip is the likely culprit for these symptoms, which may also disturb sleep
because of cough. Treatment of the underlying problem with antihistamines and topical steroids is indicated.
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
Theme: Apnoea
A
Blood cultures
CSF culture
CT scan head
EEG
pH studies
Score:
A 5 day old girl presents to casualty following a brief apnoeic episode. On examination she is apyrexial,
sweating, has a high-pitched cry and is difficult to settle.
Total Answered:
CSF culture
Tag Question
Remove Tag
A 4 month old girl presents with a 12 hour history of poor feeding and fever. She is rushed to hospital after she
stops breathing. On examination she has an Oxygen saturation of 94%, and responds to pain. Serum glucose
is 3.4 mmol/l.
pH studies
A 5 month old boy has a 2 day history of coryza and poor feeding. On the day of admission he has a brief
period of apnoea and is rushed to hospital. On examination he has 2 cm hepatomegaly and a blood glucose of
0.8 mmol/l.
Urine metabolic screen
Correct
The 5 month old presents with apnoea associated with mild infection and hypoglycaemia. This points to a metabolic
cause, and a metabolic screen should be most helpful.
Next question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Correct
Correct
Incorrect answer selected
Correct
Correct
Marfan's syndrome is a connective tissue disease with an autosomal dominant inheritance and an incidence of
4-6 per 100 000.
Score:
People with Marfan's syndrome used to have a life expectancy reduced by 50% but this is now changing
because of improved treatment of cardiovascular abnormalities such as mitral valve prolapse and aortic
Total Answered:
dissection.
In about 25% it is the result of spontaneous mutation.
Tag Question
Marfan syndrome
Remove question
Next question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
In ventricular septal defect (VSD) which of the following statements is/are true?
(Please select 1 option)
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Correct
Large defects may be associated with soft murmurs; right to left shunting causes cerebral abscesses.
Diastolic murmur occurs due to aortic incompetence (5%) or increased flow across the mitral valve and relative
Score:
mitral stenosis.
Total Answered:
Although pulmonary hypertension may occur in association with increased flow across the shunt, it may indicate
decreased flow across the shunt and increased pulmonary vascular resistance in which case the murmur would
be softer.
Tag Question
The risk of bacterial endocarditis is high in this lesion and even greater with haemodynamically trivial lesions.
Remove Tag
Next question
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
i
j
k
l
m
n
Correct
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Most babies with cyanotic congenital heart disease are small for gestational age
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Correct
Incorrect answer
Correct
Congenital heart disease occurs in 3-12 per thousand live births and many conditions such as ventricular
septal defect and tetralogy of Fallot may present in infancy, with 50% presenting in infancy and the rest
presenting later in life (sometimes in adulthood eg atrial septal defect). Growth failure is masked by fluid
retention and reduced urine volume which leads to inappropriate weight gain. Pulmonary stenosis is associated
Score:
Total Answered:
with Noonan's syndrome (chromosome 12q24.1 defect) but this will not show up on normal karyotyping; it also
occurs in congenital Rubella, connective tissue disorders and William's syndrome-not chromosomal
abnormalities. In females of XO karyotype coarctation and bicuspid aortic valve may occur. Fallots tetralogy
Tag Question
typically presents with hypercyanotic spells characterised by anxiety, air hunger and respiratory distress
Remove Tag
Next question
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Correct
j
k
l
m
n
i
j
k
l
m
n
Correct
j
k
l
m
n
i
j
k
l
m
n
Cyanosis
i
j
k
l
m
n
j
k
l
m
n
Correct
Correct
Incorrect answer selected
A small ventricular septal defect is classically associated with the holosystolic murmur at the left sternal edge.
The risk of infective endocarditis is greater in haemodynamically insignificant defects. The second heart sound
may be obscured by the murmur, but is normally split. Cyanosis occurs if there is Eisenmengers syndrome. A
mid diastolic murmur at the apex is associated with a moderate sized shunt and increased flow through the left
atrium.
Next question
Score:
Total Answered:
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
Supraventricular tachycardia:
True / False
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Correct
Correct
Digoxin may be administered in all forms of supraventricular tachycardia in which the atrioventricular node is
involved except in those with a pre excitation syndrome that are greater than 1-year-old. Supraventricular
tachycardia though most commonly associated with a structurally normal heart with an accessory pathway, may
be a feature of congenital heart disease. Transplacental passage of anti Ro SSA and anti La SSB antibodies in
maternal systemic lupus erythematosus can result in neonatal lupus syndrome and associated cardiac rhythm
Score:
Total Answered:
disturbances; most commonly complete heart block. Feeding difficulty is a common manifestation of cardiac
insufficiency.
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
i
j
k
l
m
n
Patients with ventricular septal defects require daily prophylactic ampicillin to prevent bacterial
endocarditis
Correct
i
j
k
l
m
n
j
k
l
m
n
Ductus arteriosus that does not close by six months old will require surgical ligation
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Correct
Correct
Correct
Correct
Prophylactic antibiotics are only required prior to dental procedures, surgery and other invasive procedures.
If spontaneous closure of a patent ductus arteriosus does not occur, closure is recommended between six
months to one year. This can be done surgically, or, more often these days, through the trans-catheter route.
Score:
Total Answered:
Atrial septal defect may spontaneously close usually if less than 8 mm in size.
Oedema and ascites and raised jugular venous pressure are uncommon signs of heart failure in infancy.
Tag Question
Further reading:
Congenital Heart Defects MedlinePlus
Next question
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
i
j
k
l
m
n
A persistent patent ductus arteriosus is the commonest cardiology complication of Down syndrome
Correct
j
k
l
m
n
i
j
k
l
m
n
A ventricular septal defect may close spontaneously in less than 20% of cases
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Transposition of great arteries is the commonest form of congenital heart disease causing cyanosis in the
newborn period
Correct
i
j
k
l
m
n
j
k
l
m
n
When congenital heart disease is associated with congenital rubella it is commonly a persistent patent
ductus arteriosus
Correct
Correct
Total Answered:
Remove Tag
Remove question
Next question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
Mitral atresia.
Correct
TAPVC is associated with cyanosis in the newborn. Total anomalous pulmonary venous connection (TAPVC) consists of
an abnormality of blood flow in which all 4 pulmonary veins drain into systemic veins or the right atrium with or without
pulmonary venous obstruction. Systemic and pulmonary venous blood mix in the right atrium. PDA, ASD and VSD are
left to right shunts. Tricuspid atresia is typically associated with cyanosis rather than Mitral.
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Community
Work Hard
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
A chest x-ray showing signs of increased pulmonary blood flow (increased pulmonary plethora) is compatible
with a diagnosis of:
True / False
i
j
k
l
m
n
j
k
l
m
n
Correct
i
j
k
l
m
n
j
k
l
m
n
Correct
i
j
k
l
m
n
j
k
l
m
n
Pulmonary tetralogy
j
k
l
m
n
i
j
k
l
m
n
Fallots tetralogy
j
k
l
m
n
i
j
k
l
m
n
Ventricular septal defect will cause increased blood flow through the right ventricle and pulmonary trunk, as will
patent ductus arteriosis which connects the left pulmonary artery and descending aorta. In fallots and
pulmonary tetralogy there will be decreased flow due to infundibular stenosis. Coarctation, a narrowing of the
aorta near the left subclavian vein is associated with normal pulmonary vasculature.
Next question
Score:
Total Answered:
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
True / False
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
mitral incompetence associated with a rigid posterior valve leaflet but a normal anterior leaflet
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Correct
Correct
Correct
Correct
Correct
d-10% of cases secondary to increasing left atrial pressure. Soft late snap - actually a 'tumour plop' that mimics the
opening snap of Mitral Stenosis. (Wassermil M, Warkentin DL, Ravin A: Myxoma of the left atrium: Phonocardiographic
study of three cases. Circulation 1962;25:5056 )
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Community
Work Hard
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
True / False
i
j
k
l
m
n
j
k
l
m
n
constrictive pericarditis
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
tricuspid stenosis
j
k
l
m
n
i
j
k
l
m
n
ventricular tachycardia
j
k
l
m
n
i
j
k
l
m
n
ventricular pacing
Canon waves are seen with unsynchronised closure of the tricuspid valve and right atrial contraction, i.e. when the right
atrium contracts against a closed tricuspid valve. Giant V waves are seen with constrictive pericarditis. Tall a waves, but
not cannon a waves, are seen with Tricuspid stenosis.
Next question
Score:
Total Answered:
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
Which ONE of the following statements is true about the Austin Flint murmur?
(Please select 1 option)
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
It can be distinguished from the murmur of mitral stenosis by absence of presystolic accentuation
i
j
k
l
m
n
j
k
l
m
n
Correct
The Austin Flint murmur is a low frequency mid/late diastolic murmur which may show pre-systolic accentuation
and is virtually indistinguishable from that of mitral stenosis. It is due to partial closure of the anterior leaflet of
the mitral valve by the regurgitant jet. There is no correlation between presence of murmur and severity of AR,
or aetiology. The first heart sound is normal but in severe cases, it may be absent.
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
j
k
l
m
n
j
k
l
m
n
Mental retardation
j
k
l
m
n
Pulmonary stenosis
i
j
k
l
m
n
Retinal detachment
Correct
Marfan's syndrome is an autosomal dominant condition associated with ocular abnormalities such as upwards
lens dislocation and retinal detachment ( Retinal detachment in Marfan syndrome: clinical characteristics and
surgical outcome. Retina. 2002 Aug;22(4):423-8).
Score:
Total Answered:
Upper to lower body ratio (head to symphysis pubis : symphysis pubis to toes) is decreased in Marfan's
syndrome.
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Community
Work Hard
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
i
j
k
l
m
n
Eisenmengers syndrome
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Tetralogy of Fallot
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Correct
Correct
The commonest examples of a left-to-right shunt are an atrial septal defect (ASD), ventricular septal defect
(VSD) and patent ductus arteriosus (PDA). Children with this defect are usually not cyanosed (providing there
is no left ventricular failure or reversal of the shunt).
Score:
Fallots tetralogy is the commonest form of a right-to-left shunt and the children are cyanosed. Eisenmengers
Total Answered:
syndrome occurs when there is reversal of the left-to-right shunt (to a right-to-left shunt), due to irreversible
pulmonary vessel disease.
Tag Question
Next question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
C Is familial
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
E Treated with beta adrenergic blockers has a lower risk of sudden death
Correct
Incorrect answer selected
Correct
Incorrect answer selected
Correct
Hypertrophic cardiomyopathy has a well recognised familial often dominant form of inheritance.
A It is also associated with Pompe's disease and familial lentiginosis.
Score:
B ECHO is the best screening tool. The ECG has low sensitivity but high specificity for ventricular hypertrophy.
Total Answered:
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
True / False
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
Correct
Correct
Correct
Correct
Correct
VSDs are the commonest congenital heart defect with the vast majority being small often spontaneously closing and of
no haemodynamic significance. Small residual VSDs may be picked up due to the loud murmur (Maladie de Roger) and
VSDs are associated with increased pulmonary blood flow. Larger VSDs would be associated with biventricular
hypertrophy associated with volume overload.
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Community
Work Hard
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
True / False
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
mitral regurgitation
Correct
Correct
Hypertrophic cardiomyopathy is defined as the unexplained, asymmetical or concentric hypertrophy of the undilated left
ventricle. There is also hypertrophy of the right ventricle. It may be inherited as an autosomal dominant condition, but at
least half of cases may be the result of sporadic mutation. Double apical impulse may be felt, with diastolic dysfunction
being typical. Outflow obstruction develops over time associated with increasing hypertrophy and associated mitral
regurgitation is common.
Score:
Total Answered:
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
Which of the following are true regarding randomised controlled trials in single patients (n of 1 trials)?
True / False
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
A. In an n of 1 trial the treatment and placebo are given in random treatment periods in the same patient.
B. The results are specific to the one drug and one patient studied and cannot usually be generalised.
C. Or where the practitioner has doubts. They are also useful for dosing or working out if a symptom is a side
Score:
Total Answered:
effect or not.
D. Drugs with short effects are best as long wash-out periods need to be included for long-acting drugs.
Tag Question
E. The studies are with single patients on or off a drug and do not normally require ethics committee approval.
(DTB 1998;36(5):40)
Next question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Sign Out
Help
Group Learning
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
In mitral stenosis caused by rheumatic heart disease, prophylaxis against endocarditis is necessary in:
True / False
i
j
k
l
m
n
j
k
l
m
n
cystoscopy
j
k
l
m
n
i
j
k
l
m
n
dental scaling
i
j
k
l
m
n
j
k
l
m
n
caesarean section
i
j
k
l
m
n
j
k
l
m
n
cardiac catherization
j
k
l
m
n
i
j
k
l
m
n
transesophageal echocardiogram
NICE guidelines in 2008 suggest that antibiotic prophylaxis is not required prior to any of the above
procedures. A lack of evidence to support the administration of antibiotics in the prevention of infective
endocarditis is cited, as well as the small risk of anaphylaxis associated with antibiotic use.
Score:
http://www.nice.org.uk/nicemedia/pdf/CG64PIEQRG.pdf
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
True / False
i
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
mitral stenosis
j
k
l
m
n
i
j
k
l
m
n
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
i
j
k
l
m
n
Correct
This is the correct answer
Incorrect answer selected
Correct
A loud first heart sound is due to abrupt closure of the mitral valve against a high left atrial pressure. MR occurs with
papillary muscle rupture and thereby 1st heart sound is soft.A2 and P2 are loud in systemic HT and pulmonary
hypertension respectively.
Next question
Score:
Total Answered:
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
A 15-year-old female presents following a sore throat with chest pain, fever, and a skin rash. Examination reveals a diastolic
murmur. Her ASO titre is elevated. Which of the following is a major criterion for the diagnosis of Rheumatic fever?
Fever
j
k
l
m
n
Raised ESR
i
j
k
l
m
n
Polyarthritis
j
k
l
m
n
Migratory erythema
j
k
l
m
n
Prolonged PR interval
Correct
Polyarthritis together with erythema marginatum, Sydenham's chorea, carditis and subcutaneous nodules constitute the
major criteria associayed with Rheumatic fever. Minor criteria include raised ESR, Arthralgia, pyrexia and a prolonged PR
interval. Migratory erythema is associated with a glucagonoma.
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
Tetralogy of Fallot
Which of the above is the most likely diagnosis in the following cases?
Score:
A 7-week-old infant presents with breathlessness on feeding and failure to thrive. On examination his femoral
pulses are difficult to feel but present. Chest radiograph shows cardiomegaly and increased vascular markings.
Coarctation of the aorta
Total Answered:
6
Tag Question
Correct
Absent or weak femoral pulses suggest coarctation. Remember association with Turner's syndrome in females.
A 13-year-old girl is referred for evaluation of her short stature. She is pre-pubertal. On auscultation she has
an ejection systolic murmur in the second and third left intercostal spaces radiating to the back, but is
asymptomatic.
Pulmonary valve stenosis
Remove Tag
Remove question
Correct
The murmur describes pulmonary stenosis which could also be a left peripheral pulmonary stenosis. She is
short and has delayed puberty, and coupled with the cardiac findings, would suggest Noonan's syndrome.
Correct
Tetralogy of Fallot may present later than in the neonatal period. The ejection systolic murmur is from the
infundibular stenosis. The desaturation results from the right to left shunt across the VSD.
Next question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
A newborn baby, one of twins born at term, is noted to be centrally cyanosed soon after birth. Which of the following is the most
likely cause?
i
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
j
k
l
m
n
Tricuspid atresia
Correct
VSD and PDA are left to right shunts; coarctation of the aorta is not associated with cyanosis. Tricuspid atresia and
transposition of the great arteries are both cyanotic congenital heart diseases and present in the immediate newborn
period. Of the 2 transposition of the great arteries is more common and hence more likely to be the cause.
Score:
Total Answered:
Next question
Tag Question
Remove Tag
Remove question
My Profile
Exam Revision
Work Smart
Scores
Work Hard
Community
Group Learning
Sign Out
Help
Saved Tests
Revision Advice
Tagged Questions
NOTE: Many features on this website require Javascript and cookies. You can enable both via your browser's preference settings.
Session Analysis
DMSA scan
Echocardiogram
Renal angiography
Urine catecholamines
U+Es, creatinine
Ultarsound KUB
A 15-year-old girl is brought to A+E having collapsed at a party. On examination she has a dry mouth, a heart
rate of 110/min and blood pressure of 150/110 mmHg.
Score:
Total Answered:
Correct
In the 15-year-old girl there is acute hypertension, most likely related to drugs. The most common offender these days is
Tag Question
A 6-year-old boy presents with headache on defaecation. On examination his blood pressure in the right arm is
140/100 mmHg and he has a 2/6 systolic murmur.
Renal angiography
Remove question
be loudest over the scapula. Four limb BPs are usually diagnostic, but echocardiography is will identify the precise
structural lesion.
A 2 month old infant is found to have a blood pressure of 120/90 mmHg persistently. He was born at 25/40
gestation, was ventilated for 14 days and is still in oxygen.
DMSA scan
In evaluating raised blood pressure first decide whether it is acute or chronic. Second is it related to drugs. Third is it
localised.
Next question