UKMLA Applied Knowledge Test (MSRA-style single best answer) · Cardiovascular and Respiratory Medicine

Cardiovascular medicine

24 practice questions, each with the answer and an explanation.

Practise Cardiovascular medicine now

Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 24 questions

  1. A man has had 3 hours of crushing chest pain and the ECG shows ST elevation in leads V2 to V5. The nearest primary PCI centre can deliver treatment within 60 minutes. What is the best reperfusion stra…
  2. Which immediate drug should be offered to a patient with suspected acute coronary syndrome unless contraindicated?
  3. Which drug class has been shown to reduce mortality in chronic heart failure with reduced ejection fraction?
  4. A 72-year-old woman with non-valvular atrial fibrillation has hypertension and type 2 diabetes but no other relevant history. What is her CHA2DS2-VASc score?
  5. A 48-year-old man has non-valvular atrial fibrillation and hypertension, and no other risk factors. Which statement reflects NICE guidance on anticoagulation?
  6. Which anticoagulant is the appropriate choice for stroke prevention in a patient with atrial fibrillation and a mechanical mitral valve?
  7. A man has new-onset atrial fibrillation of 5 hours' duration with a blood pressure of 70/40 mmHg and chest pain. What is the most appropriate treatment?
  8. A 54-year-old man has clinic readings averaging 152/94 mmHg and an ambulatory blood pressure average of 145/90 mmHg. How is his hypertension classified by NICE?
  9. A 62-year-old man of white European origin without diabetes needs treatment for hypertension. Which drug is first-line according to NICE?
  10. A patient started on ramipril develops a persistent dry cough. What is the most appropriate change?
  11. A 58-year-old has a QRISK3 10-year cardiovascular risk of 12 percent. What is the most appropriate step?
  12. A 78-year-old has exertional syncope, angina and an ejection systolic murmur radiating to the carotids with a slow-rising pulse. What is the most appropriate definitive treatment if the stenosis is se…
  13. A man who injects drugs has a fever and a new pansystolic murmur at the left sternal edge. How should he be investigated before antibiotics?
  14. A young man has pleuritic chest pain relieved by sitting forward, a pericardial rub, and widespread concave ST elevation with PR depression. What is the best initial treatment?
  15. A man has abrupt tearing chest pain radiating to the back, a 30 mmHg difference in systolic pressure between the arms, and a widened mediastinum. Blood pressure is 190/110 mmHg. While arranging CT ang…
  16. A woman with a high probability of pulmonary embolism by the Wells score has a CT pulmonary angiogram delayed by several hours. What is the correct interim management?
  17. A man has a swollen, tender calf and a two-level Wells score of 3. The proximal leg vein ultrasound cannot be done for 12 hours. What does NICE advise?
  18. An ECG shows P waves and QRS complexes occurring independently at a ventricular rate of 35 beats per minute, with dizziness. What is the diagnosis and the definitive treatment?
  19. What is the first-line management offered to a patient with troublesome intermittent claudication?
  20. At what age are men in England invited for a single abdominal aortic aneurysm ultrasound screening?
  21. An inferior ST-elevation myocardial infarction occurs with ST elevation in leads II, III and aVF. Which artery is most likely occluded?
  22. A man with inferior myocardial infarction has hypotension, raised jugular venous pressure and clear lung fields. Which treatment is most appropriate for the hypotension?
  23. A patient on digoxin with chronic heart failure is vomiting, has yellow-tinged vision and a potassium of 2.9 mmol/L. The ECG shows atrial tachycardia with block. What is the specific treatment for lif…
  24. What is the definition of orthostatic hypotension used to diagnose postural hypotension?

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