All of the following are true for the medication class of Sodium Gluocose Troasportase Inhibitors (SGLT2-inhibitors) except:

The beneficial cardiovascular features in heart failure are mostly related to glucose lowering effect

The beneficial cardiovascular features are not related to weight loss

Although not completely understood, it is though that some benefits relates to cardiac metabolism

The haemodynamic effects of reduced plasma volume are observed

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With regards to dyslipidaemia in patients with diabetes, all of the following are correct except:

Patients with very high cardiovascular risk, LDL reduction by 50% and LDL goal of < 1.4 mmol/L is recommended

Dyslipdaemia can be ruled out with normal total cholesterol, LDL and TG levels

Statin therapy is not recommended in pregnant women for primary or secondary prevention

Statin therapy is indicated in all patients with type one diabetes and high cardiovascular risk

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In relation to pre-excitation and supraventricular tachycardias, all of the following are true except:

The most common arrhythmia in WPW syndrome is AVRT followed by atrial fibrillation

Sudden cardiac death in pre-excited SVT is due to rapid conduction through accessory pathway leading to ventricular fibrillation

The risk of sudden cardiac death in WPW syndrome is about 2-3% annually

Non-invasive testing is recommended for asymptomatic patients with high risk occupations or athletes

Amiodarone is not recommended for acute treatment of hemodynamically stable patient

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In relation to cardiovascular disease in pregnancy, all of the following are true except:

Pregnancy is not recommended in women with severe pulmonary hypertension

Lactation is safe in patients taking warfarin

In patients with hypertrophic cardiomyopathy, beta blockers are recommended to continue throughout pregnancy

Intervention prior to pregnancy is recommended in patients with asymptomatic moderate mitral stenosis

Same infective endocarditis prophylaxis rules apply to pregnant women compared to non pregnant women

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In addition to their lipid lowering effect, which group of medications reduce inflammation measured by high sensitivity CRP?

Ezetimibe

PCSK9 monoclonal antibodies

Statins

Cholestyramine

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A 53 year old diabetic woman with chest pain was found to have multivessel CAD and is planned for CABG. She takes Aspirin, Rosuvastatin, Metformin, Dapagliflozin & Metoprolol. Which medication(s) must be discontinued several days prior to CABG?

Aspirin

Metoprolol and Dapagliflozin

Dapagliflozin

Metformin and Dapagliflozin

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31 year old lady 38 weeks pregnant, GlP0A0, presenting with shortness of breath, bilateral lower limb oedema and fatigue. She has bibasal crackles, elevated JVP-lOcm, pansystolic murmur at the apical area with displaced apex beat. The likely pathology is

Severe aortic valve stenosis

Large atrial septal defect

Peripartum cardiomyopathy

Severe mitral valve stenosis

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Which of the following is not true regarding Adenosine?

Has a half life of about 30 seconds

Indicated to terminate wide-complex regular tachycardia

Contra-indicated in reactive airway disease

Endothelial-independent coronary vasodilator

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Low dose Colchicine has been shown to improve prognosis in patients with established coronary disease thought to be via which mechanism of action?

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Sodium-Glucose Cotransporter-2 inhibitors are effective in treating which of the following cardiac diseases?

Coronary artery disease

Heart failure with preserved ejection fraction

Heart failure with reduced ejection fraction

Cardiac amyloidosis

Hypertrophic cardiomyopathy

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The first line therapy for symptomatic highburden premature ventricular contraction with a normal ejection fraction i:

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A 75 year old man presented to hospital feeling dizzy. Identify the conduction block location based on his ECG shown below?

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31 year old male sustained a cardiac arrest while playing footy, post resuscitation ECG is shown here. Following recovery, which is the most definitive test for the diagnosis?

Cardiac stress test

Cardiac PET

Cardiac electrophysiological study

Cardiac MRI

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A 61 year old lady is diagnosed with paroxysmal atrial fibrillation & is started Flecainide 100mg BD for rhythm control. She presented 2 weeks later with Tachycardia. Which could be the reason for her presentation with this rhythm?

Previous asymptomatic myocardial infarction

QT interval Prolongation

Underlying structural heart disease

All of the above

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A 39 year old woman developed a syncopal event following palpitations. She was diagnosed with hypertrophic cardiomyopathy confirmed on cardiac MRI showing septal thickness of 35mm during hospital stay. Which of the following will increase her risk of SCD?

Family history of hypertrophic cardiomyopathy

Reduced left ventricular ejection fraction

Presence of ventricular ectopics

Presence of paroxysmal atrial fibrillation

Absence of late gadolinium enhancement on cardiac MRI

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A 61 year old lady presents with palpitations and is diagnosed with paroxysmal atrial fibrillation. Which of the following is not an indication for INOAC thromboemb,olic prevention?

Diabetes Mellitus

Previous myocardial infarction

Severe mitral valve stenosis

Evidence of heart failure

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A 60 year old man with no previous comorbidities is diagnosed with cardiac amyloidosis in context of new atrial fibrillation. His CHAIDSVASC score is 0. The most appropriate thromboembolic prophylactic treatment is:

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Chronic inflammation has been found to have a role in which of the following stages of atherosclerosis?

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A 72 year old lady sustained inferior STEMI and was treated with primary PCI. She was later found to have a Hb of 9 g/dl. The value of restrictive (Hb<8g/dl) compared to liberal (Hb=<10g/dl) transfusion strategy was shown in the REALITY study

Improved 30-day MACE compared to liberal strategy

Non-inferior for 30-day MACE compared to liberal strategy

less likely to develop infection or lung injury compared to liberal strategy

No difference in safety endpoints

B&C

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82 year old female with paroxysmal AF and CKD, on apixaban, sotalol, pravastatin and aspirin, presents with recurrent syncope and the following ECG was recorded

The arrhythmia is treated with IV magnesium

The ECG shows artefact and repeat ECG is required

IV Arniodarone is the treatment of choice

Emergent coronary angiography is lifesaving

Dose escalation of the current anti-arrhythmic regimen is essential

Current score: 0 / 28

A 67 year old woman with history of peripheral vascular disease and ongoing smoking is being treated for hypertension with maximum doses of ACE-I, Thiazide diuretic, Amlodipine & Moxonidine. Her 24h ABPM revealed average BP of 165/95. Next step is:

Add metoprolol

Add spironolactone

Emphasize low-salt diet

Renal artery doppler and endocrinological work up

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A 76 year old lady presented with chest pain lasting for 1 hour and has an elevated hsTroponin of 120 (normal <25) and T wave inversion in the inferior leads. The patient should receive which of the following GDMT prior to angiography the next day?

Aspirin, Statin, Enoxaparin

Aspirin, Ticagrelor, Statin, Enoxaparin

Aspirin, Prasugrel, Statin

Aspirin, Clopidogrel, Statin, Enoxaparin

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Which is not true for patients with cardiogenic shock complicating acute coronary syndromes?

Culprit lesion only PCI is safer than complete revascularisation

Early revascularisation is recommended including urgent CABG

NSTEMI with cardiogenic shock has better prognosis compared with STEMI and cardiogenic shock

1 :2-3 patients may not survive hospital admission

Cardiogenic shock in context of cardiac arrest is an indication for urgent invasive angigoraphy

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A 34 year old smoker sustained anterior STEMI 4 months ago (see recent ECG) and currently has LVEF of 25% on the most recent TTE. He is on maximum doses of Bisoprolol, Entresto and Eplerenone. The best next step for management includes?

Repeat coronary angiography

Implantable cardioverter-defibrillator (ICD)

Cardiac resynchronisaton therapy (CRT)

Combined cardiac resynchronisation + defibrillation (CRT-D)

Reassess LV unction in 3 months

Current score: 0 / 28

A 63 year-old man on haemodialysis developed atrial fibrillation and was commenced on Sotalol for a rhythm control strategy. Which of the following is not part of treatment for this ventric1ular arrhythmia?

Intravenous Metoprolol

Cessation of QT prolonging medication

lsoprenaline infusion or temporary pacing

IV Magnesium

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The most common cause for developing severe aortic valve stenosis in younger patients (<60-70 years) is?

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A 48 year old male, presented with NSTEMI , angiography revealed TVD and subsequently had CABG. Postoperatively, what is the best guideline driven anti platelet strategy?

You answered 0 out of 28 questions correctly

Final score: 0 / 28

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Q1 : Correct !

Q1: Wrong, the correct answer is: The beneficial cardiovascular features in heart failure are mostly related to glucose lowering effect

Current score: 0 / 28

Q2 : Correct !

Q2: Wrong, the correct answer is: Dyslipdaemia can be ruled out with normal total cholesterol, LDL and TG levels

Current score: 0 / 28

Q3 : Correct !

Q3: Wrong, the correct answer is: Non-invasive testing is recommended for asymptomatic patients with high risk occupations or athletes

Current score: 0 / 28

Q4 : Correct !

Q4: Wrong, the correct answer is: Intervention prior to pregnancy is recommended in patients with asymptomatic moderate mitral stenosis

Current score: 0 / 28

Q5 : Correct !

Q5: Wrong, the correct answer is: Statins

Current score: 0 / 28

Q6 : Correct !

Q6: Wrong, the correct answer is: Dapagliflozin

Current score: 0 / 28

Q7 : Correct !

Q7: Wrong, the correct answer is: Peripartum cardiomyopathy

Current score: 0 / 28

Q8 : Correct !

Q8: Wrong, the correct answer is: Indicated to terminate wide-complex regular tachycardia

Current score: 0 / 28

Q9 : Correct !

Q9: Wrong, the correct answer is: Anti-inflammatory effects

Current score: 0 / 28

Q10 : Correct !

Q10: Wrong, the correct answer is: Heart failure with preserved ejection fraction

Current score: 0 / 28

Q11 : Correct !

Q11: Wrong, the correct answer is: Beta blocker

Current score: 0 / 28

Q12 : Correct !

Q12: Wrong, the correct answer is: AV node

Current score: 0 / 28

Q13 : Correct !

Q13: Wrong, the correct answer is: Cardiac MRI

Current score: 0 / 28

Q14 : Correct !

Q14: Wrong, the correct answer is: All of the above

Current score: 0 / 28

Q15 : Correct !

Q15: Wrong, the correct answer is: Reduced left ventricular ejection fraction

Current score: 0 / 28

Q16 : Correct !

Q16: Wrong, the correct answer is: Obesity

Current score: 0 / 28

Q17 : Correct !

Q17: Wrong, the correct answer is: Severe mitral valve stenosis

Current score: 0 / 28

Q18 : Correct !

Q18: Wrong, the correct answer is: NOAC or Warfarin

Current score: 0 / 28

Q19 : Correct !

Q19: Wrong, the correct answer is: All of the above

Current score: 0 / 28

Q20 : Correct !

Q20: Wrong, the correct answer is: B&C

Current score: 0 / 28

Q21 : Correct !

Q21: Wrong, the correct answer is: The arrhythmia is treated with IV magnesium

Current score: 0 / 28

Q22 : Correct !

Q22: Wrong, the correct answer is: Renal artery doppler and endocrinological work up

Current score: 0 / 28

Q23 : Correct !

Q23: Wrong, the correct answer is: Aspirin, Statin, Enoxaparin

Current score: 0 / 28

Q24 : Correct !

Q24: Wrong, the correct answer is: NSTEMI with cardiogenic shock has better prognosis compared with STEMI and cardiogenic shock

Current score: 0 / 28

Q25 : Correct !

Q25: Wrong, the correct answer is: Implantable cardioverter-defibrillator (ICD)

Current score: 0 / 28

Q26 : Correct !

Q26: Wrong, the correct answer is: Intravenous Metoprolol

Current score: 0 / 28

Q27 : Correct !

Q1: Wrong, the correct answer is:

The beneficial cardiovascular features in heart failure are mostly related to glucose lowering effect

Q2: Wrong, the correct answer is:

Dyslipdaemia can be ruled out with normal total cholesterol, LDL and TG levels

Q3: Wrong, the correct answer is:

Non-invasive testing is recommended for asymptomatic patients with high risk occupations or athletes

Q4: Wrong, the correct answer is:

Intervention prior to pregnancy is recommended in patients with asymptomatic moderate mitral stenosis

Q5: Wrong, the correct answer is:

Statins

Q6: Wrong, the correct answer is:

Dapagliflozin

Q7: Wrong, the correct answer is:

Peripartum cardiomyopathy

Q8: Wrong, the correct answer is:

Indicated to terminate wide-complex regular tachycardia

Q9: Wrong, the correct answer is:

Anti-inflammatory effects

Q10: Wrong, the correct answer is:

Heart failure with preserved ejection fraction

Q11: Wrong, the correct answer is:

Beta blocker

Q12: Wrong, the correct answer is:

AV node

Q13: Wrong, the correct answer is:

Cardiac MRI

Q14: Wrong, the correct answer is:

All of the above

Q15: Wrong, the correct answer is:

Reduced left ventricular ejection fraction

Q16: Wrong, the correct answer is:

Obesity

Q17: Wrong, the correct answer is:

Severe mitral valve stenosis

Q18: Wrong, the correct answer is:

NOAC or Warfarin

Q19: Wrong, the correct answer is:

All of the above

Q20: Wrong, the correct answer is:

B&C

Q21: Wrong, the correct answer is:

The arrhythmia is treated with IV magnesium

Q22: Wrong, the correct answer is:

Renal artery doppler and endocrinological work up

Q23: Wrong, the correct answer is:

Aspirin, Statin, Enoxaparin

Q24: Wrong, the correct answer is:

NSTEMI with cardiogenic shock has better prognosis compared with STEMI and cardiogenic shock

Q25: Wrong, the correct answer is:

Implantable cardioverter-defibrillator (ICD)

Q26: Wrong, the correct answer is:

Intravenous Metoprolol

Q27: Wrong, the correct answer is:

Bicuspid aortic valve

Q28: Wrong, the correct answer is:

Aspirin + Clopidogrel

Q1: Wrong, the correct answer is:

Exertional dyspnoea

Q2: Wrong, the correct answer is:

Atrial flutter

Q3: Wrong, the correct answer is:

Young patient with syncope, non-sustained VT and diagnosis of arrhythmogenic right ventricular dysplasia

Q4: Wrong, the correct answer is:

Ebstein anomaly

Q5: Wrong, the correct answer is:

A 75 year old man with bio-prosthetic AVR undergoing dental extraction

Q6: Wrong, the correct answer is:

A 25 year old man with giant cell myocarditis

Q7: Wrong, the correct answer is:

Haemodialysis patients are at higher risk of staph aureus bacteraemia and health care associated infective endocarditis

Q8: Wrong, the correct answer is:

Gynecomastia

Q9: Wrong, the correct answer is:

Allowing a nitrate-free interval of 8-12 hours per day

Q10: Wrong, the correct answer is:

Lignocaine

Q11: Wrong, the correct answer is:

A holosystolic murmur heard at the left sternal border

Q12: Wrong, the correct answer is:

All of the above

Q13: Wrong, the correct answer is:

The ablation group had significantly lower rates of death and hospitalisation compared to the medical group

Q14: Wrong, the correct answer is:

None of the above

Q15: Wrong, the correct answer is:

Exercise based rehabilitation improves functional capacity

Q16: Wrong, the correct answer is:

Abdominal aortic aneurysm of 5.5 cm

Q17: Wrong, the correct answer is:

Could be congenital or acquired

Q18: Wrong, the correct answer is:

No difference in exercise time between the two groups

Q19: Wrong, the correct answer is:

Secundum ASD