MCQ - Choose the Culprit Drug

A 60 year old male with a history of congestive heart failure and atrial fibrillation states his vision has been mostly yellow recently. He has noted lack of appetite and weight loss. Laboratory studies reveal and elevated potassium level. Which of the following is the likely causing his symptoms?

Nitroglycerine

Digoxin

Amiodarone

Spironolactone

Sildenafil

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Cardiology MCQ- Cause of Sudden Cardiac Death

A 19 year old girl is noted to have a reduced upper to lower body segment ratio, positive Walker and Steinberg signs, and pectus carinatum. Her father died suddenly at the age of 32. She is subsequently diagnosed with Marfan’s syndrome. Which of the following was the likely cause of death of her father?

Congestive heart failure

Aortic dissection

Myocardial infarction

Aortic valve regurgitation

Mitral valve prolapse

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Echocardiography- Massive Pericardial Effusion

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Cardiology MCQ - Make your Diagnosis

A 72 year old female with a history of breast cancer and tobacco use complains of dizziness and dyspnea on exertion. Her heart sounds are distant and her systolic blood pressure is noted to markedly decrease with inspiration. Which of the following is the most likely diagnosis?

A) Constrictive cardiomyopathy

B) Mitral valve Stenosis

C) Congestive heart failure

D) Pulmonary embolus

E) Cardiac Tamponade

Answer    E

                 Cancer is the most common cause of pericardial effusion and when enough fluid accumulates in the pericardial space, cardiac tamponade occurs. “Pulsus paradoxus” is when there is a decrease in systolic blood pressure during inspiration due to failure of the right ventricle to accept the normal increased venous return that occurs with inspiration. This also results in a “Kussmal’s sign” or elevated jugular venous distension during inspiration (normally the opposite occurs). Treatment is with emergent pericardiocentesis.

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