New Series of Interactive Cardiology MCQs 17
🫀 Advanced Cardiology Series – Part 17
Interactive Cardiology MCQs #17
Post-Graduate Level Clinical, EP, Structural & Hemodynamics Masterclass
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Q1
During coronary angiography, Fractional Flow Reserve (FFR) is measured to assess the hemodynamic significance of an intermediate coronary stenosis. What is the standard FFR cut-off value below which revascularization is indicated to improve outcomes?
Q2
A patient presents with chest pain that has now resolved. The ECG shows deep, symmetrically inverted T waves in leads V2 and V3 without Q waves or significant ST elevation. This is recognized as Wellens’ Syndrome. What does this specific ECG pattern indicate?
Q3
The ATTR-ACT trial demonstrated a significant reduction in mortality and cardiovascular hospitalizations for patients with Transthyretin Amyloid Cardiomyopathy (ATTR-CM) using Tafamidis. What is the specific mechanism of action of Tafamidis?
Q4
An otherwise healthy 30-year-old presents with palpitations. The ECG shows a wide-complex tachycardia. Which of the following morphologic patterns strongly points toward Idiopathic Right Ventricular Outflow Tract (RVOT) Ventricular Tachycardia?
Q5
In a patient with classical low-flow, low-gradient severe aortic stenosis (LVEF < 40%, AVA < 1.0 cm², Mean Gradient < 40 mmHg), a low-dose dobutamine stress echocardiogram is performed. What specific finding defines the presence of “contractile reserve”?
Q6
During physical examination of the jugular venous pulse (JVP), the intermittent presence of giant “Cannon A waves” is a classic sign of which hemodynamic phenomenon?
Q7
A 14-year-old female is diagnosed with Congenital Long QT Syndrome Type 2 (LQT2). Which specific trigger is most classically associated with initiating Torsades de Pointes in this specific genotype?
Q8
On Cardiac MRI, what is the characteristic distribution of Late Gadolinium Enhancement (LGE) seen in patients with Hypertrophic Cardiomyopathy (HCM)?
Q9
According to ACC/AHA guidelines, what is the target International Normalized Ratio (INR) for a patient receiving a modern bileaflet mechanical Mitral Valve replacement (with no other thromboembolic risk factors)?
Q10
During an echocardiogram, continuous-wave Doppler of the aortic valve reveals Aortic Regurgitation (AR). Which Pressure Half-Time (PHT) value indicates that the aortic regurgitation is severe?
Q11
Drugs like Alirocumab and Evolocumab are powerful lipid-lowering agents. What is the specific cellular mechanism of PCSK9 inhibitors?
Q12
On an ECG, typical Cavo-Tricuspid Isthmus (CTI)-dependent counterclockwise Atrial Flutter exhibits a very specific “saw-tooth” wave morphology in the leads. What is this classic pattern?
Q13
A 22-year-old patient who underwent a Fontan palliation for single ventricle physiology in childhood presents with severe edema, hypoalbuminemia, and chronic diarrhea. What dreaded complication of the Fontan circulation is this patient exhibiting?
Q14
A patient on chronic digoxin therapy for heart failure presents with nausea, visual disturbances (yellow halos), and palpitations. The ECG shows a wide-complex tachycardia with an axis that alternates by 180 degrees beat-to-beat. What is this classic arrhythmia?
Q15
According to the World Health Organization (WHO) clinical classification of Pulmonary Hypertension (PH), a patient with severe mitral stenosis and secondary pulmonary hypertension belongs to which specific group?
Q16
A patient with Atrial Fibrillation of unknown duration (but definitely > 48 hours) undergoes a successful electrical cardioversion to normal sinus rhythm. Regardless of their baseline CHA2DS2-VASc score, what is the mandatory minimum duration of systemic anticoagulation required POST-cardioversion?
Q17
When a patient experiences In-Stent Restenosis (ISR) months after the deployment of a Bare Metal Stent (BMS), what is the primary pathophysiological mechanism responsible for the re-narrowing?
Q18
Tetralogy of Fallot consists of four classic anatomical features (VSD, Overriding aorta, RVOT obstruction, RV hypertrophy). Which of these features is the primary determinant of the clinical severity and degree of cyanosis?
Q19
A patient presents to the ER with sharp, pleuritic chest pain that improves upon leaning forward. What are the hallmark ECG findings of Stage 1 Acute Pericarditis?
Q20
SGLT2 inhibitors (like Dapagliflozin and Empagliflozin) have transformed heart failure management. Aside from osmotic diuresis, what is proposed as a direct myocardial cellular mechanism for their cardiovascular benefit?
Q21
During echocardiographic assessment of left ventricular diastolic function, a “Restrictive Filling Pattern” (Grade 3 Diastolic Dysfunction) is characterized by a very stiff left ventricle and markedly elevated left atrial pressure. Which mitral inflow E/A ratio defines this pattern?
Q22
A CT scan reveals an acute Stanford Type B Aortic Dissection in a hemodynamically stable patient without end-organ malperfusion or intractable pain. What is the standard, first-line management?
Q23
According to international STEMI guidelines, for a patient presenting directly to a PCI-capable hospital, what is the maximum recommended First Medical Contact (FMC)-to-Device (door-to-balloon) time goal?
Q24
When screening a patient for Transcatheter Edge-to-Edge Repair (TEER / MitraClip) for severe mitral regurgitation, which anatomical criterion must be met to avoid creating clinically significant iatrogenic mitral stenosis?
Q25
In patients who have undergone Orthotopic Heart Transplantation, what is the ‘gold standard’ test utilized for the routine surveillance and diagnosis of acute cellular rejection?
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About The Author
Johnson Francis
Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal