A 70 year old female has a past medical history of hypertension. she has had 2 syncopal episodes and was found to have an ejection systolic murmur and bibasal crackles and a blood pressure of 165/115 mmHg. An ECHO was arranged and revealed aortic stenosis. Cardiac catheterisation revealed a gradient of 50mmHg across the aortic valve. Which is the most contributory to your decision for referral for valve replacement?
Presence of symptoms
Age of patient
Evidence of heart failure
Gradient
Left Ventricular Hypertrophy
A 12 year old boy who has recently been diagnosed with a sensorineural hearing loss presents with haematuria. He has recently had a cold. He is wearing glasses and his mother states the optician said he an abnormality of the lens of his eye. From the following which is the most likely diagnosis?
Alport’s syndrome
Bergers syndrome
Haemolytic Uraemic Syndrome
Bartter’s Syndrome
Minimal change disease
A 19 years old guy is suffering from severe pain right at the middle of chest. Most appropriate cause would be
1 heart disease
2 oesophagitis
3peptic ulcer
4 gastric carcinoma
5 pneumonia
4/10. A 12 day old infant, exclusively fed cow’s milk formula, presents to the ER appearing greyish/cyanotic. With 5L/minute oxygen by mask, his radial artery paO2 is 236 torr. His most likely diagnosis is:
. . . . . a. Tetralogy of Fallot
. . . . . b. Persistent Pulmonary Hypertension
. . . . . c . Methemoglobinemia
. . . . . d. Transposition of the Great Vessels
A 23 year old present with palpitations intermittently. She is known to suffer from anxiety attacks. However on auscultation of the heart there is evidence of a late systolic murmur with a mid systolic click. It is worsened by the standing position. What is the most likely diagnosis?
Mitral valve prolapse
Normal variant
Atrial Myxoma
Aortic Stenosis
Mitral stenosis
What disease is most likely to be associated with Ischaemic optic atrophy?
Giant Cell Arteritis
Rheumatoid arthritis
Inflammatory bowel disease
Ankylosing Spondylitis
SLE
What disease is most likely to be associated with Ischaemic optic atrophy?
Giant Cell Arteritis
Rheumatoid arthritis
Inflammatory bowel disease
Ankylosing Spondylitis
SLE
A 23 year old present with palpitations intermittently. She is known to suffer from anxiety attacks. However on auscultation of the heart there is evidence of a late systolic murmur with a mid systolic click. It is worsened by the standing position. What is the most likely diagnosis?
Mitral valve prolapse
Normal variant
Atrial Myxoma
Aortic Stenosis
Mitral stenosis
What disease is most likely to be associated with Ischaemic optic atrophy?
Giant Cell Arteritis
Rheumatoid arthritis
Inflammatory bowel disease
Ankylosing Spondylitis
SLE
A 30 year old female presents with sudden onset left hip pain with no history of trauma. She has a history of brittle asthma, on long term steroids. On examination there is reduction of flexion, abduction and internal rotation in the left hip. What is the most sensitive investigation for the definitive diagnosis, you would organise in the first instance?
Bone scan correct answer
MRI of hip
Ultrasound of hip
X-ray
CT scan
.
Hints: In the early stages bone scan is very useful. MRI is then utilised for confirmation
A 23 year old female presents with a discoid rash, photosensitivity and painful joints. She has also noticed an increased frequency of oral ulcers. There is also evidence of microscopic haematuria and proteinuria. What antibody is specific to the diagnosis?
Anti dsDNA antibody
Antinuclear antibody
Anti-centromere antibody
Rheumatoid factor
Anti smooth muscle antibody
Explanation