Welcome to your Thrombosis, Embolism, Pulmonary Embolism & Pulmonary Hypertension
1.
A patient with a regular narrow-complex tachycardia receives intravenous adenosine. The rhythm terminates immediately. Which electrophysiological effect most directly explains this response?
2.
A 70-year-old man with atrial fibrillation has a ventricular rate of 132/min. Echocardiography shows significantly reduced left ventricular systolic function. Which drug is least appropriate for ventricular rate control?
3.
A patient with acute pericarditis is given corticosteroids early despite having no contraindication to NSAIDs or colchicine. Which subsequent problem becomes more likely?
4.
A patient presents with severe bradycardia, hypotension and AV block after taking an excessive dose of propranolol. Which drug has a specific antidotal role?
5.
A patient with recurrent atrial arrhythmia is prescribed flecainide. Which ECG change best reflects its principal electrophysiological effect?
6.
A patient with suspected cardiac tamponade is hypotensive and breathless. Which intervention could worsen his condition by further reducing venous return?
7.
A patient with malignant pericardial effusion develops tachycardia and hypotension. Echocardiography shows right atrial collapse. Which hemodynamic change is responsible for the deterioration?
8.
A 28-year-old man develops chest pain, palpitations and reduced ejection fraction after a viral prodrome. Coronary arteries are normal. Which finding would most strongly support myocardial rather than isolated pericardial involvement?
9.
A patient taking amiodarone develops weight loss, tremor and heat intolerance. Which property of the drug best explains this complication?
10.
A patient with suspected myocarditis develops complete heart block and worsening heart failure. What is the most appropriate management principle?
11.
A patient treated with procainamide for recurrent tachyarrhythmia develops arthralgia, fever and positive antinuclear antibodies. Which adverse effect is most likely?
12.
A patient with suspected myocarditis develops complete heart block and worsening heart failure. What is the most appropriate management principle?
13.
A patient with digoxin toxicity presents with vomiting, confusion, bradycardia and ventricular ectopy. Which additional factor most likely increased the risk of toxicity?
14.
A patient with uncomplicated presumed viral pericarditis is started on an NSAID. Which additional drug most effectively reduces the risk of recurrence?
15.
A patient with recurrent atrial arrhythmia is prescribed flecainide. Which ECG change best reflects its principal electrophysiological effect?
16.
A patient receiving sotalol develops dizziness. ECG shows marked QT prolongation. Which complication is the greatest concern?
17.
A patient treated with procainamide for recurrent tachyarrhythmia develops arthralgia, fever and positive antinuclear antibodies. Which adverse effect is most likely?
18.
A patient with malignant pericardial effusion develops tachycardia and hypotension. Echocardiography shows right atrial collapse. Which hemodynamic change is responsible for the deterioration?
19.
A 70-year-old man with atrial fibrillation has a ventricular rate of 132/min. Echocardiography shows significantly reduced left ventricular systolic function. Which drug is least appropriate for ventricular rate control?
20.
A patient with recurrent ventricular arrhythmia receives lidocaine. Why does this drug act more effectively in ischemic ventricular tissue than in normal atrial tissue?
21.
A patient with intermittent palpitations has a resting ECG showing a short PR interval and ventricular pre-excitation. He later develops atrial fibrillation with a very rapid broad-complex ventricular response. Which drug should be avoided?
22.
A patient with uncomplicated presumed viral pericarditis is started on an NSAID. Which additional drug most effectively reduces the risk of recurrence?
23.
A patient with a regular narrow-complex tachycardia receives intravenous adenosine. The rhythm terminates immediately. Which electrophysiological effect most directly explains this response?
24.
A patient presents with severe bradycardia, hypotension and AV block after taking an excessive dose of propranolol. Which drug has a specific antidotal role?
25.
A patient with acute pericarditis has diffuse ST elevation. Which feature best differentiates this from an acute transmural myocardial infarction?
26.
A patient with intermittent palpitations has a resting ECG showing a short PR interval and ventricular pre-excitation. He later develops atrial fibrillation with a very rapid broad-complex ventricular response. Which drug should be avoided?
27.
A patient with suspected cardiac tamponade is hypotensive and breathless. Which intervention could worsen his condition by further reducing venous return?
28.
A patient with digoxin toxicity presents with vomiting, confusion, bradycardia and ventricular ectopy. Which additional factor most likely increased the risk of toxicity?
29.
A patient with recurrent ventricular arrhythmia receives lidocaine. Why does this drug act more effectively in ischemic ventricular tissue than in normal atrial tissue?
30.
A 28-year-old man develops chest pain, palpitations and reduced ejection fraction after a viral prodrome. Coronary arteries are normal. Which finding would most strongly support myocardial rather than isolated pericardial involvement?
31.
A patient receiving sotalol develops dizziness. ECG shows marked QT prolongation. Which complication is the greatest concern?
32.
A patient with myocarditis is advised to avoid strenuous exercise during active disease. What is the main reason for this recommendation?
33.
A patient with acute pericarditis has diffuse ST elevation. Which feature best differentiates this from an acute transmural myocardial infarction?
34.
A patient taking amiodarone develops weight loss, tremor and heat intolerance. Which property of the drug best explains this complication?
35.
A 55-year-old man with previous myocardial infarction develops sustained monomorphic ventricular tachycardia. Which mechanism most likely maintains this rhythm?
36.
A patient with atrial fibrillation of uncertain duration is being considered for elective cardioversion. Why is anticoagulation assessment necessary before restoring sinus rhythm?
37.
A patient with acute pericarditis is given corticosteroids early despite having no contraindication to NSAIDs or colchicine. Which subsequent problem becomes more likely?
38.
A 55-year-old man with previous myocardial infarction develops sustained monomorphic ventricular tachycardia. Which mechanism most likely maintains this rhythm?
39.
A patient with myocarditis is advised to avoid strenuous exercise during active disease. What is the main reason for this recommendation?
40.
A patient with atrial fibrillation of uncertain duration is being considered for elective cardioversion. Why is anticoagulation assessment necessary before restoring sinus rhythm?
