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Cardiology MCQ 385: Transition zone
Normal transition zone is at: a) V1/V2 b) V3/V4 c) V5/V6 d) None of the above [“Click here for the answer with explanation”, “Correct Answer:”] b) V3/V4 Transition zone is the lead/leads in which rS pattern in right oriented leads changes to the qR pattern of left oriented leads. Usually it occurs in V3/V4. Early occurs is known as ‘early transition’. Persistence of rS pattern right upto V6 occurs in clockwise rotation, often seen in chronic obstructive airways disease. The post Cardiology MCQ 385: Transition zone appeared first on Cardiophile MD.
Source: Cardiophile MD - November 21, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ 385: Transition zone in ECG
Normal transition zone in ECG is at: a) V1/V2 b) V3/V4 c) V5/V6 d) None of the above Correct answer: b) V3/V4 Transition zone in ECG (chest leads) is the lead/leads in which rS pattern in right oriented leads changes to the qR pattern of left oriented leads. Usually it occurs in V3/V4. Early occurrence is known as ‘early transition’ and later occurrence as ‘late transition’. Persistence of rS pattern right upto V6 occurs in clockwise rotation, often seen in chronic obstructive airways disease. There are two explanations for the rS pattern in all precordial leads. One is shifting down of the heart i...
Source: Cardiophile MD - November 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Gibson’s area
Gibson’s area is: a) 1st left intercostal space, left sternal edge b) 2nd left intercostal space, left sternal edge c) 3rd left intercostal space, left sternal edge d) 4th left intercostal space, left sternal edge Correct answer: a) 1st left intercostal space, left sternal edge Gibson’s area: 1st left intercostal space, left sternal edge, where the Gibson’s murmur (continuous murmur of patent ductus arteriosus) is best heard. 2nd left intercostal space, left sternal edge is the pulmonary area where the events from the pulmonary valve like pulmonary component of second heart sound, murmurs of pulmonary ste...
Source: Cardiophile MD - November 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Cardiology MCQ: Stuck on plaque
Stuck on plaque is seen in: a) Infective endocarditis b) Coronary artery disease c) Carcinoid heart disease d) None of the above Correct answer: c) Carcinoid heart disease “Stuck on plaque” is the description given to the lesions on the tricuspid valve in carcinoid heart disease and anorexigen associated valvular heart disease. The lesions appear “stuck on” the leaflets without of inflammation or damage to the underlying valve structure. Caccitolo and colleagues noted that focal surface proliferation and fibrosis (suggesting “stuck on plaque”) was a consistent finding in the surgically e...
Source: Cardiophile MD - November 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Cardiology MCQ: Hypothermia for post op arrhythmia
Hypothermia for post op arrhythmia is used in case of: a) Complete heart block b) Atrial fibrillation c) Junctional ectopic tachycardia d) None of the above Correct answer: c) Junctional ectopic tachycardia Hypothermia for post op arrhythmia is used in case of junctional ectopic tachycardia (JET). JET is a unique postoperative arrhythmia, especially seen in children after surgery for congenital heart disease and it is often difficult to treat. It is likely to recur after cardioversion as it is due to enhanced automaticity. Sedation and cooling (hypothermia) are helpful. Postoperative cardiac arrhythmias are a major cause o...
Source: Cardiophile MD - November 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Significant family history of coronary artery disease
Significant family history of coronary artery disease is taken as age below – in first degree male relative: a) 45 years b) 40 years c) 50 years d) 55 years Correct answer: d) 55 years Myocardial infarction in a male first degree relative is taken as significant family history of coronary artery disease if it is below the age of 55 years, and if it is below 65 years in case of a female first degree relative. If both parents had myocardial infarction before the age of 55 years, the risk is much higher and calls for intensive risk factor modification [World Heart Federation wep page: http://www.world-heart-federation....
Source: Cardiophile MD - November 24, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance female first degree relative first degree male relative Significant family history of coronary artery disease Source Type: blogs

Cardiology MCQ: Heparin induced thrombocytopenia syndrome (HIT)
Heparin induced thrombocytopenia (HIT) syndrome with thrombosis can be treated with: a) Unfractionated heparin b) Low molecular weight heparin c) Bivalirudin d) None of the above Correct answer: c) Bivalirudin Bivalirudin and Argatroban are two direct thrombin inhibitors which can be used in the treatment of Heparin induced thrombocytopenia (HIT) syndrome with thrombosis. Though low molecular weight heparins are less likely to cause heparin induced thrombocytopenia, once the syndrome is established, switching over to low molecular weight heparin from unfractionated heparin is not useful. The incidence of the syndrome has b...
Source: Cardiophile MD - November 24, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Argatroban Bivalirudin Heparin induced thrombocytopenia HIT Source Type: blogs

Cardiology MCQ: Minnesota Code for LBBB
Minnesota Code for LBBB (left bundle branch block) is: a) 7-1-1 b) 8-2-1 c) 9-8-1 d) 4-1-1 Correct answer: a) 7-1-1 7-1-1 codes for Complete left bundle branch block (LBBB), 7-2-1 for Complete right bundle branch block (RBBB). Minnesota Code for ECG analysis was formulated by the University of Minnesota ECG coding center. The coding for Q-QS Waves start with 1 (1-Codes). Frontal Plane QRS Axis codes start with 2 (2-Codes), tall R Waves with 3 (3-Codes), ST Segment Depression (4-Codes) and Negative T-Waves (5-Codes), Atrioventricular (A-V) Conduction Defects (6-Codes), Intraventricular Conduction Defects (7-Codes), Arrhyth...
Source: Cardiophile MD - November 24, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Heparin induced thrombocytopenia syndrome – HIT / HITS
Wrong about heparin induced thrombocytopenia syndrome (HITS): a) HIT 1 is more dangerous than HIT 2 b) HIT 1 is non-immune mediated c) HIT 2 is associated with thrombosis d) HIT 2 is also known as HITTS (Heparin Induced Thrombocytopenia and Thrombosis Syndrome) Correct answer: a) HIT 1 is more dangerous than HIT 2 HIT 1 is self limited and unlikely to worsen with continued usage of Heparin. Heparin induced thrombocytopenia syndrome (HIT / HITS) is of two types – HIT I and HIT II (HIT 1 and 2). HIT 1 is a self limiting disease and a non-immune mediated response to heparin which occurs within 1 – 4 days of exposure to h...
Source: Cardiophile MD - November 24, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Cardiology MCQ: Selvester QRS scoring
Leads not included in the Selvester QRS scoring system: a) Lead I and aVL b) Lead II and aVF c) Lead III and aVR d) None of the above Correct answer: c) Lead III and aVR Selvester QRS scoring system is a 50 criteria 31 point QRS scoring system which was developed for estimating the infarct size from ECG. Each point on the scoring system will account for about 3% of left ventricular myocardium. The scoring system used 10 of the standard 12 leads with weighting for each criteria ranging from 1 to 3 points. Lead III and aVR are not included in this scoring system. Maximum points that can be taken from each lead are as follo...
Source: Cardiophile MD - November 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Cardiovascular contraindication to pregnancy
Cardiovascular contraindication to pregnancy: a) Severe pulmonary hypertension b) Severe obstructive valvular lesions c) Marfan syndrome with dilated aorta d) All of the above Correct answer: d) All of the above Marfan syndrome with dilated aorta carries a high risk of aortic dissection during labour. Severe cyanotic congenital heart disease is another cardiovascular contraindication to pregnancy. In general obstructive lesions are poorly tolerated in pregnancy. Severe mitral stenosis can lead on to acute pulmonary edema during labour or in the immediate postpartum period. Pulmonary edema can occur earlier as well when th...
Source: Cardiophile MD - November 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Cardiology MCQ: Dressler beats
False about Dressler beats: a) Seen in ventricular tachycardia b) Fusion beats c) Named after William Dressler from Poland d) Wider than the tachycardia beats Correct answer: d) Wider than the tachycardia beats Dressler beat, named after William Dressler from Poland, is a fusion beat interrupting ventricular tachycardia. Fusion beats are recognised by narrower QRS complexes than that of the tachycardia. It is the result of fusion of the ventricular tachycardia beat with a supraventricular beat which could be originating from the sinus node or any other supraventricular focus. The presence of fusion beats (Dressler beats) a...
Source: Cardiophile MD - November 26, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Paradoxical sinus deceleration
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease. This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Original ...
Source: Cardiophile MD - November 26, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Narrow P waves
Narrow P waves are seen in: a) Sinus rhythm b) Retrograde activation through lateral pathways c) Retrograde activation through septal pathways d) None of the above Correct answer: c) Retrograde activation through septal pathways P waves are narrower if the activation is from the centre of the heart as in AVNRT or septal accessory pathways because of simultaneous activation of both atria. Sinus P waves and P waves due to retrograde activation through lateral pathways have broader P waves as there is only sequential activation of atria. P peaked P waves in right atrial overload in the absence of associated left atrial overl...
Source: Cardiophile MD - November 26, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiology MCQ: Angiotensin II receptor
Angiotensin II receptor 1 (AT1) is involved in: a) Vasoconstriction b) Proliferation c) Aldosterone secretion d) All of the above Correct answer: d) All of the above Angiotensin II is one of the most potent vasoconstrictors. It is also involved in the stimulation of aldosterone release from the zona glomerulosa of the adrenal cortex. Angiotensin receptors are G-protein coupled receptors. The important angiotensin receptors described are: AT 1, 2, 3 and 4. AT 1 is the most important and is involved in vasoconstriction, proliferation, matrix formation and aldosterone secretion. Losartan is a selective antagonist of AT1 rece...
Source: Cardiophile MD - November 27, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs