Your-Doctor Multiple Choice Questions (MCQ)

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Category: Cardiology--->Adult Congenital Heart Disease and Pregnancy
Page: 6

Question 26#Print Question

A 30-year-old woman presents to the clinic 17 weeks pregnant and becoming increasingly breathless. The LVEDD is 6.1 cm and the EF is estimated at 25%.

Which one of the following statements is false?

a. Termination of pregnancy is justified on medical grounds
b. An ACE inhibitor and beta-blocker should be started as soon as possible
c. Prescribing a nitrate and hydralazine may cause the symptoms to subside
d. The patient should rest and be admitted to hospital for this if necessary
e. Premature delivery is likely

Question 27#Print Question

A 9-year-old woman was born with transposition of the great arteries and had a Mustard repair. She has been well throughout her pregnancy, but presents at 37 weeks with a week of worsening dull central chest pain on exertion, associated with shortness of breath. 

Which one of the following statements is false?

a. The woman is probably suffering from coronary insufficiency because the hypertrophied right ventricle only has a single-vessel blood supply
b. This is an acute coronary syndrome in pregnancy, which may be a dissection; the patient should go to the catheterization laboratory
c. The patient should be treated with bed rest and antianginals
d. The patient should be induced if the cervix is favourable
e. The baby should be delivered

Question 28#Print Question

You are called to the labour ward because a 34-year-old woman has become breathless and orthopnoeic 2 hours after delivery. She is pain free. On examination she is tachycardic, tachypnoeic, and has a gallop rhythm. Blood pressure is 136/86 mmHg. On auscultation of her chest she has fine inspiratory crackles to the mid-zones. 

What is the most likely diagnosis?

a. Pulmonary embolism
b. Amniotic fluid embolus
c. Peripartum cardiomyopathy
d. Myocardial infarction
e. Tachyarrhythmia precipitating ventricular decompensation

Question 29#Print Question

A 27-year-old woman presents at 26 weeks gestation in pulmonary oedema. She recently moved to the UK from Pakistan but was previously well. An echocardiogram showed mitral valve disease. The MV area is 1.0 cm2 , mean gradient is 25 mmHg, and PHT is 220 ms.

What is the most appropriate treatment?

a. Deliver the baby by Caesarean section and arrange balloon mitral valvuloplasty
b. Deliver the baby by Caesarean section and arrange mitral valve replacement
c. Arrange urgent mitral valve replacement surgery
d. Arrange an urgent balloon mitral valvuloplasty
e. Bed rest, give diuretics, and treat with a beta-blocker

Question 30#Print Question

A 38-year-old woman presents 34 weeks pregnant to the ED in atrial fibrillation. Blood pressure is 110/62 mmHg. Echocardiograpy and blood test results are normal. 

Which of the following is not a good first line of action?

a. IV amiodarone
b. IV flecainide
c. DC cardioversion
d. IV labetolol
e. IV digoxin

Category: Cardiology--->Adult Congenital Heart Disease and Pregnancy
Page: 6 of 6