PA Wiz

Menu
Register

Report a question

You cannot submit an empty report. Please add some details.

All Cardiology

Contains all the cardiology questions from the question bank!

1 / 13

Category: Cardiovascular

1) You are Physician Associate working in the emergency department. Your next patient is a 28-year-old tall and thin man presenting with a three-week history of gradually worsening exertional shortness of breath. He has minimal alcohol intake, a 5 pack-year smoking history, and no known allergies. Systems review is unremarkable.

Vital signs: Heart rate 75 bpm, respiratory rate 18, blood pressure 140/55 mmHg, oxygen saturation 99% on ambient air and temperature 37 degrees.

During examination, a diastolic murmur is detected over the parasternal 2nd intercostal space, most audible during expiration. The apex beat is displaced. Breath sounds are normal. An ECG reveals T-wave inversion in aVL and lead I.

What is the most likely diagnosis?

 

2 / 13

Category: Cardiovascular

2) A 50 year old gentleman has been brought in by ambulance to A&E. He is complaining of chest pain.  

Vital signs: Heart rate 100bpm, blood pressure 90/110 mmHg, heart sounds are distant, he has an elevated jugular venous pressure and pulsus paradoxus >10mmHg. ECG shows electrical alternans.  

Based off the likely diagnosis what triad is seen in this presentation?

 

3 / 13

Category: Cardiovascular

3) A 60-year-old man with a medical history of hypertension, hypothyroidism, and type 2 diabetes is currently prescribed losartan, Ibuprofen, metformin, aspirin, and levothyroxine. He is expressing discomfort due to the onset of a bothersome cough.

What medication is likely to be causing this cough?

 

4 / 13

Category: Cardiovascular

4) You are a Physician Associate in the emergency department. A 50-year-old male presents with palpitations, light-headedness, and a heart rate of 160 bpm. His ECG shows narrow complex tachycardia.

What is the most likely diagnosis?

 

5 / 13

Category: Cardiovascular

5) A 50 year old gentleman from an African descent has recently been diagnosed with essential hypertension after an average ambulatory blood pressure reading of 138/90 mmHg. Past medical history includes well controlled type 2 diabetes.

What would be the first-line management for this patient? 

 

6 / 13

Category: Cardiovascular

6) Your next patient in the ED has presented with vomiting. As part of the initial work-up, an ECG was performed which shows U waves and inverted T waves.

What is the likely diagnosis?

7 / 13

Category: Cardiovascular

7) A 59-year-old Caucasian male attends his yearly diabetic review. A routine examination discloses elevated blood pressure, measuring 150/95 mmHg in the clinic. Further monitoring indicates an average daytime blood pressure of 147/95 mmHg. His latest HbA1c is 56 mmol/mol, and renal function is within the normal range. The urine dipstick results are negative.

What is the most appropriate first-line treatment?

 

8 / 13

Category: Cardiovascular

8) You are a Physician Associate in General Practice. A 60-year-old woman with a history of diabetes presents with fatigue, dyspnoea on exertion, and bilateral ankle swelling. Her BNP level is elevated.

What is the most likely diagnosis?

 

9 / 13

Category: Respiratory

9) You are a Physician Associate working in General Practice. The booking note for your next patient says, “lung problem.” He is a 60-year-old man with a background of hypertension and diabetes who presents with difficulty breathing when lying down and waking up breathless at night. Examination reveals crackles at the lung bases and swollen ankles.

What is the most likely diagnosis?

10 / 13

Category: Cardiovascular

10) You are a Physician Associate in General Practice. A 65-year-old man presents with chest pain that occurs during exertion and is relieved by rest.

What is the most likely diagnosis?

11 / 13

Category: Cardiovascular

11) You are a Physician Associate working in a cardiology clinic. A 55-year-old man with a history of hypertension and hyperlipidaemia presents with chest pain that started 2 hours ago.

His ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?

 

12 / 13

Category: Cardiovascular

12) You are a Physician Associate in the emergency department. A 70-year-old woman presents with sudden onset of severe chest pain radiating to her back. She is hypertensive and diaphoretic. What is the most likely diagnosis?

 

13 / 13

Category: Cardiovascular

13) A mental health review for a 58-year-old Caucasian male, currently using sertraline for depression, reveals elevated blood pressure during a routine examination. His clinic blood pressure measures 162/92 mmHg, and this is corroborated by an average of 140/89 mmHg from home blood pressure monitoring.

Which is the most appropriate course of action?

 

Your score is

The average score is 0%

0%

Reference Ranges:

Full blood count (FBC)
Haemoglobin (Hb)
  • Male: 130 – 180 g/L
  • Female: 115 – 165 g/L
White cell count (WCC)
  • Total: 3.6 – 11.0 x 10⁹/L
  • Neutrophils: 1.8 – 7.5 x 10⁹/L
  • Lymphocytes: 1.0 – 4.0 x 10⁹/L
  • Monocytes: 0.2 – 0.8 x 10⁹/L
  • Eosinophils: 0.1 – 0.4 x 10⁹/L
  • Basophils: 0.02 – 0.10 x 10⁹/L
Platelet count
  • 140 – 400 x10⁹/L
Red cell count (RCC)
  • Male: 4.5 – 6.5 x 10⁹/L
  • Female: 3.8 – 5.8 x 10⁹/L
Haematocrit
  • Male: 0.40 – 0.54 /L
  • Female: 0.37 – 0.47 /L
Mean cell volume (MCV)
  • 80 – 100 fL
Mean corpuscular haemoglobin (MCH)
  • 27 – 32 pg/cell
Reticulocyte count
  • 0.2 – 2%
Coagulation
Prothrombin time (PT)
  • 10 – 14 seconds
Activated partial thromboplastin time (APTT)
  • 24 – 37 seconds
Fibrinogen
  • 1.50 – 4.50 g/L
D-Dimer
  • 500 ng/mL
Haematinics
Ferritin
  • Male: 25 – 350 ng/mL
  • Female: 10 – 300 ng/mL
Vitamin B12
  • 180 – 1000 pg/mL
Folate
  • 4.0 ng/mL
Total serum iron
  • Male: 11.6 – 35.0 μmol/L
  • Female: 4.6 – 30.4 μmol/L
Transferrin
  • 2.0 – 3.6 g/L
Transferrin saturation
  • 20 – 50%
Total iron binding capacity (TIBC)
  • 45 – 81 μmol/L
Erythrocyte sedimentation rate (ESR)
  • Male: ≤ 49 years: 1 – 7
  • Male: ≥ 50 years: 2 – 10
  • Female: ≤ 49 years: 3 – 9
  • Female: ≥ 50 years: 5 – 15
 
Urea & electrolytes
Na⁺
  • 133 – 146 mmol/L
K⁺
  • 3.5 – 5.3 mmol/L
Ca²⁺ (adjusted)
  • 2.2 – 2.6 mmol/L
Mg²⁺
  • 0.7 – 1.0 mmol/L
Phosphate
  • 0.74 – 1.4 mmol/L
Chloride
  • 98 – 106 mmol/L
Urea
  • 2.5 – 7.8 mmol/L
Creatinine
  • Male: 59 – 104 μmol/L
  • Female: 45 – 84 μmol/ L
Liver function tests (LFTs)
Alkaline phosphatase (ALP)
  • 30 – 130 U/L
Alanine aminotransferase (ALT)
  • Male: < 41 U/L
  • Female: < 33 U/L
Aspartate aminotransferase (AST)
  • 1 – 45 U/l
Bilirubin
  • <21 μmol/L
GGT
  • Male: < 60 U/L
  • Female: < 40 U/L
Albumin
  • 35 – 50 g/L
Inflammatory markers
CRP
  • 5mg/L
Arterial blood gas
pH
  • 7.35 – 7.45
PaO₂
  • 11 – 13 kPa (82.5 – 97.5 mmHg)
PaCO₂
  • 4.7 – 6.0 kPa (35.2 – 45 mmHg)
HCO₃
  • 22 – 26 mmol/L
Base excess (BE)
  • (-2 to +2 mmol/L)
Metabolic tests
Serum ketones
  • < 0.6 mmol/L
Fasting blood glucose
  • 4.0 to 6.0 mmol/L
Postprandial (2 hours after eating)
  • up to 7.8 mmol/L
HbA1c
  • < 42 mmol/mol (6.0%)
Cholesterol
  • < 5 mmol/L
Triglyceride
  • 0.55 – 1.90 mmol/L
LDL
  • < 3mmol/L
HDL
  • > 1 mmol/L
Cholesterol/HDL
  • < 4
Endocrinology
TSH
  • 0.4 – 5.0 mU/L²
Free T4
  • 9 – 24 pmol/L
Free T3
  • 3.5 – 7.8 pmol/L
Parathyroid hormone
  • 10 – 65 ng/L
Growth hormone (random)
  • < 5 ng/mL
  • < 10 ng/mL
Cortisol (random)
  • 137 – 429 nmol/L
Testosterone
  • Male <50: 10-45 nmol
  • Male >50: 6.2-26 nmol
Other biochemistry tests
Serum total protein
  • 60 – 78 g/L
Troponin T
  • < 0.01 µg/L
Creatine kinase (CK)
  • Male: 40 – 320 U/L
  • Female: 25 – 200 U/L
Lactate dehydrogenase (LDH)
  • 240 – 480 U/L
Lactate (plasma)
  • 0.5 – 2.2 mmol/L
Urate
  • Male: 200 – 430 μmol/L
  • Female: 140 – 360 μmol/L
Amylase
  • 28 – 100 U/dL
Ammonia
  • 10 – 35 μmol/L
NT-proBNP
  • <75 years: <125 pg/mL
  • >75 years: <450 pg/mL
Copper
  • 70 – 150 μg/dL
Ceruloplasmin
  • 15 – 60 μmol/L
Vitamin D
  • >50 nmol/L
Serum osmolality
  • 275 – 295 mOsmol/kg
24h urine osmolality
  • 500 – 800 mOsm/kg
Random urine osmolality
  • 300 – 900 mOsm/kg
12h fluid restricted urine osmolality
  • >850 mOsm/kg
24h urine sodium (Na⁺)
  • 100 – 260 mmol/24h
24h urine potassium (K⁺)
  • 25 – 100 mmol/24h
24h urine total protein
  • < 100 mg/24h
Urine pH (random)
  • 5 – 7
Adult vital signs
Body temperature
  • 36.5°C to 37.3°C
  • 97.8°F to 99.1°F
Pulse
  • 60 – 100 beats per minute
Blood pressure
  • 90/60 – 120/80 mmHg
Respiratory rate
  • 18 breaths per minute
Pulse oximetry
  • >94%
Paediatric vital signs
Blood pressure
  • < 1 year: 70 – 90 mmHg
  • 1 – 2 years: 80 – 95 mmHg
  • 2 – 5 years: 80 – 100 mmHg
  • 5 – 12 years: 90– 110 mmHg
Heart rate
  • < 1 year: 110 – 160
  • 1 – 2 years: 100 – 150
  • 2 – 5 years: 95 – 140
  • 5 – 12 years: 80 – 120
Respiratory rate
  • < 1 year: 30 – 40
  • 1 – 2 years: 25 – 35
  • 2 – 5 years: 25 – 30
  • 5 – 12 years: 20 – 25
Tumour markers
Beta human chorionic gonadotrophin (bHCG)
  • < 5 mU/mL
Alpha fetoprotein
  • < 44 ng/mL
Prostate specific antigen (PSA)
  • < 4.0 ng/mL
Carcinoembryonic antigen (CEA)
  • Non-smokers at 50 years: < 3.6μg/L
  • Non-smokers at 70 years: < 4.1μg/L
  • Smokers: < 5μg/L
CA-125
  • < 35 U/mL
CA19-9
  • < 40 U/mL
Immunology
Anti-SS-A (La)
  • Negative: < 3 U/mL
  • Positive: > 4 U/mL
Anti-streptolysin O titre (ASOT)
  • Pre-school age: < 100
  • School age: < 250
  • Adults: < 125
Rheumatoid factor (RF)
  • Negative: < 20 U/mL
  • Positive: > 30 U/mL
Anti-mitochondrial antibodies (AMA)
  • Negative: < 10 U/mL
  • Positive: > 10 U/mL
Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)
  • Negative: < 5 U/mL
  • Positive: > 5 U/mL
Anti-histone antibodies
  • Negative: < 25 U/mL
  • Positive: > 25 U/mL
IgA
  • 110 – 560 mg/dL
IgD
  • 0.5 – 3.0 mg/dL
IgE
  • 0.01 – 0.04 mg/dL
IgG
  • 800 – 1800 mg/dL
IgM
  • 54 – 200 mg/d
Anti-ds-DNA
  • Negative: < 40 U/mL
  • Positive: > 60 U/mL
Anti-ss-DNA
  • Negative: < 8 U/mL
  • Positive: > 10 U/mL
Cytoplasmic anti-neutrophil cytoplasmic antibodies (c-ANCA)
  • Negative: < 20 U/mL
  • Positive: > 30 U/mL
Anti-SS-A (Ro)
  • Negative: < 15 U/mL
  • Positive: > 25 U/mL
Lumbar puncture results
Appearance
  • Clear and colourless
White blood cells (WBC)
  • 0 – 5 cells/µL
  • No neutrophils present, primarily lymphocytes
  • Normal cell counts do not rule out meningitis or any other pathology
Red blood cells (RBC)
  • 0 – 10/mm³
Protein
  • 0.15 – 0.45 g/L (or <1% of the serum protein concentration)
Glucose
  • 2.8 – 4.2 mmol/L (or ≥ 60% plasma glucose concentration)
Opening pressure
  • 10 – 20 cm H₂O