comments and reviews of the relevant chapters.
Cardiology Professor Bill Heddle Consultant Cardiologist Department of Cardiology Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Critical Care Medicine Dr Hanmo Li Senior Registrar, Advanced Trainee in Critical Care Medicine Intensive and Critical Care Unit Flinders Medical Centre
Dermatology Dr Alain Tran Senior Registrar, Advanced Trainee in Dermatology, Associate Lecturer Department of Dermatology Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Endocrinology Dr Angela Chen Consultant Endocrinologist Department Endocrinology Flinders Medical Centre
Epidemiology, Statistics and Research Paul Hakendorf Manager, Clinical Epidemiology Unit Flinders Medical Centre
Chris Horwood
Senior Epidemiologist and Data Analyst
Clinical Epidemiology Unit
Flinders Medical Centre
Gastroenterology Dr Alex Barnes Consultant Gastroenterologist, Associate Lecturer Department of Gastroenterology Flinders Medical Centre and College of Medicine and Public Health, Flinders University
General and Geriatric Medicine Dr Pravin Shetty Consultant General Physician and Senior Lecturer Department of General Medicine Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Genetic Medicine Associate Professor Karen Lower Department of Molecular Medicine and Genetics College of Medicine and Public Health, Flinders University
Haematology Dr Angelina Yong Consultant Haematologist Department of Haematology Lyell McEwin Hospital
Immunology Dr Claire Reynolds Senior Registrar, Advanced Trainee in Immunology Department of Immunology Flinders Medical Centre
Infectious Disease Dr Nicholas Anagnostou Consultant Infectious Disease Physician Department of Infectious Disease Flinders Medical Centre
Medical Obstetrics Dr Jessica Gehlert Consultant Endocrinologist, Clinical Pharmacologist and Obstetric Medicine Department of Clinical Pharmacology Flinders Medical Centre
Medical Oncology Dr Anna Mislang Consultant Medical Oncologist Department of Medical Oncology Flinders Medical Centre
Mental Health Professor Michael Baigent Consultant Psychiatrist Centre for Anxiety and Related Disorders Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Nephrology Dr Sarah Tan Senior Registrar, Advanced Trainee in Nephrology, Associate Lecturer Department of Renal Medicine Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Neurology Associate Professor Tim Kleinig Consultant Neurologist and Stroke Physician The Central Adelaide Neurology Service Royal Adelaide Hospital
Pharmacology, Toxicology and Addiction Medicine Dr Jessica Gehlert Consultant Endocrinologist, Clinical Pharmacologist and Obstetric Medicine Department of Clinical Pharmacology Flinders Medical Centre
Radiology Dr Ramon Pathi Consultant Radiologist Medical Imaging Services Flinders Medical Centre
Respiratory and Sleep Medicine Dr Brendan Dougherty Consultant Respiratory Physician Department of Respiratory & Sleep Medicine Flinders Medical Centre
Dr Teng Yuan Kang
Senior Registrar, Advanced Trainee in Respiratory & Sleep Medicine, Associate Lecturer
Department of Respiratory & Sleep Medicine
Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Rheumatology Associate Professor Mihir Wechalekar Consultant Rheumatologist Department of Rheumatology Flinders Medical Centre and College of Medicine and Public Health, Flinders University
Dr Anthea Gist
Senior Registrar, Advanced Trainee in Rheumatology
Canberra Hospital, ACT
1 Cardiology
Questions
Answers can be found in the Cardiology Answers section at the end of this chapter.
1 1. A 65‐year‐old accountant undergoes an abdominal ultrasound because of mildly abnormal liver function tests. The ultrasound reveals a few mobile gallstones and a 5 cm abdominal aortic aneurysm. He drinks three to four standard drinks of alcohol every day and is an ex‐smoker. He is known to have hypertension and is taking irbesartan 150 mg daily. Blood pressure control is satisfactory with mean systolic BP of 130 mmHg.What is your most appropriate course of action?Abdominal CT with contrast immediately and suspension of driver's license.Endovascular aneurysm repair immediately.Follow up ultrasound in 6 months and continue driving.Open surgical aneurysm repair immediately.
2 2. A 39‐year‐old man with a known atrial septal defect presents to emergency department with a 6‐hour history of palpitations. His ECG is shown below:Which one of the following signs is UNLIKELY to be present?Fixed splitting of second heart sound.Fourth heart sound.Loud first heart sound.Third heart sound.
3 3. Which of the following patient characteristics is LEAST LIKELY to increase an individual's susceptibility to anthracycline cardiomyopathy?Age of 70 years.Male sex.Mediastinal radiotherapy.Positive carrier status for C282Y HFE gene.
4 4. A 65‐year‐old‐man presents with a three‐month history of exertional dyspnoea. He is found to have aortic stenosis with a valve area of 0.9 cm2 and a mean transvalvular pressure gradient of 15 mmHg. His left ventricle ejection fraction (LVEF) is 35%. A Dobutamine Stress Echocardiography (DSE) has been arranged which will provide all of the following information, EXCEPT:Confirming the suitability for valve replacement.Deciding the need for cardiac resynchronisation therapy.Predicting prognosis post valve replacement.Diagnosing low‐flow, low‐gradient aortic stenosis.
5 5. An 84‐year‐old man with severe aortic stenosis complains of shortness of breath after walking for 20 metres and a couple of episodes of unexplained collapse. He is independent with activities of daily living. His medical history includes hypertension, hyperlipidaemia, cholecystectomy, and hernia repair.What is the most appropriate management approach?Aortic valve balloon valvuloplasty.Implantable cardioverter–defibrillator (ICD).Surgical aortic valve replacement (SAVR).Transcatheter aortic valve implantation (TAVI).
6 6. You see a 75‐year‐old woman with a new diagnosis of atrial fibrillation. Her CHA2DS2‐VASc score is 4. She has a history of myocardial infarction four years ago, treated with percutaneous coronary intervention and a bare‐metal stent inserted in the right coronary artery, and is currently on aspirin.Which of the following options is the most appropriate regarding ongoing anti‐thrombotic therapy?Coronary angiogram to guide further therapy.Rivaroxaban and clopidogrel.Rivaroxaban and aspirin.Rivaroxaban monotherapy.
7 7. Beta‐blockers
