General Practice MCQ Answers: 1995



1. A=T, B=F, C=T, D=T, E=T.

Myocarditis may cause a systolic murmur on auscultation because of cardiac dilatation. The blood pressure in myocarditis is often normal, but if myocardial damage is severe there may be severe hypotension.


2. A=F, B=T, C=F, D=F, E=T.

Cardiomyopathy is recognised by left rather than right ventricular dilatation and systolic dysfunction in the absence of coronary artery, valvular, congenital or peripheral disease. Thus according to this definition, cardiomyopathy would not be associated with valve calcification. Cardiomyopathy is associated with thyrotoxicosis and acromegaly. Alcoholic cardiomyopathy has a poor prognosis 40-50% are dead within 3 to 6 years.


3. A=F, B=F, C=F, D=T, E=T.

As many as 30-50% cases diagnosed as chronic heart failure (CHF) are incorrectly labelled as such. CHF rarely occurs if both ECG and chest X-rays are normal. The JVP is a particularly useful clinical sign. In the CONSENSUS study Angiotensin Converting Enzyme (ACE)inhibitors promoted a dramatic mortality reduction in patients with severe heart failure. Thyroid function tests are important, because thyrotoxicosis is a treatable cause of heart failure. ACE inhibitors may be problematic in the elderly with hypotension and effects on renal function as two severe side effects.


Copyright Dr Ben Green 1995

Go back to the questions?

Return to General Practice On-Line