MRCP(UK)-1 PREPARATION By Sumanta Sirs Academy CARDIOLOGY Question-01 A 55-year-old man has infective endocarditis. He has refused dental work for a number of years and presented with night sweats and lethargy to his GP. Subsequent blood cultures demonstrated a S. viridans bacteraemia. On examination he is pyrexial, 37.8 oC, his BP is 110/70 mmHg, pulse is 95 bpm. He has splinter haemorrhages on examination of his fingers. Auscultation reveals a murmur consistent with mitral regurgitation. His chest is clear. The table below contains investigation results. Hb 10.7 g/dl WCC 13.1 × 109/litre PLT 211 × 109/litre Na+ 139 mmol/litre K+ 4.9 mmol/litre Creatinine 139 μmol/litre ESR 72 mm/h ECG on admission PR interval 180 ms, otherwise no significant changes Echocardiogram mitral regurgitation with evidence of vegetations Which one of the following would be considered an urgent indication for surgical intervention after 12 days of antibiotic therapy? Increasing PR interval Systolic murmur after 10 days of antibiotics Increasing fever Raised ESR Mobile vegetation > 15mm in size
Posted on: Fri, 07 Mar 2014 06:37:52 +0000
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