Module test

Please provide some personal information before proceeding with this Module Assessment. This information is required for creating your certificate and will also assist us in evaluating the website.

Each of the Coronary Heart Disease Managed Clinical Networks (MCNs) in Scotland will be given the names of those who have been awarded Module Assessment Certificates within their areas. We do not collect or share information on the number of times a person attempts the Assessment, or where a certificate is not awarded.

Q.1 Answer

Unfortunately, you have answered Question 1 incorrectly or you may not have selected all the correct answers. Revise the learning materials for Cardiac investigations.

Q.1. Answer

Well done, the correct answer is all of the above.

Q.2 Answer

Unfortunately, you have answered Question 2 incorrectly. Revise the learning materials for Cardiac investigations.

Q.2 Answer

Well done, the correct answer is D. An implantable loop recorder (ILR) would allow either the patient’s husband to activate it if he is present at the time of symptoms or the patient to do so immediately after she recovers.

An event monitor has no role in syncope as it has to be activated by the patient. Continuous ECG monitoring is not indicated as the resting ECG is normal and the episode occurred 3 weeks ago. A 24 hour Holter ECG monitor is only indicated if transient symptoms occur at least once per day.

Q.3. Answer

Unfortunately, you have answered Question 3 incorrectly or you may not have selected all the correct answers. Revise the learning materials for Cardiac investigations.

Q.3. Answer

Well done, the correct answer is B and D. The transducer emits high frequency sounds waves which ‘bounce’ off the heart structures and produce images on a screen. An echo is a good way to look for any regional myocardial damage after an M.I. This can help assess overall heart function and aid decision making about further management.

Coronary arteries lie on the surface of the heart and are too small to be seen on echo. The ejection fraction is a measurement of the hearts contractility, expressed as a fraction, made by measuring the LV cavity size and volume during diastole and systole.

Q.4. Answer

Unfortunately, you have answered Question 4 incorrectly or you may not have selected all the correct answers. Revise the learning materials for Cardiac investigations.

Q.4. Answer

Well done, the correct answer is C and D. Valves are usually well visualised during TOE and one of the most common reasons for performing this procedure is to assess any significant narrowing that may require surgical intervention.

Out patient TOEs are done with local anaesthetic throat spray and a little sedation if the patient requires it. A TOE is the best way to visualise the inter-atrial septum and using agitated saline during the TOE, any defects of the IAS such as PFO or ASD can usually be easily identified.

Q.5. Answer

Unfortunately, you have answered Question 5 incorrectly. Revise the learning materials for Cardiac investigations.

Q.5. Answer

Well done, the correct answer is C. Often a DSE is done on people who cannot exercise enough on a treadmill to give useful information about the cause of their chest pain or breathlessness.

A DSE can induce arrhythmias but cannot be used to assess arrhythmias, this would require a monitoring device such as a cardiocall. Stress echos are done on low risk patients only. Optimal images are obtained when the patient’s heart rate has reached the peak calculated amount for their age i.e 220 beats / per min minus the patients age x 0.85%. Ideally this is maintained until the images are taken and there is no need to increase the HR any further than necessary.

Q.6. Answer

Unfortunately, you have answered Question 6 incorrectly. Revise the learning materials for Cardiac investigations.

Q.6. Answer

Well done, the correct answer is C. MRI uses a magnetic field and radio frequency pulses.

Q.7. Answer

Unfortunately, you have answered Question 7 incorrectly. Revise the learning materials for Cardiac investigations.

Q.7. Answer

Well done, the correct answer is B. CT angiography is a structural test of coronary arteries and does not routinely assess ventricular function.

Q.8. Answer

Unfortunately, you have answered Question 8 incorrectly. Revise the learning materials for Cardiac investigations.

Q.8. Answer

Well done, the correct answer is D. Gadolinium is not used in invasive coronary angiography.

Q.9. Answer

Unfortunately, you have answered Question 9 incorrectly. Revise the learning materials for Cardiac investigations.

Q.9. Answer

Well done, the correct answer B, atrial fibrillation.

Q.10. Answer

Unfortunately, you have answered Question 10 incorrectly. Revise the learning materials for Cardiac investigations.

Q.10. Answer

Well done, the correct answer E, ventricular tachycardia.