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MRCPI Part 2 → Cardiology

Cardiology for MRCPI Part 2

Cardiology accounts for roughly 10% of the MRCPI Part 2 blueprint. This bank has 1 item tagged to it.

How much of MRCPI Part 2 is cardiology?

Around 10% of the paper, per RCPI examination regulations and training curricula. That weighting is why the DocPasser mock builder samples sections in proportion rather than shuffling everything into one pile — practising a flat distribution trains you for a paper that does not exist.

Verification status. All 3 published figures on this page have been read in the source document and dated above. Source of truth: RCPI examination regulations and training curricula, Royal College of Physicians of Ireland. How we verify.

Sample cardiology questions

A 74-year-old woman presents with exertional syncope and breathlessness. Echocardiography shows severe aortic stenosis with a mean gradient of 52 mmHg and a valve area of 0.7 cm². Ejection fraction is 55%. She is frail with a Society of Thoracic Surgeons predicted mortality of 9%, and has severe COPD and previous mediastinal radiotherapy. What is the most appropriate management?

  1. Start an ACE inhibitor and a beta blocker for symptom control Wrong and potentially harmful. Vasodilators must be used cautiously in severe aortic stenosis because a fixed obstruction cannot compensate for a fall in systemic vascular resistance.
  2. Balloon aortic valvuloplasty as definitive treatment Wrong as definitive treatment. Restenosis occurs within months, so it is a bridge to definitive intervention or a palliative measure.
  3. Medical management with a diuretic and review in six months Wrong. Symptomatic severe aortic stenosis has a dismal prognosis without intervention, and there is no medical therapy that alters it.
  4. Conventional surgical aortic valve replacement Reasonable in a low-risk patient, but her surgical risk score, frailty, lung disease and previous mediastinal radiotherapy all push towards a transcatheter approach.
  5. Refer to the heart team for consideration of transcatheter aortic valve implantation correct Correct. Symptomatic severe aortic stenosis is an indication for intervention regardless of ejection fraction, and syncope carries a particularly poor prognosis untreated. High surgical risk from frailty, lung disease and previous mediastinal radiotherapy makes TAVI the appropriate route, and the decision belongs to a multidisciplinary heart team.

The point: Aortic stenosis becomes an intervention decision the moment it becomes symptomatic: angina, syncope, or heart failure. Severe is a mean gradient above 40 mmHg, peak velocity above 4 m/s, or area below 1 cm². Avoid vasodilators. The heart team decides surgery versus TAVI on risk and anatomy.

Source: ESC/EACTS guidelines for the management of valvular heart disease European Society of Cardiology · tier 2, specialty society or college

The other sections of MRCPI Part 2

Respiratory medicine · Gastroenterology and hepatology · Neurology · Endocrinology and metabolic medicine · Nephrology · Rheumatology · Haematology · Infectious diseases and tropical medicine · Oncology and palliative care · Dermatology · Clinical pharmacology and therapeutics · Clinical sciences and statistics · Acute and critical care medicine

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DocPasser is exam preparation material, not clinical guidance. Nothing here should be used to make a decision about a real patient. Always work from your own local guidelines and seniors.