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MRCP Part 1 Cardiology — 25 Practice MCQs with Explanations

TL;DR This article offers MRCP Part 1 Cardiology — 25 practice MCQs with explanations to sharpen your exam reasoning in ECGs, murmurs, heart failure, ischaemic disease, and arrhythmias. Use the MCQs to test yourself, understand examiner logic, and identify your weak areas ahead of the actual exam.


Why cardiology matters in MRCP Part 1

Cardiology forms a substantial and high-yield component of the MRCP Part 1 syllabus. It spans physiology, pathology, ECG interpretation, therapeutics, and complications — areas that test both your foundational science and clinical reasoning skills. The MRCP(UK) Part 1 format is two three-hour papers, 100 “best of five” MCQs per paper (i.e. one best answer among five) without negative marking. thefederation.uk+2thefederation.uk+2

Because many cardiology questions are conceptually linked (ECG → pathology → drug effect), practising well-explained MCQs helps you internalise chains of reasoning rather than memorising isolated facts.

Below, you will find a high-yield outline of cardiology topics, a sample MCQ set, traps to watch for, and a strategic checklist to prepare robustly.

(If you want the full set of 25 MCQs in one package, you can access them in the Crack Medicine QBank   — see Crack Medicine QBank below.)


Key cardiology subtopics tested & high-yield tips

Below are 5 frequently tested cardiology subtopics in Part 1, along with 1–2 study tips each:

Subtopic

What often appears

Study tip

ECG & conduction abnormalities

AV blocks, bundle branch blocks, electrolyte changes, infarct localization

Practice ECG interpretation daily; annotate leads and zones.

Valvular disease & murmurs

Murmur type, radiation, dynamic manoeuvres

Create murmur tables and flashcards (e.g. handgrip, Valsalva effects).

Ischaemic heart disease / ACS complications

STEMI evolution, post-MI rupture, cardiogenic shock

Memorise timeline of post-MI mechanical complications.

Heart failure / cardiomyopathy

Systolic vs diastolic, drug sequencing, hemodynamic labs

Draw Frank-Starling curves; build drug trees (ACEi → β-blocker → MRA).

Arrhythmias & anti-arrhythmics

SVT vs VT, torsades, drug side-effects

Focus on ECG pattern + drug mechanism + toxicity (e.g. amiodarone).

In addition, here are 5 classic “traps” or pitfalls in cardiology MCQs:

  1. Distractors that swap class names (e.g. ACE inhibitor vs ARB).

  2. Overly literal ECG wording (e.g. “slight PR prolongation” might be significant).

  3. Confusing dynamic murmur changes (e.g. HOCM vs AS).

  4. Ignoring timeline wording (e.g. “day 4 post-MI” vs “months later”).

  5. Misleading labs or vague symptoms—always map back to physiology.


Sample MCQs with detailed explanations

Below is a mini-set of 5 MCQs drawn from the 25-question package. Use these not only to test but to dissect the logic path.

Q

Question stem

Best answer

Explanation / reasoning

1

A 58-year-old male presents 5 days after anterior STEMI with sudden hypotension, muffled heart sounds, and raised JVP. What is the most likely diagnosis?

Ventricular free wall rupture → pericardial tamponade

Between days 3–7 post-MI, free wall rupture is a known complication. Tamponade features (Beck’s triad) fit.

2

A 40-year-old woman has exertional dyspnoea. On exam: a mid-diastolic rumble after an opening snap at the apex. What is the valve lesion?

Mitral stenosis

Opening snap plus mid-diastolic murmur strongly indicates MS.

3

ECG: regular narrow complex tachycardia at 180 bpm, P waves invisible. Vagal manoeuvres terminate the rhythm. What is the arrhythmia?

AV nodal re-entrant tachycardia (AVNRT)

Narrow complex SVT terminated by vagal indicates nodal re-entry.

4

A 65-year-old diabetic man is on ACE inhibitor and statin. He now has palpitations, tremor, and hyperthyroid labs. Which drug is the likely cause?

Amiodarone

Amiodarone causes both hypo- and hyperthyroidism; its long half-life matters.

5

A patient with long-standing hypertension acutely develops pulmonary oedema with BP 210/120 mmHg. What immediate management is best?

IV nitrate + loop diuretic ± CPAP

Hypertensive acute pulmonary oedema is treated aggressively with vasodilators + diuretic.

After attempting these, review every choice (even those you thought obviously wrong). See why each distractor is plausible and why it's wrong.


Medical trainee analysing ECG and practice MCQs while revising cardiology for MRCP Part 1 exam.

How to integrate the full 25 MCQs into your study plan

Below is a numbered 9-step tactical guide to use the full 25-question set (or any cardiology QBank) effectively:

  1. Simulate exam blocks — take 25 questions in ~45 minutes (avg 1.8 min per question).

  2. No skipping — answer all; flag uncertain ones for review.

  3. Immediate review — go through each answer with explanation, not only wrong ones.

  4. Trace logic paths — write out how you got or eliminated each option.

  5. Error log — maintain a running log or spreadsheet of recurring errors.

  6. Spaced repeat — re-test flagged or weak items after 1 week, then 2 weeks.

  7. Mix in unrelated subjects — interleave cardiology blocks with e.g. respiratory, renal.

  8. Mock environment weekly — include a 25-cardio set as part of full paper.

  9. Peer discussion — discuss tricky questions in study groups or online forums.

If you like, you can access the full 25-question cardiology set via the Crack Medicine QBank, which includes >7,000 exam-style MCQs with clinician-written explanations and performance analytics. Crack Medicine


Final checklist before exam day

  • Review murmur & ECG summary sheets.

  • Re-do all flagged cardiology QBank questions.

  • Read through your error log and explanations.

  • Do at least one full-length mock test (with cardiology included).

  • Sleep early and avoid last-minute topic hopping.

Finish by passing one timed 25-cardio block with ≥ 80 % accuracy. That gives you confidence you can handle cardiology under exam pressure.


FAQs

How many cardiology questions appear in MRCP Part 1?

Typically, cardiology or cardiovascular topics occupy ~10–15 % of the paper, i.e. ~15–25 questions across both papers.

Do MRCP Part 1 cardiology questions include images or ECG tracings?

Rarely. Most are text descriptions (e.g. “ECG shows tall R in V1, deep S in V5–6…”). Very few include actual images.

Is it better to memorise or understand cardiology concepts?

Understanding is essential. Memorisation helps for tables and numbers, but you must be able to reason when the stem is twisted.

Can I rely on one QBank alone for cardiology?

No. Use multiple sources, but be careful not to confuse differing conventions. Always cross-check with guidelines.

Where can I practise authentic MRCP-style cardiology MCQs?

Use the Crack Medicine QBank (exam-aligned, with analytics) or official MRCP sample questions from The Federation website.


Ready to start?

If you found this article helpful, take your learning forward:

  • Access the full set of 25 Cardiology MCQs inside the Crack Medicine QBank for deep practice.

  • Use these MCQs as part of your weekly mock test sessions to simulate exam pressure.

  • Combine them with your ongoing revision in MRCP Part 1 general medicine to maintain integration of systems.

Build your reasoning, track your mistakes, and revisit weak areas. With latent consistency, you’ll turn cardiology from “dreaded system” into an opportunity to score high.

Good luck, and stronger beats ahead!

— The Crack Medicine team


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