Quiz: Cardiology MCQs

Typical chest pain of myocardial ischemia characterized by

A a. Retrosternal compressing pain B b. Referred to left shoulder, arm, and left jaw C c. Improved by sublingual nitrate D d. All of the above

diagnosis of Rh fever by the following

A a. One major Jones criteria and one minor B b. Three minor Jones criteria only C c. Two major Jones criteria only D d. One or two major Jones criteria and two minor

Unstable angina characterized by

A a. Increased frequency of pain B b. Increased duration of pain C c. Increased severity of pain D d. All of the above

duration of secondary prevention of Rh fever in Rh carditis and residual lesion

A a. 5 years or until age of 21 B b. 10 years after the last attack or at least 40 year C c. for at least 40 years or sometimes for life D d. 10 years or well enter in adulthood

Signs of severe MS are the following except

A a. long duration of murmur B b. closing of OS from A2 C c. louder murmur of MS D d. none

the following are clinical findings of MS except

A a. accentuated Sl B b. OS with presystolic accentuated in sinus rhythm patients C c. Pansystolic murmur at lower left sternal border D d. Weak P2

patient coming to ED by typical chest pain first investigation should be done

A a. cardiac enzyme B b. chest x-ray C c. ECG D d. Echocardiography

Rate of AF true for one of the following

A a. 350-400 B b. 288-550 C c. 400-600 D d. 370-450

the following enzymes elevated in acute MI except

A a. CK B b. LDH C c. Troponin T.I D d. Alkaline phosphatase

the most dangerous symptoms with severe AS is

A a. drowsiness B b.chest pain C c. syncope D d. dyspnea

the following are signs of infective endocarditis except

A A. roth spots B B. jenway bodies C C. oslar,s nodules D D. Muller flush

the most common cause of secondary hypertension is

A a. Cushing disease B b. renal disease C c. thyrotoxicosis D d. Addison's disease

the following drugs used in treatment of hypertension except

A a. captopril B b. valsartan C c. amlodipine D d. tirifopane

the following drugs used in treatment of unstable angina

A a. asprin and clopodegrel B b. trimitazidine and potassium channels openers C c. tenormin and altiazem D d. all of the above

the following are type of dyspnea except

A a. dyspnea on severe exertion B b. exertional dyspnea C c. orthopnea D d. PND

the following Are the cause of syncope except

A a. mild mitral setenosis B b. complete heart block C c. severe aortic stenosis D d. severe pulmonary hypertension

Based on the recent IE diagnostic criteria, the two most important parameters for diagnosis of the infections are

A a. laboratory abnormalities and positive blood cultures B b. positive blood cultures and echocardiographic changes C c. positive physical findings and positive blood cultures D d. ECG and positive physical findings

45 years old female schedule for dental extraction she is prosthetic valve and allergic to penicillin the most drug indicate is

A a. ampicillin 2g orally I h before procedures B b. clindamycin 600mg orally 1 h before procedures C c.cephalexin 500mg orally 2 h before procedures D d. no need for prophylaxis

the following drugs used in treatment of infective endocarditis except

A A. streptomycin B B. vancomycin C C. penicillin D D. garamycin

the following drugs are improve mortality in heart failure except

A A. ACEIS B B. mineralocorticoids C C. Beta Blockers D D. digitalis

Accentuated first heart conditions sound (S1) is due to the following except

A A- Mitral stenosis B B- Atrialmyxoma C C- Short P-R interval D D- Hyperdynamic circulation

Which one of the following heart sounds is low pitched, presystolic Sound of ventricular filling by atrial contraction

A A-SI B B- Opening Snap C C-S4 D D- Midsystolic click

Causes of congested pulsating neck veins include all except

A A- right sided heart failure B B- increased intra-thoracic pressure C C- superior vena caval obstruction D D- hypervolaemia

As regard auscultation of the heart, which is True

A A. Diastole occurs after the first heart sound B B. Expiration increases the split of the second sound C C. A loud opening snap occurs late in diastole in severe MS D D. A fourth heart sound coincides with atrial systole

The following statement about cardiac murmurs is false

A A. Mitral valve prolapse associated with mid-systolic murmur B B.Mitral diastolic murmur best heard at the left sternal edge with the patient leaning forwards C C. Innocent cardiac murmur is soft, short, systolic and changeable D D. Graham steel murmur is a soft diastolic murmur

Diastolic murmur heard in left parasternal area in the following except

A A. PDA B B. Pulmonary Regurge C C. Aortic Regurge D D. TricuspedRegurge

Left sided fourth heart sound (S4) indicates

A A. Pulmonary stenosis B B. AF C C. Mitral Regurgitation D D. Systemic hypertension

Disorders produce suddenonset of Acute severe symptomatic MR include the following except

A A. Acute Myocardial Infarction B B. Acute viral pericarditis C C. Acute rheumatic fever D D. Acute Infective endocarditis

Which one of The following auscultatory findings are associated with the phenomena shown below

A A- Third heart sound…………- Opening of mitral valve B B- Varying intensity of S1…… Rheumatic activity C C- Soft S1……. Mitral stenosis D D- Reversed splitting of S2…… Aortic stenosis

Apical rumbling diastolic murmur is caused by except

A A- Acute RF B B- Left atrial myxoma C C- Mitral stenosis D D-Tricuspid stenosis

Clinical features suggesting severe AR include all except

A A- earlypeakholo-diastolic murmur B B- Corrigan pulse C C- displaced apex beat D D- paradoxical splitting of second heart sound

Which one of the following excludes an Austin Flint diastolic murmur?

A A- Grade 4/6 aortic regurgitation murmur B B- An opening snap. C C- An S3 gallop D D- Arterial BP of 160/60 mm Hg

In Aortic Valve disease

A A- AR may be caused byLack of cusp support due to VSD B B- splitting ofS2 increased with inspiration in severe AS. C C- Patients with anginal symptoms with severe aortic stenosis have higher mortality rate than others D D- The Austin Flint murmur is apical and systolic

All are False in patients with significant mitral stenosis except

A A- Left atrial enlargement cannot be detected on the chest X-ray B B- Mitral balloon valvuloplasty is not advisable if there is also significant mitral regurgitation C C- There is soft carly diastolic murmur D D- There is a quiet first sound and absence of an opening snap

Regarding the jugular venous pressure All are True except

A A- Normally rise during Expiration B B- Has abscent 'a' wave in atrial fibrillation C C- Tricuspid regurgitation produces large 'v' waves D D- The first heart sound occurs before the 'a wave

As regard kussmaul's sign, which statement is True

A A - It is also called hepato-jugular reflux test B B- A clinical sign of both cardiac tamponade and pulmonary embolism C C- Indicate severe Tricuspid regurge D D- There is expiratory filling of neck veins

Canon A- wave occurs in

A A. Pulmonary stenosis B B. AV dissociation C C. AF D D. Tricuspid regurge

Prominent V- wave in JVP occurs in

A A. Constrictive pericarditis B B. Pulmonary hypertension C C. ASD D D. Pericardial effusion

Which one of the following patientsneeds prophylaxis endocarditis: ?

A A. Patient with isolated secundum ASD having dental extraction B B. Patient with MV Prolapse having cystoscopy C C. Patient with Prosthetic Valve having dental cleaning and scaling D D. Patient with coarctation of aorta having cardiac catheterization

In the management of infective endocarditis

A A. Blood cultures are must be obtained when the fever peaks B B. Antibiotic therapy must be delayed till bacteriological confirmation C C. Parenteral antibiotic therapy should be continued for 2 weeks D D. Cardiac surgery considered if the vegetations are very large

The following are causes of culture negative endocarditis except

A A- Fastidious organism B B- Fungal infection C C- Recent use of antibiotics D D- Streptococcus viridians

The common pathogens late prosthetic valve endocarditis is

A a. Pneumococcus B b. Staph.Aureus C c. Strept. faecalis D d. Strept. viridans

In infective endocarditis, all are true except

A a. Streptococci and staphylococci account for over 80% of cases B b. Left heart valves are more frequently involved than right heart valves C c. Glomerulonephritis usually occurs due to immune complex disease D d. A normal echocardiogram excludes the diagnosis

The common aetiological factor of Pericarditis and pericardial effusion is

A a. chronic renal failure B b. Viral C c. Idiopathic D d. Tuberculous

All of the following are hypertensive emergenceis except

A a. Pre-eclampsia B b. Aortic dissection C c. Severe epistaxis D d. Encephalopathy

White coat hypertension is best diagnosed by

A a. Regular office measurement B b. Ambulatory blood pressure monitoring C c. Sphygnomanometer D d. Measuring blood pressure in both limbs

The following are causes of secondary Hypertension excep

A a. NSAIDS B b. catecholamines-secreting tumour C c. Renal artery stenosis D d. vascular smooth muscle hyperplasia

The following are causes of surgically correctable Hypertension except

A A. A Thyroid disorders B B. Pheochromocytoma C C. Co-arctation of Aorta D D. Chronic parenchymal renal disease

Hill sign indicates

A A. Aortic stenosis B B. Aortic regurge C C. Coarctation of aorta D D. Mitral regurgitation

The followings may occur with RT sided heart failure except

A A. PND B B. Positive hepatojugular reflux C C. RT hypochondrial pain D D. Lower limb oedema

Central cyanosis in infancy is an expected finding in the following congenital heart disease

A A. Persistent ductus arteriosus B B. Transposition of the great arteries C C. Coarctation of the aorta D D. Ventricular septal defect

Diagnosis of Rheumatic Fever in patient with an elevated ASO titre is confirmed by

A a. Fever with an elevated erythrocyte sedimentation rate B b. Arthralgia and a previous history of rheumatic fever C c. Chorea and a prolonged PR interval on EGG D d. Erythema nodosum and arthritis

As regard Aortic Dissection

A a. Anatomical classification is the most popular one B b. Duration of Acute AD is less than 4 weeks C c. Definite Therapy of Proximal Type is Surgical D d. Endovascular Stents have a role in selected cases

Commonest site of Intimal Tear in AD is

A A. Ascending Aorta in approximately 45% of cases B B. Descending Thoracic Aorta in approximately 20% of cases C C. Ascending Aorta in approximately 70% of cases D D. Arch of Aorta in approximately 10% of cases

As regard Management of Aortic Dissection

A A. Surgery is The main Therapy of Type A B B. Endovascular Repair for Complicated Type B C C. Endovascular Repair for Non-complicated Type B D D. Endovascular Repair for Non-complicated Type A

16 year boy with ejection systolic murmur with systolic click over aortic area, BP 120/70, ECG shows LV hypertrophy, The best explanation is

A A. Flow murmur B B. Coarctation of aorta C C. НОСМ D D. Bicuspid aortic valve

82 year old man, story about AS, aortic valve area = 0.75cm2 pulmonary oedema refractory to diuretics, proper Therapy is

A A. Valve replacement B B. Balloon valvuloplasty C C. Increase diuretic D D. Vasodilators

38 year old presented by Osler Triad. Most likely organismis

A A. Klebsiella B B. Staph. aureus C C. Fseudomonas D D. Strep. pneumonae

47 Y. O Male hypertensive patient presented with sudden onset of severe mid scapular pain, BP left arm 210/110, BP right arm 80/60, quiet heart sounds. Best initial therapy Aortic disease

A A- Pericardiocentesis B B- Vasodilator then Beta Blocker C C- Pulmonary embolectomy D D- Beta Blocker then Vasodilator

Features of cardiac edema are all excent

A a. edema is dependent B b. edema is bilateral and equal C c. edema of lower limbs precedes appearance of ascites D d. edema is tender and non pitting

Causes of severe cardiac pain include all except

A A. myocardial infarction B B. pericarditis C C. pulmonary embolism D D. aortic dissection

Causes of congested pulsating neck veins include all except

A A- right sided heart failure B B- increased intra-thoracic pressure C C- superior vena caval obstruction D D- hypervolaemia

Accentuated first heart sound (S1) is due to the following conditions except

A A- mitral stenosis (MS) B B- mitral regurgitation (MR) C C- short P-R interval D D- hyperdynamic circulation

Rumbling diastolic murmrith opening snap is due to

A A-aortic regurgitation B B- mitral regurgitation C C- mitral stenosis D D- tricuspied regurgitation

Causes of fourth heart sound (S4) is due to the following conditions except

A A- systemic hypertension B B- mitral stenosis C C- aortic stenosis D D- myocardial infarction

As regard kussmaul's sign:except

A A- indicates positive hepato-jugular reflex test B B- a clinical sign of both cardiac tamponade and pulmonary embolism C C- indicates Rt-sided heart failure D D- there is inspiratory filling of neck veins

Which one of the following excludes an Austin Flint diastolic rumble?

A A. Grade 2/6 short aortic regurgitation murmur B B. An opening snap C C. An S3 gallop D D. Arterial BP of 160/60 mm Hg

Which one of the following laboratory tests is the best to determine the severity of aortic stenosis?

A a. Echo demonstration of aortic valve calcification B b. ECG evidence of LV hypertrophy C c. Echo/Doppler calculations of velocity, gradient, and valve area D d. Cardiomegaly on chest X-ray

The diagnosis of rheumatic fever in apatient with an elevated ASO titre is confirmed by

A a. Fever with an elevated erythrocyte sedimentation rate B b. Arthralgia and a previous history of rheumatic fever C c. Chorea and a prolonged PR interval on EGG D d. Erythema nodosum and arthritis

Disorders typically producing the sudden onset of severe symptomatic MR include the following except

A a. Marfan's syndrome B b. constrictive pericarditis C c. acute rheumatic fever D d. infective endocarditis

Clinical features suggesting scyere aortic stenosis include

A a. delayed peak-systolic ejection murmur B b. pulsus bisferiens C c. heaving, displaced apex beat D d. syncope associated with angina

Central cyanosis in infancy is an expected finding in the following congenital heart disease

A a. Persistent ductus arteriosus B b. Transposition of the great arteries C c. Coarctation of the aorta D d. Ventricular septal defect

Which one of the following should not be administered to a patient with a non-STEMI?

A a. IV nitroglycerin B b. IV metoprolol ( beta blocker) C c. IV streptokinase D d. IV heparin

The jugular venous pressure

A a. Directly reflects left atrial pressure B b. Normally rises on inspiration C c. Has an abnormal 'a' wave in atrial fibrillation D d. Tricuspid regurgitation produces large 'v' waves

In the auscultation of the heart

A a. Diastole occurs after the first heart sound B b. Expiration increases the split of the second sound C c. A loud opening snap occurs late in diastole in severe MS D d. A fourth heart sound coincides with atrial systole

In Mitral Stenosis

A a. The severity of the stenosis is inversely proportional to the interval between the second sound and the opening snap B b. Haemoptysis may indicate pulmonary infarction C c. Atrial fibrillation is well tolerated D d. Mid diastolic rumbling murmur with variable S1 intensity

In aortic valve disease

A a. The murmur of AR is accentuated by expiration B b. splitting of S2 increased with inspiration in severe AS. C c. Patients with anginal symptoms with severe aortic stenosishave higher 5 years mortality rate than others D d. The Austin Flint murmur is apical and systolic

A contraindication of thrombolytic therapy

A A. A.50 y.o pt with previous stroke B B. Patient with his BP 170/95 mmhg C C. 35 y.o young female in menses D D. Pt with severe chest pain reffered to the back

accentuated first heart sound jound in due to the following Except

A A- Maitral stenosis B B- Atrial myxomatosis C C- Short P& R interval D D- Hyperdynamic circulation

Casses of congested pulsating neck vien include all the following except

A A- Right side HF B B- Increase intrathoracic pressure C C- Superior Vena Cava obstruction D D- Hypervolemia

As regards auscultation of the heart, which is True

A A. after the first heart sound B B. Expiration increases the split of the second sound C C. Openting snap occurs late in diastole in severe MS D D. Fourth sound coincides with atrial systole

Diagnosis of Rheumatic Fever in patient with an elevated ASO titre confirmed by

A A. Fever with an elevated erythrocyte sedimentation rate B B. Arthralgia and a previous history of Rheumatic fever C C. Chorea and a prolonged PR interval on EGG D D. Erythema nodosum and arthritis

The following statement about cardiac murmurs is true

A A. Mitral valve prolapse associated with soft diastolic murmur B B. Mitral diastolic murmur best heard at the left sternal edge with the patient leaning forwards C C. Innocent cardiac murmur is soft, short, systolic and changeable D D. Graham steel murmur is a soft mid-systolic murmur

All but one are False in patients with significant mitral stenosis

A A- Left atrial enlargement cannot be detected on the chest X-ray B B- Mitral balloon valvuloplasty is not advisable if there is also significant mitral regurgitation C C-There is soft early diastolic murmur D D- There is a quiet first sound and absence of an opening snap

Thrombus us the then after in all of the following except

A A. A STEMI B B. Massive pulmonary embolism C C. NON STEMI D D. Manive DVT

Which one of the following patients needs prophylaxis endocarditis ?

A A. Patient with isolated secundum ASD having dental extraction B B. Patient with MV Prolapse having cystoscopy C C. Patient with Prosthetic Valve having dental cleaning and scaling D D. Patient with coarctation of aorta having cardiac catheterization

The following are causes of culture negative endocarditis except

A A. A Inefficient culture techniques B B. LibmanSach endocarditis C C. Prior use of antibiotics D D. Strept bovis

The common pathogens late prosthetic valve endocarditis is

A a. Pneumococcus B b. Staph.Aureus C c. Strept. faecalis D d. Strept. viridans

All of the following are hypertensive emergenceis except

A A. Pulmonary edema B B. Aortic dissection C C. Epistaxis D D. Encephalopathy

Secondary hypertension characterized by all of the follow except

A A. Renal cause is the most common B B. Age of onset more than 55 years C C. Less severe than primary type D D. Treatment of the cause is the target

Hill sign indicator

A A. severe Aortic stenosis B B. Severe Aortic recurge C C. Coarctation of aorta D D. Mitral regurgitation

As regard to diagnos.of.antic.m

A A. A D-Dimer in specific B B. Normal chest X ray does C C. STQTT is specific echo sign D D. ECG is the most important in diagnosis

Angina in age related server AS may be dut to

A A-Increase myocardial oxygen demand B B-Coronary atherosclerosis C C- Cow cardiac output D D-All of the above

A drug contraindicated in HF due to see AS

A A-Beta blockers B B-Digitalis C C-ACE inhibitors D D-Diuretics

Acute coronary syndrome include the following

A A. Acute MI B B.Prinzmetal angina C C.Unstable angina D D. A+C

Osler Triad includes the following except

A A-Meningitis B B- Pneumonia C C-Endocarditis D D- Rheumatic activity

Central cyanosis in infancy is an expected finding in...The. following congenital heart disease

A A. 'persistent ductus arteriosus B B. Transposition of great arteries C C. Coarctation of the aorta D D.Ventricular septal defect

16 y old with ejection systolelic murmur with ejection cleck theourh aortic area BP 120/70, ECG shows LV hypertrophy. The best explanation is

A A. flow murmur B B.Coarctation of norta C C. HOCM D D. bicuspid aortic valve

82 year old man, story about AS, aortic valve ares – 0,75cm2 pulmonary oedema refractory to diuretics, proper Therapy is

A A. Valve replacement B B. Halloon valvuloplasty C C. Increase diuretic D D. Vasodilators

28 yearold a known IV drug user Presents with fever, a Roth spot on picture of fundus. Most likely organism

A A. Klebsiella B B. Staph. aureus C C. Pseudomonas D D. Strep, bovis

Sign in required