2010 Module Exam Flashcards

1
Q

What Type of endothelium found in Splenic sinus?
A. Discountinous endothelium
B. Discontinues basal lamina

A

B. Discontinues basal lamina

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2
Q

A 56 years old male presented to the ER with 60 mins duration of severe chest pain and dizziness. Also he is unresponsive to sublingual nitrate. What is the best cardiac biomarker will be found in blood sample at this time?
A. Myoglobin
B. Ck MB
C. Troponin I

A

A. Myoglobin

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3
Q

Which one of the following most likely will develop secondary hypertension?

A

A 27 years old male with BP = 170/99 and abdominal bruits

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4
Q

What’s the mechanism of action of Nitroglycerine ?

A

Increase cGMP

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5
Q

What most likely would be the effect of a drug that blocks K+ channels during repolarization?
A. Prolonged AP, Prolonged phase 4
B. prolonged AP, prolonged phase 2

A

A. Prolonged AP, Prolonged phase 4

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6
Q

What would be effected on ECG if you give a patient a drug that affects Na+ Fast Channels?
A. ST Segment
B. RR interval
C. QRS Complex

A

B. RR interval

or C

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7
Q

What’s the mechanism of action of Verapmil?

A

Ca Channels blocker

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8
Q

Which of the following studies is used to study specific genes in Kuwaiti families?

A

SNP Linkage Studies

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9
Q

Question about asking the patient about what they think of their disease and how to plan out a strategy before treating it?

A

(Sorry We don’t remember the question exactly!) P.S. They asked about the stage before this step)

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10
Q

What reduces the risk of pulmonary edema in a patient with long standing left ventricular heart failure?
A. increased pulmonary capillary pressure
B. increased heart rate
C. improved lymphatic system
D. increased blood volume

A

B. increased heart rate
or
C. improved lymphatic system

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11
Q

If we inject a patient with Sailne .. what will happen? (We don’t remember the question)
A. increase plasma concentration of ADH
B. Increase in Blood Pressure

A

B. Increase in Blood Pressure

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12
Q

Which of the following Factors has protease activity and is released from kidneys when the renal blood perfusion reduced?

A

Renin

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13
Q

An IV drug abuser was admitted to the hospital. He was diagnosed with IE , chest x- ray showed multiple lung abscess and blood culture showed +ve gram bacteria. What most likely would be the cause?

A

S.Aureus

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14
Q

A 92 years old female presented with collapsing pulse on the radial artery, and mid- Diastolic murmur. What is the Blood Pressure?

A

140/60
(I think she has Aortic Regurgitation so DBP must be low, and she is 92 years old so Compliance is reduced leading to increase SBP)

(*collapsing pulse, AKA aortic regurgitation)

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15
Q
Which of the following factors is the most contributing in movement of blood to inferior vena cava:
A. intrathoracic negative pressure
B. elastic lamellae
C. longitudinally arranged muscle fibers
D. presence of valves
E. internal elastic lamellae
A

A. intrathoracic negative pressure
or
C. longitudinally arranged muscle fibers

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16
Q

What helps aorta to maintain the blood pressure?

A

internal elastic lamina

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17
Q

What is the prominent histological feature seen in Brachiocephalic artery?

A

Elastic lamalle

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18
Q

A middle aged female presented with History of Rhematic heart disease. What valvular disease will be associated with her condition?

A

Small Vegetations on the mitral valve (History of RHD!Calcification and Aortic Stenosis?)

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19
Q

Which of the following will confirm Dilated HF?

A

Displaced apex Laterally

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20
Q

What is the mechanism of action of a drug that inhibits bile duct absorption?

A

high density LDL receptors

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21
Q

Which of the following mechanisms mediate vasoconstriction when blood pressure is increased?

A

Myogenic Regulation

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22
Q

What mechanism causes vasodilation of muscle arteries during exercise?

A

Active Hyperemia

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23
Q
A 55 years old male presented with episodes of Syncope, what is the cause?
A. 1st Degree AV Block
B. 2nd Degree AV Block
C. 3rd Degree AV Block
D. Ventricular Arrhythmia
E. Atrial Fibrillation
A

C. 3rd Degree AV Block

In 3rd Degree Block, Purkinje fibers are the pacemaker of the heart HR = 40-25 bpm
“In This range as we decrease HR, CO decreases → Syncope”

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24
Q

What drug causes consipitation as a side effect?

A

Verapmil

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25
Q

What is the mechanism that causes increase CO in anemia?

A

decrease Afterload

Anemia→low RBCs→low Viscosity→reduce SVR→reduce Afterload

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26
Q

What is the mechanism of action of Spirolactone?

A

binding to Aldestrone receptors inhibiting its effect

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27
Q

What is the mechanism of action of Nitroglycrine?

A

increase cGMP

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28
Q

A patient presented with Mitral stenosis and heart failure, what is the best drug combination?

A

Beta-blockers, Duertics, Digoxin
(Mitral Stenosis means that the ventricle needs more time to fill, so we give them Beta-blocker to reduce HR, therefore, increase diastolic time i.e. filling time increase)

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29
Q

A patient presented with Left Ventricular and septum Hypertrophy. Post-mutorm biopsy showed disarray?

A

Hypertrophic cardiomyopathy

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30
Q

Which of the following drugs dissociate slowly from Na channels and have no effect on Action Potential?

A

Flecaidine

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31
Q

Which of the following mechanism causes clubbing?

A

Capillary beds expansion

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32
Q

Which of the following drugs binds to Activated Na channels only?

A

Quinidine

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33
Q

Week 6 case arrhythmia- Valsava Manouver?

A

parasympathetic activation

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34
Q

How does the body response for increasing intracranial pressure?

A

increase Blood pressure and decrease HR

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35
Q

A mother in her 10th week of pregnancy, she had 3 children with severe congenital heart disease, and she want to check for her fetus. What test would you ask for?
A. Amionotic Fluid Aspirate
B. Chorionic Villi sample

A

B. Chorionic Villi sample (less than 12 weeks)

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36
Q

Which of the following drugs will not help a patient with angina perctuis?
A. Diuretics
B. Digioxin

A

A. Diuretics

Digioxin makes it WORSE!

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37
Q

A patient came to the ER complaining of episodes of chest pain on exertion, and he never experienced these episodes during rest. which of the following tests would you ask for?

A

Exercise ECG

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38
Q
A 63 years old male suffering from chest pain on exertion is diagnosed with classical angina pectoris. What drug is given to rapidly relieve the effect of the acute attack?
A. Nitroglycrine
B. Dobutamine
C. Aspirin
D. Verapamil 
E. Captopril
A

A. Nitroglycrine

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39
Q

Which of the following is a precursor of a powerful vasoconstriction synthesized in the liver?

A

Angiotensinogen

40
Q

What Separates the part of the atrium that develops from Sinus venorum from the part that develops from primitive atrium?

A

Cristae Terminalis

41
Q

A person with mitral reguirgitation, In which segment you can hear a murmur?
A. BC “Isovolumic contraction” + CD “Ejection”
B. CD Only “Ejection”

A

A. BC “Isovolumic contraction” + CD “Ejection”

42
Q

(Diagram) Which of the following represent the End of atrial contraction in VP-Loop?

A

C - MC

43
Q

Which of the following is used as an earlier indicator of Heart failure in patient with cancer receiving Adriamycin ?

A

Ejection fraction

44
Q

Harmless Calcification ->

A

Monk.. previous MCQs

45
Q

Which of the following is used to transfer cholesterol from the cell to premature HDL?
A. ABCA1
B. ABCG1

A

B. ABCG1

46
Q
Which of the following parameters will increase if a person change his position from supine to standing?
A. PP
B. EF
C. EDV
D. SV
E. Renal Blood flow
F. VR
A

A. PP

47
Q

What does Cholesterol Ester Transfer Protein do?

A

Transport CE/TG between VLDL and HDL

48
Q

Which of the following will lead to decrease amount of VLDL?
A. Lipoprotein lipase
B. hormone sensitive lipase

A

A. Lipoprotein lipase

49
Q

Abnormality in which of the following structures can lead to intratrial septal defect?

A

Septum Primum

50
Q

Which of the following structures form Limbus Fossa Ovalis?

A

Septum Secendum

51
Q

What is the mechanism of action of Alikisrin?

A

Decrease Renin

52
Q

A patient with Dilated Cardiomyopathy, Presented with hemiplegia of the left leg. what most likely would be the cause? Carotid Thrombus that goes to the brain?

A

mural thrombus

53
Q

Defect in which of the following structures cause failure of separation between the aorta and pulmonary trunk?

A

truncus arteriosis

54
Q

A patient presented with Cardiac temponade. which of the following events will occur?
A. decrease preload
B. Increase afterload

A

A. decrease preload

In Cardiac Temponade we have increased fluid in thoracic cavity, so the Ventricle cant expand to fill during diastole leading to decrease EDV therefore the preload

55
Q

VO2 Diferrence = 18 ml O2/100ml , VO2 Max = 60 ml O2/min/Kg Weight = 75 kg

A

25.0 L/min

56
Q

A question about calculating the Maximal CBF, Reserve and resting CBF are given

A

?

57
Q

BP before vasodilator = 160/120
BP after vasodilator = 145/105
SV = 80 ml, 50% of SV is stored in the distended aorta during systole

What is the difference in MAP?

A

15

58
Q

Diagram: The Diagram shows the change in ventricle volume during the cardiac cycle, In which point you will hear the 2nd heart sound?

A

b, c?

59
Q

What causes increase BF in coronary arteries during diastole?

A

reactive hyperemia

60
Q

What artery supplies SA node?

A

Nodal artery

61
Q

Which of the following part of the conduction system found in the intraventricular septum?

A

His bundle?

62
Q

Diagram: SBP decrease, DBP decrease, HR decrease

When patient change his position from supine to standing. How can you explain what happened after standing?

A

Auotonomic Dysfunction

63
Q

If a 55 years old patient came to you and asked you about his/her risk of developing HTN in the coming years?

A

more than 75%

64
Q

By what % the risk of developing Heart disease decreases after one year of smoking cessation?

A

50%

65
Q

A patient presented with cutaneous rash and palpable purpura. What causes this condition?

A

Leukocytoclastic Vasculitis

66
Q

Which of the following increases mortality by 5 to 6 times in patients with MI?

A

Depression

67
Q

Which of the following can lead to decrease coronary blood flow?

A

Aortic Reguirgitation

68
Q

What happens when you increase arteriolar diameter?

A

decrease resistance

69
Q

Which of the following lead to decrease in wall tension of the LV?

A

increase Thickness

70
Q

Diagram: Systemic BP increase, Renal Blood Flow decrease

Explain the above renal response?

A

Autoregulation

71
Q

What does JVP reflects?

A

pressure in the Right Atrium

72
Q

A middle-aged female had a car accident, post-mortum examination showed rupture of the ascending part of the thoracic aorta, the ascending aorta found to be ulcerative and full of plaques, Abdominal aorta showed yellow fatty streaks. What is the composition of the abdominal aorta streaks?

A

foam cells

73
Q

Which of the following is used by bacteria for adhesion to non-bacterial Thrombus?

A

Dextran

74
Q

A 55 year old female with uncontrolled high blood pressure for 10 years, what will be seen in the kidneys?

A

Hyaline Arteriosclerosis

75
Q

A patient presented with coronary artery 90% with a superimposed Thrombus. Which of the following will occur?

A

Acute MI

superimposed= cover completely/luminal

76
Q

A middle aged male, presented with systolic ejection murmur in the 2nd right intracostal space, also it can be heard in the 4th intracostal space near the sternum, it also radiates to the neck. what is the diagnosis?

A

Aortic Stenosis

77
Q

A 55 years old male, presented with sudden onset of compressing chest pain due to vasospasm. What is the diagnosis?

A

Prinzmetal Angina

78
Q

Which of the following CCB is used for blood vessels?

A

Amlodipine

79
Q

A patient had a mitral valve prolapse following acute MI. What will you see in the LV?

A

Rupture of papillary muscle

80
Q

A patient presented with diastolic murmur following acute MI. What would you see in the Left Ventricle?

A

Fibrosis of papillary muscles

81
Q

Which of the following is a characteristic feature found in Rheumatic Heart Disease?

A

Aschoff nodules

82
Q

In A patient who has a block in the Left Anterior descending artery, which is the area most susceptible to MI?

A

anterior 2/3 of intraventricular septum

83
Q

Which of the following drugs inhibit lipolysis?

A

Clofibrate

84
Q

What is the best drug used to increase HDL levels?

A

nicotinic acid

85
Q

Which of the following causes MI?

A

Rupture of soft plaque with thin fibrous cap

86
Q

Which of the following structures separate Aorta and Pulmonary trunk?

A

Spiral valve

87
Q

A 90 years old patient presented with floppy mitral valve. What would you see in a biopsy?

A

Myxomatous Degeneration

88
Q

Which of the following is found in the spleen of a patient with congestive heart failure?

A

gamna-Gandy body

89
Q

Which fetal vessel allow the blood from placenta to bypass the liver?

A

ductus venousis

90
Q

what is the most common congenital acyanotic heart disease ?

A

VSD

91
Q

which of the following inhibits HMG-CoA reductase?

A

Simvastatin

92
Q

Where is the most common place for a berry aneurysm hemorrhage?

A

Subarachnoid space

93
Q

A question about ventricular function curve and venous curve (sorry we don’t remember the question)

A

?

94
Q

What happens in hemorrhage?

A

?

95
Q

A patient presented with retinopathy, what will be his BP?

A

170/110 (Malignant hypertension)

96
Q

What activates ADH/Vasopressin?

A

Increase osmolarity

97
Q

A neonate diagnosed with tetralogy of fallot. What most likely will cause cyanosis in this baby?

A

Right to Left shunt