2018 Module Exam Flashcards by Hessa Al Salem

Which of the following accompanies LAD artery and Circumflex artery?

a) Great cardiac vein
b) Small cardiac vein
c) Middle cardiac vein

a) Great cardiac vein

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Which valve is auscultated in the 2nd left intercostal space?

a) Pulmonary valve
b) Mitral valve
c) Tricuspid valve
d) Aortic valve

a) Pulmonary valve

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The tunica media of the common carotid artery is made mainly from?

a) Collagen III
b) Collagen IV
c) Collagen I
d) Elastin

d) Elastin

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What causes separation of left to right atrioventricular canal?

a) Endocardial cushions

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What is a characteristic histological feature of the IVC?

a) Elastic lamellar in tunica media
b) Tunica adventitia with smooth muscle cells
c) Fenestrated endothelium
d) Presence of thick layer of smooth muscles in tunica media

b) Tunica adventitia with smooth muscle cells

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Newborn baby with blue tips and lips. What is the the most likely congenital disorder?

a) transposition of great vessels
b) Patent foramen ovale
c) ductus arteriosus

a) transposition of great vessels

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What nerve carries sensations from the heart?

a) Intercostal nerves
b) Vagus nerves
c) Sympathetic nerves
d) Ventral rami of T1-T4

c) Sympathetic nerves

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An elderly patient came to hospital with heart block due to AV node ischaemia. In most patients what supplies AV node?

a) Anterior interventricular artery
b) Posterior interventricular artery
c) Circumflex branch of left coronary artery
d) Left marginal artery

b) Posterior interventricular artery

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A 48 y/o male is diagnosed with stable angina, he had an episode of chest pain which is not relived by rest or nitroglycerin. Angiography showed reduced perfusion of lateral wall of left ventricle.
Which artery is occluded?

a) LAD
b) left coronary artery
c) right coronary artery
d) circumflex artery

d) circumflex artery

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What is responsible for right to left shunt in fetal circulation?

a) coronary sinus
b) ductus arteriosus
c) ductus venosus
d) pulmonary artery
e) pulmonary veins

b) ductus arteriosus

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Which of the following is a feature of Fallot’s teratology?

a) Patent ductus arteriosus
b) Patent foramen ovale
c) Pulmonary valve stenosis
d) Ectopia cardia
e) Septum secundum defect

c) Pulmonary valve stenosis

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A 50-year-old man started drug for HTN and 2 months later, he was diagnosed w/gout. Which drug causes this?

a) thiazide diuretics
b) beta blocker
c) calcium channel blocker
d) ACEI

a) thiazide diuretics

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Which of the following drugs causes lower limb edema?

a) CCB
b) ACEI
c) BB
d) Centrally acting drugs.

a) CCB

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Which of the following ECG findings is a characteristic of atrial fibrillation?

a) Wide QRS complexes
b) The absence of P waves
c) Increased voltage of QRS complexes
d) Regular QRS complexes

b) The absence of P waves

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A female patient presents with painful, pulseless right lower limb. You suspect she suffers from thrombo embolization. Which of the following conditions would have caused her thromboembolism?

a) Atrial fibrillation
b) Supraventricular tachycardia
c) Ventricular fibrillation
d) Complete heart block (3rd degree AV dissociation)

a) Atrial fibrillation

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You are called to see a patient who fell suddenly on the ground and is unconscious. Which of the following conditions requires immediate electrical cardioversion?

a) Atrial fibrillation
b) Ventricular fibrillation
c) Supraventricular tachycardia
d) Bradycardia

b) Ventricular fibrillation

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A pregnant woman complains of palpitations. Which of the following is a common arrhythmia in pregnancy?

a) Supraventricular tachycardia
b) Atrial fibrillation
c) Sinus tachycardia
d) Atrial tachycardia

c) Sinus tachycardia

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A patient came with 15 minutes duration of severe chest pain. You suspect MI. What’s the best diagnostic tool to confirm the presence of ischemia?

a) Troponin
b) urea creatinine
c) Echocardiogram
d) ECG

d) ECG

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Someone was diagnosed with HfrEF. Which drug is preferred?

a) amiadrone
b) B blockers
c) Niacin
d) Procanamide

b) B blockers

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A patient came with old inferior wall MI. What changes do you expect to see in ECG?

a) ST segment elevation in leads I/III/aVF
b) ST segment elevation in leads I/aVL
c) 3 mm ST segment depression in V3 to V5
d) Q wave in II/III/aVF

d) Q wave in II/III/aVF

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Autopsy findings of a man who died of hanging include sternocleidomastoid hemorrhage and dislocation of C2-C3 vertebrae. What is the method of hanging?

a) Judicial
b) Suicidal
c) Homicidal
d) Accidental

a) Judicial

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A patient presented to the ER with chest pain. The ECG was done, The diagnosis was acute Anterior wall Myocardial Infarction.
What’s the indication of anterior wall Myocardial Infarction?

a) ST elevation in leads I, II, aVf
b) ST elevation in leads v2 to v5
c) 3mm ST depression in leads v3 to v5
d) Q wave in leads v2, v3, v4

b) ST elevation in leads v2 to v5

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A 71-year-old patient presented with STEMI, what is the best treatment method?

a) immediate revascularation (primary PCI)
b) immediate administration of fibrinolytic therapy
c) anticoagulantion (warfarin)
d) immediate administration of …

a) immediate revascularation (primary PCI)

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A patient had a stroke and is now having atrial fibrillation. Which of the following is used for secondary prevention of stroke/thromboembolism?

a) Oral anticoagulant
b) Combination of Aspirin and clopidogrel
c) Clopidogrel only
d) Chronic IV heparin

a) Oral anticoagulant

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What is the valvular dieases that is associated with diastole murmur? a) mitral valve regurgitation b) pulmonary valve stenosis c) mitral valve stenosis d) mitral vavle prolapse

c) mitral valve stenosis

A 53 year old woman was diagnosed with a cardiac murmur. Upon echocardiography, a dilated left ventricle was found. Which of the following conditions leads to a dilated left ventricle if not treated? a) Mitral stenosis b) Aortic regurgitation c) Pulmonary regurgitation d) Aortic stenosis

b) Aortic regurgitation

Which of the followings antigens mimics cardiomyocytes in S. pyogenes? a) Flagella b) M protein c) Peptidoglycan d) lipoteichoic acid

b) M protein

A patient with heart failure takes several medication. What medication is known to cause headache? a) nitrates b) beta blockers c) digoxin d) diuretics

a) nitrates

What is the most likely causative agent in an intravenous drug addict? a) Viridans streptococcus b) Staphylococcus aureus c) Ekinella d) Kingella

b) Staphylococcus aureus

Which of the following structures of streptococcus pyogenes mimics the cardiac myosin and leads to the development of autoantibodies? a) M protein b) Flagella

a) M protein

Which of the following skin rash is present in patients with rheumatic fever a) Erythema toxicum b) Erythema marginatum c) Erythema Migrans d) Erythema Infectiosum

b) Erythema marginatum

Which microorganism infect people who drink unpasteurized milk? a) Brucella melitensis b) coxella burnetti

a) Brucella melitensis

A 55-year-old man has recent myocardial infarction and dyspnea. His x-ray shows cardiomegaly, bilateral whitish shadow on the lungs and right plural effusion. His urine excretion is significantly reduced, and his serum creatinine is increased. What causes the progression of his symptoms? a) Pulmonary edema b) Right heart failure c) Left heart failure d) Acute renal failure

c) Left heart failure

What happens in first phase of valsava maneuver? a) decreased MAP b) decreased pulse pressure c) increase HR d) increase SV e) increase VR

d) increase SV

what is a characteristic coronary artery disease in stable angina? a) hard fibrous atheromatous plaque b) ruptured atheromatous plaque c) atheromatous intimal erosion d) atheromatous plaque embolsim e) atheromatous intra intimal thrombus

a) hard fibrous atheromatous plaque

MYH-7 gene is related to what condition? a) atrial fibrillation b) familial hypertrophic cardiomyopathy c) familial hypercholesterolemia d) MI

b) familial hypertrophic cardiomyopathy

A 40 year old female presented with CHF and early onset of DM type 2, endomycardial biopsy shows myocardial fibrosis with brown granular pigment myocytes, along with elevated liver transaminases. Clinical manifestation?

a) cardiac hemosiderosis (something like that)

A patient with wavy muscle fibers and contraction band necrosis. What is the diagnosis of this patient? a) rheumatic myocarditis b) viral myocarditis c) MI d) dilated cardiomyopathy e) hypertrophic cardiomyopathy

c) MI

Which affects warfarin dose? a) VKORC1 b) age c) gender d) weight

a) VKORC1

Which confirms cardiac findings of acute rheumatic disease? a) fibrinous pericarditis b) necrosis and fibrosis of myocardium c) aschoff nodule d) vegetation on mitral valve

c) aschoff nodule

A 30 y/o IV drug user with history of fever was found dead in his home. Autopsy examination of the heart showed large, dark colored vegetations on the tricuspid valve with destruction of the valve cusps. What type of endocarditis did the patient have? a) Rheumatic b) Infective c) Limban-sac

b) Infective

A 35 year old female, asymptotic with mid systolic click, echocardiogram showed hooded deformity of the mitral valve, what is the cause behind this condition a) Myxomatous changes b) MI c) infective endocarditis

a) Myxomatous changes

What is the commonest cause of right heart failure? a) left heart failure b) polmonary emphysema c) silicosis

a) left heart failure

A genetic cause has been linked to primary hypertension. What system is affected by these genes? a) Parasympathetic nervous system b) Sympathetic nervous system c) Renin-angiotensin-aldosterone system d) Lipid metabolism e) Carbohydrate metabolism

c) Renin-angiotensin-aldosterone system

A young man died in a car accident, postmortem autopsy revealed yellowish streaks in the abdominal aorta. What could this be? (Not exactly but something similar to this) a) Intimal foam cells b) Endothelium c) Intimal fibro-fatty elevation

a) Intimal foam cells

What’s true about pleuritic chest pain? (something similar to this) a) Relieved by inspiration and worsens with expiration b) Cardiac rub on auscultation c) Localized tenderness

b) Cardiac rub on auscultation

What does pharmacogenetics assess? a) Stem therapy & drug response b) Genetic polymorphism & Drug response

b) Genetic polymorphism & Drug response

Which of the following is the most Atropine-like antiarrythmatic drug? a) Procainamide b) Disopyramide c) Quinidine d) Propanolol

b) Disopyramide

Which of the following are characteristics of class IB antiarrythmic drugs: a) Block activated and inactivated Na channels b) Block Ca channel c) Used to treat ventricular and supraventicular tachyarrhythmia d) Are all administered orally

a) Block activated and inactivated Na channels

MOA of ranolazine as anti-anginal drug a) sodium channel blocker b) calcium channel blocker c) angiotensin converting enzyme inhibitor

a) sodium channel blocker

What explains the mechanism of action of epleranone? a) selective antagonist of aldosterone receptors b) inhibits angiotensin converting enzyme c) inhibits renin release

a) selective antagonist of aldosterone receptors

What is the most likely mechanism by which ACE inhibitors work? a) Increase vascular resistance b) Decrease NO release c) Decrease preload d) Increase bradykinin degradation

c) Decrease preload

What drug slows AV conduction? a) verapamil b) amlodipine c) Nifidepine d) Doxazocin

a) verapamil

Hypertension patient with benign prostatic hyperplasia, which drug is indicated? a) Metoprolol b) Doxazosin c) Clonidine d) Furosemide

b) Doxazosin

Which one is the direct precursor of Angiotensin 1-7? a) Angiotensinogen 1 b) Renin c) Angiotensin 2 d) Angiotensin 1-9

c) Angiotensin 2

Which of the following drugs prevent the absorption of bile acids by intestine by forming an insoluble complex with bile acid salt? a) Niacin b) Furosemide c) Colestipol

c) Colestipol

The action of the angiotensin AT2 receptor will generally cause which of the following? a) Vasodilation b) Bradykinin release c) Aldosterone release

a) Vasodilation

Which drug prevent platelet aggregation and thrombosis in treating patients with unstable angina pectoris? a) aliskiren b) metoprolol c) clopidogrel

c) clopidogrel

A 65 y/o woman was diagnosed with a heart murmur with a high amplitude throughout systole. Which of the following is the best diagnosis? a) aortic regurgitation b) pulmonary stenosis c) mitral regurgitation d) mitral stenosis

c) mitral regurgitation

which of the following represent the values of the right ventricle diastolic pressure? a) 0-8 mmHg b) 8-10 mmHg

a) 0-8 mmHg

At which stage of atherosclerosis do M2 macrophages play a significant role? a) Initiation b) Progression c) Resolution d) Rupture

c) Resolution

The pressure in the vessel increased, and then the blood flow increased (dont know exactly numbers). What is the mechanism behind this regulation? a) Myogenic vasodilation b) Myogenic vasoconstriction c) Metabolic vasodilation d) Metabolic vasoconstriction e) Neural something.

b) Myogenic vasoconstriction

Which of the following remain constant at a sudden increase in preload when the inotropy and afterlaod are constant ? a) SV b) EDV c) EF d) ESV

d) ESV

Someone stands up after being in a supine position for 10 hours, what change would you see? a) Decreased HR b) Increased PP c) Increased EDV d) Increased VR

d) Increased VR

What haemodynamic changes occur in a blood vessel when a laminar flow coverts to a turbulent flow? a) Vascular distending pressure attenuates b) Resistance to blood flow decreases c) Blood viscosity diminishes d) Blood flow rate declines e) Vascular tone weakens

d) Blood flow rate declines

A patient underwent MPI and the results showed that he was symptomatic on exercise but normal at rest. What would be the most appropriate next step? a) refer for reperfusion b) Prescribe anticoagulant c) Reassure him that he is fine and take no further step d) Myocardial viability test

a) refer for reperfusion

how does the heart uptakes tcm99

it’s lipid soluble so most likely by diffusion through the membrane

Bearing in mind the Frank Starling mechanism, which sarcomere stretch produces the strongest contraction a) 2.4 b) 3.6 c) 1.2 d) 6.2

a) 2.4

Which channels responsible for cardiomyocytes relaxation? a) L-type calcium channels b) mitochondrial calcium uniporter c) ryanodine receptor channels d) IP3 channels

b) mitochondrial calcium uniporter

What is the most likely effect of a delayed inactivation of a fast sodium current? a) the speed of depolarization will increase from 300 to 600 m/s b) the membrane potential of phase 4 will be more positive c) the conduction velocity of the AV node will decrease d) the absolute refractory period will decrease e) the action potential duration will be prolonged

e) the action potential duration will be prolonged

What is the most likely mechanism by which adenosine restores the sinus rhythm in supraventricular tachycardia? a) early afterdepolarization b) delayed afterdepolarization c) AV nodal reentry d) atrial micro-reentry e) unidirectional conduction block

e) unidirectional conduction block

Which of the following occur during the first phase of valsalva maneuver? a) decrease AP b) increase HR c) decrease PP d) increase SV e) increase VR

d) increase SV

Increase pressure from 58mmgh to 70 mmgh caused an increase in blood flow. Which mechanism caused this? a) metabolic vasoconstriction b) metabolic vasodilation c) myogenic vasoconstriction d) myogenic vasodilation

c) myogenic vasoconstriction

fter a patient was given an inotropic agent his congestive heart failure and angina decreased xD What’s the reason of the decreased angina? a) Decreased SVR b) Decreased CO c) Decreased ventricular wall tension d) Increased blood flow to the coronary arteries e) Decrease in DBP

d) Increased blood flow to the coronary arteries

Which drug is known to cause headaches? a) diuretics b) nitrates c) beta blockers d) digoxin

b) nitrates

the table below shows blood flow in four organs (A-D), at perfusion pressure of 105mmHg and reduced perfusion pressure of 85mmHg. which organs shows the best autoregulation?

Premature atrial complex

2nd degree heat block Mobitz-2

Monomorphic ventricular tachycardia

What does the ECG of a patient that presents with several episodes of syncope show? a) Sinus arrhythmia b) 1st degree heart block c) 2nd degree heart block d) 3rd degree heart block e) LBBB

d) 3rd degree heart block

The electrocardiogram is most effective in detecting a decrease in? a) Ventricular contractility b) Mean blood pressure c) Total peripheral resistance d) Ejection fraction e) Coronary blood flow

e) Coronary blood flow

Patient with thromboembolism. What condition most likely predisposes him?

a) Atrial fibrillation

Increase in which of the following metabolites by insulin would inhibit fatty acid oxidation? a) NADH b) Acetyl-CoA c) Pyruvate d) Malonyl-CoA

d) Malonyl-CoA

The increase in cardiac AMP levels will increase the uptake and oxidization of which of these a) fatty acids b) glucose c) ketone bodies

a) fatty acids

there was question about the cause of bruit in carotid artery a) increased systolic pressure in carotid artery b) high velocity of blood in carotid artery

someone brought to the ER with bruises in prominent parts of his face, what is most likely the cause?

a) RTA

Which of the following is the most medicolegally informative? a) Bruise b) Abrasion c) Laceration d) Cut e) Stab

b) Abrasion

A young male brought to the ER, examination showed longitudinal scalp scar with irregular edges and some bruises what is the likely causal object? a) wooden stick b) broken bottle neck c) knife tip d) sharp blade knife e) serrated blade knife

a) wooden stick

Propagation of the action potential through the heart is fastest in the? a) SA node b) Atrial muscle c) AV node d) Purkinje fibers e) Ventricular muscle

d) Purkinje fibers

Blood pressure increases, and heart rate decreases in response to? a) Exercise b) Increased body temperature c) Exposure to high altitude d) Increase intracranial pressure e) Hemorrhage

d) Increase intracranial pressure

which of the following will decrease in response to a decrease in wall tension? a) SV b) EDV c) ESV

a) SV

what is a consequence of an increased afterload?

a) decreased SV

which of the following drugs causes hyperkalemia? a) Loop diuretics b) Eplerenone

b) Eplerenone