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Cardiology Past Papers > Ultimate Past Paper Set > Flashcards

Ultimate Past Paper Set Flashcards

1
Q 
Which of the following is not indicated in angina pectoris patient(1)
A b-blockers
B nitrates
C alpha-blockers
D aspirin
E clopidogrel
A

C alpha-blockers

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2
Q 
What is the recommended treatment for diabetic patients with hypertension?(2)
A b-blockers
B heparin
C ACE-I
D alpha-blockers
E ARB (angiotensin receptor blocker)
A 
C ACE-I
E ARB (angiotensin receptor blocker)
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3
Q

A fixed perfusion defect means:(1)
A the defect appears at rest but disappears in stress test B the defect appears both at rest and the stress test
C the defect appears at stress test but not in rest

A

B the defect appears both at rest and the stress test

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4
Q

In case of right MI best treatment is: (1)
A give the patient fluids and IABP if needed
B give the patient vasodilators in order to off load the right ventricle C perform PCI

A

C perform PCI

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5
Q

To diagnose a right MI on ECG we need:(1)
A ST elevations waves in V1-V6
B deep Q waves in V1-V4
C ST elevation on R-V4 (this is a precordial lead on the right)
D RVH signs

A

C ST elevation on R-V4 (this is a precordial lead on the right)

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6
Q 
Which of these arrhythmias are focal? (2)
A atrial tachycardia
B AVRT
C AVNRT
D WPW
E right ventricular flow tachycardia
A

A atrial tachycardia

E right ventricular flow tachycardia

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7
Q

In a case of an inferior wall MI we should perform an urgent echo to exclude: (1)
A mitral valve rupture
B vetricular septal rupture
C free wall rupture

A

A mitral valve rupture

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8
Q

In the case of ventricular extrasystole: (1)
A amiodarone is the first option
B it is benign and doesn’t require any treatment
C verapamil is the treatment of choice

A

B it is benign and doesn’t require any treatment

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9
Q 
In supraventricular tachycardia we treat with: (3)
A Carotid massage
B Valslva maneuver
C Verapamil
D Amiodarone
E Metoprolol
A

A Carotid massage
B Valslva maneuver
C Verapamil

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10
Q 
Difference in BP between upper and lower body can be present in:(2)
A Aortic coarctation
B Malignant HT
C Leukemia
D Aortic valve stenosis
E Aortic dissection
A

A Aortic coarctation

E Aortic dissection

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11
Q 
The following arrhythmias can be indications for cardioversion: (2)
A Atrial fibrillation
B WPW
C Atrial tachycardia
D AVRT
E AVNRT
A

A Atrial fibrillation

D AVRT

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12
Q

A cardiac echo is indicated: (2)
A before PCI where symptoms don’t fit the presumed diagnosis
B before heart surgery for evaluation
C always in atrial fibrillation

A

B before heart surgery for evaluation

C always in atrial fibrillation

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13
Q 
An anemic patient can present: (3)
A pallor
B tachycardia
C systolic murmur
D flush
E diastolic murmur
A

A pallor
B tachycardia
C systolic murmur

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14
Q 
When we hear a harsh, holosystolic murmur over the chest in a post-MI patient we immediately suspect: (1)
A cardiac tamponade
B PE
C pericarditis
D papillary muscle rupture
E ventricular septal rupture
A

E ventricular septal rupture

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15
Q 
Pulsus paradoxus is a sign of: (2) 
A aortic stenosis
B aortic regurgitation
C cardiac tamponade
D severe air way obstruction
A

C cardiac tamponade

D severe air way obstruction

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16
Q

How do you treat isolated ventricular extrasystoles? (2)
A It’s not necessary to treat if there are no symptoms
B The first choice is B-blocker
C The first choice is amiodarone
D Coronarography is necessary to exclude coronary artery disease E Calcium channel blocker plus B-blocker is a primary option

A

A It’s not necessary to treat if there are no symptoms

B The first choice is B-blocker

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17
Q

What does non-sustained VT means? (2)
A Duration of VT isn’t longer than 30 sec
B Five ventricular beats come subsequently
C It can cause hemodynamic instability
D The time of the VT is longer than 30 min

A

A Duration of VT isn’t longer than 30 sec

B Five ventricular beats come subsequently

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18
Q 
Which diseases may result in systemic thromboembolism? (3) 
A Aortic stenosis
B Atrial fibrillation
C Endocarditis
D Tricuspid regurgitation
E Left ventricular aneurysm
A

B Atrial fibrillation
C Endocarditis
E Left ventricular aneurysm

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19
Q 
The patient had two MIs. EF= 30%. How do you treat him after a documented fast monomorph ventricular tachycardia? (3)
A Pacemaker implantation
B ICD implantation
C B-blocker therapy
D Digitalis
E Amiodarone
A

B ICD implantation
C B-blocker therapy
E Amiodarone

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20
Q

ICDs are able to: (3)
A Terminate ventricular fibrillation with shock delivery
B Work as a pacemaker if necessary
C Terminate ventricular extrasystoles
D Terminate ventricular tachycardia with antitachycardia pacing
E Treat only tachycardias, no therapeutic options against bradycardias

A

A Terminate ventricular fibrillation with shock delivery
B Work as a pacemaker if necessary
D Terminate ventricular tachycardia with antitachycardia pacing

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21
Q

VVI pacemaker means: (2)
A One electrode in the ventricle
B One electrode in the atrium
C Two electrodes (atrium and ventricle)
D A sensed signal from the heart inhibits the pacemaker
E A sensed signal in the atrium may trigger a ventricular paced beat

A

A One electrode in the ventricle

D A sensed signal from the heart inhibits the pacemaker

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22
Q 
Causes that frequently provoke acute heart failure in patients with chronic congestive heart failure: (3)
A Arrhythmias, especially AF
B NSAIDs
C Fever
D GERD
E Ventricular premature beats
A

A Arrhythmias, especially AF
B NSAIDs
C Fever

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23
Q 
The most common cause of congestive heart failure: (1) A Chronic anemia
B Volume overload
C Ischemic heart disease
D Diabetes mellitus
E Chronic renal failure
A

C Ischemic heart disease

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24
Q 
Patients with congestive heart failure have increased risk of: (2) 
A Restless leg syndrome
B Ischemic stroke
C Cardiac tamponade
D Sudden cardiac death
E Peripheral artery disease
A

B Ischemic stroke

D Sudden cardiac death

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25
Q 
These drugs are mandatory in patients suffering from chronic heart failure, because they will increase life expectancy: (3)
A Digoxin
B ACEi
C Verospiron (spironolactone)
D Nitrates
E B-blockers
A

B ACEi
C Verospiron (spironolactone)
E B-blockers

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26
Q 
Physical signs and symptoms related to heart failure: (3)
A Orthopnea
B Hydrothorax
C Signs of cerebral edema 
D Lack of appetite
E Bronchospasm
A

A Orthopnea
B Hydrothorax
D Lack of appetite

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27
Q 
What can be the etiology of acute aortic valve regurgitation? (3) 
A Chordal rupture
B Infective endocarditis
C Aortic dissection
D Bicuspid valve
E Trauma
A

B Infective endocarditis
C Aortic dissection
E Trauma

28
Q 
What are the most frequent etiologies that can cause chronic aortic valve regurgitation? (3)
A Degenerative
B Rheumatic
C Infective endocarditis
D Congenital
E Ischemic heart disease
A

A Degenerative
B Rheumatic
D Congenital

29
Q 
Major criteria for the diagnosis of infective endocarditis: (2) 
A Fever
B Positive blood culture
C Vasculitic lesions
D Vegetation on echo
E History of IV drug abuse
A

B Positive blood culture

D Vegetation on echo

30
Q

Surgery is indicated in patients with infective endocarditis if: (3)
A Severe cardiac failure is presented due to valvular compromise
B Relapse after optimal medical therapy
C In case of septic systemic embolism
D Presentation of mitral regurgitation
E Pulmonary systolic pressure > 50 mmHg

A

A Severe cardiac failure is presented due to valvular compromise
B Relapse after optimal medical therapy
C In case of septic systemic embolism

31
Q

Myocardial perfusion testing can be useful in: (3)
A High clinical suspicion of aortic stenosis
B Resting ECG abnormalities preclude exercise stress test interpretation
C Culprit vessel identification in multi-vessel disease
D After PCI, to evaluate stent restenosis
E All of the above

A

B Resting ECG abnormalities preclude exercise stress test interpretation
C Culprit vessel identification in multi-vessel disease
D After PCI, to evaluate stent restenosis

32
Q

How is coarctation of the aorta detected? (1)
A Place the thumb of one hand on the brachial pulse and the other on the femoral pulse, and assess the simultaneously. Normally these pulses are equal in volume and timing. A delay in the femoral pulse or a reduction or absence strongly supports the diagnosis of coarctation
B Place the thumb of one hand on the brachial pulse and the other on the femoral pulse, and assess the simultaneously. Normally these pulses are equal in volume and timing. A premature femoral impulse strongly supports the diagnosis of coarctation
C A paradoxical femoral pulse on both sides supports the diagnosis of coarctation
D Alternating low and high volume beats (pulsus alternans) can be characteristic for aortic coarctation

A

A Place the thumb of one hand on the brachial pulse and the other on the femoral pulse, and assess the simultaneously. Normally these pulses are equal in volume and timing. A delay in the femoral pulse or a reduction or absence strongly supports the diagnosis of coarctation

33
Q 
When do you find an elevated JVP? (2) 
A Hypovolemia
B Acute heart failure
C Hypervolemia
D ACS
E Aortic valve regurgitation
A

B Acute heart failure

C Hypervolemia

34
Q

Which of the following best describes Dressler’s syndrome? (1)
A Hypotension, elevated JVP, clear lung fields
B Pericardial and pleural fluid, elevated ESR, and fever days to weeks after MI
C Pericardial friction rub and pain while taking a deep breath 24 hours after anterior MI
D Alternating RBBB and LBBB after anterior MI

A

B Pericardial and pleural fluid, elevated ESR, and fever days to weeks after MI

35
Q

Typical re-entry arrhythmias are: (3)
A Right ventricular outflow tract tachycardias
B Atrial flutter
C WPW
D AV nodal/ junctional re-entry tachycardia
E Atrial fibrillation

A

B Atrial flutter
C WPW
D AV nodal/ junctional re-entry tachycardia

36
Q

Typically regular narrow QRS tachycardias are: (3)
A AV nodal/ junctional re-entry tachycardia
B Atrial flutter
C Ventricular tachycardia
D WPW (orthodrom)
E WPW (antidrom)

A 
A AV nodal/ junctional re-entry tachycardia 
B Atrial flutter
D WPW (orthodrom)
37
Q 
Pericarditis can be present in: (3)
A in chronic or acute renal failure
B After MI
C In hyperthyroidism
D In young patients after upper airway infection 
E In cerebral malignancy
A

A in chronic or acute renal failure
B After MI
D In young patients after upper airway infection

38
Q 
Which medication is preferred if hypertension is combined with diabetes mellitus? (2)
A B-blockers
B Loop diuretics 
C ACEi
D Alpha blockers 
E ARBs
A

C ACEi

E ARBs

39
Q 
How would you anticoagluate your 80 yo diabetic patient who has chronic atrial fibrillation? (1)
A Aspirin
B Clopidogrel and aspirin
C Warfarin
D Ticlopidine
A

C Warfarin

40
Q

These are indications of anticoagulant therapy: (3)
A Left ventricular thrombus
B PE
C Aortic dissection
D Mechanical prosthetic valve implantation
E ICD implantation

A

A Left ventricular thrombus
B PE
D Mechanical prosthetic valve implantation

41
Q 
Which imaging tests are the most useful in the evaluation of PE? (3)
A Radionuclide lung perfusion scan 
B Pulmonary angiography
C Chest X-ray
D CT pulmonary angiography
E Contrast echo
A

A Radionuclide lung perfusion scan
B Pulmonary angiography
D CT pulmonary angiography

42
Q 
Indications of thrombolytic therapy: (2)
A PE with hemodynamic compromise 
B ST elevation MI within 12 hours
C Abdominal emboli
D Mitral valve rupture
E Left ventricular thrombi
A

A PE with hemodynamic compromise

B ST elevation MI within 12 hours

43
Q

What is characteristic of AVRT? (2)
A Irregular rhythm
B Retrograde p waves after the QRS complex
C Re-entry tachycardia involving an accessory pathway
D Pseudo r’ in lead V1 and pseudo s in inferior leads
E Life threatening arrhythmia

A

B Retrograde p waves after the QRS complex

C Re-entry tachycardia involving an accessory pathway

44
Q 
What kind of arrhythmias can we treat with RFCA? (3)
A AF
B LBBB
C WPW
D Ventricular extrasystole
E Mobitz II AV block
A

A AF
C WPW
D Ventricular extrasystole

45
Q 
What can cause paradoxical pulse? (2)
A Anterior STEMI
B Congestive heart failure
C PE
D Pericardial tamponade
E Aortic dissection
A

C PE

D Pericardial tamponade

46
Q 
When can you find a difference in BP between the upper and lower limbs? (2) 
A Aortic stenosis
B Possibly in aortic dissection
C Aortic coarctation
D Mitral stenosis
E Pericardial tamponade
A

B Possibly in aortic dissection

C Aortic coarctation

47
Q 
What is Dressler’s syndrome? (1)
A Congenital valve disease
B Post MI pericarditis
C Post MI hepato-renal syndrome
D Pericarditis in renal insufficiency
A

B Post MI pericarditis

48
Q 
Risks for atrial fibrillation (4):
A mitral stenosis
B Hyperlipidemia
C IHD
D COPD
E Pulmonary embolism
A

A mitral stenosis
C IHD
D COPD
E Pulmonary embolism

49
Q

Male with many IHD risk factors had an anterior wall MI, 3 days later vomited and was bradycardic without ST changes in the ECG. What is the best next step in the care of this patient? (1)
A To do an ECG to check if there is a new MI
B To perform CXR to check PTX
C To continue with the medical therapy
D To perform an echo to check for cardiac tamponade

A

D To perform an echo to check for cardiac tamponade

50
Q

Vasodilators medicines in case of Prinzmetal angina: (1)
A NO, Ca channel blockers, alpha blockers
B NO, Ca channel blockers
C NO, Ca channel blockers, beta blockers

A

B NO, Ca channel blockers

51
Q 
When do you anticoagulate (3):
AF—if this means Afib then it is correct
Aortic stenosis
Left ventricular aneurysm
Right ventricular dilatation
Left ventricular thrombus
A

AF—if this means Afib then it is correct
Left ventricular aneurysm
Left ventricular thrombus

52
Q

In every infarction we see changes in the ECG: (1)
True
False

A

False

53
Q

How can you asses a specific kind of arrhythmia: (1)

A

Electrophysiology

54
Q

CRT (cardiac resynchronization therapy) (3):
Increases life expectancy
Increases ejection fraction
Decreases intraventricular dysynchronization

A

Increases life expectancy
Increases ejection fraction
Decreases intraventricular dysynchronization

55
Q

The most reliable marker for IHD: (1)

A

Troponin

56
Q

The most common cause for heart failure: (1)

A

IHD

57
Q 
What can aortic dissection cause? (2) 
LV hypertrophy
RV dilatation
Pericardial effusion
Aortic regurgitation
A

Pericardial effusion

Aortic regurgitation

58
Q

The most common etiologies of mitral regurgitation?(2)
Rheumatic fever
Degenerative process
Infective endocarditis

A

Rheumatic fever

Infective endocarditis

59
Q

Choose the correct sentence (1)
A VF within the first 48 hours after MI increase mortality in the long run
B VF after the first 48 after MI increase mortality in the long run
C Idioventricular tachycardia the first 48 hours after MI increase mortality in the long run
D Idioventricular tachycardia after the first 48 after MI increase mortality in the long run

A

B VF after the first 48 after MI increase mortality in the long run

60
Q

75 years old diabetic female typical angina for 2 hours with ST depression on ECG, not relieved after medication what should you do? (1)
A wait for biomarkers if positive coronarography
B wait for biomarkers if positive thrombolysis
C urgent coronarography
D thrombolysis

A

C urgent coronarography

61
Q 
Cardiogenic shock symptoms, except: (2)
A metabolic alkalosis
B anuria- oliguria
C hyperkalemia
D low blood pressure
A

A metabolic alkalosis

C hyperkalemia

62
Q 
Which of the following are not considered to be mechanical post-MI complications? (2)
A Papillary rupture
B Ventricular free wall rupture
C Aortic regurgitation 
D Atrial fibrillation
E Septal rupture
A

C Aortic regurgitation

D Atrial fibrillation

63
Q 
Late complications (>1 week) of MI: (2)
A aneurysm
B Dressler syndrome 
C VF
D acute heart failure
A

A aneurysm

B Dressler syndrome

64
Q 
What are the most common etiologies of mitral valve stenosis? (3)
A Rheumatic fever
B Congenital
C Infective endocarditis 
D Marfan
E Cushing
A

A Rheumatic fever
B Congenital
C Infective endocarditis

65
Q 
Contraindicated in aortic stenosis: (2)
A ACEi
B Nitrate
C Ca blockers 
D B-blockers E diuretics
A

A ACEi

B Nitrate

66
Q 
What are the most common complications of mitral valve stenosis? (3)
A sustained ventricular tachycardia
B non-sustained ventricular tachycardia
C AF
D Third degree AV block
E Bigeminy
A

A sustained ventricular tachycardia
C AF
D Third degree AV block

67
Q 
What can be the etiology of acute aortic valve regurgitation? (3) 
A chorda tendinae rupture
B infective endocarditis
C aortic dissection
D bicuspid valve
E trauma
A

B infective endocarditis
C aortic dissection
D bicuspid valve
E trauma

Cardiology Past Papers (2 decks)

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