University of Perpetual Help College of Medicine Medicine Review Quiz- Cardiology

1. In a patient with MI, the pain associated is caused by a. left ventricular overload b. impending circulatory collapse c. extracellular electrolyte imbalances d. insufficient oxygen reaching the heart muscle 2. Reversible risk factors for the progress of atherosclerosis are the following, EXCEPT: a. obesity d. genetic trait b. cigarette smoking e. hypertension c. hyperlipidemia 3. This cholesterol subfraction is cardioprotective: a. VLDL c. LDL b. HDL d. triglycerides 4. Sudden acute death due to acute myocardial infarction is usually due to a. CVA c. pulmonary embolism b. angina d. ventricular arrhythmia 5. Atenolol is being given cautiously among elderly individual because of the most common side effect of atenolol which is a. allergic reaction c. cough b. pedal edema d. bradycardia 6. Patient with hypertension is prone to long term complications of the disease. Which of the following is a long term complication of hypertension? a. renal insufficiency and failure b. valvular heart disease c. endocarditis d. peptic ulcer disease 7. Blood pressure of 150/100 belongs to this stage of hypertension a. pre-hypertensive stage c. Stage II b. Stage I Situation: Mrs. Santiago was diagnosed to have ischemic heart disease and had been having chest pain when fatigued. 8. The chest pain of the above client can be classified as: a. stable angina c. prinzmetal angina b. unstable angina 9. Which of the following symptoms should the patient with unstable angina be told to report immediately to her physician? a. a change in the pattern of her pain b. pain during sexual activity c. Pain during an argument with her husband d. Pain during or after an activity such as lawn mowing. 10. In unstable angina: a. the pain is typically triggered by exertion or stress. b. the pain is typically relieved by rest. c. the pain lasts less than 2 minutes. d. the pain may occur while the patient is sleeping. 11. Which of the following factor is not considered to be a risk factor for the development atherosclerosis? a. family history of heart attack b. late onset puberty c. Total blood cholesterol level greater than 220 mg/dl d. Elevated fasting blood sugar concentration

12. Many enzymes are released into the bloodstream in increased quantities in response to a myocardial infarction. Which combinations of enzymes are cardiospecific? a. GPT and AST (serum glutamic-pyruvic transaminase and aspartate aminotransferase) b. HBDH and GGTP (hydroxybutyric dehydrogenase and glutamyl transpeptidase) c. LDH1 and CPK2 (lactic dehydrogenase isoenzyme1, and creatine phosphokinase isoenzyme2) d. LDH and GOT (lactic dehydrogenase and glutamic-oxaloacetic transaminase) 13. The thrombolytic drugs demonstrate their optimal therapeutic effect when administered: a. when prothrombin time is within normal limits b. within 4-6 hours after thrombus formation c. by the intravenous route d. with an anticoagulant 14. One of the following will reduce the oxygen requirement of the heart: A. digitalis C. dilantin B. propranolol D. Calcium 15. The most sensitive non-invasive test in the diagnosis of coronary artery disease for the most number of patient is A. angiography c. stress ECG B. stress echocardiography d. stress myocardial scintigraphy 16. The diagnosis of acute myocardial infarction according to the WHO criteria include the following, EXCEPT: A. chest pain c. enzyme changes B. hypertension d. EKG changes 17. The hallmark of an acute myocardial infarction in EKG is A. T wave inversion c. prolonged PR interval B. ST segment depression d. Prominent U wave C. Q wave prominent 18. The major goal of therapy for a patient with heart failure and pulmonary edema would be to a. increase cardiac output c. decrease peripheral edema b. improve respiratory status d. enhance comfort 19. Digoxin will be administered intravenously to this patient with heart failure, primarily because the drugs acts to a. increase cardiac output c. decrease peripheral edema b. improve respiratory status d. enhance comfort 20. Complications of atrial fibrillation can be caused by a. stasis of blood in the atria c. decreased pulse rate b. Increased cardiac output d. elevated blood pressure 21. You should be especially alert for signs and symptoms of digitalis toxicity if serum levels indicate that the patient has a a. low sodium level c. high glucose level b. high calcium level d. low potassium level 22. Mitral stenosis would demonstrate symptoms associated with congestion in the a. aorta c. right atrium b. superior vena cava d. pulmonary circulation 23. The patient has Heparin infusion ordered with a bolus of 5000 units followed by an infusion at 1200 units per hour. Which of the following parameters will be used to monitor the effectiveness of Heparin? a. PT c. INR b. PTT d. Bleeding time 24. Unresponsive shock in the course of an acute myocardial infarct implies A. excessive sympathetic discharges C. large loss of infarcted tissue B. intake of vasopressors D. psychogenic depression

25. Which of the following drugs can relieve dyspnea in CHF? a. Salbutamol by inhalation d. Beta blocker per orem b. Furosemide IV e. Digitalis by IV route c. Nitrates sublingual 26. What arrhythmia is suggested by wide complex QRS tachycardia exceeding 100 beats/minute and is associated with syncope and sudden cardiac death? a. Ventricular tachycardia c. AV junctional complexes b. Ventricular parasystole d. Ventricular fibrillation 27. Chest pain is present in patient with a. aortic dissection b. myocardial infarction c. both d. neither

28. All of the following are emergencies and require immediate attention and treatment, EXCEPT a. acute left ventricular failure d. status asthmaticus b. acute rheumatic carditis c. adult respiratory distress syndrome c. ventricular fibrillation 29. All of the following are true of sinus bradycardia, EXCEPT: A. heart rate is less than 60/min c. needs treatment B. common in athletes D. can be drug induced 30. A 16 years old woman came to you with complaint of chest pain. After work-up, you diagnose her to have mitral valve prolapse. You explain to her that MVP tends to be benign but the following may occur EXCEPT: A. angiodysplasia C. sudden cardiac death B. endocarditis D. infective embolic phenomena 31. Prinzmetal angina is best explained as a. coronary vasospasm d. periodic anemia b. periodic hypertension e. hyperthyroidism c. myocardial hyperplasia 32. The drug of choice for the acute anginal attack is A. sublingual nifedipine c. sublingual nitroglycerin b. oral nitrates D. oral nifedipine 33. A patient with acute MI presents a BP of 60/30 mm hg, cold clammy extremities (+) pulmonary congestion, reduce urine output. The drug of choice is A. isoproterenol C. dobutamine B. norepinephrine D. nitroprusside 34. One of the following is true in patients with New York Heart Association functional class IV: a. Symptoms occur with ordinary activity b. Asymptomatic at rest c. Symptoms occur even at rest d. None of the above 35. Which of the following is not a major criteria in Rheumatic Fever? a. Elevated acute phase reactants c. Sydenhams chorea b. carditis d. migratory polyarthritis 36. Which of the following ECG finding is very suggestive of Pericardial effusion? a. atrial fibrillation c. Ventricular tachycardia b. Low voltage ECG d. Atrio-ventricular blocks 37. Lack of this vitamin may contribute to hyperhomocysteinemia leading to atherosclerosis. a. Thiamine c. Vitamin E b. Vitamin B12 d. Vitamin C 38. Syphilitic aneurysms is a manifestation of this stage of syphilis. a. Primary c. tertiary b. secondary d. latent 39. Alcoholic cardiomyopathy presents with this form of cardiomyopathy. a. restrictive c. dilated b. hypertrophic d. ischemic

40. A patient with hypertension complains of bilateral pedal edema. This patient may have been maintained on which of the following drugs? a. Enalapril c. metoprolol b. Amlodipine d. Candesartan