Cardiology and CVS



1) Each of the following has been shown to 6) Which of the following is not a mechanism
improve mortality in heart failure patients for atrial fibrillation affecting cardiac function:
except: a) Decreased time for diastolic filling
a) Beta blocker b) Decreased ventricular compliance
b) ACEI c) Irregular ventricular response
c) Loop diuretic d) Loss of atrial contraction
d) Aldosterone antagonist e) Decreased time for coronary perfusion
e) Nitrate

7) Dressler's syndrome refers to:

2) Each of the following is a potential a) Migratory superficial thrombophlebitis
component of the management of both b) The clinical features of myocarditis
STEMI and UA/NSTEMI except: c) Delayed pericarditis post MI
a) PCI d) A preexcitation syndrome similar to
b) ASA WPW
c) Clopidogrel e) Cardiac myxoma
d) Beta blocker
e) Fibrinolysis
8) Each of the following is a cause of left axis
deviation except:
3) Which of the following is not an absolute a) Left anterior hemiblock
contraindication to exercise ECG stress b) Inferior MI
testing? c) WPW
a) Acute aortic dissection d) RV pacing
b) Acute MI within 2 days e) LBBB
c) Unstable angina not stabilized by
medical therapy
d) Asymptomatic aortic stenosis 9) Each of the following in and of itself is a
e) Symptomatic heart failure not controlled potential indication for AAA repair except:
by therapy a) Rate of enlargement 1.0 cm/yr
b) Comorbid HTN, COPD and smoking
c) Size = 5.5 cm in a male
4) According to the newest set of ACC/AHA d) Size = 5.5 cm in a female
Guidelines, which of the following is an e) Ruptured aneurysm
indication for infective endocarditis
prophylaxis before bowel surgery ?
a) Previous infective endocarditis
b) Mitral stenosis
c) Bicuspid aortic valve
d) Prosthetic cardiac valve
e) None of the above

5) Each of the following is an ECG feature of

acute MI except:
a) U wave
b) T wave inversion
c) ST depression
d) New LBBB
e) Tall "hyperacute" T waves
10) The subendothelium is the most vulnerable 14) Endocarditis in an I.V. drug user:
segment of the heart from an ischemic a) Is equally prevalent to that of the normal
standpoint. The major reason for this is: population
a) The highest oxygen utilization is in the b) Transthoracic Echocardiography is
subendocardium highly sensitive in diagnosing
b) Coronary flow to the subendocardium c) Is typically caused by S. pneumoniae
occurs almost completely during diastole d) Is typically found on the tricuspid valve
whereas other regions receive some flow e) Is typically found on the aortic valve,
during systole as well producing a systolic ejection murmur
c) The subendocardium has a diminished
aerobic capacity
d) There is less potential for 15) Nitroglycerin administered sublingually may
collateralization to the subendocardium contribute to the relief of myocardial
e) The ratio of capillary to myocyte is less in ischemic pain by each of the following
the subendocardium than in other mechanisms EXCEPT:
regions a) Coronary vasodilation
b) Decreased venous pooling resulting in
increased cardiac preload
11) Impaired coronary flow reserve is c) Reduced systemic vascular resistance
associated with each of the following d) Reduced ventricular volume
conditions EXCEPT:
a) Severe aortic stenosis
b) Severe systemic hypertension with left 16) A 48 year-old male is brought to the ED with
ventricular hypertrophy CPR being administered. The ECG shows
c) Severe mitral stenosis in the presence of electrical activity present but you cannot
atrial fibrillation palpate a carotid pulse. Which of the
d) A totally occluded coronary artery but following is not on the differential for
with excellent collateral supply from the pulseless electrical activity?
contralateral (i.e. opposite) coronary a) Alkalosis
artery b) Hypokalemia
e) An isolated 30% diameter stenosis of a c) Cardiac tamponade
coronary artery d) Hypothermia
e) Tension pneumothorax

12) Which of the following would NOT be part of

your plan for the treatment of acute 17) Which of the following is not a surgically
ventricular fibrillation? correctable cause of hypertension?
a) Electrical defibrillation a) Aortic coarctation
b) Lidocaine b) Renal artery atherosclerosis
c) Epinephrine c) Pheochromocytoma
d) Amiodarone d) Primary hyperaldosteronism (Conn
e) Manganese syndrome)
e) None of the above

13) Which of the following is not an aggravating

factor of congestive heart failure? 18) Which of the following findings is
a) Hypertension inconsistent with cardiac tamponade?
b) Thyrotoxicosis a) Hypotension
c) Alcohol b) Pulsus paradoxus
d) Inactivity c) Kussmaul sign
e) Arrhythmia d) Jugular venous distension
e) Muffled heart sounds
19) Which of the following is the most common 24) All of the following are causes of left axis
cardiac manifestation of systemic lupus deviation (LAD) on ECG except?
erythematosus? a) Inferior myocardial infarction
a) Myocarditis b) WPW / pre-excitation / bypass tract
b) Pericarditis c) Hyperkalemia
c) Myocardial infarction d) Mechanical shift: Expiration, high
d) Mitral valve prolapse diaphragm from pregnancy, ascites,
abdominal tumors, etc.
e) Aortic stenosis
20) Which of the following is false regarding the
clinical findings of significant aortic
stenosis? 25) All of the following are the causes of right
a) Cresendo-decresendo systolic murmur axis deviation (RAD) on ECG except?
with left ventricular hypertrophy a) Right ventricular hypertrophy
b) Diminished or absent S2 b) Right bundle branch block
c) Severe cases cause paradoxical c) Lateral infarction
splitting d) Hypercalcemia
d) Parvus-et-tardus carotid upstroke e) WPW / Preexcitation / Bypass tract
e) Radiates to axilla

26) All of the following are criteria for the

21) All of the following are signs of increasing CHADS2 score for assessing the risk for
severity of AS except: stroke among patients with atrial fibrillation
a) Late peaking of murmur except?
b) Diminished or absent S2 a) Heart Failure
c) Radiation to carotids b) High blood pressure
d) Increased apical carotid delay c) History of smoking
e) Lack of brachio-radial delay d) Over 75 years old
e) Diabetes mellitus

22) All of the following can lead to elevation of

Troponin except? 27) When wide complex tachycardia is seen on
a) Myocarditis an ECG, all of the following signs and
b) Hypothyroidism symptoms suggest ventricular tachycardia
c) Pulmonary embolism (VT) rather than supraventricular
d) Subarachnoid haemorrhage tachycardia (SVT)?
e) Extreme exercise a) Carotid massage and adenosine
terminate the arrhythmia
b) Cannon A waves present on physical
23) All of the following are causes for low exam
voltage on a 12-lead ECG except? c) History of CAD and previous MI
a) Hypokalemia d) Capture or fusion beats
b) Pericardial effusion e) AV dissociation
c) Thick chest wall, barrel chest, COPD,
orobesity
d) Generalized edema 28) All of the following are causes of prolonged
e) Hypothyroidism with myxedema QT interval except
a) Coronary artery disease
b) Hypercalcemia
c) Sotolol
d) Tricyclic antidepressants
e) Hypothermia
ANSWERS
7. C 13. D 19. B 25. D
1. C 8. E 14. D 20. E 26. C
2. E 9. B 15. B 21. E 27. A
3. D 10. B 16. A 22. B 28. B
4. E 11. E 17. E 23. A (hypocalcemia
5. A 12. E 18. C 24. E causes
6. B prolonged QT)