Monday, October 29, 2012

Cardiovascular system multiple choice questions 1

Q 1. Which of the following conditions is not associated with sinus bradycardia?

A.Brucellosis

B. Leptospirosis

C.Hypothyroidism

D.Advanced liver disease

E. Typhoid fever

ANSWER. B

Q 2. All of the following are common consequences of congenital heart disease in the adult except

A.Eisenmenger syndrome

B. erythrocytosis

C.infective endocarditis

D.pulmonary hypertension

E. stroke

ANSWER. E

Q 3. Acute hyperkalemia is associated with which of the following electrocardiographic changes?

A.QRS widening

B. Prolongation of the ST segment

C.A decrease in the PR interval

D.Prominent U waves

E. T-wave flattening

ANSWER. A

Q 4. All of the following clinical findings are consistent with severe mitral stenosis except

A.atrial fibrillation

B. opening snap late after S2

C.pulmonary vascular congestion

D.pulsatile liver

E. right-ventricular heave

ANSWER. B

Q 5. A 37-year-old male with Wolff-Parkinson-White syndrome develops a broad-complex irregular tachycardia at a rate of 200 beats per minute. He appears comfortable and has little hemodynamic impairment. Useful treatment at this point might include

A.Digoxin

B. Amiodarone

C.Propranolol

D.Verapamil

E. Direct-current cardioversion

ANSWER. E

Q 6. In African Americans with New York Heart Association class II heart failure, which of the following drug combinations should be added to an angiotensinconverting enzyme inhibitor and beta blocker?

A.Hydralazine/angiotensin receptor blockers

B. Hydrazaline/digoxin

C.Isosorbide dinitrate/angiotensin receptor blockers

D.Isosorbide dinitrate/digoxin

E. Isosorbide dinitrate/hydralazine

ANSWER. E

Q 7. All of the following medications have been shown to worsen heart failure in patients with left ventricular systolic dysfunction except

A.angiotensin receptor blockers

B. calcium channel antagonists

C.nonsteroidal anti-inflammatory drugs (NSAIDs)

D.sotalol

E. thiazolidinediones

ANSWER. A

Q 8. Which of the following is true regarding dose escalation of angiotensin-converting enzyme (ACE) inhibitors and beta blockers in patients newly diagnosed with congestive heart failure?

A.ACE inhibitors should be escalated on a daily basis to maximal tolerated doses, while beta blockers should be gently increased in dose over weeks, as tolerated.

B. Beta blockers should be escalated on a daily basis to maximal tolerated doses, while ACE inhibitors should be gently increased in dose over weeks, as tolerated.

C.Both should be escalated rapidly to maximally tolerated doses.

D.Both should be escalated slowly to maximally tolerated doses.

E. Both should be initiated at full doses

ANSWER. A

Q 9. All of the following findings on echocardiographic assessment of patients with congestive heart failure with preserved ejection fraction are relevant except

A.atrial fibrillation

B. left atrial dilatation

C.left ventricular wall thickness

D.left ventricular diastolic filling as measured by tissue Doppler

E. systolic anterior motion of the mitral valve

ANSWER. E

Q 10. A 28-year-old man with long-standing cardiomyopathy presents with worsening dyspnea. Physical examination reveals a blood pressure of 85/50 mmHg, heat rate of 112 beats/min, elevated jugular venous pressure, positive hepatojugular reflex, quiet S1/S2, apical S3, no pulmonary rales, and 3+ lower extremity edema. Chest radiograph shows no pulmonary edema and a small left-sided pleural effusion. What information does the patient’s pulmonary examination give you in regards to his likely pulmonary capillary wedge pressure?

A.It is likely to be elevated.

B. It is likely to be normal.

C.It is likely to be decreased.

D.No information

ANSWER. D

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