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CARDIOVASCULAR SYSTEM

Total questions: 50

Worksheet time: 19mins

Name
Class
Date
1.

The apex of the heart is directed:

a)

Downward, backward and to the left

b)

Downward, forward and to the left

c)

Downward, backward and to the right

d)

Downward, backward and to the left

2.

The heart has 3 surfaces, which of the following is the correct match:

a)

Sternocostal : superior surface

b)

Diaphragmatic : posterior surface

c)

Apex: inferior surface

d)

Base : posterior surface

3.

The normal position of the apex is at the level of the:

a)

4th right ICS

b)

5th right ICS

c)

4th left ICS

d)

5th left ICS

4.

The lower border of the heart consists of:

a)

Right atrium and right ventricle

b)

Right ventricle and left ventricle

c)

Right atrium and left ventricle

d)

Left atrium and left ventricle

5.

In pericarditis, pericardial fluid accumulates, compressing the heart, causing cardiac tamponade. One important finding during the physical examination is the presence of PERICARDIAL FRICTION RUB. In managing these patients, paracentesis is done. How should the needle be introduced in paracentesis?

a)

The needle is introduced to the left of the xiphoid process in a downward and backward direction, at an angle of 45 degrees.

b)

The needle is introduced to the right of the xiphoid process in a downward and backward direction, at an angle of 45 degrees.

c)

The needle is introduced to the left of the xiphoid process in an upward and backward direction, at an angle of 45 degrees.

d)

The needle is introduced to the right of the xiphoid process in an upward and backward direction, at an angle of 45 degrees.

6.

This structure of the right ventricle connects the papillary muscles to the cusps of the tricuspid valve.

a)

Moderator band

b)

Chordae tendinae

c)

Bands of papillae

d)

Musculi pectinati

7.

Most of the blood from the heart drains into the right atrium directly through:

a)

Great cardiac vein

b)

Small and middle cardiac veins

c)

Anterior cardiac vein

d)

Coronary sinus

8.

In ischemia, T wave inversion in this leads represent the high lateral wall:

a)

V5 and V6

b)

II, III and AVF

c)

I and AVL

d)

V3 and V4

9.

In an electrocardiogram, the presence of saw-tooth appearance in P-waves indicates:

a)

Atrial Flutter

b)

Atrial Fibrillation

c)

Ventricular Fibrillation

d)

Atrioventricular Nodal Reentrant Tachycardia

10.

Cardiac output is a function of:

a)

Heart rate and blood pressure

b)

Heart rate and respiratory rate

c)

Blood pressure and stroke volume

d)

Heart rate and stroke volume

11.

This method of measuring the blood pressure measures only the systolic pressure:

a)

Pachon Method

b)

Korotkoff Method

c)

Auscultatory Method

d)

Riva-Rocci method

12.

What is the mean arterial pressure of a patient with a BP reading of 140/80 mmHg

a)

80 mmHg

b)

90 mmHg

c)

100 mmHg

d)

120 mmHg

13.

In atherosclerosis, critical stenosis is the stage at which the occlusion is sufficiently severe to produce tissue ischemia. In coronary circulation, this occurs when there is _____% decrease in luminal corss-sectional area

a)

50

b)

60

c)

70

d)

80

14.

In MI, a clenched fist held over the chest is called (a)   sign:

15.

This cardiac enzyme is considered as the "gold standard" for MI:

a)

CK-MB

b)

Troponin I

c)

Troponin T

d)

LDH

16.

This cardiac enzyme is said to be 100% cardiospecific:

a)

CK-MB

b)

Troponin T

c)

Troponin I

d)

Troponin S

17.

As part of the management for ACS, chest pain must be relieved. These drugs lead to systemic venodilation with reduction in left ventricular end-diastolic volume and pressure.

a)

Aspirin

b)

Clopidogrel

c)

Nitroglycerin

d)

Beta blockers

18.

In administering nitrates, what is the most effective route for acute relief of angina?

a)

Transdermal Patch

b)

Oral

c)

Intramuscular

d)

Sublingual

19.

The pathophysiology of ACS involves increased platelet aggregation. This drug inhibits platelet aggregation by reducing the production of thromboxane A2 by inhibiting platelet cyclooxygenase (COX):

a)

Abciximab

b)

Clopidogrel

c)

Fondaparinux

d)

Aspirin

20.

Like aspirin, the drug clopidogrel also reduces platelet aggregation but through a different mechanism. It acts as an antagonist to which ADP receptor:

(a)  

21.

Anti-integrin agents are directed against platelet integrin GPIIb/IIIa, which is the final effector pathway of platelet aggregation. Which of the following is an example of this agent?

a)

Clopidogrel

b)

Abciximab

c)

Aspirin

d)

Ticagrelor

22.

Heparin, which is an anticoagulant, may also reduce the symptoms and prevent infarction in unstable angina. Among the anticoagulants, which has the best efficacy-safety profile?

a)

LMW Heparin (Enoxaparin)

b)

Heparinoid pentasaccharide (Fondaparinux)

c)

Thrombin inhibitor (Hirudin)

d)

Rivaroxaban

23.

These cells in the kidney release renin:

(a)  

24.

These cells in the kidney trigger contraction of the afferent arteriole in response to elevated sodium.

(a)  

25.

The most common cause of hypertension is:

a)

Diabetes

b)

Renal Diseases

c)

Genetic Diseases

d)

Idiopathic

26.

According to the AHA guidelines, a patient with a blood pressure of 130/70 is classified as:

a)

Normal

b)

Elevated

c)

Stage 1 Hypertension

d)

Stage 2 Hypertension

27.

According to the AHA guidelines, a patient with a blood pressure of 120/80 is classified as:

a)

Normal

b)

Elevated

c)

Stage 1 Hypertension

d)

Stage 2 Hypertension

28.

What is the blood pressure goal of a 60-year old hypertensive with no other comorbidities?

a)

SBP: <150 mmHg

DBP: <90 mmHg

b)

SBP: <140 mmHg

DBP: <90 mmHg

c)

SBP: <140 mmHg

DBP: <80 mmHg

d)

SBP: <120 mmHg

DBP: <80 mmHg

29.

Orthostatic Hypertension is a decrease in systolic blood pressure by > _____ mmHg OR in diastolic blood pressure by > _____ mmHg within ______ mins from supine to upright position.

a)

20, 20, 3

b)

20, 20, 5

c)

20, 10, 3

d)

20, 10, 5

30.

These antihypertensive drugs act on the Na/Cl symporter in the distal convoluted tubule leading to enhanced NaCl excretion:

a)

Loop Diuretics

b)

Thiazide Diuretics

c)

Potassium Sparing Diuretics

d)

Calcium Channel BLockers

31.

This is an example of a loop diuretic:

a)

Metolazone

b)

Amiloride

c)

Triamterene

d)

Furosemide

32.

A 27-year old male was diagnosed with stage I hypertension 2 years prior to consult. He was given an anti-hypertensive drug, which was said to be a potassium-sparing diuretic. Suddenly, he noticed enlargement of breast size for which he sought consult. What drug was given to the patient?

a)

Spironolactone

b)

Metolazone

c)

AmilorideTriamterene

d)

Amiloride

33.

A patient with history of asthma was diagnosed with hypertension. Which beta blocker must be given to the patient?

a)

Propanolol

b)

Nadolol

c)

Atenolol

d)

Timolol

34.

A patient with hypertension was given a single-drug therapy. After days of taking the medication, he noticed coughing more often. What anti-hypertensive drug was given to the patient?

a)

Losartan

b)

Enalapril

c)

Hydralazine

d)

Amlodipine

35.

This cause of heart failure leads to reduced ejection fraction:

a)

MI

b)

Fibrosis

c)

Thyrotoxicosis

d)

Restrictive cardiomyopathy

36.

This cause of heart failure causes a preserved ejection fraction:

a)

Dilated cardiomyopathy

b)

Hypertension

c)

Chronic Anemia

d)

Thyrotoxicosis

37.

_________ and __________ are the cardinal symptoms of heart failure.


(Separate your answers with a comma: ex. headache, cough)

(a)  

38.

In heart failure, this describes dyspnea in lateral decubitus position:

a)

Orthopnea

b)

Paroxysmal nocturnal dyspnea

c)

Trepopnea

d)

Apnea

39.

Mr. Tapu Lan is a medical student who started medical school in XU-JPRSM at the age of 45. He usually goes to the library during his vacant time to study. During his 3rd year in medical school, he noticed that going to Ma'am Connie's office has made breathing more difficult. He sought consult and was diagnosed to have heart failure. What is his NYHA classification?

a)

NYHA I

b)

NYHA II

c)

NYHA III

d)

NYHA IV

40.

In physical examination, JVP is best assessed from pulsations in the:

a)

Right internal carotid artery

b)

Right external carotid artery

c)

Right internal jugular vein

d)

Right external jugular vein

41.

This diagnostic test is the gold standard for measuring volumes, mass and ejection fraction of both right and left ventricle.

a)

2D Echocardiography with Doppler

b)

CT Scan without contrast

c)

CT Scan with contrast

d)

Cardiac MRI

42.

Which of the following is a sensitive cardiac biomarker for heart failure?

a)

Lactate dehydrogenase

b)

Troponin I

c)

B-type natriuretic peptide

d)

CK-MB

43.

The JVP is an essential parameter to be measured if heart failure is suspected. It is considered abnormal if it measures more than ______ cm from the sternal angle or more than _____ cm from the right atrium.

a)

3, 8

b)

5, 8

c)

8, 3

d)

8, 5

44.

What is the upper limit for BNP and pro-BNP?

a)

BNP: 100 pg/mL

Pro-BNP: 200 pg/mL

b)

BNP: 200 pg/mL

Pro-BNP 100pg/mL

c)

BNP: 100 pg/mL

Pro-BNP: 300 pg/mL

d)

BNP: 300 pg/mL

Pro-BNP: 100 pg/mL

45.

In heart failure, this results from redistribution of fluid from splanchnic circulation and lower extremities into the central circulation.

a)

Fatigue

b)

Dyspnea

c)

Orthopnea

d)

Paroxysmal Nocturnal Dyspnea

46.

In hypertensive crisis, the blood pressure is:

a)

SBP > 200 mmHg

DBP > 120 mmHg

b)

SBP > 200 mmHg

DBP > 100 mmHg

c)

SBP > 180 mmHg

DBP > 120 mmHg

d)

SBP > 180 mmHg

DBP > 100 mmHg

47.

The difference between hypertensive emergency and emergency is:

a)

Systolic blood pressure

b)

Diastolic blood pressure

c)

Mean arterial pressure

d)

End organ damage

48.

What is the target HBA1C level of a diabetic patient who had MI?

a)

<6%

b)

<6.5%

c)

<7%

d)

<7.5%

49.

In patients with rheumatic fever, secondary prophylaxis is indicated. What is the duration of prophylaxis for those with RF but without carditis?

a)

10 years after last attack or until 40 years old (whichever is longer)

b)

10 years after last attack or until 21 years old (whichever is longer)

c)

5 years after last attack or until 21 years old (whichever is longer)

d)

Prophylaxis is only needed for 10 days

50.

Carvallo's sign is a blowing holosystolic murmur that is intensified by inspiration, and is found in:

a)

Mitral stenosis

b)

Mitral regurgitation

c)

Tricuspid stenosis

d)

Tricuspid regurgitation