WorksheetsCARDIOVASCULAR SYSTEM
Total questions: 50
Worksheet time: 19mins
The apex of the heart is directed:
Downward, backward and to the left
Downward, forward and to the left
Downward, backward and to the right
Downward, backward and to the left
The heart has 3 surfaces, which of the following is the correct match:
Sternocostal : superior surface
Diaphragmatic : posterior surface
Apex: inferior surface
Base : posterior surface
The normal position of the apex is at the level of the:
4th right ICS
5th right ICS
4th left ICS
5th left ICS
The lower border of the heart consists of:
Right atrium and right ventricle
Right ventricle and left ventricle
Right atrium and left ventricle
Left atrium and left ventricle
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?
The needle is introduced to the left of the xiphoid process in a downward and backward direction, at an angle of 45 degrees.
The needle is introduced to the right of the xiphoid process in a downward and backward direction, at an angle of 45 degrees.
The needle is introduced to the left of the xiphoid process in an upward and backward direction, at an angle of 45 degrees.
The needle is introduced to the right of the xiphoid process in an upward and backward direction, at an angle of 45 degrees.
This structure of the right ventricle connects the papillary muscles to the cusps of the tricuspid valve.
Moderator band
Chordae tendinae
Bands of papillae
Musculi pectinati
Most of the blood from the heart drains into the right atrium directly through:
Great cardiac vein
Small and middle cardiac veins
Anterior cardiac vein
Coronary sinus
In ischemia, T wave inversion in this leads represent the high lateral wall:
V5 and V6
II, III and AVF
I and AVL
V3 and V4
In an electrocardiogram, the presence of saw-tooth appearance in P-waves indicates:
Atrial Flutter
Atrial Fibrillation
Ventricular Fibrillation
Atrioventricular Nodal Reentrant Tachycardia
Cardiac output is a function of:
Heart rate and blood pressure
Heart rate and respiratory rate
Blood pressure and stroke volume
Heart rate and stroke volume
This method of measuring the blood pressure measures only the systolic pressure:
Pachon Method
Korotkoff Method
Auscultatory Method
Riva-Rocci method
What is the mean arterial pressure of a patient with a BP reading of 140/80 mmHg
80 mmHg
90 mmHg
100 mmHg
120 mmHg
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
50
60
70
80
In MI, a clenched fist held over the chest is called (a) sign:
This cardiac enzyme is considered as the "gold standard" for MI:
CK-MB
Troponin I
Troponin T
LDH
This cardiac enzyme is said to be 100% cardiospecific:
CK-MB
Troponin T
Troponin I
Troponin S
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.
Aspirin
Clopidogrel
Nitroglycerin
Beta blockers
In administering nitrates, what is the most effective route for acute relief of angina?
Transdermal Patch
Oral
Intramuscular
Sublingual
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):
Abciximab
Clopidogrel
Fondaparinux
Aspirin
Like aspirin, the drug clopidogrel also reduces platelet aggregation but through a different mechanism. It acts as an antagonist to which ADP receptor:
(a)
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?
Clopidogrel
Abciximab
Aspirin
Ticagrelor
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?
LMW Heparin (Enoxaparin)
Heparinoid pentasaccharide (Fondaparinux)
Thrombin inhibitor (Hirudin)
Rivaroxaban
These cells in the kidney release renin:
(a)
These cells in the kidney trigger contraction of the afferent arteriole in response to elevated sodium.
(a)
The most common cause of hypertension is:
Diabetes
Renal Diseases
Genetic Diseases
Idiopathic
According to the AHA guidelines, a patient with a blood pressure of 130/70 is classified as:
Normal
Elevated
Stage 1 Hypertension
Stage 2 Hypertension
According to the AHA guidelines, a patient with a blood pressure of 120/80 is classified as:
Normal
Elevated
Stage 1 Hypertension
Stage 2 Hypertension
What is the blood pressure goal of a 60-year old hypertensive with no other comorbidities?
SBP: <150 mmHg
DBP: <90 mmHg
SBP: <140 mmHg
DBP: <90 mmHg
SBP: <140 mmHg
DBP: <80 mmHg
SBP: <120 mmHg
DBP: <80 mmHg
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.
20, 20, 3
20, 20, 5
20, 10, 3
20, 10, 5
These antihypertensive drugs act on the Na/Cl symporter in the distal convoluted tubule leading to enhanced NaCl excretion:
Loop Diuretics
Thiazide Diuretics
Potassium Sparing Diuretics
Calcium Channel BLockers
This is an example of a loop diuretic:
Metolazone
Amiloride
Triamterene
Furosemide
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?
Spironolactone
Metolazone
AmilorideTriamterene
Amiloride
A patient with history of asthma was diagnosed with hypertension. Which beta blocker must be given to the patient?
Propanolol
Nadolol
Atenolol
Timolol
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?
Losartan
Enalapril
Hydralazine
Amlodipine
This cause of heart failure leads to reduced ejection fraction:
MI
Fibrosis
Thyrotoxicosis
Restrictive cardiomyopathy
This cause of heart failure causes a preserved ejection fraction:
Dilated cardiomyopathy
Hypertension
Chronic Anemia
Thyrotoxicosis
_________ and __________ are the cardinal symptoms of heart failure.
(Separate your answers with a comma: ex. headache, cough)
(a)
In heart failure, this describes dyspnea in lateral decubitus position:
Orthopnea
Paroxysmal nocturnal dyspnea
Trepopnea
Apnea
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?
NYHA I
NYHA II
NYHA III
NYHA IV
In physical examination, JVP is best assessed from pulsations in the:
Right internal carotid artery
Right external carotid artery
Right internal jugular vein
Right external jugular vein
This diagnostic test is the gold standard for measuring volumes, mass and ejection fraction of both right and left ventricle.
2D Echocardiography with Doppler
CT Scan without contrast
CT Scan with contrast
Cardiac MRI
Which of the following is a sensitive cardiac biomarker for heart failure?
Lactate dehydrogenase
Troponin I
B-type natriuretic peptide
CK-MB
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.
3, 8
5, 8
8, 3
8, 5
What is the upper limit for BNP and pro-BNP?
BNP: 100 pg/mL
Pro-BNP: 200 pg/mL
BNP: 200 pg/mL
Pro-BNP 100pg/mL
BNP: 100 pg/mL
Pro-BNP: 300 pg/mL
BNP: 300 pg/mL
Pro-BNP: 100 pg/mL
In heart failure, this results from redistribution of fluid from splanchnic circulation and lower extremities into the central circulation.
Fatigue
Dyspnea
Orthopnea
Paroxysmal Nocturnal Dyspnea
In hypertensive crisis, the blood pressure is:
SBP > 200 mmHg
DBP > 120 mmHg
SBP > 200 mmHg
DBP > 100 mmHg
SBP > 180 mmHg
DBP > 120 mmHg
SBP > 180 mmHg
DBP > 100 mmHg
The difference between hypertensive emergency and emergency is:
Systolic blood pressure
Diastolic blood pressure
Mean arterial pressure
End organ damage
What is the target HBA1C level of a diabetic patient who had MI?
<6%
<6.5%
<7%
<7.5%
In patients with rheumatic fever, secondary prophylaxis is indicated. What is the duration of prophylaxis for those with RF but without carditis?
10 years after last attack or until 40 years old (whichever is longer)
10 years after last attack or until 21 years old (whichever is longer)
5 years after last attack or until 21 years old (whichever is longer)
Prophylaxis is only needed for 10 days
Carvallo's sign is a blowing holosystolic murmur that is intensified by inspiration, and is found in:
Mitral stenosis
Mitral regurgitation
Tricuspid stenosis
Tricuspid regurgitation
