WorksheetsBlock 4 Quiz
Total questions: 214
Worksheet time: 2hrs 47mins
Which statement below is correct about the "typical angina pectoris"?
A) Typical angina pectoris does not resolves by taking sublingual nitrates
B) Typical angina pectoris may radiate to left groin
C) A retrosternal squeezing pain which is provoked by rapid climbing of stairs and resolving with in five minutes by resting is a typical angina pectoris
D) Typical angina pectoris is a symptom of peripheral artery disease
E) Typical angina pectoris is a knife cutting abrupt chest pain
A
B
C
D
E
Which of the following statements is/are true for heart failure?
I. Renal perfusion and urine output is decreased during heart failure
II. Venous pressure does not change in heart failure patients
III. Heart failure is defined as reduced ability of the heart to pump enough blood to meet the body's needs
IV. Sympathetic nervous system is activated during the low cardiac output
V. Most frequent cause of heart failure is myocardial ischemia
A) II, III, IV B) I, III, IV, V C) II, III, V D) I, II, III, V E) I, II, IV
A
B
C
D
E
Which one of the following enzyme uses zinc as a cofactor in heme biosynthesis? A) ALAS-1
B) Ferrochelatase
C) Hydroxymethylbilane synthase
D) Amino levulinic acid dehydratase
E) Uroporphyrinogen III synthase
A
B
C
D
E
By which of the following vector is Rickettsia provazekii transmitted by?
A) Flea
B) Louse
C) Mite
D) Hard tick
E) Soft tick
A
B
C
D
E
Which interval represents the Atrial -Ventricular conduction on ECG?
A) QT interval B) ST interval C) PR interval D) QRS interval E) None of them above
A
B
C
D
E
Which of the following anaerobic gram-positive rod is related to Bacterial vaginosis?
A) Actinomyces israelii
B) Veillonella parvula
C) Mobiluncus curtisii
D) Prevotella disiens
E) Propionibacterium propionicum
A
B
C
D
E
Which of the following problem causes Type II-A Hyperlipidemia?
A) LDL receptor defect
B) Overproduction of VLDL
C) Excessive production of APO-B
D) Abnormal APO-E
E) Lipoprotein lipase deficiency
A
B
C
D
E
Which of the following is the least effective mechanism in developing hypoxemia? A) Ventilation perfusion mismatch
B) Hypoventilation
C) Shunt
D) Diffusion abnormality
E) None of the above
A
B
C
D
E
Which one of the following enzyme is located in the mitochondrion in heme biosynthesis?
A) Ferrochelatase
B) Uroporphyrinogen III synthase
C) Hydroxymethylbilane synthase
D) Uroporphyrinogen decarboxylase
E) Aminolevulinic acid dehydratase
A
B
C
D
E
A 45 years old female with a properly measured blood pressure 145/95 mmHg is defined which grade of hypertension?
A) High normal
B) Grade 1 hypertension
C) Grade 2 hypertension
D) Grade 3 hypertension
E) Isolated systolic hypertension
A
B
C
D
E
Which of the following statement is FALSE?
A) CK-MB is highly specific to the heart tissue
B) Myoglobin has an early rise 1-3 hours in serum
C) Troponins are not found in smooth muscles
D) Troponin I levels may be elevated up to 10 days after infarction
E) Myoglobin is highly specific to the heart tissue
A
B
C
D
E
Which of the following is a function of lipoprotein lipase?
A) hydrolysis of triacylglycerols of plasma lipoproteins to supply fatty acids to various tissues
B) mediates the efflux of cholesterol from tissues to lipoprotein particles
C) mediated the receptor mediated endocytosis of lipoprotein remnants
D) intracellular lipid breakdown of lipoproteins
E) intestinal uptake of dietary fat
A
B
C
D
E
Which of the following statement is FALSE about artherosclerosis?
A) Male gender is a risk factor
B) Smoking is a risk factor
C) Low serum homocysteine level is a risk factor
D) Elevated CRP level is a risk factor
E) Elevated blood pressure level is a risk factor
A
B
C
D
E
Which one of the following is not considered as a hemoprotein?
A) Hemoglobin
B) Cytochrome p450
C) Myoglobin
D) Catalase
E) Calmodulin
A
B
C
D
E
Which of the following statements is/are true about shock?
I. Activity of sympathetic nervous system is increased during the shock
II. Waste products are not removed from the tissues effectively
III. Blood flow to the tissues is inadequate during shock
IV. Cardiac output may be increased during shock
V. Oxygen and nutrient supply to the tissues is not deteriorated in shock
A) I, II, III, IV B) II, III, V C) I, II, III, IV, V D) I, III, V E) I, II, IV, V
A
B
C
D
E
Which of The following isn't one of the Disorders Predisposing to Cor Pulmonale? A) Disorders Affecting Chest Movement
B) Diffuse pulmonary interstitial fibrosis
C) Recurrent pulmonary thromboembolism
D) Disorders Inducing Pulmonary Arterial Constriction
E) Tricuspid valve stenosis
A
B
C
D
E
Which of the following options is not correct for the Ductus arteriosus?
A) Within 1 to 2 days of birth in healthy term infants, the ductus constricts and closes
B) The ductus arteriosus arises from the left pulmonary artery and joins the aorta just distal to the origin of the left subclavian artery
C) Ductus arteriosus closes in response to decreased pulmonary vascular resistance
D) Ductus arteriosus closes in response to increased arterial oxygenation
E) Ductus arteriosus closes in response to increasing local levels of prostaglandin E2
A
B
C
D
E
Which of the following is the most frequent primary tumors of the heart in infants and children?
A) Myxomas
B) Papillary fibroelastomas
C) Lipomas
D) Fibromas
E) Rhabdomyomas
A
B
C
D
E
In which stage of the lung development, surfactant production begins, but it is not enough to prevent atelactasis?
A) pseudoglandular period
B) canalicular period
C) terminal sac period
D) saccular period
E) alveolar period
A
B
C
D
E
Which one of the following drugs can be used to block the compensatory mechanisms that can occur during antihypertensive drug therapy?
A) Vasodilators
B) Angiotensin converting enzyme inhibitors
C) Beta blockers
D) Angiotensin receptor blockers
E) Calcium channel blockers
A
B
C
D
E
Which of the following is wrong about the main features of obstructive and restrictive pulmonary diseases?
A) Obstructive (airway) disease, characterized by an increase in resistance to air flow caused by partial or compelete obstruction at any level
B) In diffuse restrictive diseases, FVC is reduced
C) Restrictive disease, characterized by decreased total lung capacity
D) In patients with Obstructive (airway) disease forced vital capacity (FVC) is either normal or slightly decreased,
E) Obstructive (airway) disease, characterized by reduced expansion of lung parenchyma
A
B
C
D
E
What is the necessity of pyridostigmine use for preventing organophosphate toxicity?
A) Reversible block of acetylcholinesterase enzyme
B) Decrease of organophosphate bioavailability
C) Reversible block of choline acetyl-transferase
D) Block of muscarinic receptors
E) Depletion of acetylcholine vesicles
A
B
C
D
E
In a study of new diuretics, an investigational drug was given daily for 8 d and urine output was analyzed. The following data were obtained. Which mechanism best explains the effects shown on the graph?
A) Carbonic anhydrase inhibition
B) Blockade of a Na+/K+/2Cl- transporter in the ascending limb of the loop of Henle
C) Blockade of a NaCl transporter in the distal convoluted tubule
D) Osmotic diuresis
E) Block of aldosterone in the cortical collecting tube
Which option of the following is wrong for aortic coarctation?
A) Turner syndrome frequently have coarctation
B) An "infantile" preductal form featuring hypoplasia of the aortic arch proximal to a PDA
C) In Preductal coarctation the ductus arteriosus is patent
D) In Preductal coarctation the right ventricle typically is hypertrophied.
E) Preductal coarctation with a PDA usually presents early in life, classically as cyanosis localized to the upper half of the body.
A
B
C
D
E
Which of the following statement is the consequences of the volume-loaded hypertrophy induced by regular aerobic exercise?
A) Sudden cardiac death
B) Pathological hypertrophy
C) Increased resting heart rate
D) Increased blood pressure
E) Increase in capillary density
A
B
C
D
E
Which of the following is not one of the features of the Hypertrophic cardiomyopathy?
A) It is characterized by myocardial hypertrophy
B) It is characterized by defective diastolic filling
C) It is characterized by in one third of cases-ventricular outflow obstruction
D) The heart is thick-walled, heavy, and hyper-contractile
E) It is involves primarily the right ventricle
A
B
C
D
E
Which one of the following is true for Coxiella?
A) especially seen in winter
B) restricted to far east
C) mainly transmitted by inhalation
D) Ticks play an important role in transmission
E) always intracellular
A
B
C
D
E
Which of the apolipoprotein that is present in chylomicron serves as the activator of lipoprotein lipase?
A) Apo B100 B) Apo B48 C) Apo CII D) Apo AI E) ApoE
A
B
C
D
E
Which one of the following bacteria is the cause of rat bite-fever?
A) Cardiobacterium hominis
B) Streptobacillus moniliformis
C) Capnocytophoga fumigatus
D) Bartonella henselae
E) Bacillary angiomatosis
A
B
C
D
E
Which of the following is a common clinical manifestation in Hyperlipidemia Type II-B?
A) Eruptive xhantoma
B) Corneal arcus
C) Palmar xhantoma
D) Tuberous xhantoma
E) Ischemic heart diseases
A
B
C
D
E
Which one of the following finding is not observed in variegate porphyria?
A) Urinary ALA concentration is increased
B) Fecal protoporphyrin IX is increased in concentration
C) Increased fecal coproporphyrin III concentration
D) Urinary porphobilinogen concentration is increased
E) Increased urinary coproporphyrin III concentration
A
B
C
D
E
Which one is right below for Dyspnea (sensation of difficult or uncomfortable breathing, breathlessness or shortness of breath; labored or difficult breathing)?
A) Orthopnea; dyspnea on lying flat
B) Paroxysmal nocturnal dyspnea (PND) refers to attacks of severe dyspnea and coughing that generally occur at night. It usually awakens the person from sleep, and may be quite frightening.
C) Platypnea is shortness dyspnea that is relieved when lying down and worsens when sitting or standing. It is the opposite of ortophenea.
D) Trepopnea is dyspnea (shortness of breath) that is sensed while lying on one side. (lateral recumbent position).
E) All of them
Which of the following choice demonstrate the lowest alveolar ventilation (mL/min) level depending on the tidal volume and respiratory frequency obtained with pulmonary function test?
A) 300 mL tidal volume with 30 breaths in minute
B) 500 mL tidal volume with 10 breaths in minute
C) 750 mL tidal volume with 10 breaths in minute
D) 1000 mL tidal volume with 10 breaths in minute
E) 1250 mL tidal volume with 8 breaths in minute
A
B
C
D
E
Which one of the following statement is not correct regarding the structure of porphyrins?
A) Porphyrins are colored and they emit a strong red flourescence
B) Spectrophotometry can be used to analyze porphyrins
C) Coproporphyrins are soley found in feces wheras uroporphyrins are soley found in urine
D) ALA and PBG can be measured by colorimetric tests
E) Porphyrinogens are recuded forms of porphyrins
A
B
C
D
E
Which one of the following is the rate limiting enzyme for heme biosynthesis in liver?
A) Uroporphyrinogen III synthase
B) ALAS-2
C) ALAS-1
D) Porphobilinogen synthase
E) Ferrochelatase
A
B
C
D
E
Choose the toxigenic pathogen which inactivates regulatory proteins of inhibitory transmitters, due to spastic paralysis?
A) C.tetani B) C.perfringens C) C.botulinum D) C.difficile E) C.septicum
A
B
C
D
E
Which of the following is responsible for selective uptake of HDL cholesterol by the liver?
A) Apo CII protein
B) Scavenger receptor BI
C) ABCA1 transporter
D) Apo AI protein
E) LDL-Receptor-Related Protein
A
B
C
D
E
Choose the causative agent of ornitosis disease, which one can not be transmitted human to human
A) Chlamydophila pneumoniae
B) Streptococcus pneumoniae
C) Mycoplasma pneumoniae
D) Rickettsia prowazekii
E) Chlamydophila psittaci
A
B
C
D
E
Indicate the most common anaerobic pathogen which is responsible intraabdominal infection
A) Prevotella melaninogenica
B) Veillonella parvula
C) Bacteroides fragilis
D) Fusobacterium nucleatum
E) Propionibacterium acnes
A
B
C
D
E
Recurrent pulmonary infection, bronchospasm and daily sputum production refer to.........
A) centrilobular emphysema
B) panacinar emphysema
C) bronchial asthma
D) bronchiectasis
E) pneumonia
A
B
C
D
E
Which one of the following is the activator protein of lecithin-cholesterol acyl transferase?
A) Apo B100 B) Apo AI C) Apo AII D) Apo CII E) Apo E
A
B
C
D
E
Which one of the following is true for Rickettsia?
A) Gram positive
B) Humans are the main reservoir
C) strict extracellular
D) No LPS
E) Best seen by Giemsa
A
B
C
D
E
Which one from the followings is a vaccine prevented pathogen in Clostridium species?
A) C.tetani B) C.botunilum C) C.perfringens D) C.difficile E) C. novyii
A
B
C
D
E
Which of the following statements is/are true for heart failure?
I. Heart failure is defined as reduced ability of the heart to pump enough blood to meet the body's needs
II. Most frequent cause of heart failure is myocardial ischemia
III. Renal perfusion and urine output is increased during heart failure
IV. Sympathetic nervous system is activated during the low cardiac output
V. Venous pressure does not change in heart failure patients
A) II, III, IV
B) I, II, III, IV, V
C) II, III, V
D) I, II, III, V
E) I, II, IV
All of the following statements are true regarding anaerobic infections except
a) Presence of foul odor
b) Presence of large quantity of gas
c) Presence of black color or brick-red fluorescence
d) Always monomicrobial
e) Presence of sulfur granules
A
B
C
D
E
Which one of the following reaction occurs spontaneously in heme biosynthesis?
A) Conversion of ALA to porphobilinogen
B) Conversion of hydroxymethylbilane to uroporphyrinogen III
C) Conversion of proporphyrinogen IX to protoporphyrin IX
D) Conversion of protoporphyrin IX to heme
E) Conversion of hydroxymethylbilane to Uroporphyrinogen I
A
B
C
D
E
Which anaerobic pathogen is responsible both necrotising enteritis and severe soft tissue infections with its toxins?
A) Actinomyces turicensis
B) Bacteroides fragilis
C) Clostridium difficile
D) Prevotella melaninogenica
E) Clostridium perfringens
A
B
C
D
E
Which one of the following bacteria is among the smallest free living bacteria?
A) Treponema B) Mycoplasma C) Chlamydia D) Rickettsia E) Cyanobacteria
A
B
C
D
E
I - Troponin I
II - CK-MB
III - Troponin T
IV - BNP
V - CRP
Which one of the above, is a biomarker of cardiac injury?
A) I B) I and II C) IV D) V E) I, II and III
A
B
C
D
E
Which of the following describes the role of cholesterol ester transfer protein?
A) It is the major structural protein of HDL
B) It exchanges cholesterol esters from HDL to other lipoproteins
C) It converts cholesterol to cholesterol esters in LDL
D) It acts as a ligand for hepatic receptors of HDL
E) It is an activator of lecithin-cholesterol acyl transferase
A
B
C
D
E
Which of the following problem causes Type IV Hyperlipidemia?
A) LDL receptor defect
B) Overproduction of VLDL
C) Excessive production of APO-B
D) Abnormal APO-E
E) Lipoprotein lipase deficiency
A
B
C
D
E
Which one of the following is classified as an erythropoetic type of porphyria?
A) Porphyria cutanea tarda
B) Protoporphyria
C) Hereditary coproporphyria
D) Acute intermittant porphyria
E) Variegate porphyria
A
B
C
D
E
Which antibacterial is the drug of choice in Cat-scratch disease?
A) Ciprofloxacin
B) Azithromycin
C) Tetracyclin
D) Penicillin
E) Cephalosporin
A
B
C
D
E
Which of the following statement is/are true regarding the pacemaker activity in the heart?
I. Catecholamines act through ß 1-adrenergic receptors and increase sinoatrial node pacemakers activity
II. Acetylcholine increases sinoatrial node pacemaker activity
III. The pacemaker current (or funny current) is provided by self-activated non-specific cation channels
IV. The shapes of action potentials of pacemaker cells and heart muscle cells are identical
V. The membranes of pacemaker cells and the membranes of contractile heart cells have different set.
A) I, IV, V
B) II, III, V
C) II, III, IV, V
D) I, III, V
E) I, II, III, IV
Which of the following toxin could be detected in all strains of C. perfringens?
A) alpha-lesitinase
B) ß-neurotoxin
C) Enterotoxin
D) Delta-hemolysine
E) E-lethal toxin
A
B
C
D
E
I - Troponin I
II - CK-MB
III - Troponin T
IV - BNP
V - CRP
Which one of the above, is a biomarker of hemodynamic stress?
A) I B) I and II C) IV D) V E) I, II and III
A
B
C
D
E
Which one of the following is the rate limiting enzyme for heme biosynthesis in bone marrow?
A) Porphobilinogen synthase
B) ALAS-1
C) ALAS-2
D) Ferrochelatase
E) Protoporphyrinogen oxidase
A
B
C
D
E
Which of the following statement is FALSE about artherosclerosis?
A) Male gender is a risk factor
B) Smoking is a risk factor
C) High serum homocysteine level is a risk factor
D) Low CRP level is a risk factor
E) Elevated blood pressure level is a risk factor
A
B
C
D
E
Which of the following is a common clinical manifestation in Hyperlipidemia Type III?
A) Eruptive xhantoma
B) Corneal arcus
C) Palmar xhantoma
D) Tuberous xhantoma
E) Ischemic heart diseases
A
B
C
D
E
Which one of the following disease results from decreased levels or ineffectiveness of uroporphyrinogen decarboxylase within the liver?
A) X-linked sideroblastic anemia
B) Protoporphyria
C) Porphyria cutanea tarda
D) Variegate porphyria
E) Hereditary coproporphyria
A
B
C
D
E
Which anaerobic gram-negative rod is able to growth in 20% Bile and hydrolyse Esculin, as a basis of specific media?
A) Prevotella bivia
B) Bacteroides fragilis
C) Fusobacterium necrophorum
D) Fusobacterium nucleatum
E) Porphyromonas gingivalis
A
B
C
D
E
Which patient suffered from one of the following symptoms is not appropriate for the use of physo
A) Bladder atony
B) Glaucoma
C) Bronchial asthma
D) Prostatic hypertrophy
E) Cataract operation
A
B
C
D
E
Which of the following options regarding atelectasis is wrong?
A) Atelectasis, also known as collapse, is loss of lung volume caused by inadequate expansion of air spaces
B) Resorption atelectasis occurs when an obstruction prevents air from reaching distal airways. C) Compression atelectasis is usually associated with accumulation of fluid, blood, or air within the pleural cavity
D) Contraction atelectasis occurs when local or diffuse fibrosis affecting the lung or the pleura hamper lung expansion.
E) In resorption atelectasis, the mediastinum shift towards the opposite side.
A
B
C
D
E
Which of the following is The most characteristic finding of the acute respiratory distress syndrome (ARDS)?
A) Capillary congestion
B) Necrosis of alveolar epithelial cells
C) Interstitial and intraalveolar edema and hemorrhage
D) Accumulation of neutrophil cells
E) Hyaline membranes
A
B
C
D
E
The diagnosis of acute rheumatic fever is made based on serologic evidence of previous streptococcal infection in conjunction with two or more of the Jones criteria. Which of the following is not one of this criteria?
A) Carditis
B) Migratory polyarthritis of large joints
C) Subcutaneous nodules
D) Erythema marginatum in the skin
E) Osler nodes
A
B
C
D
E
Which one is correct for lung adenocarcinomas?
A) More centrally located
B) Without a central scar
C) The most common type of lung cancer in smokers
D) Grow slowly and form smaller masses than do the other subtypes
E) They never metastasize at an early stage
A
B
C
D
E
A newborn child developed cyanosis soon after birth. The doctor tells the boy's mother that he has a congenital heart defect, as well as patent ductus arteriosus (PDA). Doctor says that keeping the PDA open is important for the child's survival. Doctor says prostaglandin E2 will be used to keep the PDA open. Doctor also says that child should be operated as soon as possible. Without surgery most patients die within the first months of life. Accordingly, which congenital heart week does the child have?
A) Tetralogy of Fallot
B) VSD
C) Patent Foramen Ovale
D) Aortic Coarctation
E) Transposition of the Great Arteries
The wall of the trachea is supported by c-shaped rings of hyaline cartilage in the adult body. From which layer of the developing embryo does cartilage plate of the trachea originate?
A) Endoderm
B) Splanchnic mesoderm
C) Somatic mesoderm
D) Mesenchyme of the 4th pharyngeal arches
E) Neural crest cell
A
B
C
D
E
Which of the following statement is not one of the cardinal features of Tetralogy of Fallot?
A) VSD
B) Right ventricular outflow tract obstruction
C) Overriding of the VSD by the aorta
D) Right ventricular hypertrophy
E) Subaortic stenosis
A
B
C
D
E
Dilated cardiomyopathy (DCM) is characterized by pro-gressive cardiac dilation and contractile (systolic) dysfunction. Although many individuals with DCM have a familial (genetic) form, DCM can also result from various aquired myocardial insults. Which of the following is not one of them?
A) Myocarditis
B) Toxicities
C) Pregnancy
D) Iron overload
E) Endomyocardial fibrosis
A
B
C
D
E
Which of the following is not one of the Major Risk Factors for Artherosclerosis?
A) Genetic abnormalities
B) Family history
C) Diabetes
D) Male gender
E) Congestive heart failure
A
B
C
D
E
Which of the following isn't one of the causes of regurgitation (back flow) of blood?
A) Endocarditis
B) Chordal rupture
C) Disruption of the supporting structures of the aorta
D) Disruption of the supporting structures of the mitral annulus
E) Pericarditis
A
B
C
D
E
When a baby is born and takes the first breath transitional and structural changes occur in cardiovascular system. Which of the following is not included within these changes?
A) The amount of blood flowing through the lung vessels increases rapidly and ductus arteriosus closes by muscular contraction of its wall.
B) Increased left atrial and decreased right atrial pressures close the oval foramen.
C) Bulbar and truncal ridges fuse and forming aorticopulmonary septum.
D) Change in oxygen tension closes the umbilical arteries by contraction of the smooth musculature.
E) Due to cessation of placental blood flow, umbilical vein and ductus venosus are closed.
Which one is the effect of atropine?
A) Accommodation paralysis
B) Bronchoconstriction
C) Hypersalivation
D) Miozis
E) Diarrhoae
A
B
C
D
E
Which of the following is not one of the clincal signs of sarcoidosis?
A) Bilateral hilar adenopathy
B) Constitutional signs and symptoms (fever, fatique, weight loss, anorexia, night sweats)
C) Cutaneous lesion (Erythema nodosum)
D) Eye involvement (iritis or iridocyclitis)
E) Wheezing
A
B
C
D
E
Which of the following isn't one of the Disorders Predisposing to Cor Pulmonale?
A) Chronic obstructive pulmonary disease
B) Diffuse pulmonary interstitial fibrosis
C) Recurrent pulmonary thromboembolism
D) Primary pulmonary hypertension
E) Congenital heart disease
A
B
C
D
E
A 13-year-old girl with mild persistent allergic asthma started a treatment that included an inhaled bronchodilator "as needed". A drug with which of the following mechanisms of action would be most appropriate for this patient's inhaler?
A) Blockade of alpha1 adrenoreceptors
B) Blockade of M2 cholinergic receptors
C) Activation of ß2 adrenoreceptors
D) Activation of H1 histamine receptors
E) Activation of leukotriene receptors
A
B
C
D
E
Which of the following statement - is the best measure of hypertrophy in volume-overloaded hearts?
A) Right ventricle diameter
B) Left ventricle diameter
C) Left ventricular wall thickness
D) Right ventricular wall thickness
E) Heart weight
A
B
C
D
E
Which of the following is not one of the cardiac clinical manifestations or complications of left ventricular failure?
A) Enlarged heart (cardiomegaly)
B) Tachycardia
C) A third heart sound (S3)
D) Mitral regurgitation and a systolic murmur
E) Orthopnea
A
B
C
D
E
Which of the following is a progressive chest pain that occurs even at rest?
A) Chronic ischemic heart disease
B) Unstable angina
C) Sudden cardiac death
D) Stable angina
E) Prinzmetal angina
A
B
C
D
E
A) Hyperkalemia
B) Hypernatremia
C) Hyponatremia
D) Hypocalcemia
E) Hypervolemia
A
B
C
D
E
A) Acetazolamide
B) Amiloride
C) Furosemide
D) Hydrochlorothiazide
E) Spironolactone
A
B
C
D
E
Which one of the following is true regarding the antihypertensive mechanism of action of minoxidil?
A) Release of nitric oxide from the drug
B) Activation of dopamine D1 receptors
C) Release of nitric oxide from the endothelium
D) Hyperpolarization of vascular smooth muscle through opening of potassium channels
E) Reduction of calcium influx via L-type channels
A
B
C
D
E
Which one of the following is one of the desirable anti-anginal effects achieved with combination of nitrates and Beta blockers?
A) Increase in net myocardial oxygen requirement
B) Decrease in heart rate
C) Increase in arterial pressure
D) Increase in end diastolic pressure
E) Decrease in ejection time
A
B
C
D
E
Which of the following tumors is the most common tumor of the heart?
A) Angiosarcomas B) Papillary fibroelastomas C) Lipomas D) Fibromas E) Myxomas
A
B
C
D
E
Which of the following is the most common congenital valvular lesion?
A) Mitral valve stenosis
B) Tricuspid valve stenosis
C) mitral valve prolapsus
D) Aortic valvular disease related with Marfan syndrome
E) Bicuspid aortic valve
A
B
C
D
E
Which one of the following drugs primarily acts by blocking L-type calcium channels and is classified as class IV-antiarrythmic drug?
A) Adenosine B) Procainamide C) Lidocaine D) Diltiazem E) Amiodarone
A
B
C
D
E
Which of the following options is not correct for the Ductus arteriosus?
A) Within 1 to 2 days of birth in healthy term infants, the ductus constricts and closes
B) The ductus arteriosus arises from the left pulmonary artery and joins the aorta just distal to the origin of the left subclavian artery
C) Ductus arteriosus closes in response to decreased pulmonary vascular resistance
D) Ductus arteriosus closes in response to increased arterial oxygenation
E) Ductus arteriosus closes in response to increasing local levels of prostaglandin E2
A premature female infant is born about 24 weeks after fertilization and develops rapid, labored breathing shortly after birth. She is immediately transferred to intensive care where she is diagnosed with hyaline membrane disease (HMD). Which of the following is mainly associated with HMD?
A) Lack of lung surfactant
B) Type I pneumocyte undevelopment
C) Oxygen therapy at birth
D) Vaginal delivery
E) Maternal obesity
Which of the following is not a type of arrhythmia?
A) Tachycardia
B) Bradycardia
C) Irregular rhythm with normal ventricular contraction
D) Ventricular fibrillation
E) Palpitation
A
B
C
D
E
A 2.1-kg baby born was born at 34 weeks gestation by vaginal delivery. One hour after birth, the baby appeared hypothermic and lethargic. Apgar scores were low, and blood pressure was 55/35 mm Hg. Lab tests revealed that the newborn had a genetic dopamine ß-hydroxylase deficiency. Lab tests would have also shown which of the following results?
A) Very low plasma levels of norepinephrine
B) Very low plasma levels of dopamine
C) High plasma levels of epinephrine
D) High urinary levels of normetanephrine
E) Low urinary levels of homovanillic acid
Which of the following is wrong about the main features of obstructive and restrictive pulmonary diseases?
A) Obstructive (airway) disease, characterized by an increase in resistance to air flow caused by partial or complete obstruction at any level
B) In patients with Obstructive (airway) disease the forced expiratory volume at 1 second (FEV1), is significantly decreased
C) Restrictive disease, characterized by decreased total lung capacity
D) In diffuse restrictive diseases, forced vital capacity FVC is reduced
E) In Obstructive (airway) disease the expiratory flow rate is normal or reduced proportionately
Which of the following is NOT one of the main immunologic mecanisms of noninfectious vasculitis?
A) Immune complex deposition
B) Antineutrophil cytoplasmic antibodies (ANCAs)
C) Anti-endothelial cell antibodies
D) Autoreactive T cells
E) Infarction induced by microbial agents
A
B
C
D
E
Which of the following diuretics would be most useful in the acute treatment of a comatose patient with traumatic brain injury and cerebral edema?
A) Acetazolamide B) Amiloride C) Chlorthalidone D) Furosemide E) Mannitol
A
B
C
D
E
When is the granulation tissue most prominent during the evolution of morphologic changes in myocardial infarction?
A) 1-2 weeks after myocardial infarction
B) 1-2 days after myocardial infarction
C) 4-12 hours after myocardial infarction
D) 4-5 weeks after myocardial infarction
E) more than 8 weeks after myocardial infarction
A
B
C
D
E
A 65-year-old man, recently diagnosed with prostatic hyperplasia, started treatment with prazosin, one tablet daily. Which of the following adverse effects would be most likely to occur during the first days of therapy?
A) Mydriasis
B) Impaired micturition
C) Pale and cold skin
D) Bronchoconstriction
E) Postural hypotension
A
B
C
D
E
Which of the following is wrong regarding Emphysema?
A) Emphysema is characterized by permanent enlargement of the air spaces distal to the terminal bronchioles
B) Centriacinar (centrilobular) emphysema is most common in cigarette smokers
C) Panacinar emphysema occurs more commonly in the lower lung zones and is associated with alpha1-anti-trypsin deficiency
D) The characteristic finding of the Distal acinar (paraseptal) emphysema is the presence of multiple, bullae.
E) Significant fibrosis is seen in the alveolar wall in emphysema
Which of the following is not correct regarding Calcific Aortic Stenosis?
A) Calcific aortic degeneration is the most common cause of aortic stenosis
B) In most cases, calcific degeneration is asymptomatic
C) Cardiac output is maintained only by virtue of concentric left ventricular hypertrophy
D) The chronic outflow obstruction can drive left ventricular pressures to 200 mm Hg or more
E) Calcific aortic stenosis occur most commonly on a tricuspid aortic valve.
A
B
C
D
E
Which of the following is not one of the consequences of cyanotic heart disease? A) Hypertrophic osteoarthropathy
B) Polycythemia
C) Increased risk for infective endocarditis
D) Increased risk for systemic embolization
E) Left ventricular hypertrophy
A
B
C
D
E
Which one of the following is correct for malignant mesothelioma?
A) It is related to occupational exposure to asbestos in the air
B) The combination of cigarette smoking and asbestos exposure greatly increases the risk of malignant mesothelioma
C) The latent period is 1-5 years after initial asbestos exposure
D) Distant metastases are very common
E) Clear cell type is the most common
A
B
C
D
E
A 51-year-old man, recently diagnosed with pheochromocytoma, was scheduled for surgery to remove the tumor. One week before surgery, phenoxybenzamine was prescribed. Which of the following actions most likely mediated the therapeutic effect of the drug in the patient's disease?
A) Decrease peripheral vascular resistance
B) Increase cardiac output
C) Decrease epinephrine release from the adrenal medulla
D) Increase heart rate
E) Decrease firing from the vasomotor center
A
B
C
D
E
Which of the following is NOT a feature of antineutrophil cytoplasmic antibodies (ANCAs)?
A) directly activate neutrophils
B) play role in releasing of reactive oxygen species and proteolytic enzymes
C) lead to endothelial cell injury
D) antigenic targets of ANCA are primarily intracellular
E) circulating antibodies are accessible
A
B
C
D
E
tWhich drug causes to decrease both systolic and diastolic blood pressure and also leads to tachycardia?
A) Isoprenaline B) Norepinephrine C) Phenylephrine D) Propranolol E) Ephedrine
A
B
C
D
E
Which of the following options regarding atelectasis is wrong?
A) Atelectasis, also known as collapse, is loss of lung volume caused by inadequate expansion of air spaces
B) Resorption atelectasis occurs when an obstruction prevents air from reaching distal airways.
C) Basal atelectasis resulting from a failure to breathe deeply commonly occurs in bedridden patients
D) Contraction atelectasis occurs when local or diffuse fibrosis affecting the lung or the pleura hamper lung expansion.
E) Foreign body aspiration is one of the reasons of the Compression atelectasis
A
B
C
D
E
When is the coagulation necrosis detectable earliest during the evolution of morphologic changes in myocardial infarction?
A) 4-12 hours after myocardial infarction
B) 0-1,5 hours after myocardial infarction
C) 1-3 days after myocardial infarction
D) 7-10 days after myocardial infarction
A
B
C
D
Which of the following is wrong about the main features of obstructive and restrictive pulmonary diseases?
A) Obstructive (airway) disease, characterized by an increase in resistance to air flow caused by partial or complete obstruction at any level
B) Restrictive disease, characterized by reduced expansion of lung parenchyma
C) Restrictive disease, characterized by decreased total lung capacity
D) In patients with Obstructive (airway) disease forced vital capacity (FVC) is either normal or slightly decreased,
E) In diffuse restrictive diseases, FVC is reduced may be normal
A
B
C
D
E
A 32 year-old woman delivers an infant at 39 weeks of gestation (based on the last time of menstruation). After birth, the infant develops cyanosis and very rapid breathing and --- to the neonatal intensive care unit. Chest x-ray reveals the presence of air bronchograms and diffuse bilateral atelectasis, but lungs appear to be of normal size and there is no apparent al---- diaphragm. As a result of the tests, the pediatrician diagnoses hyaline membrane disease. What distinguishing feature would you expect in the morphologic features of this disease?
A) pulmonary capillary hemangiomatosis and hematoma
B) protein-rich, fibrin rich exudation into the alveolar space
C) vasculopathy
D) eosinophilic infiltration of vessels
E) increased airway wall smooth muscle mass, alveolar hypoplasia
Which one of the following drug classes is not used in acute heart failure?
A) Diuretics
B) ACE inhibitors
C) Beta adrenoreceptor agonists
D) Vasodilators
E) Natriuretic peptide
A
B
C
D
E
Which option of the following is wrong for aortic coarctation?
A) Turner syndrome frequently have coarctation
B) An "infantile" preductal form featuring hypoplasia of the aortic arch proximal to PDA
C) Postductal coarctation without a PDA usually is asymptomatic, and the disease may remain unrecognized well into adulf life
D) In postductal coarctation, the aorta is sharply constricted by a tissue ridge adjacent to the nonpatent ligamentum arteriosum.
E) In Postductal coarctation the ductus arteriosus is patent
A
B
C
D
E
Which of the following therapies would be most useful in the management of severe hypercalcemia?
A) Acetazolamide plus saline infusion
B) Furosemide plus saline infusion
C) Hydrochlorothiazide plus saline infusion
D) Mannitol plus saline infusion
E) Spironolactone plus saline infusion
A
B
C
D
E
Which kind of receptors are activated to provide sufficient blood for extremeties while an atlet is running?
A) alpha 1
B) Beta 2
C) alpha 2
D) N
E) M
A
B
C
D
E
Which of the following is not expected in a patient with systemic hypertension for a long time?
A) Congestive heart failure
B) Ischemic heart disease
C) Renal damage
D) Cerebrovascular stroke
E) Liver damage
A
B
C
D
E
Which of the following is the chest pain that occurs at certain levels of exertion?
A) Chronic ischemic heart disease
B) Stable angina
C) Sudden cardiac death
D) Unstable angina
E) Prinzmetal angina
A
B
C
D
E
Which one of the following enzyme can be inhibited by lead in heme biosynthesis?
A) Porphobilinogen synthase
B) ALA synthase
C) Coproporphyrinogen oxidase
D) Protoporphyrinogen oxidase
E) Hydroxymethylbilane synthase
A
B
C
D
E
Which option of the following is wrong for aortic coarctation?
A) Turner syndrome frequently have coarctation
B) An "infantile" preductal form featuring hypoplasia of the aortic arch proximal to a PDA
C) In Preductal coarctation the ductus arteriosus is patent
D) In postductal coarctation, the aorta is sharply constricted by a tissue ridge adjacent to the nonpatent ligamentum arteriosum
E) In postductal coarctation the right ventricle is hypertrophied
A
B
C
D
E
By which of the following method is epidemic typhus diagnosed routinely by?
A) Microscopy B) Culture C) Antibody detection D) PCR E) Antigen detection
A
B
C
D
E
A 55-year-old woman suffering from postural hypotension started a treatment with an alpha1-adrenergic drug. Which of the following is a body site where autonomic receptors are primarily alpha1 adrenergic?
A) Bronchial muscle
B) Sphincter muscle of the iris
C) Atrioventricular node
D) Purkinje fibers
E) Skin vessels
A
B
C
D
E
I - LDL
II - VLDL
III - Chylomicrons
Which of the above lipoproteins get elevated in serum in Hyperlipidemia Type II-B?
A) I
B) II
C) III
D) I and II
E) I and III
A
B
C
D
E
Which enzyme has a function on the metabolism of norepinephrine?
A) Tyrosine hydroxylase
B) Dopa decarboxylase
C) Dopamine beta hydroxylase
D) Aromatic amino acid decarboxlase
E) Monoamine oxydase
A
B
C
D
E
Which of the followings is correct for Takayasu arteritis?
A) renal involvement is a major cause of death
B) 1/3 of patients have chronic hepatitis B infection
C) marked weakening of the pulses in the upper extremities is typical
D) bloody stools caused by gastrointestinal lesions are typical
E) the clinical course is episodic
A
B
C
D
E
Which drug is currently used in bronchospastic disorders?
A) Atropine B) Mecamylamine C) Homatropine D) Ipratropium E) Scopolamine
A
B
C
D
E
Which of the following is not one of the consequences of cyanotic heart disease? A) Hypertrophic osteoarthropathy
B) Polycythemia
C) Increased risk for infective endocarditis
D) Increased risk for systemic embolization
E) Pulmonary hypertension
A
B
C
D
E
It is characterized by myocardial hypertrophy, defective diastolic filling, and, in one third of cases, ventricular outflow obstruction. Which diseases is mention above?
A) Arrhythmogenic right ventricular cardiomyopathy
B) Restrictive cardiomyopathy
C) Endomyocardial fibrosis
D) Loeffler endomyocarditis
E) Hypertrophic cardiomyopathy
A
B
C
D
E
A 16-year-old patient is in the emergency department receiving nasal oxygen. She has a heart rate of 125 bpm, a respiratory rate of 40 breaths/min, and a peak expiratory flow <50% of the predicted value. Wheezing and rales are audible without a stethoscope. Which of the following drugs does not have a direct bronchodilator effect?
A) Salbutamol B) Terbutaline C) Prednisone D) Theophylline E) Ipratropium
A
B
C
D
E
Diastolic dysfunction refers to an inability of the heart to adequately relax and fill. According to the definition above, which of the following is not a cause of diastolic dysfunction?
A) Massive left ventricular hypertrophy
B) Myocardial fibrosis
C) Amyloid deposition
D) Constrictive pericarditis
E) Infective endocarditis
A
B
C
D
E
Which of the following options is not correct for the Ductus arteriosus?
A) Within 1 to 2 days of birth in healthy term infants, the ductus constricts and closes
B) Ductus arteriosus closes in response to decreased local levels of prostaglandin E2
C) Ductus arteriosus closes in response to decreased pulmonary vascular resistance
D) Ductus arteriosus closes in response to increased arterial oxygenation
E) Ductal closure can be accelerated in infants with hypoxia
A
B
C
D
E
Which one of the following drugs can be used to block the compensatory mechanisms that can occur during antihypertensive drug therapy?
A) Vasodilators
B) Diuretics
C) Beta agonists
D) Angiotensin receptor blockers
E) Calcium channel blockers
A
B
C
D
E
A graduate student is planning to make a high-altitude climb in South America while on vacation. He will not have time to acclimate slowly to altitude. A drug th--- preventing high altitude sickness is
A) Acetazolamide
B) Amiloride
C) Demeclocycline
D) Desmopressin
E) Ethacrynic acid
A
B
C
D
E
Which drug can easily enter into the central nervous system?
A) Hyosin-N-butil bromür
B) Scopolamine
C) Atropine methyl nitrate
D) Homatropine methyl bromide
E) Metscopolamine
A
B
C
D
E
Which one is correct for lung adenocarcinomas?
A) They never metastasize at an early stage
B) The most common type of lung cancer in men
C) Central scar is never seen
D) Atypical adenomatous hyperplasia (AAH) is one of the precursor lesions for it
E) The most common type of lung cancer in smokers
A
B
C
D
E
Which of the following is not one of the histological findings of acute respiratory distress syndrome (ARDS)?
A) Capillary congestion
B) Necrosis of alveolar epithelial cells
C) Interstitial and intraalveolar edema and hemorrhage
D) Hyaline membranes
E) Accumulation of eosinophil cells
A
B
C
D
E
Which of the following is not expected in a patient with arrhythmia?
A) loss of consciousness (syncope)
B) Patient may note a "racing heart"
C) Patient may note a palpitations
D) Sudden cardiac death
E) Orthopnea
A
B
C
D
E
A 16-year-old male snorted cocaine for the first time at a party. A few minutes later he felt euphoric, and friends noted that his pupils were dilated. Which of the following molecular actions most likely mediated the mydriasis?
A) Inhibition of monoamine oxidase A
B) Blockade of alpha2 receptors in sympathetic terminals
C) Inhibition of norepinephrine reuptake into sympathetic terminals
D) Stimulation of epinephrine release from adrenal medulla
E) Stimulation of norepinephrine release from sympathetic terminals
A
B
C
D
E
Which of the following is less relevant or not relevant to pure right-sided heart failure?
A) Systemic and portal venous congestion
B) Hepatic enlargement
C) Splenic enlargement
D) Peripheral edema
E) Pulmonary congestion
A
B
C
D
E
Which of the following cardiac defect occurs when conotruncal septum fail to follow its normal spiral course and runs straight down?
A) Persistent truncus arteriosus
B) Tetralogy of Fallot
C) Membranous ventricular septal defect
D) Transposition of great vessels
E) Tricuspid atresia
A
B
C
D
E
Which of the following is not considered within the results of cardiac looping?
A) U-shaped d-loop has created with apex pointing to left
B) The cephalic portion has bend dorsocranially and caudal portion has bend ventrally to right
C) Atrium incorporated into pericardial cavity and common atrium has formed
D) Atrioventricular region has narrowed and formed the atrioventricular canal
E) The smooth walled heart tube has begin to form primitive trabeculae in two areas
A
B
C
D
E
A 25-year-old man experienced severe motion sickness whenever he traveled by air or sea. He felt much better using a transdermal patch to apply a drug before travelling. Blockade of which of the following receptors most likely mediated the therapeutic effect of the drug in the patient's disorder?
A) ß2 adrenergic
B) D2 dopaminergic
C) 5-HT3 serotoninergic
D) M1 cholinergic
E) N-cholinergic
A
B
C
D
E
Which of the following statement is FALSE?
A) CK-MB is highly specific to the heart tissue
B) Myoglobin has a late 6-9 hours in serum
C) Troponins are not found in smooth muscles
D) Troponin I levels may be elevated up to 10 days after infarction
E) Myoglobin is not very specific to the heart tissue
A
B
C
D
E
Which one of the following finding is not observed in variegate porphyria?
A) Urinary ALA concentration is increased
B) Fecal protoporphyrin IX is increased in concentration
C) Increased fecal coproporphyrin III concentration
D) Urinary porphobilinogen concentration is increased
E) Increased urinary coproporphyrin III concentration
A
B
C
D
E
Which causes of chest pain can kill?
A) Pulmonary Embolism
B) Aortic Dissection
C) Pneumothorax
D) Pneumonia
E) All of the above
A
B
C
D
E
Which of the following statements is/are true regarding the pacemaker activity in the heart?
I. Impulses cannot be generated in the sinoatrial node unless it is activated by the sympathetic nervous system
II. Acetylcholine slows down sinoatrial node pacemaker activity
III. The pacemaker current (or funny current) is provided by self-activated non-specific cation channels.
IV. The membranes of pacemaker cells and the membranes of contractile heart cells have different set of channels, or carrier proteins
V. The shapes of action potentials of pacemaker cells and heart muscle cells are identical
A) II, III, IV B) II, III, IV, V C) II, III, V D) I, II, III,V E) I, II, III, IV
A
B
C
D
E
Which of the following pathogen is the most common causative agent of Non-Gonococal Urethritis?
A) Chlamydia trachomatis
B) Mycoplasma genitalium
C) Mycoplasma hominis
D) Ureaplasma urealyticum
E) Chlamydophila psittaci
A
B
C
D
E
Which of the following anaerobic bacteria is shown as grom-positive branching long rods?
A) Actinomyces israelii
B) Bacteroides fragilis
C) Mobiluncus curtisii
D) Veillonella parvula
E) Propionibacterium acnes
A
B
C
D
E
A 45 years old female with a properly measured blood pressure 145/95 mmHg is defined which grade of hypertension?
A) High normal
B) Grade 1 hypertension
C) Grade 2 hypertension
D) Grade 3 hypertension
E) Isolated systolic hypertension
A
B
C
D
E
Which one of the following infection is vaccine preventable?
A) Ehrlichia chaffeensis
B) Ehrlichia ewingii
C) Rickettsia typhi
D) Rickettsia prowazekii
E) Rickettsia akari
A
B
C
D
E
I - LDL II - VLDL III - Chylomicrons
Which of the above lipoproteins get elevated in serum in Hyperlipidemia Type I?
A) I
B) II
C) III
D) I and II
E) I and III
A
B
C
D
E
Which one of the following is not a biomarker of cardiac injury?
A) Troponin T B) Myoglobin C) CK-MB D) ALT E) Troponin I
A
B
C
D
E
Which of the following statement is FALSE?
A) CK-BB is highly specific to the heart tissue
B) Myoglobin has an early rise 1-3 hours in serum
C) Troponins are not found in smooth muscles
D) Troponin I levels may be elevated up to 10 days after infarction
E) Myoglobin is not very specific to the heart tissue
A
B
C
D
E
Which of the following is an integral apolipoprotein present in VLDL, IDL, and LDL? A) Apo B100 B) Apo B48 C) Apo CII D) Apo A-I E) ApoE
A
B
C
D
E
Which one of the following disease cannot be classified as acute porphyria?
A) Acute intermittant porphyria
B) Variegate porphyria
C) Hereditary coproporphyria
D) Porphobilinogen synthase deficiency porphyria
E) Porphyria cutanea tarda
A
B
C
D
E
Which one of the following enzyme is located in the cytosol in heme biosynthesis? A) ALA synthase
B) Ferrochelatase
C) Protoporphyrinogen oxidase
D) Uroporphyrinogen decarboxylase
E) Coproporphyrinogen oxidase
A
B
C
D
E
Which of the followings indicate the lymph nodes found inside the lungs?
A) Bronchopulmonary lymph nodes
B) Pulmonary lymph nodes
C) Anterior mediastinal lymph nodes
D) Bronchomediastinal lymph nodes
E) Tracheobronchial lymph nodes
A
B
C
D
E
Which one of the following laboratory finding is not observed in hereditary coproporphyria?
A) Fecal coproporphyrin III is increased in concentration
B) Urinary coproporphyrin III is increased in concentration
C) Fecal protoporphyrin IX is increased in concentration
D) Urinary ALA concentration is increased
E) Urinary porphobilinogen concentration is increased
A
B
C
D
E
Which is the optimal growth condition for strict anaerobic bacteria?
A) The presence of 5-10% of oxygen
B) The presence of <0.5% of oxygen
C) The presence of 2% to 8% of oxygen
D) Grow well under aerobic or anaerobic conditions
E) The presence of >10% of oxygen
A
B
C
D
E
Which one of the following is not a hepatic type of porphyria?
A) X-linked sideroblastic anemia
B) Acute intermittant porphyria
C) ALA dehydratase deficiency porphyria
D) Hereditary coproporphyria
E) Porphyria cutanea tarda
A
B
C
D
E
Which of the followings indicate the lymph nodes found in the hilum of the lungs? A) Bronchomediastinal lymph nodes
B) Bronchopulmonary lymph nodes
C) Pulmonary lymph nodes
D) Tracheobronchial lymph nodes
E) Anterior mediastinal lymph nodes
A
B
C
D
E
57 years old male admits to your clinic with left chest pain, also pain or left shoulder and nausea. He says the symptoms started 5 hours ago. Which laboratory test will be useless to understand if he is having a myocardial infarction?
A) Troponin T B) Myoglobin C) ALT D) CK-MB E) Troponin I
A
B
C
D
E
According to the left ventricular volume-pressure loop given below, which of the following statement is TRUE?
A) Dashed line represents reduced afterload condition
B) Dashed line represents increased preload condition
C) Dashed line represents reduced venous return condition
D) Dashed line represents increased stroke volume condition
E) Dashed line may represent a hypertension condition
A
B
C
D
E
Which one of the following disease is characterized by uroporphyrinogen I synthase deficiency
A) Porphyria cutanea tarda
B) Acute intermittant porphyria
C) Hereditary coproporphyria
D) Protoporphyria
E) Variegate coproporphyria
A
B
C
D
E
Which of the following statements is/are true about shock?
I. Oxygen and nutrient supply to the tissues is inadequate during any kind of shock II. Blood flow to the tissues is inadequate during shock
III. Cardiac output is always decreased during shock
IV. Cardiac output may be increased during shock
V. Waste products are not removed from the tissues effectively
A) I, IV, V B) II, III, V C) II, III, IV, V D) I, III, V E) I, II, IV, V
A
B
C
D
E
52 years old male admits to emergency with dyspnea and exertion. Her pulse is 142 bpm. You are suspecting congestive heart failure. What laboratory test is more useful to confirm?
A) Troponin T B) Myoglobin C) BNP D) CK-MB E) Troponin I
A
B
C
D
E
Following pressure-volume loops are obtained under two different conditions. Based on the available information which of the following statement is CORRECT?
A) Dashed line represents reduced afterload condition
B) Dashed line represents increased preload condition
C) Dashed line represents reduced venous return condition D) Dashed line may represent an aortic stenosis condition
E) Dashed line may represent the inotropic effect of adrenaline
A
B
C
D
E
Which one of the statements is true for Borrelia?
A) Erythema migrans is seen in relapsing fever
B) Lyme disease is transmitted by soft ticks
C) Epidemic relapsing fever is transmitted by hard ticks
D) Serology is valuable in the diagnosis of Lyme disease
E) Giemsa staining has no value because of their thinness
A
B
C
D
E
Which one of the following is true for spirochetes?
A) Gram positive
B) Easily recognised by gram staining
C) Non-motile
D) Thick
E) Spiral shaped
A
B
C
D
E
For which of the spirochetes is there a vaccination for herds and pets?
A) Treponema pallidum
B) Borrelia reccurrentis
C) Borrelia interrogans
D) Borrelia garinii
E) Leptospira interrogans
A
B
C
D
E
Which of the following options is not correct for myasthenia gravis?
A) Myasthenia gravis is caused by autoantibodies that block the function of postsynaptic acetylcholine receptors at motor end plates
B) 60% of cases are associated with thymic hyperplasia
C) Myasthenia gravis frequently manifests with ptosis or diplopia
D) Characteristically, repetitive use or electrophysiologic stimulation of muscles makes the weakness more severe
E) Administration of cholinesterase inhibitors are not effective
A
B
C
D
E
Which of the following options is not correct for myasthenia gravis?
A) Myasthenia gravis is caused by autoantibodies that block the function of postsynaptic acetylcholine receptors at motor end plates
B) 60% of cases are associated with thymic hyperplasia
C) Myasthenia gravis frequently manifests with ptosis or diplopia
D) Effective treatments include cholinesterase inhibitory drugs, immunosuppression, plasmapheresis, and (in patients with thymic lesions) thymectomy.
E) Characteristically, repetitive use or electrophysiologic stimulation of muscles makes the muscles stronger.
A
B
C
D
E
Which of the following statements is/are true regarding the pacemaker activity in the heart?
I. Impulses cannot be generated in the sinoatrial node unless it is activated by the sympathetic nervous system
II. Acetylcholine slows down sinoatrial node pacemaker activity
III. The pacemaker current (or funny current) is provided by self-activated non-specific cation channels
IV. The shapes of action potentials of pacemaker cells and heart muscle cells are identical
V. The membranes of pacemaker cells and the membranes of contractile heart cells have different set of channels, or carrier proteins
A) I, IV, V B) II, III, V C) II, III, IV, V D) I, II, III, V E) I, II, III, IV
A
B
C
D
E
Which of the following mediates the transport of cholesterol from cells to HDL?
A) LDL-Receptor-Related Protein
B) LDL receptor
C) Scavenger receptor A1
D) ABCA1 transporter
E) Cholesterol ester transfer protein
A
B
C
D
E
Which of the following statement is FALSE about artherosclerosis?
A) Female gender is a risk factor
B) Smoking is a risk factor
C) High serum homocysteine level is a risk factor
D) Elevated CRP is a risk factor
E) Elevated blood pressure level is a risk factor
A
B
C
D
E
Which one of the following is true for Mycoplasma?
A) Gram negative
B) Thin peptidoglycan
C) Grows slowly
D) Anaerob
E) Intracellular pathogen
A
B
C
D
E
Which one is the anaerobic gram-positive rod that causes pseudomembranous colitis?
A) Actinomyces naeslundii
B) Bacteroides fragilis
C) Clostridium perfringens
D) Clostridium difficile
E) Prevotella melanonigenica
A
B
C
D
E
While examining an 18 years old baby, if you measure BP as 165/85 mmHg from the right arm but 110/50 mmHg from the ankle. What may be the most probable disease?
A) Essential hypertension
B) Conn syndrome
C) Reno-vascular hypertension
D) Coarctation of the Aorta
E) Feocromocitom
A
B
C
D
E
42 years old non-smoker female patient was admitted to the hospital with complaints of Acute onset Cough, Sputum, Chest Pain and Fever. And chest radiography and CT images showing the consodilations with air bronchograms. What is your primarily diagnosis?
A) Pneumonia
B) Pulmonary Embolism
C) Lung cancer
D) Pleural effusion
E) Pneumothorax
A
B
C
D
E
tWhich of the following statement is not one of clinical features of Tetralogy of Fallot?
A) The hemodynamic consequences of tetralogy of Fallot are right-to-left shunting
B) Decreased pulmonary blood flow
C) Increased aortic volumes
D) The clinical severity largely depends on the degree of pulmonary outflow obstruction
E) As the child grows cyanosis decreases
A
B
C
D
E
Which of the following statement is the most common cause of myocarditis?
A) Trypanosoma cruzi
B) Cytomegalovirus
C) Human immunodeficiency virus
D) Influenza virus
E) Coxsackie viruses
A
B
C
D
E
Laryngeal atresia is an anomaly that may occur during the development of the larynx. Which of the following leads to the laryngeal atresia?
A) Failure of recanalization of the epithelial cells
B) Incomplete division of the cranial part of the foregut
C) Poor development of the splanchnic mesoderm
D) Failure of migration of the neural crest cells
E) Poor development of the somatic mesoderm
A
B
C
D
E
Which of the following statement is wrong regarding pneumoconiosis?
A) Pneumoconiosis is a term originally coined to describe lung disorders caused by inhalation of mineral dusts.
B) Simple Coal Worker's Pneumoconiosis is characterized by the presence of coal macules and larger coal nodules
C) Silicosis is currently the most prevalent chronic occupational disease in the world
D) Asbestos may cause lung cancer
E) Mesothelioma is the result of the Coal Worker's Pneumoconiosis
A
B
C
D
E
Which one of the followings is NOT correct for malignant mesothelioma?
A) the latent period is 1-5 years after initial asbestos exposure
B) is a rare cancer of mesothelial cells
C) arises in the parietal or visceral pleura
D) is related to occupational exposure to asbestos in the air
E) the combination of cigarette smoking and asbestos exposure does not increases the risk of malignant mesothelioma
A
B
C
D
E
Which one is NOT correct for lung adenocarcinomas?
A) Adenocarcinoma in situ (AIS) is also called as bronchioloalveolar carcinoma
B) The most common type of lung cancer in women and nonsmokers
C) The tumor is more peripherally located with a central scar
D) They never metastasize at an early stage
E) Tumor of any size that has invaded to depths greater than 5 mm is called invasive adenocarcinoma
A
B
C
D
E
Which of the following cardiac defect occurs when heart and vessels are reversed left to rightas a mirror image and accompanied by transposition of abdominal viscera?
A) Tetralogy of Fallot
B) Ectopia cordis
C) Coarctation of aorta
D) Isolated dextrocardia
E) Dextrocardia with sinus inverus
A
B
C
D
E
Which one of the following clinical cases is not appropriate for the use of propranol?
A) Hypertension
B) Angina pectoris
C) Tachyarrhythmia
D) Diabetes mellitus
E) Migraine
A
B
C
D
E
What is the leading cause of Sudden Cardiac Death in older victims?
A) Mitral valve prolapse
B) Congenital coronary arterial abnormalities
C) Myocarditis
D) hypertrophic cardiomyopathy
E) Coronary artery disease
A
B
C
D
E
Which of The following isn't one of the Disorders Predisposing to Cor Pulmonale? A) Disorders Affecting Chest Movement
B) Diffuse pulmonary interstitial fibrosis
C) Recurrent pulmonary thromboembolism
D) Disorders Inducing Pulmonary Arterial Constriction
E) Mitral stenosis
A
B
C
D
E
Which patient suffered from one of the following symptoms is not appropriate for the use of latanoprost & traveloprost
a) Bladder aorta
b) Glaucoma
c) Bronchial asthma
d) Prostatic hypertrophy
e) Cataract operation
A
B
C
D
E
Which one of the following statements is true for Weil disease?
A) Mainly lungs are affected
B) Serology has no place in diagnosis
C) Doxycyclin has place in prophylaxis
D) No congenital infection
E) Growth is very quick in ordinary media
A
B
C
D
E
Which one of the following statements is true for Treponema?
A) In this genus all subspecies cause Syphilis
B) Has got an exotoxin for tissue destruction
C) Easily Giemsa stained
D) Motile
E) Cattle are the main host
A
B
C
D
E
Which one of the following statement is true for Borrelia?
A) So thin that can not be stained
B) In vitro culture is impossible
C) Vector born
D) Non-motile
E) Only darkfield microscopy is used
A
B
C
D
E
Which one is true for Syphilis?
A) Restricted to certain regions of the World
B) Has a seasonal occurance especially in winters
C) Humans are the only natural host
D) Syphilitic chancre is a painful ulcer occuring in 5-7 days
E) Chancre is characteristic in the tertiary syphilis
A
B
C
D
E
Which of the following is not one of the histopathological features of Asthma?
A) Thickening of airway wall
B) Sub-basement membrane fibrosis
C) An increase in size of the submucosal glands
D) Hypertrophy and/or hyperplasia of the bronchial muscle
E) Dilatation of the airways
A
B
C
D
E
Which one is WRONG about the following effects of pilocarpine?
A) Miosis
B) Glaucoma crisis
C) Pupillary block
D) Accommadation spasm
E) Conjunctival vessel vasodilation
A
B
C
D
E
When is the interstitial infiltration of neutrophils most prominent during the evolution of morphologic changes in myocardial infarction?
A) 1-3 days after myocardial infarction
B) 0-1,5 hours after myocardial infarction
C) 4-12 hours after myocardial infarction
D) 7-10 days after myocardial infarction
E) 2-8 weeks after myocardial infarction
A
B
C
D
E
The diagnosis of acute rheumatic fever is made based on serologic evidence of previous streptococcal infection in conjunction with two or more of the Jones criteria. Which of the following is not one of this criteria?
A) Carditis
B) Elevated acute phase reactants
C) Subcutaneous nodules
D) Sydenham chorea
E) Erythema nodosum
A
B
C
D
E
Which tissue is the most sensitive to atropine effects?
A) Heart
B) Vasculary smooth muscle
C) Salivary gland
D) Gastrointestinal smooth muscle
E) Eye
A
B
C
D
E
Which one of the following drugs is approved only for use of refractory ventricular tachycardias or intractable supraventricular arrhythmias?
A) procainamide
B) lidocaine
C) flecainide
D) disopyramide
E) quinidine
A
B
C
D
E
A 6-year-old boy was brought unconscious to the emergency department. His parents reported that the boy had eaten an apple bought from a local vendor 2 hours earlier. Physical examination showed that the boy was salivating profusely and was incontinent with regard to both urine and feces. He had pinpoint pupils, moist skin, and shallow respiration. A diagnosis was made, and two appropriate drugs were administered intravenously. Which of the following pairs of drugs were most likely given?
A) Physostigmine and atropine
B) Physostigmine and pralidoxime
C) Physostigmine and propranolol
D) Pralidoxime and propranolol
E) Atropine and pralidoxime
A
B
C
D
E
Which of the following is not expected in a patient with arrhythmia?
A) Patients may by unaware of a rhythm disorder.
B) Patient may note a “racing heart"
C) Patient may note a palpitations
D) Light headedness
E) Chest pain
A
B
C
D
E
Which of the following chest pain is associated with vessel spasm?
A) Chronic ischemic heart disease
B) Prinzmetal angina
C)Unstable angina
D) Sudden cardiac death
E) Stable angina
A
B
C
D
Which of the followings is correct for giant cell (temporal) arteritis?
A) 1 /3 of patients have chronic hepatitis B infection
B) usually seen in young adults
C) is a chronic, granulomatous inflammation of large to small size arteries D)peripheral neuritis is always seen
E) rapidly accelerating hypertension is seen due to renal artery involvement
A
B
C
D
E
In which stage of the lung development, major elements have formed, but structures involved with gas exchange have not formed. Survival is NOT possible, if born at this stage.
A) pseudoglandular period
B) canalicular period
C) terminal sac period
D) saccular period
E) alveolar period
A
B
C
D
E
A 60-year-old man hospitalized following a myocardial infarction showed a pronounced decrease in blood pressure and urine output 2 hours after the admission. A diagnosis of cardiogenic shock was made, and an emergency therapy was started. An adrenergic drug was given by intravenous infusion. Which of the following drugs fitting this profile would be appropriate for the patient?
A) Dopamine
B) Norepinephrine
C) Isoproterenol
D) Atropine
E) Phenylephri
A
B
C
D
E
Which of the following is not one of the consequences of cyanotic heart disease? A) Hypertrophic osteoarthropathy
B) Polycythemia
C) Increased risk for infective endocarditis
D) Increased risk for systemic embolization
E) Pulmonary edema
A
B
C
D
E
Which one is affected by botulinum toxin?
A) Reuptake of choline
B) Reuptake of Norepnephrine
C) Biotransforniation of acetylcholine
D) Partial exocytosis of acetylcholine
E) Synthesis of Norepinephrine
A
B
C
D
E
It is an autosomal dominant disorder that classically manifests with right-sided heart failure and rhythm disturbances. Almost 10% of cases of sudden deaths in athletes have been ascribed to this entity. Morphologically, the right ventricular wall is severely thinned owing to myocyte replacement by fatty infiltration and lesser amounts of fibrosis? Which diseases is mention above?
A) Hypertrophic cardiomyopathy
B) Restrictive cardiomyopathy
C) Endomyocardial fibrosis
D) Loeffler endomyocarditis
E) Arrhythmogenic right ventricular cardiomyopathy
A
B
C
D
E
Which of the following is not one of the Major Risk Factors for Atherosclerosis?
A) Genetic abnormalities
B) Family history
C) Diabetes
D) Male gender
E) Hemochromatosis
A
B
C
D
E
Which of the following is wrong about lung function, anatomy, and histology?
A) Bronchioles, are distinguished from bronchi by the lack of cartilage within their walls
B) Bronchioles do not contain submucosal glands in their wall
C) Additional branching of bronchioles leads to terminal bronchiole
D) The part of the lung distal to the terminal bronchiole is called an acinus
E) Alveolar epithelium, consisting of a continous layer of two principal cell types : rounded type II pneumocytes covering 95% of the alveolar surface; and flattened, plate-like type I pneumocytes
A
B
C
D
E
Restrictive cardiomyopathy is characterized by a primary decrease in ventricular compliance, resulting in impaired ventricular filling during diastole. Which of the following is not one of them?
A) Endomyocardial fibrosis
B) Amyloidosis
C) Loeffler endomyocarditis
D) Radiation fibrosis
E) Peripartum cardiomyopathy
A
B
C
D
E
Which of the followings is NOT a feature of immune complex associated vasculitis?A) circulating antibodies are accessible in blood circulation
B) specific antigen can not always be known
C) drugs and infectious agents might be etiologic agents
D) systemic lupus erytematosus is an example of this type of vasculitis
E) the antigenic targets are primarily intracellular
A
B
C
D
E
Which one of the followings is correct for malignant mesothelioma?
A) the latent period is 25 to 40 years, after initial asbestos exposure
B) 5% of persons with this cancer have a history of exposure to asbestos
C) The combination of cigarette smoking and asbestos exposure greatly increases the risk of malignant mesothelioma
D) is very common cancer of mesothelial cells
E) distant metastases are common
A
B
C
D
E
Which of the following is not one of the histopathological features of Chronic bronchitis?
A) Goblet cell metaplasia
B) Mucuous plugging
C) Inflammation
D) Fibrosis
E) Dilatatation of the airways
A
B
C
D
E
Which of the following cardiac defect occurs when extreme cavitation of myocardial tissue is formed during formation of ventricular walls and interventricular septum
A) Membranous ventricular septal defect
B) Muscular ventricular septal defect
C) Sinus venosus defect
D) Ostium secundum defect
E) Ectopia cordis
A
B
C
D
E
Which one is the effect of methacholine?
A) Diarrhoea B) Midriasis C) Bronchodilation D) Tachycardia E) Dry mouth
A
B
C
D
E
After successfull treatment of the acute attack, the patient was referred to the outpatient clinic for follow-up treatment of asthma. Which of the following is not an established prophylactic strategy for asthma?
A) Avoidance of antigen exposure
B) Blockade of histamine receptors
C) Blockade of leukotriene receptors
D) IgE antibody blockade
E) Inhibition of phospholipase A-2
A
B
C
D
E
Which one of the following is one of the desirable anti-anginal effects achieved with combination of nitrates and Beta blockers?
A) Increase in net myocardial oxygen requirement
B) Increase in heart rate
C) Decrease in arterial pressure
D) Increase in end diastolic pressure
E) Decrease in ejection time
A
B
C
D
E
