CVS Gemini Quiz Flashcards
(319 cards)
1
Q
Which of the following is a content of the thoracic cavity? A) Stomach B) Lungs C) Liver D) Spleen
A
B) Lungs. The lungs are a primary organ located within the thoracic cavity
2
Q
Which of the following accurately describes a boundary of the mediastinum? A) Superiorly by the diaphragm B) Inferiorly by the thoracic inlet C) Anteriorly by the sternum D) Posteriorly by the abdominal wall
A
C) Anteriorly by the sternum. The mediastinum’s boundaries are detailed in TLO 1.1.2.
3
Q
Which division of the mediastinum contains the heart? A) Superior mediastinum B) Anterior mediastinum C) Middle mediastinum D) Posterior mediastinum
A
C) Middle mediastinum. TLO 1.1.2 enumerates the contents of each mediastinal division
4
Q
Which of the following describes the innervation of the pericardium? A) Primarily by the vagus nerve B) Primarily by sympathetic nerves C) Primarily by the phrenic nerve D) Primarily by spinal nerves
A
C) Primarily by the phrenic nerve. TLO 1.1.3 describes the innervation of the pericardium.
5
Q
What is a primary function of the pericardium? A) To pump blood B) To prevent overfilling of the heart C) To produce hormones D) To filter blood
A
B) To prevent overfilling of the heart. The functions of the pericardium are discussed in TLO 1.1.3.
6
Q
Which of the following is considered a great vessel of the heart? A) Renal artery B) Pulmonary artery C) Femoral vein D) Hepatic portal vein
A
B) Pulmonary artery. The structure and great vessels of the heart are described in TLO 1.1.4.
7
Q
Which coronary artery typically supplies the interventricular septum? A) Right coronary artery B) Circumflex artery C) Left anterior descending artery D) Marginal artery
A
C) Left anterior descending artery. The branches and distribution of the coronary arteries are described in TLO 1.1.4.
8
Q
In what direction does deoxygenated blood flow into the heart? A) From the left atrium to the left ventricle B) From the right atrium to the right ventricle C) From the pulmonary veins to the left atrium D) From the aorta to the systemic circulation
A
B) From the right atrium to the right ventricle. TLO 1.1.4 explains the direction of blood flow in the heart.
9
Q
Which statement accurately compares the right and left sides of the heart? A) The right side pumps oxygenated blood
A
while the left side pumps deoxygenated blood. B) The left ventricle has a thicker wall than the right ventricle. C) The right atrium is larger than the left atrium. D) Both sides pump blood to the systemic circulation.
10
Q
Where is the heart primarily located? A) In the right thoracic cavity B) Posterior to the esophagus C) In the mediastinum
A
slightly to the left D) Superior to the diaphragm
11
Q
Which of the following is a major vessel whose position is clinically relevant? A) Radial artery B) Superior vena cava C) Gastric artery D) Splenic vein
A
B) Superior vena cava. TLO 1.2.2 describes the location and position of major vessels.
12
Q
Which area is typically relevant for palpation of the apex beat? A) Second intercostal space
A
right sternal border B) Fifth intercostal space
13
Q
Where is the aortic valve best auscultated? A) Second intercostal space
A
right sternal border B) Fifth intercostal space
14
Q
During which phase of the cardiac cycle does ventricular filling primarily occur? A) Ventricular ejection B) Isovolumetric contraction C) Ventricular diastole D) Atrial systole
A
C) Ventricular diastole. The cardiac cycle is described in TLO 1.3.1.
15
Q
Which of the following statements correctly describes the relationship between blood volume
A
pressure
16
Q
What does “ejection fraction” refer to in the context of heart function? A) The amount of blood pumped by the heart per minute B) The percentage of blood pumped out of the ventricle with each beat C) The pressure in the aorta during ventricular contraction D) The volume of blood remaining in the ventricle after systole
A
B) The percentage of blood pumped out of the ventricle with each beat. TLO 1.3.3 explains terms used to describe heart function.
17
Q
What does the ‘a’ wave in the Wigger’s diagram represent? A) Atrial contraction B) Ventricular contraction C) Aortic valve opening D) Mitral valve closing
A
A) Atrial contraction. Wigger’s diagram is interpreted in TLO 1.3.4.
18
Q
Which layer of the myocardium is primarily responsible for the pumping action of the heart? A) Epicardium B) Endocardium C) Myocardial muscle layer D) Pericardium
A
C) Myocardial muscle layer. The structure of the myocardium is described in TLO 1.4.1.
19
Q
What is the primary function of intercalated discs in cardiomyocytes? A) To provide structural support B) To facilitate rapid electrical signal transmission C) To store calcium ions D) To produce ATP
A
B) To facilitate rapid electrical signal transmission. The structure and function of cardiomyocytes are described in TLO 1.4.2.
20
Q
Which of the following is a determinant of cardiac output? A) Blood pressure B) Heart rate C) Peripheral resistance D) Venous tone
A
B) Heart rate. Cardiac output and its determinants are explained in TLO 1.4.3.
21
Q
Which factor directly increases venous return to the heart? A) Decreased blood volume B) Increased peripheral resistance C) Skeletal muscle pump activity D) Vasodilation
A
C) Skeletal muscle pump activity. TLO 1.4.4 discusses factors affecting venous return.
22
Q
Which valve prevents backflow of blood from the right ventricle to the right atrium? A) Aortic valve B) Pulmonary valve C) Mitral valve D) Tricuspid valve
A
D) Tricuspid valve. The anatomy and histology of atrioventricular and semilunar valves are discussed in TLO 1.5.1.
23
Q
During which phase of the cardiac cycle do the semilunar valves open? A) Ventricular filling B) Isovolumetric contraction C) Ventricular ejection D) Atrial contraction
A
C) Ventricular ejection. The physiology and function of the atrioventricular and semilunar valves are discussed in TLO 1.5.2.
24
Q
The first heart sound (S1) is primarily caused by the closure of which valves? A) Aortic and pulmonary valves B) Mitral and tricuspid valves C) Mitral and aortic valves D) Tricuspid and pulmonary valves
A
B) Mitral and tricuspid valves. The generation and characteristics of physiologic heart sounds are discussed in TLO 1.5.3.
25
What is a common consequence of aortic valve insufficiency? A) Pulmonary hypertension B) Left ventricular volume overload C) Right atrial enlargement D) Mitral valve stenosis
B) Left ventricular volume overload. The consequences of insufficient valvular function are explained in TLO 1.5.4.
26
Which structure is the primary pacemaker of the heart? A) Atrioventricular (AV) node B) Purkinje fibers C) Sinoatrial (SA) node D) Bundle of His
C) Sinoatrial (SA) node. TLO 1.6.1 identifies the structures involved in the cardiac conduction pathway.
27
In what order does electrical activity spread through the heart's conduction system? A) AV node → SA node → Bundle of His → Purkinje fibers B) SA node → AV node → Bundle of His → Purkinje fibers C) Purkinje fibers → Bundle of His → AV node → SA node D) Bundle of His → SA node → AV node → Purkinje fibers
B) SA node → AV node → Bundle of His → Purkinje fibers. The spread of electrical activity across the heart is described in TLO 1.6.2.
28
What is the primary function of the AV node in cardiac conduction? A) To initiate the heartbeat B) To rapidly conduct impulses to the ventricles C) To delay the electrical impulse before it reaches the ventricles D) To synchronize atrial and ventricular contraction
C) To delay the electrical impulse before it reaches the ventricles. The functions of the SA node
29
During which phase of an action potential does repolarization occur? A) Phase 0 (depolarization) B) Phase 1 (initial repolarization) C) Phase 2 (plateau) D) Phase 3 (rapid repolarization)
D) Phase 3 (rapid repolarization). The general phases of an action potential are described in TLO 1.7.1.
30
How does ventricular repolarization correlate with the mechanical function of the heart? A) It leads to ventricular contraction. B) It correlates with ventricular relaxation
allowing for refilling. C) It causes atrial depolarization. D) It initiates the opening of the aortic valve.
31
What is the primary ion channel responsible for the rapid depolarization in a cardiac myocyte action potential? A) L-type calcium channels B) Potassium channels C) Fast sodium channels D) T-type calcium channels
C) Fast sodium channels. How an action potential triggers cardiac myocyte contraction is described in TLO 1.7.3.
32
Which of the following is a characteristic of the ventricular action potential? A) It lacks a stable resting membrane potential. B) It has a prominent plateau phase (Phase 2). C) It is primarily driven by calcium influx. D) It has a slower conduction velocity than pacemaker cells.
B) It has a prominent plateau phase (Phase 2). Characteristics of the ventricular action potential are described in TLO 1.7.4.
33
What distinguishes the pacemaker action potential from a ventricular myocyte action potential? A) A stable resting membrane potential B) A plateau phase C) Spontaneous depolarization (pacemaker potential) D) Faster conduction velocity
C) Spontaneous depolarization (pacemaker potential). Characteristics of the pacemaker action potential are described in TLO 1.7.5.
34
Which nervous system generally slows down the heart rate? A) Sympathetic nervous system B) Parasympathetic nervous system C) Somatic nervous system D) Enteric nervous system
B) Parasympathetic nervous system. Cardiac innervation and the cardiac conduction pathway are discussed in TLO 1.8.1.
35
What is the effect of noradrenaline on cardiac conduction? A) Decreases heart rate and conduction velocity B) Increases heart rate and conduction velocity C) Has no effect on conduction D) Causes vasodilation
B) Increases heart rate and conduction velocity. The effect of the sympathetic nervous system in cardiac conduction and the role of noradrenaline are described in TLO 1.8.2.
36
What is the effect of acetylcholine on cardiac conduction? A) Increases heart rate and conduction velocity B) Decreases heart rate and conduction velocity C) Causes vasoconstriction D) Leads to increased contractility
B) Decreases heart rate and conduction velocity. The effect of the parasympathetic nervous system in cardiac conduction and the role of acetylcholine are described in TLO 1.8.3.
37
Which of the following factors can influence the cardiac conduction pathway? A) Blood glucose levels B) Electrolyte imbalances C) Skin temperature D) Bone density
B) Electrolyte imbalances. The factors that influence the cardiac conduction pathway are enumerated in TLO 1.8.4.
38
Which of the following is a major artery throughout the body? A) Renal vein B) Carotid artery C) Hepatic vein D) Jugular vein
B) Carotid artery. The major arteries
39
Which of the following is a physical feature of a large elastic artery like the aorta? A) Thick muscular layer B) Prominent external elastic lamina C) High compliance D) Small lumen
C) High compliance. The physical and functional features of conducting arteries are described under TLO 2.1.2.
40
Which of the following is a physical feature of a venule? A) Thick
muscular walls B) Large lumen compared to wall thickness C) High pressure D) Extensive elastic tissue
41
Which histological feature is more prominent in arterial walls compared to venous walls? A) Thinner tunica media B) More extensive elastic tissue in large arteries C) Presence of valves D) Larger lumen
B) More extensive elastic tissue in large arteries. The histological features of arterial and venous walls are compared and contrasted under TLO 2.1.4.
42
According to the relationship between pressure
volume
43
What is "cardiac preload"? A) The force the ventricle must overcome to eject blood B) The volume of blood in the ventricles at the end of diastole C) The resistance to blood flow in the systemic circulation D) The pressure in the aorta during systole
B) The volume of blood in the ventricles at the end of diastole. Cardiac preload and afterload and the factors affecting them are discussed under TLO 2.2.2.
44
Which of the following is a primary determinant of cardiac output? A) Total peripheral resistance B) Mean arterial pressure C) Stroke volume D) Blood viscosity
C) Stroke volume. The determinants of cardiac output are discussed under TLO 2.2.3.
45
What is the definition of mean arterial pressure (MAP)? A) The average pressure in the venous system B) The average pressure in the arteries during one cardiac cycle C) The pressure in the right atrium D) The peak systolic pressure
B) The average pressure in the arteries during one cardiac cycle. Mean arterial pressure is defined under TLO 2.3.1.
46
Which of the following parameters directly contributes to Mean Arterial Pressure (MAP)? A) Central venous pressure (CVP) B) End-diastolic volume (EDV) C) Total peripheral resistance (TPR) D) Pulmonary artery pressure (PAP)
C) Total peripheral resistance (TPR). The parameters contributing to MAP are identified and defined under TLO 2.3.2.
47
If heart rate increases
what is the immediate effect on blood pressure
48
Which factor
when increased
49
What does "basal vascular tone" refer to? A) The maximum possible constriction of blood vessels B) The resting level of contraction in vascular smooth muscle C) The complete relaxation of blood vessels D) The ability of blood vessels to stretch
B) The resting level of contraction in vascular smooth muscle. Basal vascular tone is explained under TLO 2.3.5.
50
What is the primary role of extrinsic regulators on arterial smooth muscle? A) To maintain local blood flow independent of systemic needs B) To regulate systemic blood pressure and distribution of blood flow C) To directly exchange nutrients and waste products with tissues D) To prevent blood clotting within the arteries
B) To regulate systemic blood pressure and distribution of blood flow. The primary role of extrinsic regulators on arterial smooth muscle is described under TLO 2.4.1.
51
How does Angiotensin II affect arterial smooth muscle? A) Causes vasodilation B) Causes vasoconstriction C) Has no direct effect D) Inhibits sympathetic activity
B) Causes vasoconstriction. TLO 2.4.2 explains how various extrinsic regulators affect arterial smooth muscle.
52
What is the subsequent effect of histamine release on blood pressure? A) Increases blood pressure B) Decreases blood pressure C) No change in blood pressure D) Causes temporary increase followed by decrease
B) Decreases blood pressure. The subsequent effect of each extrinsic regulator on blood pressure is described under TLO 2.4.3.
53
What is the primary role of intrinsic regulators on arterial smooth muscle? A) To control long-term blood pressure regulation B) To regulate systemic blood volume C) To maintain local blood flow consistent with tissue metabolic needs D) To initiate blood clotting
C) To maintain local blood flow consistent with tissue metabolic needs. The primary role of intrinsic regulators on arterial smooth muscle is described under TLO 2.5.1.
54
How does an increase in O2 levels affect arterial smooth muscle in most tissues? A) Causes vasodilation B) Causes vasoconstriction C) Has no effect D) Causes a transient increase in blood flow
B) Causes vasoconstriction. TLO 2.5.2 explains how various intrinsic regulators affect arterial smooth muscle.
55
What is the subsequent effect of increased lactic acid on blood pressure in local tissues? A) Increases local blood pressure B) Decreases local blood pressure C) No change in local blood pressure D) Causes systemic hypertension
B) Decreases local blood pressure. The subsequent effect of each intrinsic regulator on blood pressure is described under TLO 2.5.3.
56
What is autoregulation in the context of blood flow? A) Regulation of blood pressure by the brain B) The ability of an organ to maintain relatively constant blood flow despite changes in perfusion pressure C) The process of blood clotting to prevent blood loss D) The mechanism by which the heart regulates its own rhythm
B) The ability of an organ to maintain relatively constant blood flow despite changes in perfusion pressure. Autoregulation and its determining factors at various locations are described under TLO 2.5.4.
57
Where are baroreceptors primarily located for short-term blood pressure regulation? A) In the kidneys B) In the carotid sinus and aortic arch C) In the skeletal muscles D) In the brainstem
B) In the carotid sinus and aortic arch. The location of baroreceptors and their function are identified and described under TLO 2.6.1.
58
What is the role of the autonomic nervous system in short-term blood pressure regulation? A) To control long-term fluid balance B) To rapidly adjust heart rate
contractility
59
If a person stands up quickly and experiences a drop in blood pressure
how does the baroreceptor reflex typically respond to correct this? A) Decreases heart rate and causes vasodilation B) Increases heart rate and causes vasoconstriction C) Decreases heart rate and inhibits vasoconstriction D) Increases heart rate and inhibits vasodilation
60
Which organ is responsible for producing renin in the RAAS system? A) Liver B) Adrenal gland C) Kidney D) Lung
C) Kidney. The structures involved in the renin-angiotensin-aldosterone system (RAAS) are identified under TLO 2.7.1.
61
What is the primary role of the Renin-Angiotensin-Aldosterone System (RAAS)? A) To regulate blood glucose levels B) To primarily lower blood pressure C) To regulate blood volume and blood pressure D) To control immune responses
C) To regulate blood volume and blood pressure. The primary role of RAAS is described under TLO 2.7.2.
62
What is the correct sequential step in the RAAS system after renin is released? A) Angiotensinogen is converted to Angiotensin I B) Angiotensin II is converted to Angiotensin I C) Aldosterone is released from the adrenal gland D) ACE converts Angiotensin II to Angiotensin I
A) Angiotensinogen is converted to Angiotensin I. The processes involved in the RAAS system are sequentially described under TLO 2.7.3.
63
How does an overactive RAAS system typically alter blood pressure? A) Leads to decreased blood pressure B) Leads to increased blood pressure C) Has no effect on blood pressure D) Causes fluctuations in blood pressure
B) Leads to increased blood pressure. How changes in RAAS alter blood pressure is described under TLO 2.7.4.
64
How does high salt intake affect the RAAS system? A) It activates the RAAS system
increasing renin release. B) It suppresses the RAAS system
65
What is the definition of hypertension? A) Abnormally low blood pressure B) Consistently high blood pressure C) Fluctuating blood pressure D) High heart rate
B) Consistently high blood pressure. Hypertension is defined and its types are discussed under TLO 2.8.1.
66
Which of the following is a recognized risk factor for hypertension? A) Low sodium intake B) Regular exercise C) Obesity D) Young age
C) Obesity. The epidemiology and risk factors of hypertension are described under TLO 2.8.2.
67
What is a key pathophysiological feature of essential hypertension? A) Decreased peripheral vascular resistance B) Increased sympathetic nervous system activity C) Decreased activity of the RAAS system D) Decreased cardiac output
B) Increased sympathetic nervous system activity. The pathophysiology of essential hypertension is described under TLO 2.8.3.
68
What defines a hypertensive crisis? A) Mild elevation in blood pressure with no symptoms B) Sudden
severe elevation in blood pressure that can cause organ damage C) Gradual increase in blood pressure over several months D) Hypertension that resolves spontaneously
69
According to common classifications
what blood pressure reading would typically be considered Stage 1 hypertension? A) 110/70 mmHg B) 130/85 mmHg C) 160/100 mmHg D) 90/60 mmHg
70
Which of the following is a common clinical manifestation of hypertension? A) Hypoglycemia B) Headache C) Hypotension D) Bradycardia
B) Headache. The clinical manifestations of hypertension are discussed under TLO 2.9.2.
71
Which diagnostic tool is essential for the initial diagnosis of hypertension? A) Echocardiogram B) Blood pressure measurement C) ECG D) Angiography
B) Blood pressure measurement. The diagnosis of hypertension is discussed under TLO 2.9.3.
72
Which of the following is a lifestyle modification recommended for the management of hypertension? A) Increased red meat consumption B) Regular aerobic exercise C) High sodium intake D) Reduced fluid intake
B) Regular aerobic exercise. The management of hypertension is outlined under TLO 2.10.1.
73
What is the mechanism of action of ACE inhibitors in managing hypertension? A) They block calcium channels. B) They prevent the conversion of Angiotensin I to Angiotensin II. C) They block beta-adrenergic receptors. D) They increase sodium reabsorption in the kidneys.
B) They prevent the conversion of Angiotensin I to Angiotensin II. The mechanism of action of various antihypertensive drugs is described under TLO 2.10.2.
74
What is a primary goal in the management of a hypertensive emergency? A) Gradual reduction of blood pressure over days B) Rapid reduction of blood pressure to target within minutes to hours to prevent end-organ damage C) Maintaining blood pressure at extremely low levels D) Administering oral medications only
B) Rapid reduction of blood pressure to target within minutes to hours to prevent end-organ damage. The management of hypertensive emergency is outlined under TLO 2.10.3.
75
Which of the following is a potential complication of prolonged hypertension? A) Hypothyroidism B) Atherosclerosis C) Anemia D) Osteoporosis
B) Atherosclerosis. The complications of hypertension are discussed under TLO 2.11.1.
76
How does hypertension contribute to the pathophysiology of left ventricular hypertrophy? A) By decreasing afterload B) By increasing preload C) By increasing the workload on the left ventricle D) By causing direct myocardial damage
C) By increasing the workload on the left ventricle. The pathophysiology of various hypertension-related complications is briefly explained under TLO 2.11.2.
77
Which lifestyle modification is known to promote healthy blood pressure? A) High intake of saturated fats B) Smoking cessation C) Sedentary lifestyle D) Excessive alcohol consumption
B) Smoking cessation. Lifestyle modifications to promote healthy blood pressure are discussed under TLO 2.11.3.
78
What is the primary function of capillaries in the circulatory system? A) To carry oxygenated blood away from the heart B) To return deoxygenated blood to the heart C) To facilitate the exchange of nutrients and waste products between blood and tissues D) To regulate blood pressure
C) To facilitate the exchange of nutrients and waste products between blood and tissues. Capillary structure is described under TLO 3.1.1.
79
Which process describes the movement of fluid out of the capillary into the interstitial space? A) Reabsorption B) Diffusion C) Filtration D) Osmosis
C) Filtration. The processes occurring across the capillary wall for substance movement are described under TLO 3.1.2.
80
Which factor favors filtration out of the capillary? A) High interstitial fluid hydrostatic pressure (IFHP) B) High blood colloid osmotic pressure (BCOP) C) High capillary hydrostatic pressure (CHP) D) High interstitial fluid colloid osmotic pressure (IFCOP)
C) High capillary hydrostatic pressure (CHP). The factors affecting fluid movement across the capillary wall are described under TLO 3.1.3.
81
What is a primary role of the lymphatic system? A) To transport oxygenated blood to tissues B) To return excess interstitial fluid to the circulatory system C) To produce red blood cells D) To regulate blood glucose levels
B) To return excess interstitial fluid to the circulatory system. The role of the lymphatic system is described under TLO 3.1.4.
82
What is oedema defined as? A) An increase in blood pressure B) An accumulation of excess fluid in the interstitial space C) A decrease in red blood cell count D) Inflammation of blood vessels
B) An accumulation of excess fluid in the interstitial space. Oedema is defined under TLO 3.2.1.
83
Which of the following pathophysiological processes can lead to oedema? A) Decreased capillary hydrostatic pressure B) Increased plasma protein concentration C) Impaired lymphatic drainage D) Decreased interstitial fluid osmotic pressure
C) Impaired lymphatic drainage. The pathophysiological processes causing oedema are described under TLO 3.2.2.
84
Which of the following is a common cause of oedema due to increased capillary hydrostatic pressure? A) Liver failure B) Kidney disease C) Heart failure D) Malnutrition
C) Heart failure. Common causes leading to the pathological processes of oedema are identified under TLO 3.2.3.
85
Which of the following is a clinical sign of pulmonary oedema? A) Pitting oedema in the ankles B) Ascites C) Kerley B lines on chest X-ray D) Hepatomegaly
C) Kerley B lines on chest X-ray. Site-specific clinical manifestations of oedema are identified under TLO 3.2.4.
86
What is heart failure defined as? A) A condition where the heart completely stops beating B) A syndrome where the heart is unable to pump sufficient blood to meet the body's metabolic needs C) A sudden blockage of a coronary artery D) An inflammation of the heart muscle
B) A syndrome where the heart is unable to pump sufficient blood to meet the body's metabolic needs. Heart failure is defined under TLO 3.3.1.
87
Which of the following is a common risk factor for heart failure? A) Low blood pressure B) Diabetes mellitus C) Anemia D) Hypothyroidism
B) Diabetes mellitus. The risk factors and etiology of heart failure are enumerated and discussed under TLO 3.3.2.
88
Which classification system is commonly used for heart failure
based on functional capacity? A) TNM staging B) NYHA (New York Heart Association) classification C) Glasgow Coma Scale D) Framingham Risk Score
89
Which of the following is a common clinical feature of left heart failure? A) Peripheral oedema B) Jugular venous distension C) Dyspnoea (shortness of breath) D) Hepatomegaly
C) Dyspnoea (shortness of breath). The pathophysiology and clinical features of left heart failure are discussed under TLO 3.3.4.
90
Which of the following is a common clinical feature of right heart failure? A) Pulmonary oedema B) Orthopnoea C) Peripheral oedema D) Crackles on lung auscultation
C) Peripheral oedema. The pathophysiology and clinical features of right heart failure are discussed under TLO 3.3.5.
91
What is cardiac remodeling defined as? A) The surgical repair of heart valves B) Changes in the size
shape
92
Which of the following can cause cardiac remodeling? A) Regular low-intensity exercise B) Chronic hypertension C) A diet low in sodium D) Adequate sleep
B) Chronic hypertension. The causes of cardiac remodeling are enumerated under TLO 3.4.2.
93
What is a complication of concentric remodeling? A) Increased ventricular chamber size B) Decreased ventricular wall thickness C) Diastolic dysfunction D) Increased cardiac output
C) Diastolic dysfunction. Concentric remodeling and its complications are discussed under TLO 3.4.3.
94
What is a complication of eccentric remodeling? A) Decreased ventricular chamber size B) Increased ventricular wall thickness C) Systolic dysfunction D) Improved ejection fraction
C) Systolic dysfunction. Eccentric remodeling and its complications are discussed under TLO 3.4.4.
95
Which of the following is a key component in the diagnosis of heart failure? A) A complete blood count B) Liver function tests C) Clinical findings like orthopnoea D) Thyroid function tests
C) Clinical findings like orthopnoea. The steps to diagnose heart failure are identified under TLO 3.5.1.
96
Which laboratory investigation is commonly used to diagnose heart failure? A) Troponin B) Brain Natriuretic Peptide (BNP) C) C-reactive protein (CRP) D) D-dimer
B) Brain Natriuretic Peptide (BNP). Modalities used to diagnose heart failure are described under TLO 3.5.2.
97
Which of the following is a relevant pathological finding on a chest X-ray indicative of heart failure? A) Prominent bronchi B) Increased lung volumes C) Cardiomegaly D) Absence of pleural effusions
C) Cardiomegaly. Relevant pathological findings are described under TLO 3.5.3.
98
Which of the following is a common complication of heart failure? A) Deep vein thrombosis B) Hyperglycemia C) Renal dysfunction D) Hypothyroidism
C) Renal dysfunction. Complications of heart failure are described under TLO 3.5.4.
99
What is a common pharmacological agent used in the management of acute decompensated heart failure to reduce fluid overload? A) Beta-blockers B) ACE inhibitors C) Frusemide D) Digoxin
C) Frusemide. The management and pharmacology of acute decompensated heart failure are described under TLO 3.6.1.
100
Which class of drugs is a cornerstone in the management of chronic heart failure due to its ability to reduce mortality and morbidity? A) Calcium channel blockers B) Alpha-blockers C) ACE inhibitors D) Direct vasodilators
C) ACE inhibitors. The management and pharmacology of chronic heart failure are described under TLO 3.6.2.
101
What is shock defined as? A) A sudden drop in blood glucose B) A state of cellular and tissue hypoxia due to reduced oxygen delivery C) An allergic reaction to a foreign substance D) A severe emotional response
B) A state of cellular and tissue hypoxia due to reduced oxygen delivery. Shock is defined and its types are enumerated under TLO 3.7.1.
102
Which of the following is typically the first stage of shock? A) Irreversible stage B) Compensated stage C) Progressive stage D) Refractory stage
B) Compensated stage. The stages of shock are identified under TLO 3.7.2.
103
What is the primary pathophysiological event in cardiogenic shock? A) Widespread vasodilation B) Severe bleeding C) Failure of the heart to pump adequate blood D) A severe allergic reaction
C) Failure of the heart to pump adequate blood. The pathophysiology of cardiogenic shock is discussed under TLO 3.7.3.
104
Which clinical manifestation is characteristic of the progressive stage of cardiogenic shock? A) Warm
flushed skin B) Bounding pulses C) Hypotension and signs of end-organ hypoperfusion D) Bradycardia
105
What is a key component in the initial management of cardiogenic shock? A) Administration of large volumes of intravenous fluids B) Vasopressors to improve blood pressure C) Immediate surgical intervention D) High-dose insulin
B) Vasopressors to improve blood pressure. The management of cardiogenic shock is outlined under TLO 3.7.5.
106
What does the P wave on an ECG represent? A) Ventricular depolarization B) Atrial repolarization C) Atrial depolarization D) Ventricular repolarization
C) Atrial depolarization. Components of the normal ECG and their reflections are identified and explained under TLO 4.1.1 and TLO 4.1.2.
107
What electrical activity does the QRS complex on an ECG reflect? A) Atrial depolarization B) Ventricular repolarization C) Ventricular depolarization D) Atrial contraction
C) Ventricular depolarization. TLO 4.1.2 explains what each component of an ECG reflects.
108
When considering a standard 12-lead ECG
which leads are considered "inferior leads"? A) V1
109
When interpreting an ECG
what does "axis" refer to? A) The overall direction of electrical flow in the heart B) The rate of the heartbeat C) The regularity of the heart rhythm D) The size of the heart chambers
110
Which of the following ECG findings is characteristic of sinus bradycardia? A) Heart rate >100 bpm with a regular rhythm B) Heart rate <60 bpm with a regular rhythm C) Irregularly irregular rhythm D) Absence of P waves
B) Heart rate <60 bpm with a regular rhythm. Sinus rhythm
111
What is tachyarrhythmia defined as? A) A heart rate slower than normal B) An irregular heart rhythm with a normal rate C) A heart rhythm that is abnormally fast D) A heart rhythm that is abnormally slow and irregular
C) A heart rhythm that is abnormally fast. Tachyarrhythmia is defined and its generalized clinical manifestations are described under TLO 4.3.1.
112
Which of the following is a common risk factor for atrial fibrillation? A) Hypothyroidism B) Hypertension C) Bradycardia D) Hypotension
B) Hypertension. The risk factors/etiology for various tachyarrhythmias are identified under TLO 4.3.2.
113
Which ECG finding is characteristic of atrial fibrillation? A) Regular R-R interval with narrow QRS B) Sawtooth P waves C) Irregularly irregular R-R interval with no distinct P waves D) Wide QRS complexes with no preceding P waves
C) Irregularly irregular R-R interval with no distinct P waves. Various tachyarrhythmias are identified on ECG under TLO 4.3.3.
114
What is the primary pathophysiological mechanism in ventricular fibrillation? A) Re-entry circuit in the atria B) Multiple chaotic electrical impulses in the ventricles C) Prolonged PR interval D) Blockage of the AV node
B) Multiple chaotic electrical impulses in the ventricles. The pathophysiological process for various tachyarrhythmias is described under TLO 4.3.4.
115
What is bradyarrhythmia defined as? A) An abnormally fast heart rhythm B) An abnormally slow heart rhythm C) An irregular heart rhythm D) A normal heart rhythm with occasional extra beats
B) An abnormally slow heart rhythm. Bradyarrhythmia is defined and its generalized clinical manifestations are described under TLO 4.4.1.
116
Which ECG finding is characteristic of a 1st degree heart block? A) Progressively lengthening PR interval until a QRS is dropped B) Constant PR interval but longer than normal (>0.20 seconds) C) No relationship between P waves and QRS complexes D) More P waves than QRS complexes
B) Constant PR interval but longer than normal (>0.20 seconds). Various heart blocks are identified on ECG under TLO 4.4.2.
117
Which of the following can be an etiology for 3rd degree heart block? A) Exercise B) Myocardial infarction C) Atrial septal defect D) Hyperthyroidism
B) Myocardial infarction. The risk factors/etiology for various heart blocks are identified under TLO 4.4.3.
118
What is the pathophysiological process in 3rd degree heart block? A) Intermittent blockage of impulses at the AV node B) Complete dissociation between atrial and ventricular electrical activity C) Slowed conduction through the atria D) Shortening of the PR interval
B) Complete dissociation between atrial and ventricular electrical activity. The pathophysiological process for various heart blocks is described under TLO 4.4.4.
119
Which modality is commonly used for continuous monitoring of heart rhythm over an extended period to diagnose arrhythmias? A) Standard 12-lead ECG B) Chest X-ray C) Holter monitor D) Echocardiogram
C) Holter monitor. Modalities used to diagnose arrhythmias are identified under TLO 4.5.1.
120
Which of the following is a common complication of atrial fibrillation? A) Deep vein thrombosis B) Stroke C) Myocardial infarction D) Pulmonary embolism
B) Stroke. Complications of the listed arrhythmias are described under TLO 4.5.2.
121
Which class of antiarrhythmic drugs primarily blocks potassium channels? A) Class I (Na+ channel blockers) B) Class II (β-blockers) C) Class III (K+ blockers) D) Class IV (Ca2+ channel blockers)
C) Class III (K+ blockers). Appropriate pharmacological management options for arrhythmias are identified under TLO 4.6.1.
122
How do Beta-blockers primarily exert their antiarrhythmic effect? A) By prolonging the QT interval B) By decreasing automaticity and conduction velocity C) By increasing sodium influx D) By directly stimulating the SA node
B) By decreasing automaticity and conduction velocity. The mechanism of action for various antiarrhythmic drugs is described under TLO 4.6.2.
123
What is the purpose of cardiac ablation in treating arrhythmias? A) To implant a pacemaker B) To deliver a shock to reset the heart rhythm C) To destroy specific heart tissue that is causing the arrhythmia D) To open blocked coronary arteries
C) To destroy specific heart tissue that is causing the arrhythmia. Appropriate interventional approaches to arrhythmias are identified and described under TLO 4.6.3.
124
Which lifestyle modification is important for secondary prevention of arrhythmias? A) Avoiding all physical activity B) Maintaining a healthy weight C) Increasing caffeine intake D) Consuming high-sodium foods
B) Maintaining a healthy weight. Lifestyle modifications required for secondary prevention are identified under TLO 4.6.4.
125
Why do heart murmurs occur? A) Due to normal blood flow through healthy valves B) Due to turbulent blood flow through abnormal heart valves or structures C) Due to electrical disturbances in the heart D) Due to inflammation of the pericardium
B) Due to turbulent blood flow through abnormal heart valves or structures. Why murmurs occur is described under TLO 5.1.1.
126
How does the Valsalva manoeuvre typically affect the intensity of murmurs associated with hypertrophic cardiomyopathy? A) Increases intensity B) Decreases intensity C) Has no effect D) Causes the murmur to disappear
A) Increases intensity. How murmurs are affected by various maneuvers is described under TLO 5.1.2.
127
When do S3 heart sounds typically occur? A) During atrial contraction B) Immediately after S1
due to rapid ventricular filling C) Immediately after S2
128
Which type of murmur is associated with aortic stenosis? A) Diastolic murmur B) Systolic ejection murmur C) Pansystolic murmur D) Continuous murmur
B) Systolic ejection murmur. Murmurs associated with left and right-side valve lesions are to be familiarized under TLO 5.1.4.
129
What is Aortic Stenosis (AS)? A) Narrowing of the mitral valve B) Narrowing of the aortic valve C) Leakage of the aortic valve D) Inflammation of the aortic valve
B) Narrowing of the aortic valve. AS is defined and its epidemiology explained under TLO 5.2.1.
130
What is a common cause of Aortic Stenosis in older adults? A) Rheumatic fever B) Congenital bicuspid valve C) Calcific degeneration D) Infective endocarditis
C) Calcific degeneration. The causes and pathophysiology of AS are discussed and explained under TLO 5.2.2.
131
Which of the following is a classic clinical feature of severe Aortic Stenosis? A) Palpitations B) Ankle oedema C) Angina
syncope
132
Which diagnostic modality is most crucial for confirming the diagnosis and assessing the severity of Aortic Stenosis? A) ECG B) Chest X-ray C) Echocardiogram D) Cardiac catheterization
C) Echocardiogram. The diagnosis of AS is discussed under TLO 5.2.4.
133
What is a definitive treatment for severe
symptomatic Aortic Stenosis? A) Medical management with diuretics B) Aortic valve replacement (surgical or TAVI) C) Anticoagulation therapy D) Strict bed rest
134
What is Mitral Stenosis (MS)? A) Leakage of the mitral valve B) Narrowing of the mitral valve C) Inflammation of the mitral valve D) Prolapse of the mitral valve
B) Narrowing of the mitral valve. MS is defined and its epidemiology explained under TLO 5.3.1.
135
What is the most common cause of Mitral Stenosis worldwide? A) Congenital anomaly B) Infective endocarditis C) Rheumatic fever D) Degenerative calcification
C) Rheumatic fever. The causes and pathophysiology of MS are discussed and explained under TLO 5.3.2.
136
Which of the following is a characteristic clinical feature of Mitral Stenosis? A) Systolic murmur radiating to the carotids B) Opening snap followed by a diastolic rumble C) Bounding peripheral pulses D) Widened pulse pressure
B) Opening snap followed by a diastolic rumble. The clinical features of MS are discussed under TLO 5.3.3.
137
Which diagnostic tool is essential for the diagnosis and assessment of Mitral Stenosis? A) Stress ECG B) Cardiac MRI C) Echocardiogram D) Holter monitor
C) Echocardiogram. The diagnosis of MS is discussed under TLO 5.3.4.
138
What is a potential management option for severe Mitral Stenosis? A) Aortic valve replacement B) Percutaneous balloon valvuloplasty C) Statin therapy D) ACE inhibitor therapy
B) Percutaneous balloon valvuloplasty. The management of MS is outlined under TLO 5.3.5.
139
What is Aortic Regurgitation (AR)? A) Narrowing of the aortic valve B) Failure of the aortic valve to close completely
leading to backflow of blood C) Inflammation of the aortic valve D) Aortic valve prolapse
140
Which of the following can cause chronic Aortic Regurgitation? A) Acute myocardial infarction B) Rheumatic heart disease C) Papillary muscle rupture D) Chordae tendineae rupture
B) Rheumatic heart disease. The causes and pathophysiology of AR are discussed and explained under TLO 5.4.2.
141
Which clinical sign is characteristic of significant chronic Aortic Regurgitation? A) Low pulse pressure B) Pulsus paradoxus C) Wide pulse pressure (e.g.
water-hammer pulse) D) Diminished peripheral pulses
142
Which imaging modality is crucial for the diagnosis and quantification of Aortic Regurgitation? A) Chest X-ray B) CT scan C) Echocardiogram D) Nuclear stress test
C) Echocardiogram. The diagnosis of AR is discussed under TLO 5.4.4.
143
What is a key management strategy for asymptomatic severe Aortic Regurgitation with evidence of left ventricular dysfunction? A) Observation only B) Aortic valve replacement C) Diuretic therapy D) Beta-blocker therapy
B) Aortic valve replacement. The management of AR is outlined under TLO 5.4.5.
144
What is Mitral Regurgitation (MR)? A) Narrowing of the mitral valve B) Leakage of the mitral valve
leading to backflow of blood into the left atrium C) Inflammation of the mitral valve D) Prolapse of the mitral valve without significant regurgitation
145
Which of the following is a common cause of acute Mitral Regurgitation? A) Rheumatic fever B) Myocardial infarction leading to papillary muscle rupture C) Degenerative valve disease D) Congenital valve anomaly
B) Myocardial infarction leading to papillary muscle rupture. The causes and pathophysiology of MR are discussed and explained under TLO 5.5.2.
146
Which of the following is a characteristic clinical feature of chronic Mitral Regurgitation? A) Diastolic murmur B) Pansystolic murmur radiating to the axilla C) Opening snap D) Crescendo-decrescendo systolic murmur
B) Pansystolic murmur radiating to the axilla. The clinical features of MR are discussed under TLO 5.5.3.
147
Which diagnostic tool is essential for evaluating Mitral Regurgitation? A) Cardiac MRI B) Stress ECG C) Echocardiogram D) Blood test for cardiac enzymes
C) Echocardiogram. The diagnosis of MR is discussed under TLO 5.5.4.
148
What is a common management approach for severe symptomatic Mitral Regurgitation? A) Medical management with ACE inhibitors only B) Percutaneous coronary intervention C) Mitral valve repair or replacement D) Anticoagulation only
C) Mitral valve repair or replacement. The management of MR is outlined under TLO 5.5.5.
149
What is tricuspid regurgitation? A) Narrowing of the tricuspid valve B) Leakage of the tricuspid valve
allowing backflow of blood into the right atrium C) Inflammation of the tricuspid valve D) Prolapse of the tricuspid valve
150
Which of the following can lead to secondary tricuspid regurgitation? A) Rheumatic heart disease B) Pulmonary hypertension C) Infective endocarditis on a prosthetic valve D) Aortic stenosis
B) Pulmonary hypertension. The causes and pathophysiology of tricuspid regurgitation are discussed and explained under TLO 5.6.2.
151
Which clinical feature is characteristic of severe tricuspid regurgitation? A) Left ventricular hypertrophy B) Pulmonary oedema C) Pulsating jugular venous distension D) Angina
C) Pulsating jugular venous distension. The clinical features of tricuspid regurgitation are discussed under TLO 5.6.3.
152
Which diagnostic modality is most useful for assessing tricuspid regurgitation? A) ECG B) Chest X-ray C) Echocardiogram D) Cardiac CT
C) Echocardiogram. The diagnosis of tricuspid regurgitation is discussed under TLO 5.6.4.
153
What is a key aspect of managing tricuspid regurgitation
especially if secondary to other conditions? A) Direct surgical repair of the tricuspid valve as a first line B) Treating the underlying cause
154
Which modality is a primary diagnostic tool for valvular heart disease
providing real-time imaging of valve structure and function? A) ECG B) Chest X-ray C) Cardiac auscultation D) Echocardiogram
155
Which of the following is a relevant pathological finding in valvular heart disease? A) Normal leaflet motion B) Leaflet fusion C) Absence of calcification D) Normal annular size
B) Leaflet fusion. Relevant pathological findings in valvular heart disease are identified under TLO 5.7.2.
156
Which of the following is an appropriate interventional management option for severe valvular heart disease? A) Long-term diuretic therapy B) Percutaneous valve repair (e.g.
MitraClip) C) Lifestyle modifications only D) Statin therapy
157
Which of the following is a common complication of valvular heart disease? A) Hypertension B) Diabetes mellitus C) Left ventricular remodeling D) Thyroid dysfunction
C) Left ventricular remodeling. Complications of valvular heart disease are identified under TLO 5.7.4.
158
What is myocardial ischaemia defined as? A) Complete blockage of a coronary artery B) Reduced blood flow to the myocardium
leading to an imbalance between oxygen supply and demand C) Inflammation of the pericardium D) Necrosis of myocardial tissue
159
Which of the following is a determinant of myocardial oxygen demand? A) Heart rate B) Coronary artery diameter C) Oxygen saturation of blood D) Red blood cell count
A) Heart rate. The determinants of myocardial oxygen demand are discussed under TLO 7.1.2.
160
Which of the following is a common cause of myocardial ischemia? A) Anemia B) Coronary artery atherosclerosis C) Pulmonary embolism D) Deep vein thrombosis
B) Coronary artery atherosclerosis. The causes of myocardial ischemia are enumerated under TLO 7.1.3.
161
Which type of angina is characterized by coronary artery spasm? A) Chronic stable angina B) Unstable angina C) Printzmetal's variant angina D) Microvascular angina
C) Printzmetal's variant angina. Printzmetal's variant angina
162
What ECG change is characteristic of myocardial ischemia? A) ST segment elevation B) ST segment depression or T wave inversion C) Prolonged PR interval D) Wide QRS complex
B) ST segment depression or T wave inversion. The ECG changes of angina are discussed under TLO 7.1.5.
163
What is a cornerstone of medical management for stable angina? A) Immediate angioplasty B) Nitrates C) High-dose anticoagulants D) Loop diuretics
B) Nitrates. The management of angina is outlined under TLO 7.1.6.
164
Which of the following is a major modifiable risk factor for atherosclerosis? A) Age B) Gender C) Hypertension D) Family history
C) Hypertension. The risk factors for atherosclerosis are enumerated under TLO 7.2.1.
165
What is the initiating event in the pathogenesis of atherosclerosis? A) Formation of a thrombus B) Endothelial injury and dysfunction C) Lipid accumulation in the adventitia D) Calcification of the arterial wall
B) Endothelial injury and dysfunction. The pathogenesis of atherosclerosis is described under TLO 7.2.2.
166
What is a characteristic microscopic feature of an advanced atherosclerotic plaque? A) Absence of lipid core B) A fibrous cap overlying a necrotic lipid core C) Uniform distribution of smooth muscle cells D) Predominance of red blood cells
B) A fibrous cap overlying a necrotic lipid core. The microscopic features of an atherosclerotic plaque are discussed under TLO 7.2.3.
167
How does plaque rupture contribute to myocardial infarction (MI)? A) By causing vasodilation and increased blood flow B) By forming a thrombus that occludes the artery C) By directly narrowing the artery without thrombus formation D) By improving endothelial function
B) By forming a thrombus that occludes the artery. The contribution of rupture versus erosion in causing MI is described under TLO 7.2.4.
168
Which of the following is an anti-atherosclerotic therapy
including lifestyle modification? A) Increasing intake of saturated fats B) Smoking cessation C) Reducing physical activity D) Increasing trans-fat consumption
169
Which of the following is a major type of lipid found in the body? A) Glucose B) Amino acids C) Triacylglycerols D) Nucleic acids
C) Triacylglycerols. The major types of lipids are identified and described under TLO 7.3.1.
170
Which of the following is a type of lipoprotein responsible for transporting cholesterol from the liver to peripheral tissues? A) High-density lipoprotein (HDL) B) Low-density lipoprotein (LDL) C) Chylomicron D) Very low-density lipoprotein (VLDL)
B) Low-density lipoprotein (LDL). The types of lipoproteins are identified under TLO 7.3.2.
171
What is a primary function of LDL? A) To remove cholesterol from peripheral tissues B) To transport dietary triglycerides C) To deliver cholesterol to peripheral cells D) To synthesize new triglycerides
C) To deliver cholesterol to peripheral cells. The basic structure and function of lipoproteins with an emphasis on LDL are described under TLO 7.3.3.
172
What is the function of apolipoproteins in lipoproteins? A) To store fatty acids B) To provide structural stability and act as enzyme cofactors or receptor ligands C) To form the lipid core D) To synthesize cholesterol
B) To provide structural stability and act as enzyme cofactors or receptor ligands. The basic structure and function of apolipoproteins are described under TLO 7.3.4.
173
What is the relationship between high levels of LDL and atherosclerosis? A) High LDL levels protect against atherosclerosis. B) High LDL levels promote the development of atherosclerosis. C) LDL levels have no direct relationship with atherosclerosis. D) High LDL levels cause vasodilation.
B) High LDL levels promote the development of atherosclerosis. The relationship between LDL and atherosclerosis is described under TLO 7.3.5.
174
How do statins primarily lower lipid levels? A) By inhibiting cholesterol absorption in the intestine B) By increasing LDL receptor activity C) By inhibiting HMG-CoA reductase
a key enzyme in cholesterol synthesis D) By increasing the excretion of triglycerides
175
What is the role of HDL as a defense mechanism against atherosclerosis? A) It promotes the accumulation of cholesterol in arteries. B) It facilitates reverse cholesterol transport from peripheral tissues back to the liver. C) It increases the oxidation of LDL. D) It inhibits nitric oxide production.
B) It facilitates reverse cholesterol transport from peripheral tissues back to the liver. The role of HDL as a defense mechanism is described under TLO 7.3.7.
176
What is a common agent used to lower triglyceride levels? A) Statins B) Fibrates C) Ezetimibe D) PCSK9 inhibitors
B) Fibrates. The role of triglycerides (TG) in heart disease and agents used to lower TG levels are described under TLO 7.3.8.
177
What is a common characteristic of the epidemiology of MI? A) It is more common in younger individuals. B) Incidence increases with age. C) It affects females more often than males. D) It is rare in developed countries.
B) Incidence increases with age. The epidemiology of MI is described under TLO 7.4.1.
178
Which of the following is a significant risk factor for myocardial infarction (MI)? A) Regular low-intensity exercise B) Smoking C) Low cholesterol levels D) High fiber diet
B) Smoking. The risk factors of MI are enumerated under TLO 7.4.2.
179
What is the primary pathophysiological event leading to most myocardial infarctions? A) A sudden drop in blood pressure B) Prolonged vasospasm of a coronary artery C) Rupture of an atherosclerotic plaque leading to thrombus formation and complete occlusion D) Viral infection of the myocardium
C) Rupture of an atherosclerotic plaque leading to thrombus formation and complete occlusion. The pathophysiology of MI is described under TLO 7.4.3.
180
Which of the following is a classic clinical manifestation of myocardial infarction? A) Gradual onset of chest pain over hours B) Pleuritic chest pain that worsens with breathing C) Crushing
substernal chest pain radiating to the left arm or jaw D) Pain relieved immediately by antacids
181
Which ECG change is characteristic of a STEMI (ST-elevation myocardial infarction)? A) ST segment depression B) T wave inversion C) ST segment elevation D) Prolonged PR interval
C) ST segment elevation. The ECG changes of NSTEMI and STEMI are discussed under TLO 7.4.4.
182
Which ECG finding is a strong indicator of an acute myocardial infarction? A) Tall R waves in V1 B) ST segment elevation in contiguous leads C) Prolonged QT interval D) Prominent U waves
B) ST segment elevation in contiguous leads. The ECG findings in MI are discussed under TLO 7.5.1.
183
Which cardiac biomarker is considered the most specific for myocardial injury and is crucial for MI diagnosis? A) Creatine Kinase (CK) B) Lactate Dehydrogenase (LDH) C) Troponin I or T D) Myoglobin
C) Troponin I or T. The role of cardiac biomarkers in the diagnosis of MI is explained under TLO 7.5.2.
184
Which imaging study can assess myocardial viability and perfusion in the context of MI? A) Chest X-ray B) Echocardiogram C) Cardiac MRI D) Abdominal ultrasound
C) Cardiac MRI. The imaging studies in MI are discussed under TLO 7.5.3.
185
What is a characteristic morphological feature of a myocardial infarct after several days? A) Hemorrhage and acute inflammation B) Fibrous scar tissue formation C) Intact myocardial cells D) Fatty infiltration
A) Hemorrhage and acute inflammation. The morphological features of a myocardial infarct are discussed under TLO 7.5.4. (Note: While fibrous scar tissue forms later
186
When selecting appropriate diagnostic tests for Ischemic Heart Disease (IHD)
what is a key consideration? A) Patient's height B) Patient's age and risk factors C) Blood type D) Eye color
187
What is a cornerstone of medical management for an acute MI? A) Long-term oral antibiotics B) Immediate reperfusion therapy (e.g.
PCI or thrombolysis) C) High-dose steroids D) Strict fluid restriction
188
What is the mechanism of action of nitrates in managing MI? A) They cause vasoconstriction. B) They reduce myocardial oxygen demand by causing vasodilation
especially venodilation. C) They directly increase heart rate. D) They increase blood pressure.
189
What is a key interventional approach to managing a STEMI? A) Coronary artery bypass grafting (CABG) only B) Percutaneous coronary intervention (PCI) C) Long-term oral antiplatelet therapy as sole treatment D) Heart transplant
B) Percutaneous coronary intervention (PCI). The interventional approaches to MI are described under TLO 7.6.3.
190
Which of the following is a potential complication of MI? A) Hypertension B) Arrhythmias C) Hyperthyroidism D) Appendicitis
B) Arrhythmias. The complications of MI are discussed under TLO 7.7.1.
191
Which lifestyle alteration is crucial for secondary prevention after an MI? A) Increased consumption of processed foods B) Maintaining a sedentary lifestyle C) Smoking cessation D) Avoiding all medications
C) Smoking cessation. Lifestyle alterations required for secondary prevention are discussed under TLO 7.7.2.
192
Which of the following is a relevant cellular origin of the heart? A) Endoderm B) Ectoderm C) Mesoderm D) Neural crest cells
C) Mesoderm. Relevant cellular origins of the heart are identified under TLO 8.1.1.
193
What initiates electrical conduction in the heart during embryonic development? A) The vagus nerve B) Spontaneous depolarization of pacemaker cells C) Hormonal influences D) Neural stimulation from the brain
B) Spontaneous depolarization of pacemaker cells. The processes involved in the initiation of electrical conduction in the heart are described under TLO 8.1.2.
194
Which of the following processes is involved in the partitioning of the atria during heart development? A) Formation of the interventricular septum B) Growth of the septum primum and septum secundum C) Development of the semilunar valves D) Formation of the aorticopulmonary septum
B) Growth of the septum primum and septum secundum. The processes involved in partitioning of the AV canal
195
What is a key process involved in the formation of heart valves? A) Direct fusion of myocardial cells B) Endocardial cushion development C) Growth of neural crest cells D) Formation of trabeculae carneae
B) Endocardial cushion development. The processes involved in valve formation are described under TLO 8.2.2.
196
Which embryonic structure gives rise to the great arteries like the aorta? A) Common cardinal veins B) Aortic arches C) Vitelline veins D) Umbilical veins
B) Aortic arches. The processes involved in the development of various circulatory structures are described under TLO 8.3.1.
197
How does fetal circulation differ from postnatal circulation in terms of oxygenation? A) In fetal circulation
the lungs are the primary site of oxygen exchange. B) In fetal circulation
198
In fetal circulation
what is the primary pathway for oxygenated blood from the placenta to bypass the fetal liver? A) Foramen ovale B) Ductus arteriosus C) Ductus venosus D) Umbilical arteries
199
In the fetal circulatory pathway
the blood in the umbilical arteries is primarily: A) Oxygenated B) Deoxygenated C) A mixture of both D) Rich in nutrients but no oxygen
200
Which fetal adaptation shunts blood from the pulmonary artery directly into the aorta
bypassing the non-functional lungs? A) Foramen ovale B) Ductus venosus C) Ductus arteriosus D) Umbilical vein
201
Which anatomical change occurs to the fetal cardiovascular system at birth? A) The foramen ovale remains open. B) The ductus arteriosus dilates. C) The umbilical arteries become the medial umbilical ligaments. D) The pulmonary vascular resistance decreases.
D) The pulmonary vascular resistance decreases. The anatomical changes that occur to the fetal CVS at birth are identified under TLO 8.5.1.
202
When does the foramen ovale typically close after birth? A) Immediately at birth B) Within the first few hours or days after birth C) Several weeks after birth D) Around the age of one year
B) Within the first few hours or days after birth. When and why these fetal CVS changes occur at birth are described under TLO 8.5.2.
203
What is the outcome of the closure of the ductus arteriosus after birth? A) Increased blood flow to the lungs B) Increased blood flow to the systemic circulation C) Persistence of right-to-left shunting D) Development of pulmonary hypertension
A) Increased blood flow to the lungs. The outcome of these fetal CVS changes at birth is described under TLO 8.5.3.
204
What is a congenital heart defect? A) A heart condition acquired during adulthood B) A structural problem with the heart that is present at birth C) An inflammation of the heart muscle D) A blockage of a coronary artery
B) A structural problem with the heart that is present at birth. Congenital heart defect is defined and examples are provided under TLO 8.5.4.
205
What is a common clinical feature of patent ductus arteriosus (PDA)? A) Cyanosis B) Systolic ejection murmur C) Continuous machine-like murmur D) Clubbing of fingers
C) Continuous machine-like murmur. The etiology
206
Which of the following is a common clinical manifestation of a large ventricular septal defect (VSD)? A) Cyanosis B) Right-to-left shunt with normal pulmonary pressure C) Heart failure symptoms (e.g.
dyspnea
207
Which of the following describes the pathophysiology of an atrial septal defect (ASD)? A) Left-to-right shunting of blood at the atrial level B) Right-to-left shunting of blood at the atrial level C) Obstruction to blood flow from the left atrium to the left ventricle D) Obstruction to blood flow from the right atrium to the right ventricle
A) Left-to-right shunting of blood at the atrial level. The etiology
208
What is the primary difference between a patent foramen ovale (PFO) and an atrial septal defect (ASD)? A) PFO is a structural defect
while ASD is a functional defect. B) PFO is a failure of fusion of the septum secundum
209
Which of the following defects is NOT part of the Tetralogy of Fallot? A) Ventricular septal defect B) Pulmonary stenosis C) Aortic stenosis D) Overriding aorta
C) Aortic stenosis. The etiology
210
What is the primary clinical manifestation of Transposition of the Great Arteries (TGA) in a newborn if not immediately treated? A) Pink baby with a loud murmur B) Severe cyanosis C) Systemic hypertension D) Lower limb ischemia
B) Severe cyanosis. The etiology
211
What is coarctation of the aorta? A) A narrowing of the pulmonary artery B) A narrowing of the aorta
typically near the ductus arteriosus C) A complete absence of the aorta D) A dilated aorta
212
Which of the following is a clinical manifestation of severe pulmonary stenosis in infancy? A) Bounding peripheral pulses B) Cyanosis
especially with a right-to-left shunt through a patent foramen ovale C) Systemic hypertension D) Loud P2 heart sound
213
Why do cardiovascular system (CVS) changes occur during pregnancy? A) To decrease cardiac output B) To support the metabolic demands of the growing fetus and placenta C) To reduce blood volume D) To increase peripheral vascular resistance
B) To support the metabolic demands of the growing fetus and placenta. Why CVS changes occur during pregnancy is explained under TLO 8.9.1.
214
Which of the following is a cardiovascular system (CVS) change that occurs during normal pregnancy? A) Decreased cardiac output B) Decreased plasma volume C) Increased red cell mass D) Increased peripheral vascular resistance
C) Increased red cell mass. The CVS changes that occur during pregnancy are identified under TLO 8.9.2.
215
How does the increased cardiac output during pregnancy primarily occur? A) Due to decreased heart rate B) Due to increased stroke volume and heart rate C) Due to vasoconstriction D) Due to decreased blood volume
B) Due to increased stroke volume and heart rate. How each cardiovascular change during pregnancy occurs is discussed under TLO 8.9.3.
216
What is pre-eclampsia defined as? A) Gestational hypertension with proteinuria B) Hypertension that develops before pregnancy C) Chronic hypertension in pregnancy without proteinuria D) Hypertension that resolves immediately after delivery
A) Gestational hypertension with proteinuria. Pre-eclampsia is defined under TLO 8.9.4.
217
Which of the following is a risk factor for pre-eclampsia? A) Multiparity (many previous pregnancies) B) History of chronic hypertension C) Young maternal age (under 20) D) Normal body mass index
B) History of chronic hypertension. The risk factors/etiology for pre-eclampsia are described under TLO 8.9.5.
218
Which of the following is a clinical manifestation of pre-eclampsia? A) Hypoglycemia B) Convulsions (eclampsia) C) Hypotension D) Bradycardia
B) Convulsions (eclampsia). The clinical manifestations of pre-eclampsia are identified under TLO 8.9.6.
219
What is a key management approach for severe pre-eclampsia? A) Expectant management with close monitoring B) Delivery of the fetus C) High-dose aspirin throughout pregnancy D) Fluid restriction
B) Delivery of the fetus. The management approaches to pre-eclampsia are described under TLO 8.9.7.
220
Which of the following is a serious complication associated with pre-eclampsia? A) Anemia B) Deep vein thrombosis C) HELLP syndrome D) Hypothyroidism
C) HELLP syndrome. Complications associated with pre-eclampsia are described under TLO 8.9.8.
221
What is endocarditis defined as? A) Inflammation of the outer layer of the heart B) Inflammation of the inner lining of the heart (endocardium) and heart valves C) Inflammation of the heart muscle D) Inflammation of the pericardial sac
B) Inflammation of the inner lining of the heart (endocardium) and heart valves. Endocarditis is defined and its risk factors are enumerated under TLO 9.1.1.
222
Which of the following is a common etiologic agent of infective endocarditis (IE)? A) Viruses B) Fungi C) Bacteria
particularly Staphylococcus aureus D) Parasites
223
What is a key step in the pathogenesis of infective endocarditis? A) Formation of a sterile thrombus on a damaged valve B) Direct bacterial invasion of healthy endocardium C) Autoimmune reaction against heart valves D) Genetic predisposition to valve inflammation
A) Formation of a sterile thrombus on a damaged valve. The pathogenesis of IE is described under TLO 9.1.3.
224
Which of the following is a classic clinical manifestation of infective endocarditis? A) Joint pain (arthralgia) B) Splinter hemorrhages C) Hypertension D) Bradycardia
B) Splinter hemorrhages. The clinical manifestations of IE are discussed under TLO 9.1.4.
225
Which investigation is crucial for the diagnosis of infective endocarditis
allowing visualization of vegetations on heart valves? A) ECG B) Chest X-ray C) Blood cultures D) Echocardiogram
226
What is a cornerstone of the management of infective endocarditis? A) Long-term oral corticosteroids B) High-dose intravenous antibiotics C) Immediate surgical valve replacement D) Strict fluid restriction
B) High-dose intravenous antibiotics. The management of IE is outlined under TLO 9.2.2.
227
Which of the following is a common complication of infective endocarditis? A) Renal failure B) Embolic events (e.g.
stroke) C) Hypoglycemia D) Peripheral oedema
228
Which of the following is a common etiologic agent of myocarditis? A) Bacteria B) Viruses (e.g.
Coxsackievirus) C) Fungi D) Parasites
229
What is the primary pathogenic mechanism in viral myocarditis? A) Direct bacterial invasion of myocardial cells B) Autoimmune response triggered by viral infection leading to myocardial inflammation C) Deposition of amyloid protein in the myocardium D) Ischemic injury to the heart muscle
B) Autoimmune response triggered by viral infection leading to myocardial inflammation. The pathogenesis of viral myocarditis is described under TLO 9.3.2.
230
Which of the following is a common clinical manifestation of myocarditis? A) Sharp
pleuritic chest pain relieved by sitting forward B) Symptoms of heart failure
231
Which investigation is often used to diagnose myocarditis
though it is invasive? A) ECG B) Echocardiogram C) Endomyocardial biopsy D) Chest X-ray
232
What do the Dallas criteria describe in the context of myocarditis? A) Clinical symptoms of myocarditis B) ECG findings specific to myocarditis C) Microscopic features on endomyocardial biopsy for diagnosis of myocarditis D) Treatment guidelines for myocarditis
C) Microscopic features on endomyocardial biopsy for diagnosis of myocarditis. Dallas criteria and the microscopic features of myocarditis are discussed and described under TLO 9.4.2.
233
What is a key aspect of the management of acute myocarditis
especially in severe cases? A) Aggressive immunosuppression B) Supportive care and management of heart failure symptoms C) Long-term anticoagulation D) Surgical repair of heart valves
234
What is a potential long-term complication of myocarditis? A) Complete resolution without sequelae B) Development of dilated cardiomyopathy C) Renal failure D) Hyperthyroidism
B) Development of dilated cardiomyopathy. The complications and prognosis of myocarditis are discussed under TLO 9.4.4.
235
What is pericarditis defined as? A) Inflammation of the inner lining of the heart B) Inflammation of the heart muscle C) Inflammation of the pericardial sac surrounding the heart D) Inflammation of the heart valves
C) Inflammation of the pericardial sac surrounding the heart. Pericarditis is defined and its causes are enumerated under TLO 9.5.1.
236
Which of the following is a characteristic clinical manifestation of acute pericarditis? A) Chest pain relieved by lying flat B) Sharp
pleuritic chest pain that worsens with inspiration and is relieved by sitting forward C) Crushing substernal chest pain radiating to the left arm D) Non-exertional chest pain
237
How does the chest pain of acute pericarditis typically differ from that of myocardial infarction? A) Pericarditis pain is crushing and radiates
MI pain is sharp and pleuritic. B) Pericarditis pain worsens with inspiration/lying flat
238
Which investigation is often used to diagnose pericarditis and evaluate for effusion? A) Cardiac catheterization B) Echocardiogram C) Blood culture D) Angiography
B) Echocardiogram. The investigations used and diagnostic findings of pericarditis are discussed under TLO 9.6.1.
239
What is a common initial management approach for acute viral pericarditis? A) High-dose corticosteroids B) NSAIDs and colchicine C) Emergency pericardiocentesis D) Antibiotics
B) NSAIDs and colchicine. The management of pericarditis is outlined under TLO 9.6.2.
240
Which of the following is a potential complication of pericarditis? A) Myocardial infarction B) Cardiac tamponade C) Deep vein thrombosis D) Pulmonary hypertension
B) Cardiac tamponade. The complications and prognosis of pericarditis are discussed under TLO 9.6.3.
241
What is Acute Rheumatic Fever (RF)? A) A chronic inflammatory disease affecting the heart
joints
242
What is the primary etiology of Acute Rheumatic Fever? A) Viral infection B) Unresolved Group A Streptococcus pharyngitis C) Fungal infection D) Genetic predisposition
B) Unresolved Group A Streptococcus pharyngitis. The etiology and pathogenesis of RF are discussed under TLO 9.7.2.
243
What are Aschoff bodies in the context of Rheumatic Heart Disease? A) Bacterial colonies on heart valves B) Fibrinous exudates in the pericardium C) Pathognomonic inflammatory lesions in the heart myocardium D) Calcifications in the arteries
C) Pathognomonic inflammatory lesions in the heart myocardium. The morphological features in acute RF and RHD are described under TLO 9.7.3.
244
Which of the following is a major clinical manifestation of Acute Rheumatic Fever? A) Unilateral joint pain B) Polyarthritis (migratory) C) Macular rash on the face D) Bradycardia
B) Polyarthritis (migratory). The clinical manifestations of RF and RHD are discussed under TLO 9.7.4.
245
Which of the following is a major criterion in the modified Jones criteria for the diagnosis of Acute Rheumatic Fever? A) Fever B) Arthralgia C) Carditis D) Elevated ESR
C) Carditis. Jones criteria for the diagnosis of RF are enumerated under TLO 9.8.1.
246
What is a key aspect in the diagnosis of Acute Rheumatic Fever
besides clinical criteria? A) Cardiac MRI B) Evidence of preceding Group A Streptococcus infection C) Genetic testing D) Liver function tests
247
What is the cornerstone of management for Acute Rheumatic Fever to prevent recurrent episodes and progressive heart damage? A) Long-term steroid therapy B) Penicillin prophylaxis C) Surgical valve replacement D) Anticoagulation
B) Penicillin prophylaxis. The management of RF is outlined under TLO 9.8.3.
248
Which of the following is a major complication of Acute Rheumatic Fever? A) Myocarditis B) Chronic kidney disease C) Rheumatic Heart Disease (valvular damage) D) Peripheral neuropathy
C) Rheumatic Heart Disease (valvular damage). The complications and prognosis of RF are discussed under TLO 9.8.4.
249
What is the typical origin of a cardiac myxoma? A) Ventricular wall B) Atrial septum
particularly the left atrium C) Aortic valve D) Pericardial sac
250
Which of the following is a classic clinical feature of a left atrial myxoma that can mimic valvular stenosis? A) Constant
unchanging murmur B) Symptoms that vary with body position (e.g.
251
Which diagnostic imaging modality is most effective for diagnosing cardiac myxoma? A) Chest X-ray B) ECG C) Echocardiogram D) Stress test
C) Echocardiogram. The diagnosis of myxoma is discussed under TLO 9.9.3.
252
What is the definitive treatment for a cardiac myxoma? A) Medical management with antiarrhythmics B) Radiation therapy C) Surgical excision D) Chemotherapy
C) Surgical excision. The treatment options and prognosis for myxoma are discussed under TLO 9.9.4.
253
What is Carney complex in relation to familial myxomas? A) A genetic disorder characterized by multiple myxomas and other tumors/lesions B) A specific type of myxoma found in the right ventricle C) A common complication of myxoma D) A pharmacological treatment for myxoma
A) A genetic disorder characterized by multiple myxomas and other tumors/lesions. Familial myxomas are described and the components of Carney complex are listed under TLO 9.9.5.
254
What is dilated cardiomyopathy (DCM) defined as? A) Thickening of the ventricular walls B) Dilation and impaired contraction of one or both ventricles C) Stiffening of the ventricular walls D) Replacement of myocardial tissue with fibrous tissue
B) Dilation and impaired contraction of one or both ventricles. Cardiomyopathy and dilated cardiomyopathy are defined
255
Which of the following is a functional class of cardiomyopathy? A) Ischemic B) Hypertensive C) Restrictive D) Valvular
C) Restrictive. The functional classes of cardiomyopathy are identified under TLO 10.1.2.
256
Which of the following is a common etiology of dilated cardiomyopathy (DCM)? A) Restrictive pericarditis B) Chronic hypertension C) Viral myocarditis D) Aortic stenosis
C) Viral myocarditis. The etiology of DCM is discussed under TLO 10.1.3.
257
What is a common clinical manifestation of dilated cardiomyopathy? A) Hypertrophic cardiomyopathy B) Symptoms of heart failure (e.g.
dyspnoea
258
Which diagnostic modality is crucial for confirming the diagnosis of dilated cardiomyopathy and assessing ventricular function? A) ECG B) Chest X-ray C) Echocardiogram D) Cardiac catheterization
C) Echocardiogram. The diagnosis and morphological features of DCM are discussed under TLO 10.1.5.
259
What is a key aspect of the management of dilated cardiomyopathy? A) Aggressive physical exercise B) Lifestyle modifications and guideline-directed medical therapy for heart failure C) Immediate heart transplant for all patients D) Avoidance of all medications
B) Lifestyle modifications and guideline-directed medical therapy for heart failure. The management and prognosis of DCM are outlined under TLO 10.1.6.
260
What is Hypertrophic Cardiomyopathy (HCM) defined as? A) Dilation of the ventricles with impaired systolic function B) Symmetrical thickening of the ventricular walls due to pressure overload C) Asymmetrical left ventricular hypertrophy not explained by pressure overload D) Inflammation of the pericardium
C) Asymmetrical left ventricular hypertrophy not explained by pressure overload. HCM is defined and its epidemiology is described under TLO 10.2.1.
261
What is the most common etiology of Hypertrophic Cardiomyopathy (HCM)? A) Viral infection B) Genetic mutations C) Chronic alcohol abuse D) Ischemic heart disease
B) Genetic mutations. The etiology of HCM is discussed under TLO 10.2.2.
262
Which of the following is a common clinical manifestation of Hypertrophic Cardiomyopathy? A) Severe peripheral oedema B) Sudden cardiac death
especially in young athletes C) Hypertension D) Peripheral neuropathy
263
Which diagnostic finding is characteristic of Hypertrophic Cardiomyopathy on echocardiogram? A) Dilated left ventricle B) Concentric left ventricular hypertrophy C) Asymmetrical septal hypertrophy D) Reduced ejection fraction
C) Asymmetrical septal hypertrophy. The diagnosis and morphological features of HCM are discussed under TLO 10.2.4.
264
What is a management strategy for Hypertrophic Cardiomyopathy to reduce symptoms and risk of sudden death? A) Statin therapy B) Beta-blockers or calcium channel blockers to improve diastolic filling C) Loop diuretics to reduce preload D) Vasodilators
B) Beta-blockers or calcium channel blockers to improve diastolic filling. The management and prognosis of HCM are outlined under TLO 10.2.5.
265
What is restrictive cardiomyopathy defined as? A) Dilation of the ventricles with impaired systolic function B) Thickening of the ventricular walls due to pressure overload C) Stiffening of the ventricular walls
leading to impaired diastolic filling D) Replacement of myocardial tissue with fat
266
Which of the following is an etiology of restrictive cardiomyopathy? A) Chronic alcohol abuse B) Myocardial infarction C) Amyloidosis D) Viral infection
C) Amyloidosis. The etiology of restrictive cardiomyopathy is discussed under TLO 10.3.2.
267
Which of the following is a common clinical manifestation of restrictive cardiomyopathy? A) Angina B) Signs of right-sided heart failure (e.g.
peripheral oedema
268
Which diagnostic finding on echocardiogram is suggestive of restrictive cardiomyopathy? A) Dilated ventricles with thin walls B) Significant left ventricular outflow tract obstruction C) Impaired ventricular filling with preserved ejection fraction D) Regional wall motion abnormalities
C) Impaired ventricular filling with preserved ejection fraction. The diagnosis of restrictive cardiomyopathy is discussed under TLO 10.3.4.
269
What is the management approach for restrictive cardiomyopathy? A) Aggressive medical therapy to improve contractility B) Treatment of the underlying cause (if identifiable) and symptomatic relief C) Immediate heart transplant for all patients D) Angioplasty
B) Treatment of the underlying cause (if identifiable) and symptomatic relief. The management and prognosis of restrictive cardiomyopathy are outlined under TLO 10.3.5.
270
What is Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) defined as? A) A condition where the left ventricle is primarily affected B) A genetic heart muscle disease characterized by progressive fibrofatty replacement of the right ventricular myocardium C) A type of cardiomyopathy caused by alcohol abuse D) A congenital defect leading to right ventricular outflow tract obstruction
B) A genetic heart muscle disease characterized by progressive fibrofatty replacement of the right ventricular myocardium. ARVC is defined and its epidemiology is described under TLO 10.4.1.
271
What is the primary etiology of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)? A) Viral infection B) Genetic mutations in desmosomal proteins C) Chronic hypertension D) Ischemic heart disease
B) Genetic mutations in desmosomal proteins. The etiology of ARVC is discussed under TLO 10.4.2.
272
Which of the following is a common clinical manifestation of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)? A) Left ventricular hypertrophy B) Ventricular arrhythmias
especially from the right ventricle C) Aortic stenosis D) Mitral regurgitation
273
Which diagnostic finding is suggestive of ARVC on ECG? A) Q waves in inferior leads B) Epsilon wave (small positive deflection at the end of the QRS in V1-V3) C) Left axis deviation D) Short PR interval
B) Epsilon wave (small positive deflection at the end of the QRS in V1-V3). The diagnosis and morphological features of ARVC are discussed under TLO 10.4.4.
274
What is a key aspect of the management of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) to prevent sudden cardiac death? A) Aggressive anti-hypertensive therapy B) Implantable cardioverter-defibrillator (ICD) C) Long-term anticoagulant therapy D) Dietary changes only
B) Implantable cardioverter-defibrillator (ICD). The management and prognosis of ARVC are outlined under TLO 10.4.5.
275
What is pericardial effusion defined as? A) Inflammation of the pericardium B) Accumulation of fluid in the pericardial sac C) Thickening of the pericardium D) Infection of the pericardium
B) Accumulation of fluid in the pericardial sac. Pericardial effusion is defined and its causes are enumerated under TLO 10.5.1.
276
Which of the following is a common clinical manifestation of a large pericardial effusion? A) Sharp
pleuritic chest pain B) Muffled heart sounds and signs of cardiac compression C) Hypertension D) Bounding pulses
277
Which diagnostic modality is essential for identifying and quantifying pericardial effusion? A) ECG B) Chest X-ray C) Echocardiogram D) Cardiac CT
C) Echocardiogram. The diagnosis of pericardial effusion is discussed under TLO 10.5.3.
278
What is the management approach for a small
asymptomatic pericardial effusion? A) Urgent pericardiocentesis B) Close observation and treatment of the underlying cause C) Immediate surgical drainage D) Aggressive diuretic therapy
279
Which of the following is a potential complication of pericardial effusion? A) Myocarditis B) Cardiac tamponade C) Aortic dissection D) Pulmonary embolism
B) Cardiac tamponade. The complications and prognosis of pericardial effusion are discussed under TLO 10.5.5.
280
What is cardiac tamponade defined as? A) Inflammation of the heart muscle B) Compression of the heart due to accumulation of fluid in the pericardial sac
impairing cardiac filling C) A severe form of pericarditis D) Dilation of the heart chambers
281
What is a key hemodynamic change observed in cardiac tamponade? A) Increased cardiac output B) Increased central venous pressure and decreased arterial blood pressure C) Decreased central venous pressure D) Increased ventricular filling
B) Increased central venous pressure and decreased arterial blood pressure. Hemodynamic changes in cardiac tamponade are discussed under TLO 10.6.2.
282
Which of the following is a clinical feature of cardiac tamponade (Beck's Triad)? A) Hypertension
bradycardia
283
How do symptoms of a rapidly accumulating effusion differ from a slowly accumulating effusion leading to tamponade? A) Rapidly accumulating effusions cause more acute and severe symptoms of cardiac compression. B) Slowly accumulating effusions cause more acute symptoms. C) Symptoms are always the same regardless of accumulation rate. D) Rapidly accumulating effusions are always asymptomatic.
A) Rapidly accumulating effusions cause more acute and severe symptoms of cardiac compression. The distinction between symptoms of rapidly accumulating and slowly accumulating effusion is discussed under TLO 10.6.3.
284
What is pericardiocentesis? A) Surgical removal of the pericardium B) Puncture of the pericardial sac to drain fluid C) Administration of medication into the pericardial sac D) Imaging technique to visualize the pericardium
B) Puncture of the pericardial sac to drain fluid. Pericardiocentesis is described and the prognosis of cardiac tamponade is discussed under TLO 10.6.4.
285
What is constrictive pericarditis defined as? A) Acute inflammation of the pericardium B) Fluid accumulation in the pericardial sac C) Thickening and rigidity of the pericardium
impairing diastolic filling D) A congenital absence of the pericardium
286
Which of the following is a common clinical manifestation of constrictive pericarditis? A) Pulsus paradoxus B) Kussmaul's sign (paradoxical rise in JVP with inspiration) C) Left ventricular hypertrophy D) Acute chest pain
B) Kussmaul's sign (paradoxical rise in JVP with inspiration). The clinical manifestations of constrictive pericarditis are discussed under TLO 10.7.2.
287
Which diagnostic finding on echocardiogram is often seen in constrictive pericarditis? A) Dilated ventricles B) Normal pericardial thickness C) Flattened diastolic ventricular septal wall motion D) Increased ventricular contractility
C) Flattened diastolic ventricular septal wall motion. The diagnosis of constrictive pericarditis is discussed under TLO 10.7.3.
288
How does constrictive pericarditis differ from restrictive cardiomyopathy in terms of the heart's pathology? A) Constrictive pericarditis involves myocardial stiffness
while restrictive cardiomyopathy involves pericardial stiffness. B) Constrictive pericarditis is primarily a pericardial disease
289
What is the definitive treatment for severe constrictive pericarditis? A) Medical management with diuretics B) Pericardiectomy (surgical removal of the pericardium) C) Long-term anti-inflammatory drugs D) Heart transplant
B) Pericardiectomy (surgical removal of the pericardium). The management of constrictive pericarditis is outlined under TLO 10.7.5.
290
What is peripheral vascular disease (PVD)? A) Disease affecting the arteries of the heart B) Disease affecting blood vessels outside of the heart and brain C) Disease affecting the veins only D) Disease affecting the lymphatic system
B) Disease affecting blood vessels outside of the heart and brain. Peripheral vascular disease and acute limb ischemia are defined under TLO 11.1.1.
291
Which of the following is a common cause of acute limb ischemia? A) Gradual narrowing of arteries B) Arterial embolism C) Venous insufficiency D) Vasculitis
B) Arterial embolism. The causes and clinical manifestations of acute limb ischemia are listed and discussed under TLO 11.1.2.
292
What is a critical component in the immediate management of acute limb ischemia? A) Long-term antiplatelet therapy B) Revascularization to restore blood flow C) Compression stockings D) Exercise therapy
B) Revascularization to restore blood flow. The diagnosis and management of acute limb ischemia are discussed under TLO 11.1.3.
293
What is a common clinical manifestation of chronic lower limb ischemia? A) Sudden
severe pain B) Intermittent claudication (leg pain with exercise
294
Which of the following is a key aspect of the management of chronic limb ischemia? A) Immediate surgical bypass for all patients B) Smoking cessation and exercise therapy C) High-dose anticoagulation D) Restrictive footwear
B) Smoking cessation and exercise therapy. The diagnosis and management of chronic limb ischemia are discussed under TLO 11.1.5.
295
What is Aortic Dissection (AD)? A) A localized dilation of the aorta B) A tear in the inner layer of the aorta
allowing blood to flow between the layers C) Inflammation of the aortic wall D) A complete blockage of the aorta
296
Which of the following is a significant risk factor for aortic dissection? A) Hypotension B) Marfan syndrome C) Low cholesterol D) Regular exercise
B) Marfan syndrome. The risk factors and role of cystic medial degeneration in AD are enumerated and discussed under TLO 11.2.2.
297
Which classification system for aortic dissection divides dissections based on involvement of the ascending aorta? A) New York Heart Association (NYHA) classification B) Stanford classification (Type A and Type B) C) Well's criteria D) Duke criteria
B) Stanford classification (Type A and Type B). The Stanford and DeBakey classification of AD are discussed under TLO 11.2.3.
298
What is a classic clinical manifestation of aortic dissection? A) Gradual onset of dull chest pain B) Sudden
severe tearing or ripping pain in the chest or back C) Pain relieved by leaning forward D) Pain worsening with exertion
299
What is the definitive diagnostic imaging modality for aortic dissection? A) Chest X-ray B) ECG C) CT angiography of the aorta D) Echocardiogram
C) CT angiography of the aorta. The diagnosis and management of AD are discussed and outlined under TLO 11.2.5.
300
What is an aneurysm defined as? A) A blood clot within a blood vessel B) A localized
abnormal dilation of a blood vessel or the heart C) A tear in the wall of a blood vessel D) An inflammation of a blood vessel
301
Which of the following is a classification of aneurysm based on its morphology? A) Dissecting aneurysm B) Fusiform aneurysm C) Ruptured aneurysm D) Symptomatic aneurysm
B) Fusiform aneurysm. The classification of aneurysm and the pathogenesis of aortic aneurysm are discussed under TLO 11.3.2.
302
What is a common clinical manifestation of an abdominal aortic aneurysm (AAA)? A) Acute
severe abdominal pain B) Pulsatile mass in the abdomen C) Peripheral oedema D) Cyanosis
303
What is a key aspect of managing an asymptomatic
small abdominal aortic aneurysm? A) Immediate surgical repair B) Regular surveillance with imaging C) Long-term anticoagulation D) High-dose steroids
304
What are varicose veins defined as? A) Arteries that have become abnormally dilated B) Superficial veins that have become abnormally dilated and tortuous C) Deep veins that are inflamed D) Small capillaries that have ruptured
B) Superficial veins that have become abnormally dilated and tortuous. Varicose veins are defined under TLO 11.4.1.
305
What is a primary pathogenic factor contributing to varicose veins? A) Arterial hypertension B) Valvular incompetence in superficial veins C) Deep vein thrombosis D) Arterial spasm
B) Valvular incompetence in superficial veins. The pathogenesis and clinical manifestations of varicose veins are discussed under TLO 11.4.2.
306
Which investigation is suitable for identifying venous reflux and confirming the diagnosis of varicose veins? A) Arterial duplex ultrasound B) Venous duplex ultrasound C) CT angiography D) MRI
B) Venous duplex ultrasound. Suitable investigations and diagnostic findings for varicose veins are identified under TLO 11.4.4.
307
What is a common management approach for symptomatic varicose veins? A) Arterial bypass surgery B) Compression therapy and elevation C) Immediate amputation D) Systemic antibiotic therapy
B) Compression therapy and elevation. The management
308
What is the primary pathogenesis of Deep Venous Thrombosis (DVT)? A) Arterial narrowing B) Virchow's triad (venous stasis
endothelial injury
309
Which investigation is the gold standard for diagnosing Deep Venous Thrombosis (DVT)? A) D-dimer test B) Venous duplex ultrasound C) Arteriogram D) ECG
B) Venous duplex ultrasound. Suitable investigations and diagnostic findings for DVT are identified under TLO 11.5.2.
310
What is a key aspect of the management of DVT? A) Compression stockings only B) Anticoagulation to prevent clot extension and embolism C) Immediate surgical thrombectomy for all DVTs D) High-dose aspirin as sole therapy
B) Anticoagulation to prevent clot extension and embolism. The management
311
What is chronic venous insufficiency? A) A condition where arteries are narrowed B) A condition resulting from incompetent venous valves
leading to sustained venous hypertension C) An acute inflammation of deep veins D) A blockage of the lymphatic system
312
Which of the following is a common clinical manifestation of chronic venous insufficiency? A) Acute limb pain B) Skin changes such as hyperpigmentation
lipodermatosclerosis
313
Which investigation is most useful for diagnosing and assessing the severity of chronic venous insufficiency? A) Arterial Doppler B) Venous duplex ultrasound C) Angiography D) CT scan
B) Venous duplex ultrasound. Suitable investigations and diagnostic findings for chronic venous insufficiency are identified under TLO 11.6.3.
314
What is a cornerstone of the management of chronic venous insufficiency? A) Surgical vein stripping for all patients B) Compression therapy and elevation C) Long-term antibiotic therapy D) Arterial bypass surgery
B) Compression therapy and elevation. The management
315
What is vasculitis defined as? A) Inflammation of lymphatic vessels B) Inflammation of the heart chambers C) Inflammation of blood vessel walls D) Inflammation of nerves
C) Inflammation of blood vessel walls. Vasculitis is defined under TLO 11.7.1.
316
Which of the following is a type of large-vessel vasculitis? A) Polyarteritis nodosa B) Granulomatosis with polyangiitis (Wegener's) C) Giant cell arteritis D) Leukocytoclastic vasculitis
C) Giant cell arteritis. Different types of vasculitis are identified under TLO 11.7.2.
317
Which of the following describes a pathogenic mechanism for non-infectious vasculitis? A) Direct bacterial invasion of the vessel wall B) Immune complex deposition in the vessel wall C) Fungal infection causing vessel wall destruction D) Parasitic infestation of the blood vessels
B) Immune complex deposition in the vessel wall. The different pathogenic mechanisms to develop vasculitis are discussed under TLO 11.7.3.
318
Which of the following is a common clinical manifestation of vasculitis? A) Hypoglycemia B) Palpable purpura or skin lesions C) Bradycardia D) Increased bone density
B) Palpable purpura or skin lesions. The clinical manifestations of vasculitis are described under TLO 11.7.4.
319
Which diagnostic tool is often used to confirm the diagnosis of vasculitis? A) ECG B) Blood pressure measurement C) Biopsy of affected tissue D) Auscultation
C) Biopsy of affected tissue. The diagnosis and management of vasculitis are discussed and outlined under TLO 11.7.5.
