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Flashcards in Samplex 2014 Set A Deck (34)
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1

This type of congenital heart disease is usually seen in patients with congenital rubella syndrome:

a. PDA
b. ASD
c. VSD
d. Lutembacher’s syndrome

A

2

Common atrioventricular septal defect is usually seen in patients with:

a. Congenital rubella syndrome
b. Trisomy 21
c. Eisenmengerization syndrome
d. Marfan’s syndrome

B

3

A 22/M consults at your clinic with typical Marfanoid habitus. The following classical findings are usually seen in patients with Marfan’s syndrome except:

a. Arm span longer than the height of the patient
b. Lens dislocation
c. PDA
d. Aortic insufficiency

C

4

The following are components of Pentalogy of Fallot except:

a. Right ventricular outflow tract obstruction
b. Right ventricular hypertrophy
c. Anomalous pulmonary venous return
d. ASD
e. VSD
f. Overriding aorta

C

5

The 3rd trimester and the period immediately prior to labor are the most crucial periods among pregnant women with cardiac conditions because of a number of physiologic alterations during these times. The following parameters are increased during the 3rd trimester of pregnancy except:

a. Total blood volume
b. Peripheral vascular resistance
c. Stroke volume
d. Diastolic BP
e. B only
f. B and D

F

6

The following are correctly paired except

a. Definite IE: 2 major criteria, 1major and 2 minor criteria, 5 minor criteria of Dukes criteria
b. Definite IE: cultures of peripheral emboli consistent with organisms implicated on IE
c. Probable IE: 1 major and 1 minor criteria, 3 minor criteria
d. Rejected IE: alternative diagnosis more likely, histopathology and cultures of vegetation/emboli not consistent with endocarditis
e. Rejected IE: fever lyses 3-4 days antibiotic therapy

A

7

The most common cause of prosthetic valve IE

D

8

What is the most common predisposing condition for native valve endocarditis?

a. Congenital heart disease
b. Mitral valce prolapsed
c. RHD
d. IV drug use

C

9

Which among these patients should receive IE prophylaxis?

a. Patients with MVP undergoing diagnostic bronchoscopy
b. Patient with unrepaired cyanotic heart disease undergoing dental extraction
c. Patient with isolated secundum ASD for esophagogastroduodenoscopy
d. Patient with cardiac pacemaker for colonoscopy

B

10

The following can be considered as minor criteria in the diagnosis of IE except:

a. Predisposing heart condition
b. IV drug use
c. Janeway lesions
d. Oslers nodes
e. Fever>38.2
f. Glomerulonephritis

E

11

What is the hallmark of mitral stenosis on 2D echo?

A. Commisural fusion of the mitral leaflets
B. Anterior doming motion of the anterior leaflet on diastole
C. Mean gradient of greater than 5 mm Hg
D. Calcified mitral leaflets

A

12

Differentials for diastolic murmur heard at apex?

A. Tricuspid stenosis
B. Austin-flint murmur
C. Mitral stenosis
D. tumor plop

C

13

What happens to the click of mitral valve prolapse when a patient inhales?

A. It increases in intensity
B. It decreases in intensity
C. It occurs earlier
D. It occurs later

C

14

Which of the following pathological finding would you expect in a patient with aortic stenosis?

a. Left ventricular dilatation
b. Left ventricular hypertrophy
c. Dilated left atrium
d. Multiple chamber dilatation

B

15

Which of the following is most commonly affected in RHD?

A. mitral valve
B. Aortic valve
C. tricuspid valve
D. Pulmonary valve

A

16

If your patient has atrial fibrillation, what heart sound would you not expect to hear?

a. S1
b. S2
c. S3
d. S4

D

17

Upon inhalation, you would expect the splitting of S2 to

A. remain the same
B. widen
C. narrow
D. who cares

B

18

What physiologic maneuver would increase venous return?

A. standing
B. valsalva
C. squatting
D. isometric hand grip

C

19

Which valvular lesion is notorious to have the largest hearts?

A. Aortic regurgitation
B. Aortic stenosis
C. Mitral stenosis
D. Mitral regurgitation

A

20

The following heart sounds are systolic, except?

A. Mitral valve prolapse click
B. Opening snap
C. Aortic stenosis murmur
D. Mitral regurgitation murmur

B

21

A 55/F with hypertension & diabetes with shortness of breath with minimal exertion is in what stage of heart failure?

A. Stage A
B. Stage B
C. Stage C
D. Stage D

D

22

On precordial palpatio, there was note of thrill at the level of the 4th ICS LPSB with a systolic murmur that is increased with inspiration. This is consistent with

a. grade 5/6 TR
b. grade 4/6 TR
c. grade 4/6 TS
d. grade 4/6 AR

B

23

A 10 year old female consulted for weakness and respiratory distress. She had fever 2 weeks ago with associated knee pains. 1 week ago, she had body malaise, palpitation and pallor. 3 days ago, she had poor appetite with dyspnea. PE on admission: HR 140, RR 24, T 37.8C. Pale, mild cardiorespiratory distress, adynamic precordium, muffled heart sounds, tachycardic, regulatr rhythm, soft systolic murmur at the apex, no hepatomegaly, good pulses and fair perfusion, inflamed right knee. What is your diagnosis?

a. acute rheumatic fever with carditis
b. acute rheumatic fever with carditis and arthritis
c. RHD with MR
d. viral myocarditis

B

24

CXR done revealed cardiomegaly and pulmonary congestion. What is the classification of carditis?

a. no carditis
b. mild carditis
c. moderate carditis
d. severe carditis

D

25

9 month old girl with tachypnea, excessive sweating, and feeding intolerance was found to have 45 XO chromosomes. Her BP was 130/80 on the R arm and she had a grade 3/6 systolic ejection murmur at the left parasternal border. Her popliteal pulses were weak. An echocardiogram would most likely reveal:

a. AS
b. ASD
c. CoA
d. TOF

C

26

5/M was brought to the emergency room for respiratory distress. She had high grade fever for 4 days with cough, colds, and progressive dyspnea. PE on admission: HR 160, RR 42, awake but weak, harsh breath sounds, adynamic precordium, no heave or thrill, soft heart sounds but tachycardic, no murmur, liver 5cm below right costal margin. CXR showed cardiomegaly. Which of the following heart disease is not a differential diagnosis?

a. Acute pericarditis
b. Dilated cardiomyopathy
c. Infective endocarditis
d. Myocarditis

C

27

In VSD, the presence of heart failure is due to the following except:

a. location or type of VSD
b. pulmonary vascular resistance
c. size of the defect
d. weight of the patient

D

28

56/M, hypertensive, smoker, with mild chest heaviness noted to occur every time he climbs 2 flights of stairs, relieved after a few minutes of resting.

A. Typical angina
B. Atypigal angina
C. Gastroesophageal reflux
D. Pleuritic pain
E. Musculoskeletal pain

A

29

Enumerate the 4 major risk factors in the development of coronary artery diseases.

Answer: SEX-HDL

Smoking
Eating (Overeating or Obesity)
eXercise (lack of)
Hypertension
Diabetes
hyperLipidemia

30

The following are cardinal manifestations of aortic stenosis except:

A. Syncope
B. Dyspnea
C. Chest pain
D. Edema

D