Internal Medicine/ Cardiology


·      Cardiology OXF.

                                                                           I.            Common Cardiac Presentations.

1.    Chest Pain.
***) Young medical student complains of chest pain, palpitation, dyspnea, and feeling of impending death. The symptoms occur every time when he is studying. The most likely diagnosis is: Q2012
A.    Conversion disorder
B.     Panic attack
C.     Somatoform disorder
D.    Hypochondriasis
E.     Syncope

Answer: B* Panic attack

***) All of the following can cause chest pain, except:
A.    Angina
B.     Myocardial infarction
C.     Hypertrophic cardiomyopathy
D.    Pericarditis
E.     Dissecting aortic aneurysm

Answer: C* Hypertrophic cardiomyopathy

2.    Syncope.
***) Which of the following is classical feature of cardiac syncope:
A.    Gradual onset
B.     Warning symptoms
C.     Rapid recovery
D.    Residual neurological deficit
E.     Precipitated by sudden turning of the head

Answer: C* Rapid recovery

3.    Postural Hypotension.
***) All of the following are causes of postural hypotension, except:
A.    Diabetes
B.     Hypovolemia
C.     Prolonged bed rest
D.    Addison's disease
E.     Hyperthyroidism

Answer: E* Hyperthyroidism

4.    Pulses.
***) Collapsing pulse is found in all of the following, except:
A.    Aortic regurgitation
B.     Patent ductus arteriosus
C.     Mitral stenosis
D.    Pregnancy
E.     Anemia

Answer: C* Mitral stenosis

5.    Heart Murmurs.
***) One of the following can cause pansystolic murmur: Q2012
A.    Coarctation of the aorta
B.     Aortic regurgitation
C.     Mitral regurgitation
D.    Atrial septal defect
E.     Aortic stenosis

Answer: C* Mitral regurgitation

***) Diastolic murmur occurs in all of the following conditions, except:
A.    Mitral stenosis
B.     Aortic stenosis
C.     Austin Flint murmur
D.    Graham-Steel murmur
E.     Aortic regurgitation

Answer: B* Aortic stenosis

***) All of the following can cause systolic murmur, except:
A.    Aortic regurgitation
B.     Aortic stenosis
C.     Pulmonary stenosis
D.    Ventricular septal defect
E.     Mitral regurgitation

Answer: A* Aortic regurgitation

6.    Cardiac Arrest.
***) In cardiac arrest all of the following drugs may be used, except:
A.    Adrenaline
B.     Neostigmine
C.     Calcium chloride
D.    Isoprenaline
E.     Lignocaine

Answer: B* Neostigmine

                                                                                                 II.            Cardiac Investigations.

1.    ECG Abnormalities.
***) All of the following are causes of sinus tachycardia, except:
A.    Fever
B.     Hypothyroidism
C.     Pregnancy
D.    Anemia
E.     Cardiac failure

Answer: B* Hypothyroidism

***) All of the following may cause bradycardia, except:
A.    Myxedema
B.     Atenolol
C.     Raised intracranial pressure
D.    Jaundice
E.     Salbutamol

Answer: E* Salbutamol

***) Bradycardia can be caused by all of the following, except:
A.    Digoxin
B.     Obstructive jaundice
C.     Anticholinergic drug
D.    Hypothyroidism
E.     Heart block

Answer: C* Anticholinergic drug

***) The characteristic ECG finding in ventricular aneurysm is:
A.    Persistent ST depression
B.     Left bundle branch block
C.     Lack of Q waves
D.    First degree AV Block
E.     Persistent ST elevation

Answer: E* Persistent ST elevation

2.    ECG Additional Points.
***) Concerning right ventricular hypertrophy all are true, except:
A.    It is a characteristic feature of transposition of great vessels
B.     It is a characteristic feature of tetralogy of Fallot
C.     It is a characteristic feature of tricuspid atresia
D.    It is diagnosed when R in V1 exceeds 20mm
E.     It is associated with plethoric lung fields

Answer: C* It is a characteristic feature of tricuspid atresia

3.    Exercise ECG Test.
***) All of the following are contraindications of exercise electrocardiography, except:
A.    Recent myocardial infarction
B.     Unstable angina
C.     Diagnosis of chest pain
D.    Uncompensated heart failure
E.     Malignant hypertension

Answer: C* Diagnosis of chest pain

4.    Cardiac Anatomy.
***) The heart chamber that is situated most posterior is the:
A.    Right atrium
B.     Right ventricle
C.     Left atrium
D.    Left ventricle
E.     A+D

Answer: C* Left atrium

                                                                                             III.            Cardiovascular Drugs.

1.    Beta-blockers.
***) Indications for the use of Beta-blockers include all of the following, except:
A.    Hypothyroidism
B.     Angina
C.     Hypertension
D.    After myocardial infarction
E.     Congestive heart failure

Answer: A* Hypothyroidism

***) Indications for the use of Beta-blockers include all of the following, except:
A.    Hypertension
B.     Ischemic heart disease
C.     Migraine
D.    Bronchial asthma
E.     Anxiety

Answer: D* Bronchial asthma

***) Side effects of propranolol include all of the following, except:
A.    Cold extremities
B.     Depression
C.     Nightmares
D.    Bronchospasm
E.     Tremors

Answer: E* Tremors

2.    Digoxin.
***) The treatment of digitalis-induced arrhythmia may include all of the following, except:
A.    Withdrawal of digitalis
B.     Phenytoin administration
C.     Calcium gluconate administration
D.    Potassium supplements
E.     Xylocaine administration

Answer: C* Calcium gluconate administration


***) All of the following are side effects of digoxin therapy, except:
A.    Nausea and vomiting
B.     Yellow vision
C.     AV block
D.    Ventricular extrasystole
E.     Insomnia

Answer: E* Insomnia

3.    ACE inhibitors.
***) All of the following are side effects of ACE-inhibitors, except: Q2012
A.    Hypokalemia
B.     Angioneurotic edema
C.     Hyperkalemia
D.    Dry cough
E.     Hypotension

Answer: A* Hypokalemia

                                                               IV.            Cardiac Diseases and Conditions.

1.    Angina Pectoris.
***) A 65 year old male, presented complaining of retrosternal chest pain of 4 months duration, the pain precipitated with walking uphill, last 5 minutes, relieved with rest. Clinical examination was normal, and electrocardiogram was normal sinus rhythm. The most likely diagnosis is:
A.    Stable angina pectoris
B.     Unstable angina
C.     Chronic pericarditis
D.    Musculoskeletal
E.     Reflux esophagitis

Answer: A* Stable angina pectoris

***) Which of the following drug is useful in the treatment of angina pectoris:
A.    Salbutamol
B.     Propranolol
C.     Digoxin
D.    Quinidine
E.     Phenytoin

Answer: B* Propranolol

2.    Acute Coronary Syndrome (ACS).
***) 50 years old male presented with 1 hour retrosternal chest pain, BP 85/62, JVP is 10 cm, ECG shows 3 mm ST elevation in II, III, aVF and ST depression in V1, V4, and troponin is positive. The most likely diagnosis is: Q2012
A.    Unstable angina
B.     Stable angina
C.     Anterior wall MI
D.    Inferior wall and right ventricular MI
E.     Stroke

Answer: D* Inferior wall and right ventricular MI

***) All the following can cause false positive troponin except: Q2012
A.    Septic shock
B.     Pulmonary embolism
C.     Pulmonary edema
D.    Uncontrolled HTN
E.     Renal failure

Answer: D* Uncontrolled HTN

***) All the following can cause increased in troponin except: Q2012
A.    Pulmonary edema
B.     MI
C.     Pneumonia
D.    Congestive heart failure
E.     Myocarditis

Answer: C* Pneumonia

***) All the following are features of metabolic syndrome except: Q2012
A.    BP over than 135/85
B.     LDL over than 160
C.     FBS over than 110
D.    HDL less than 50 in females
E.     Waist circumference over than 40 inches in males

Answer: B* LDL over than 160

***) Risk factors for ischemic heart disease include all the following, except:
A.    Hypertension
B.     Smoking
C.     Obesity
D.    High cholesterol level
E.     High level of high density lipoproteins (HDL)

Answer: E* High level of high density lipoproteins (HDL)

***) Risk factors for ischemic heart disease include all the following, except:
A.    Excessive exercise
B.     Positive family history
C.     Cigarette smoking
D.    Hypertension
E.     Hyperlipidemia

Answer: A* Excessive exercise

***) Major risk factors for coronary artery disease include all the following except:
A.    Hypertension
B.     Smoking
C.     Male sex
D.    Elevated low density lipoprotein level (LDL)
E.     Elevated high density lipoprotein level (HDL)

Answer: E* Elevated high density lipoprotein level (HDL)

***) All of the following are risk factors for coronary artery disease, except:
A.    Hyperlipoproteinemia
B.     Diabetes mellitus
C.     Hypertension
D.    Obesity
E.     Diet rich in polyunsaturated fats

Answer: E* Diet rich in polyunsaturated fats

***) The prognosis of myocardial infarction is adversely affected by all of the following, except:
A.    Diabetes mellitus
B.     Left ventricular failure
C.     Syncope
D.    Advancing age
E.     Nausea and vomiting

Answer: E* Nausea and vomiting

***) All of the followings are true regarding chest pain of myocardial infarction, except:
A.    Duration more than 30 minutes
B.     Associated with nausea
C.     Relieved with sublingual nitrate
D.    Not related to breathing
E.     Left shoulder radiation

Answer: D* Not related to breathing

***) In acute myocardial infarction, all are true except:
A.    Can be silent
B.     Can lead to heart failure
C.     May result in sudden death
D.    Always treated conservatively
E.     Pain relief is of utmost importance

Answer: D* Always treated conservatively

***) In myocardial infarction the following serum enzyme rises latest and remains elevated for the longest period:
A.    SGOT
B.     LDH
C.     Alkaline phosphatase
D.    CPK
E.     Acid phosphatase

Answer: B* LDH

3.    Management of Acute Coronary Syndrome.
***) 60 years old male presented with chest pain, ECG shows ST elevation in V1 V6, BP 165/95. The patient has an episode of upper GI bleeding 6 months ago, and the nearest cath lab is 2 hours away. Best next step: Q2012
A.    Send him to cath lab immediately
B.     Give him thrombolytic, because there is no contraindication
C.     Don’t give him thrombolytic due to recent bleeding
D.    Don’t give him thrombolytic due to high BP and recent bleeding
E.     Don’t give him thrombolytic due to high BP

Answer: B* Give him thrombolytic, because there is no contraindication

***) All of the following about myocardial infarction are true, except:
A.    May present with pulmonary edema
B.     Streptokinase is used in management
C.     Morphine is helpful
D.    Captopril is contraindicated
E.     Arrhythmias are the commonest cause of death in the first hour

Answer: D* Captopril is contraindicated

***) The management of unstable angina includes all of the following, except:
A.    Aspirin
B.     Anticoagulants
C.     Digoxin
D.    Nitrates
E.     Beta blockers

Answer: C* Digoxin

***) All of the following are used in the treatment of acute myocardial infarction, except:
A.    Morphine
B.     Streptokinase
C.     Nitroglycerin
D.    Aspirin
E.     Salbutamol

Answer: E* Salbutamol

4.    Complications of Myocardial Infarction.
***) All of the followings are complications of myocardial infarction, except: Q2012
A.    Rupture chorda tendeni
B.     Mitral regurgitation
C.     DVT
D.    Pericarditis
E.     Recurrent laryngeal nerve palsy

Answer: E* Recurrent laryngeal nerve palsy

***) All of the followings are complications of myocardial infarction, except:
A.    Atrial fibrillation
B.     Heart failure
C.     Systemic embolization
D.    Endocarditis
E.     Papillary muscle rupture

Answer: D* Endocarditis

***) Myocardial rupture as a complication of myocardial infarction is most likely to occur during the:
A.    1st Week
B.     2nd Week
C.     3rd Week
D.    4th Week
E.     5th Week

Answer: A*1st Week

5.    Arrhythmias.
***) Patient known to have Wolff-Parkinson-White (WPW) syndrome presented with atrial fibrillation, stable vitals. The best management is: Q2012
A.    Verapamil IV
B.     Digoxin IV
C.     DC shock
D.    Amiodarone IV
E.     Diltiazem IV

Answer: D* Amiodarone IV

***) 50 years old male asthmatic presented with palpitations, BP 130/85, ECG showed narrow QRS complex, regular, absent P wave. The best management is: Q2012
A.    Propranolol IV
B.     Diltiazem IV
C.     Adenosine IV
D.    DC shock
E.     Amiodarone IV

Answer: B* Diltiazem IV

***) All the followings are antiarrhythmics drugs, except: Q2012
A.    Xylocaine
B.     Terbutaline
C.     Quinidine
D.    Amiodarone
E.     Procainamide

Answer: B* Terbutaline

***) Electrical cardioversion is a useful mode of therapy in each of the following, except:
A.    Ventricular tachycardia
B.     Ventricular fibrillation
C.     Bradycardia due to hypothyroidism
D.    Atrial fibrillation
E.     Atrial flutter

Answer: C* Bradycardia due to hypothyroidism

6.    Narrow Complex Tachycardia.
***) Each of the following may be useful in the treatment of paroxysmal supraventricular tachycardia, except:
A.    Atropine
B.     Digitalis
C.     Beta-blockers
D.    Verapamil
E.     Carotid sinus massage

Answer: A* Atropine

7.    Broad Complex Tachycardia.
***) All of the following drugs may be used in the treatment of acute ventricular tachycardia, except:
A.    Digoxin
B.     Lignocaine
C.     Procainamide
D.    Flecainide
E.     Bretylium

Answer: A* Digoxin

***) All of the following drugs may be used to treat ventricular tachycardia, except:
A.    Lignocaine
B.     Amiodarone
C.     Verapamil
D.    Phenytoin
E.     Procainamide

Answer: C* Verapamil

***) Recognized causes of ventricular extrasystoles include all of the following, except:
A.    Hypokalemia
B.     Beta blockers drugs
C.     Digitalis
D.    Quinidine
E.     Tricyclic antidepressants

Answer: D* Quinidine

8.    Atrial Fibrillation.
***) All of the following are causes of atrial fibrillation, except:
A.    Ischemic heart disease
B.     Rheumatic heart disease
C.     Digitalis
D.    Thyrotoxicosis
E.     Pneumonia

Answer: C* Digitalis

9.    Heart Failure.
***) All of the following are features of left ventricular failure, except:
A.    Orthopnea
B.     Peripheral edema
C.     Pulsus alternans
D.    Bilateral basal crepitations
E.     Kerley B lines on chest X-ray

Answer: B* Peripheral edema

***) Signs of left ventricular failure include all of the following, except:
A.    Third heart sound
B.     Triple rhythm
C.     Pulsus alternans
D.    Bilateral basal crepitation
E.     Gross liver enlargement

Answer: E* Gross liver enlargement

***) Signs of left heart failure include all of the following, except:
A.    Gallop rhythm
B.     Basal crepitation
C.     Pulsus alternans
D.    Hepatomegaly
E.     Displaced and sustained apical impulse

Answer: D* Hepatomegaly

***) A 50 years old male who was seen in the casualty complained of sudden onset severe left anterior chest pain radiating to the left arm. It was not relieved by sublingual nitrates. He was short of breath; frothy blood was coming out of his mouth. He was hypotensive, cold, cyanotic and profusely sweating. There were diffuse bilateral wheezes and basal crepitations on chest examination. The heart sounds were soft and there was third heart sound, but there were no murmurs. Patient suffering from:
A.    Acute bronchial asthma
B.     Angina pectoris with acute bronchial asthma
C.     Acute pulmonary edema secondary to myocardial infarction
D.    Acute viral pneumonia with pleuritic chest pain
E.     Dissecting aneurysm

Answer: C* Acute pulmonary edema secondary to myocardial infarction

***) Crepitations which are late inspiratory and unchanged with cough are typical of: Q2012
A.    Pneumonia
B.     Lung fibrosis
C.     Pleural effusion
D.    Pulmonary edema
E.     Subcutaneous emphysema

Answer: D* Pulmonary edema

***) Pulmonary edema may complicate all of the following, except:
A.    Diuretic therapy
B.     Rapid withdrawal of air from pleural cavity
C.     Bums
D.    Radiotherapy of the chest
E.     Septicemia

Answer: A* Diuretic therapy

***) Pulmonary edema is caused by all except:
A.    Fallot Tetralogy
B.     Acute glomerulonephritis
C.     Aspiration of hydrocarbons
D.    Left to right shunt
E.     Hypervolemia

Answer: E* Hypervolemia

10.           Management of Heart Failure.
***) The following drugs are used in the treatment of congestive cardiac failure, except:
A.    Captopril
B.     Morphine
C.     Chlorothiazide
D.    Bumetanide
E.     Digoxin

Answer: B* Morphine

11.           Hypertension.
***) Causes of secondary hypertension include all of the following, except: Q2012
A.    Renal artery stenosis
B.     Crohn's disease
C.     Cushing's syndrome
D.    Polycystic kidney disease
E.     Primary hyperaldosteronism

Answer: B* Crohn's disease

***) One of the following is not antihypertensive drug: Q2012
A.    Atenolol
B.     Lisinopril
C.     Simvastatin
D.    Candesartan
E.     Amlodipine

Answer: C* Simvastatin

***) Uncontrolled hypertension increases risk of all of the following, except:
A.    Early death
B.     Myocardial infarction
C.     Pulmonary embolism
D.    Cerebral hemorrhage
E.     Confusion state

Answer: C* Pulmonary embolism

***) Causes of secondary hypertension include all of the following, except:
A.    Addison's disease
B.     Renal artery stenosis
C.     Primary hyperaldosteronism
D.    Coarctation of aorta
E.     Acromegaly

Answer: A* Addison's disease

***) All of the following are causes of endocrine hypertension, except:
A.    Conn's syndrome
B.     Pheochromocytoma
C.     Hypoparathyroidism
D.    Acromegaly
E.     Cushing's syndrome

Answer: C* Hypoparathyroidism

***) A blood pressure cuff that is too small gives:
A.    False low readings
B.     False high readings
C.     Slightly lower readings than usual
D.    Markedly lower readings than usual
E.     Accurate readings

Answer: B* False high readings

12.           Management of Hypertension.
***) All of the following drugs are used in the treatment of hypertension, except:
A.    Nifedipine
B.     Captopril
C.     Dopamine
D.    Hydralazine
E.     Propranolol

Answer: C* Dopamine

***) All of the following drugs are used in the management of hypertensive crises, except:
A.    Nitroprusside
B.     Hydralazine
C.     Nifedipine
D.    Salbutamol
E.     Diazoxide

Answer: D* Salbutamol

***) The following drugs could be given safely as a treatment of hypertension to a patient with peripheral vascular disease, except:
A.    Alpha-methyldopa
B.     Nifedipine
C.     Captopril
D.    Propranolol
E.     Hydrochlorothiazide

Answer: D* Propranolol

13.           Rheumatic Fever.
***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A.    Arthritis
B.     Prolongation of PR interval on ECG
C.     Chorea
D.    Erythema marginatum
E.     Subcutaneous nodules

Answer: B* Prolongation of PR interval on ECG

***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A.    Carditis
B.     Polyarthritis
C.     Chorea
D.    Arthralgia
E.     Erythema marginatum

Answer: D* Arthralgia

***) All of the following are major criteria of rheumatic fever, except:
A.    Fever
B.     Carditis
C.     Polyarthritis
D.    Chorea
E.     Subcutaneous nodules

Answer: A* Fever

***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A.    Arthritis
B.     Prolongation of PR interval on ECG
C.     Chorea
D.    Erythema marginatum
E.     Subcutaneous nodules

Answer: B* Prolongation of PR interval on ECG

***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A.    Carditis
B.     Polyarthritis
C.     Chorea
D.    Arthralgia
E.     Erythema marginatum

Answer: D* Arthralgia

***) Major manifestations of rheumatic fever include all the following except:
A.    Polyarthritis
B.     Carditis
C.     Chorea
D.    Erythema nodosum
E.     Subcutaneous nodules

Answer: D* Erythema nodosum

***) John's major criteria in rheumatic fever include all of the following, except:
A.    Carditis
B.     Chorea
C.     Arthritis
D.    Rheumatic nodules
E.     Erythema multiforme

Answer: E* Erythema multiforme

***) All of the following drugs are used on the treatment of rheumatoid fever, except:
A.    Penicillin
B.     Erythromycin
C.     Aspirin
D.    Prednisone
E.     Copper

Answer: E* Copper

14.           Mitral Valve Disease.
***) Rheumatic heart disease affects most commonly one of the following:
A.    Pulmonary valve
B.     Aortic valve
C.     Mitral valve
D.    Tricuspid valve
E.     Aortic and tricuspid valve

Answer: C* Mitral valve

***) Signs of mitral stenosis include all of the following, except:
A.    Loud first heart sound
B.     Wide pulse pressure
C.     Opening snap
D.    Pre-systolic murmur
E.     Rumbling mid-diastolic murmur

Answer: B* Wide pulse pressure

15.           Aortic Valve Disease.
***) All of the following about aortic stenosis are true, except:
A.    May be of rheumatic origin
B.     Causes sudden death
C.     May present as angina of effort
D.    Causes wide pulse pressure
E.     Causes left ventricular hypertrophy

Answer: D* Causes wide pulse pressure

***) In aortic stenosis all of the following are true, except:
A.    Causes fainting attacks
B.     Angina is a common symptom
C.     The second heart sound is quite
D.    There is often previous history of syphilis
E.     Sudden death may occur

Answer: D* There is often previous history of syphilis

***) Signs of aortic regurgitation include all of the following, except:
A.    Capillary pulsation in the nail beds
B.     Head nodding
C.     High-pitched early diastolic murmur
D.    Pistol shot femoral pulses
E.     Small volume pulse (slow-rising pulse)

Answer: E* Small volume pulse (slow-rising pulse)

***) Signs of aortic regurgitation include all of the following, except:
A.    Wide pulse pressure
B.     Early diastolic blowing murmur
C.     Pulsus paradoxus
D.    Left ventricular impulse
E.     Pistol shot femoral pulses

Answer: C* Pulsus paradoxus

16.           Infective Endocarditis.
***) The site of endocarditis in drug abusers is: Q2012
A.    Mitral valve
B.     Tricuspid valve
C.     Aortic valve
D.    ASD
E.     SA node

Answer: B* Tricuspid valve

***) The most common organism in infective endocarditis is:
A.    Streptococcus fecalis
B.     Staphylococcus aureus
C.     Staphylococcus epidermis
D.    Streptococcus viridans
E.     Candida albicans

Answer: D* Streptococcus viridans

***) All of the following are features of infective endocarditis, except:
A.    Clubbing
B.     Hepatomegaly
C.     Anemia
D.    Osler's nodes
E.     Splinter hemorrhages

Answer: B* Hepatomegaly

***) All of the following are recognized finding in infective endocarditis, except:
A.    Hematuria
B.     Changing murmur
C.     Koilonychia
D.    Osler's node
E.     Splenomegaly

Answer: C* Koilonychia

***) Clinical features of subacute bacterial endocarditis (SBE) may include all of the following, except:
A.    Anemia
B.     Splenomegaly
C.     Low grade fever
D.    General weakness
E.     Anorexia

Answer: C* Low grade fever

***) The following physical signs can be found on examination of the hands of a patient with infective endocarditis, except:
A.    Erythema marginatum
B.     Osler's nodules
C.     Splinter hemorrhage
D.    Clubbing of the fingers
E.     Janeway lesion

Answer: A* Erythema marginatum

***) All of the following are important aspects in the prevention of subacute bacterial endocarditis in patients with ventricular septal defect, except:
A.    The general condition of teeth
B.     The use of antibiotics for dental extraction
C.     The use of antibiotics for tonsillectomy
D.    Early use of antibiotics for bacterial infections of the respiratory tract
E.     Monthly injections of long acting penicillin

Answer: E* Monthly injections of long acting penicillin

17.           Pericardial Disease.
***) The most common feature of pericarditis involvement on physical examination is:
A.    Cardiac tamponade
B.     Ewart's sign
C.     Friction rub
D.    Venous distension
E.     Paradoxical pulse

Answer: C* Friction rub

***) The following about acute pericarditis are true, except:
A.    May be secondary to myocardial infarction
B.     Radiation is a recognized cause
C.     Anticoagulant may be given safely
D.    The pain is relieved by leaning forward
E.     Prednisolone may be needed

Answer: C* Anticoagulant may be given safely

***) The following are causes of acute pericarditis, except:
A.    Rheumatoid arthritis
B.     Coxsakie B virus
C.     Myocardial infarction
D.    Systemic lupus erythematosus
E.     Hyperthyroidism

Answer: E* Hyperthyroidism

***) The following about pericardial effusion are true, except:
A.    Pericardial friction rub may be present
B.     Causes pulsus paradoxus
C.     May occur in uremic patients
D.    Causes wide pulse pressure
E.     Jugular venous pressure is raised

Answer: D* Causes wide pulse pressure

***) In the management of traumatic pericardial effusion all are true except:
A.    Pericardiocentesis
B.     Subxiphoid pericardiotomy (pericardial window)
C.     Thoracotomy with pericardiectomy
D.    Instillation of tetracycline in pericardial space
E.     Treatment of the underlying cause

Answer: D* Instillation of tetracycline in pericardial space

***) In acute cardiac tamponade all of the following are true, except:
A.    It may occur after injuries or cardiac surgery
B.     It produces a shock-like state
C.     The cardiac dullness is enlarged
D.    Jugular venous pressure is lowered with collapse of neck veins
E.     Immediate relief by aspiration or exploration must be done

Answer: D* Jugular venous pressure is lowered with collapse of neck veins


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