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Mcqs Faculty of General Medicine VI Year MCQs Faculty of General Medicine VI year 1. Mitral valve according to it’s B. Indentation of the middle third structure also is called: of the esophagus by an enlarged A. Bicuspid left atrium B. Tricuspid C. Notching of the ribs C. Aortic D. Bounding, full pulse D. Pulmonary E. Angina pectoris E. No correct answer 5. Which arrhythmia develops most 2. How many cusps does the right oftenly in patient with mitral atrioventricular valve have? stenosis? A. 2 A. Atrial fibrillation B. 3 B. Atrioventricular block C. 4 C. Supraventricular tachycardia D. 5 D. Ventricular fibrillation E. 6 E. Wolff-Parkinson-White syndrome 3. Mitral stenosis in 99% of all cases is caused by: 6. Choose ECG signs typical for atrial A. Infective endocarditis fibrillation: 1. Negative T wave; 2. B. Congenital mitral stenosis Absence of P wave; 3. S-T C. Myxoma elevation; 4. f waves; 5. Different D. Rheumatic heart disease R-R distance. E. Mitral annual calcification A. 1, 2, 3 B. 2, 3 4 4. After suffering a streptococcal throat C. 2, 4, 5 infection, a 12-year-old boy D. 1, 3, 5 develops cardiac symptoms that E. All are correct are attributed to rheumatic fever. Years later, at the age of 34 he is 7. Choose chest x-ray findings typical admitted to the hospital with for mitral stenosis: 1. Convexity pulmonary edema. Further from enlarged left atrial examination reveals a diastolic appendage 2. Straightening of left murmur at the apex and mitral heart border 3. Left ventricular stenosis is diagnosed. Before hypertrophy 4.Large aorta 5. surgical evaluation, which of the Small aorta following findings can be A. 1, 2, 3 attributed to mitral stenosis? B. 2, 3, 4 A. Large left ventricle C. All are correct D. 1, 2, 4 E. 1, 2, 5 2 B. Percutaneous aortic balloon 8. Clinical signs and symptoms of valvuloplasty suffers from a mitral stenosis develops with the relatively high complication reduction of the area of mitral and recurrence rate valve orifice less then: C. Percutaneous aortic balloon A. 2 cm 2 valvuloplasty has a relatively B. 3 cm 2 low complication and C. 4 cm 2 recurrence rate D. 5 cm 2 D. Open mitral commissurotomy E. 7 cm 2 can be successfully performed if there is limited calcification, 9. Which instrumental examination leaflet stiffness, chordal fusion is a method of choice to make E. Commissurotomy carries up to diagnosis and specify valvular a 20% chance of reoperation heart disease? within 5 years and a 60% A. ECG chance at 10 years B. Holter monitoring C. Doppler ultrasound test 12. Which signs are typical for patients D. Coronarography with aortic stenosis? Choose E. Cardiac catheterization correct combination: 1. Dyspnea; 2. Orthopnea; 3. Angina pectoris; 10. Indications for surgical treatment of 4. Syncope; 5. Congestive heart patients with mitral stenosis are: 1. failure. Critical mitral stenosis (mitral A. 1, 2, 3 valve orifice area less then 1 cm 2); B. 2, 3, 4 2. Symptomatic patients; 3. C. 1, 2, 4 Systemic embolism; 4. Mitral D. 3, 4, 5 valve gradient 12-15 mmHg; 5. E. All are correct End-diastolic gradient 8-10 mmHg. 13. On auscultation “Austin Flint A. 1, 2, 3 murmur” is associated with: B. 2, 3, 4 A. Mitral stenosis C. 1, 2, 5 B. Aortic regurgitation D. 2, 3, 5 C. Aortic stenosis E. All are correct D. Mitral regurgitation E. Tricuspid regurgitation 11. Which statement is wrong concerning surgical treatment of 14. A 63-year-old woman fell while patients with mitral stenosis? crossing the street after her A. Percutaneous balloon Thursday afternoon bridge game. valvuloplasty is a new Attempts at resuscitation for cardiac technique used for minimally arrest by the emergency medical invasive treatment of patients service (EMS) team were with mitral stenosis; unsuccessful. The woman had previously been diagnosed as 3 having aortic stenosis and left infancy. His atrial rate on ECG is ventricular hypertrophy. In addition 450 bpm, and his ventricular rate is to these factors, which of the 160 bpm. His pulse rate is 88 bpm. following predisposes to sudden The left atrium is enlarged. Similar cardiac death? findings were noted 1 year ago, but A. Split first heart sound he declined to take any medication. B. Hypokalemia Treatment should entail which of C. Soft murmur at left of sternum the following? that varies with inspiration A. Continue with colonoscopy D. Failure of the central venous B. Continue with colonoscopy pressure (CVP) to rise more after administration of than 1 cm H2O with 30-second parenteral antibiotics pressure on the liver C. Immediate administration of (hepatojugular reflux) antibiotics and follow-up E. CVP of -1 cm H2O colonoscopy at a later date D. Immediate administration of 15. While lying on the examining table anticoagulation and digoxin before colonoscopy, a 68-year-old and follow-up colonoscopy at a electrician notes palpitations. The later date colonoscopy was scheduled as a E. Immediate electrocardioversion routine procedure following with a current of 300–400 J removal of a benign polyp 1 year earlier. He had rheumatic fever in 17. After experiencing progressive infancy. His atrial rate on ECG is chest pain for 2 months, a surgical- 450 bpm, and his ventricular rate is supply store owner undergoes a CT 160 bpm. His pulse rate is 88 bpm. scan that reveals a space-occupying The left atrium is enlarged. Similar lesion of the wall of the left atrium, findings were noted 1 year ago, but which was confirmed to be he declined to take any medication. myxoma. There is no evidence of Make the diagnosis? disease elsewhere. What would the A. Mitral stenosis, atrial fibrilation next line of treatment be? B. Mitral stenosis, AV block A. Excision of a myxoma C. Mitral regurgitation, performed with a bypass paroxysmal tachycardia procedure D. Tricuspid regurgitation, atrial B. Excision of a myxoma fibrilation performed without a bypass E. Aortic stenosis procedure C. Insertion of a pacemaker 16. While lying on the examining table D. Chemotherapy before colonoscopy, a 68-year-old E. Radiotherapy electrician notes palpitations. The colonoscopy was scheduled as a 18. Following a car accident, a 52-year- routine procedure following old lawyer complains of pain in the removal of a benign polyp 1 year left abdomen and back. After arrival earlier. He had rheumatic fever in of the EMS team, her pulse rate is 4 84 bpm, but of small volume. She patients with valvular heart states that she has some cardiac diseases: 1. Valvular calcification, condition but is uncertain of its 2. Cardiac chamber enlargement, 3. nature. Which is the most likely Low ejection fraction, 4. Diastolic cause of the small pulse volume? filling disorder, 5. Pulmonary A. Aortic regurgitation congestion. B. Mitral regurgitation A. 1, 2, 5 C. Aortic stenosis B. 1, 3, 4 D. Tricuspid regurgitation C. 1, 4, 5 E. Hyperthyroidism D. 2, 3, 5 E. 2, 3, 4 19. On auscultation “Opening snap sound” is associated with: 23. Echocardiography allow real-time A. Mitral stenosis assessment of all, EXCEPT: B. Aortic regurgitation A. Chamber size C. Aortic stenosis B. Wall thickness D. Mitral regurgitation C. Valve appearance E. Tricuspid regurgitation D. Valve motion E. Extrasystole presence 20. Choose ECG signs typical for mitral stenosis: 1. Atrial fibrillation; 24. Cardiac catheterization is used to 2. Left atrium enlargement; 3. Right measure (choose correct answer): atrium enlargement; 4. Right A. Valve structure ventricle hypertrophy. B. Valve motion A. 1, 2, 3 C. Valve gradients B. 2, 3, 4 D. Valve vegetations C. 1, 2, 4 E. Chamber size D. 1, 2 E. All are correct 25. Afterload reduction with vasodilator agents is applied to 21. The mechanisms that compensate enhance pressure gradients in hemodynamics derangements patients with valvular heart disease. associated with valvular heart Choose the right combination of disease include all, EXCEPT: disorders, in which afterload A. Atrial chamber enlargement reduction can improve circulation. B. Ventricular chamber 1. Mitral regurgitation, 2. Aortic enlargement insufficiency, 3. Aortic stenosis, 4. C. Myocardial hypertrophy Mitral stenosis. D. Increased adrenergic A. 1,2 stimulation B. 1,3 E. Hypovolemia C. 1,4 D. 2,3 22. The routine posteroanterior and E. 2,4 lateral chest roentgenogram may provide nonspecific information in 5 26. Operation for aortic stenosis is indicated for all symptoms, EXCEPT: 30. In deciding the tactics of treatment A. LV hypertrophy of patients with severe limb B. Congestive heart failure ischemia of unknown origin, the C. Calculated valve area less optimal combination of the than 0.8 cm2 following instrumental methods of D. Angina pectoris investigation are: 1. E. Syncope Sphygmography 2. Aorto- arteriography 3. Thermography; 4. 27. Mitral stenosis can cause all Ultrasound dopplerography 5. following conditions, EXCEPT: Occlusive plethysmography. Select A. Atrial fibrillation the correct combination: B. Pulmonary hypertension А. 1,2,3; C. Right ventricular dilation В. 2,3; D. LV hypertrophy С. 4,5; E. Hemoptysis D. 2,4; Е. 1,3,5. 28. For acute occlusion of main arteries of the extremities are typical: 1. 31. In case of femoral artery embolism, Paleness; 2. Pain; 3. Edema; 4. ischemia III-B degree (last stage – Paresthesia; 5. No pulse. Choose the limb contractures) the method of correct configuration of answers: choice of treatment is: А. 1,2,4,5; А. Emergency embolectomy; B. 4,5; В. Thrombolysis; C. 2,3; С. Anticoagulant therapy; D. 1,2,3; D. Symptomatic therapy; E. All correct. Е. Primary amputation of limb. 29. In the absence, in patients with 32. Cause of brachial artery embolism embolism of femoral artery, of a may be any disease, except: heart disease as the cause of А.
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