Cardiology Exam Questions 2022 PDF

Course “Cardiology” Exam questions 2022. spring autumn Propedeutic _ P P-1.The second heart sound above the aortic valvs in case of aortic stenosis usually is: A) Increased B) Weakened C) Normal D) Split P-2. The first loud tone at the heart apex is more typical for: A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis D) Aortic regurgitation E) Arterial hypertension P-3. Facies Corvisart is typical for: A) hepatic failure; B) Myxoedema; C) Peritonitis; D) heart failure; E) vitamin B12 deficiency anaemia P-4. Apex beat is intensified due to: A) left ventricle hypertrophy; B) right ventricle dilatation C) right ventricle dilatation and hypertrophy D) right atrium dilatation and hypertrophy P-5. Epigastric pulsation can be caused by: (select one or more) 1) hepatic pulsation 2) pulsation of a hypertrophic right ventricle 3) pulsation of a hypertrophic left ventricle 4) pulsation of a. abdominalis 5) pulsation of a hypertrophic right atrium P-6. Pulsation at the 2nd intercostal space to the right of the sternum originates from: A) right ventricle; B) aorta; C) a. subclavia dx.; D) right atrium. P-7. Apex beat displaced downwards and to the left is typical for: A) dilatation of the left ventricle; B) hypertrophy of the right ventricle; C) hypertrophy of the left atrium; D) hypertrophy of the right atrium P-8. Apex beat displaced to the left is typical for: A) hypertrophy of the left ventricle; B) severe dilatation of the left ventricle; C) severe hypertrophy of the left atrium; D) severe hypertrophy of the right atrium P-9. Apex beat is not displaced to the left and downwards in case of: A) mitral stenosis B) aortic regurgitation C) arterial hypertension D) myocarditis P-10. Pulsus irregularis is: A) pulse waves of different volume B) irregular pulse waves C) different pulse in symmetric arteries D) pulse waves of different peaks P-11. Pulsus inaequalis is: A) different pulse in symmetric arteries B) pulse of different amplitude in the artery C) irregular pulse P-12. Pulsus paradoxus is when: A) the pulse disappears on inhalation B) the pulse disappears on exhalation C) there is no standardization of the fullness degree D) no standardization for the alteration of rate P-13. Pulsus alternans is typical for: A) heart failure B) heart tamponade C) hypertrophic obstructive cardiomyopathy P-14. Pulsus alternans is classified as such when: A) every second pulse wave disappears B) pulse waves of normal amplitude interchange with waves of a lower amplitude C) pauses of normal duration interchange with prolonged pauses D) amplitude increases on a. radialis sinistra during exhalation, whereas during inhalation amplitude increases on a. radialis dextra P-15. Pulsus filiformis is typical for: A) Shock B) right ventricle failure C) aortic regurgitation P-16. Pulsus celer et altus is typical for: A) mitral regurgitation B) aortic regurgitation C) aortic ostium stenosis D) tricuspid stenosis E) pulmonary stenosis P-17. Pulse pressure is increased in case of: A) aortic opening stenosis B) aortic regurgitation C) mitral regurgitation D) tricuspid regurgitation E) pulmonary regurgitation P-18. Pulsus filiformis is typical for: A) aortic ostium stenosis B) arterial hypertension C) blood loss D) mitral stenosis E) mitral regurgitation P-19. The auscultation point of mitral valve is: A) the 5th intercostal space, 1 cm medially from l. medioclavicularis sin. B) the lowest part of the sternum C) the attachment place of processus xyphoideus and sternum D) the 4th intercostal space to the right of the sternum P-20. The auscultation points of aortic valve are: A) the 2nd intercostal space to the right of the sternum B) the 2nd intercostal space to the left of the sternum C) Erb’s point D) the lowest third of the sternum The right answer is: 1) A 2) B 3) C 4) A, B 5) A, C 6) A, D P-21. The auscultation points of pulmonic valve is: A) the 3rd intercostal space by the left border of the sternum B) the connection point of the 4th right rib and the sternum C) the middle third of the sternum D) the lower third of the sternum E) processus xyphoideus F) The 2nd intercostal space by the left border of the sternum G) The 5th intercostal space by the left border of the sternum P-22. The auscultation points of pulmonicc valve is: A) Erb’s point B) The 3rd intercostal space to the right of the sternum C) The 2nd intercostal space to the left of the sternum D) The 2nd intercostal space to the right of the sternum E) The 3rd intercostal space to the right of the sternum P-23. Aortic accentuation of the II sound is when: A) the IInd sound at the aorta is louder than the IInd sound at tr. Pulmonalis B) The IInd sound at the aorta is louder than the Ist sound at the aorta C) The IInd sound at the aorta is louder than the Ist sound at the apex D) indicates hypertension in the large circuit E) indicates hypertension in the small circuit The right answer is: 1) A 2) B 3) C 4) A, D 5) B, E 6) C, E P-24. Pulmonary accentuation of the II sound is: A) when the IInd sound at tr. pulmonalis is louder than the IInd sound at the aorta B) when the IInd sound at tr. pulmonalis is louder than the Ist sound at tr. pulmonalis C) when the IInd sound at tr. pulmonalis is louder than the Ist sound at the tricuspid valve D) indicative of hypertension of the small circuit E) indicative hypertension of the large circuit The right answer is: 1) A 2) B 3) C 4) A, D 5) B, D 6) A, E P-25. S2 accentuation at the aorta is not typical for: A) primary arterial hypertension B) nephritic syndrome C) aortic atherosclerosis D) aortic coarctation E) mitral stenosis P-26. Audible S3 in a patient of age 40 or older year indicates: A) ventricular systolic dysfunction B) nothing, it can be physiological C) bentricular diastolic dysfunction D) increased contractility of myocardium P-27. S4 can be heard, if: A)ventricular myocardial diastolic function – relaxation – is disturbed B) atrial contraction is intensified C) ventricular contraction is intensified P-28. Mesosystolic click is audible in case of: A) mitral stenosis B) organic mitral regurgitation C) mitral valve prolapse P-29. Murmur audible in the beginning of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) Pansystolic P-30. Murmur audible in the middle of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) Pansystolic P-31. Murmur audible at the end of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) Pansystolic P-32. Murmur audible throughout the whole systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic P-33. Murmur audible in the beginning and in the middle of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) protomesosystolic P-34. Murmur of a gradually increasing pitch is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform P-35. Murmur of a gradually reducing pitch is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform P-36. Murmur of a pitch which increases in the beginning of the heart cycle but then reduces is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform P-37. Murmur of a constant pitch is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform P-38. Murmur audible in the beginning of diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic P-39. Murmur audible in the middle of diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic P-40. Murmur audible at the end of diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic P-41. Murmur throughout diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic P-42. Systolic murmur between scapulae is evidence of: A) mitral regurgitation B) aortic stenosis C) coarctation of aorta D) pulmonary stenosis P-43. The following is not characteristic of Frederic Still murmur: A) it is often audible in children B) it is well audible at the pulmonary valve auscultation point, but never at the apex C) its loudness is 1/6–3/6 by Levine grading scale D) it is not palpable E) it is audible during systole P-44. Crescendo cardiac murmur: A) Increases B) Decreases C) is of a constant amplitude D) increases, then decreases P-45. Decrescendo cardiac murmur: A) Increases B) Decreases C) is of a constant amplitude D) decreases, then increases P-46. Lentiform cardiac murmur: A) Increases B) Decreases C) is of a constant amplitude D) decreases, then increases P-47. Diamond-shaped cardiac murmur: A) increases, then decreases B) increases C) decreases D) is of a constant amplitude Valvular heart diseases - V V-1. Mitral valve prolapse is described by the following: A) mesosystolic click at the apex B) late systolic murmur at the apex C) systolic murmur at Erb’s point D) diastolic murmur at Erb’s point The right answer is: 1) A 2) A, B 3) A, C 4) A, D 5) B, D V-2. The systolic murmur at the apex beat is typical finding for: A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis V-3. Which valvular heart disease causes early congestion in the lungs? A) Aortic stenosis B) Mitral stenosis C) Aortic regurgitation D) Mitral regurgitation E) Tricuspid regurgitation V-4. Which is not direct signs of mitral stenosis? A) Presystolic murmur B) Mitral valve opening snap C) Diastolic murmur D) Left atrium enlargement E) ECHO mitral stenosis sign V-5. Rheumatism can damage: A) Only endocardium B) Only myocardium C) Myocardium and pericardium D) All three heart layers V-6. Witch heart disorder is characterized by a triad of symptoms: 1. Angina 2. Fainting 3. Shortness of breath A) Mitral stenosis B) Mitral regurgitation C) Aortic regurgitation D) Dilated cardiomyopathy E) Aortic stenosis V-7. Mitral valve prolapse is suspected for 35 years old asthenic woman based on auscultation and clinical data. Which of the following methods may be the best to confirm the diagnosis? A) Chest X-ray in two projections B) ECG at rest C) Stress ECG test D) Myocardial scintigraphy E) Echocardiography V-8. Dizziness and syncope are typical symptoms of: A) Mitral stenosis B) Mitral regurgitation C) Aortic regurgitation D) Aortic stenosis V-9. Angina is a typical symptom of: A) Mitral stenosis B) Mitral regurgitation C) Pulmonary artery stenosis D) Aortic stenosis E) Aortic regurgitation V-10. Increased pulse pressure amplitude is typical of: A) Mitral regurgitation B) Mitral stenosis C) Aortic regurgitation V-11. Which examination method is used to diagnose mitral stenosis? A) ECG B) X-ray investigation C) Myocardial scintigraphy D) Echocardiography V-12. Diastolic murmur at III/IV intercostal space left from sternum is characteristic for: A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis D) Aortic regurgitation V-13. The normal systolic pressure (mm Hg) a. pulmonalis at rest is: A) 3 - 12 B) 15 – 25 C) 32 – 42 D) 45 – 53 E) 54 – 61 V-14. What statement is incorrect? The following symptoms are typical for isolated severe aortic regurgitation: A) Left ventricular enlargement. B) High amplitude pulse pressure. C) Diastolic murmurs over the aortic valve. D) Visible aortic pulsation in supraclavicular areas. E) Increased systolic gradient between the left ventricle and the aorta. V-15. What is not a typical symptom of aortic regurgitation: A) Visible capillary pulse. B) Early diastolic murmur. C) Heart sounds above the arterial blood vessels. D) Pulsus celer et altus. E) Increased systolic gradient between the left ventricle and the aorta V-16. Lower extremity thromboembolism is a common complication of: 1. Mitral stenosis of left atrium. 2. Left heart valve bacterial endocarditis. 3. Thrombi from right ventricular intertrabecular spaces in case of heart failure. 4. Atherosclerosis in aorta. 5. Mesenteric veins. A) Only 1 is correct B) Only 1, 2 and 3 are correct C) Only 1, 2 and 4 are correct D) Only 1, 3, 4 and 5 are correct E) All 1 - 5 are correct V-17. What statement is incorrect? Mitral valve prolapse is often manifested by: A) Late systolic murmur. B) Atypical chest pain and palpitations. C) Rhythm and repolarization phase ECG changes. D) Easily identifiable echocardiogramm signs. E) Poor prognosis. V-18. Mitral valve prolapse is a common, often benign finding. All are serious complications except: A) Infectious endocarditis. B) Paroxysmal supraventricular tachycardia. C) Syncope. D) Ischemic ECG changes. E) Third degree AV block. V-19. The basic concept that distinguishes the mitral and aortic valve disease mechanisms, origin and pathogenesis is that: A) Mitral valve has two leaflets, aortic valve - three leaflets; B) Mitral valve is an endocardial structure, aortic valve – arterial structure; C) Mitral valve is exposed to a lower hydrodynamic pressure; V-20. Clubbing fingers are typical for: A) Acute pneumonia; B) Congenital valvular heart diseases; C) Cholelithiasis; D) Urolithiasis; V-21. Marked pulsation of a. carotis is typical for patients with: A) Aortic stenosis; B) Aortic regurgitation; C) Mitral regurgitation; D) Tricuspid regurgitation; E) Pulmonary regurgitation; V-22. Pupil pulsation is typical for: A) Mitral stenosis; B) Tricuspid regurgitation; C) Aortic ostium stenosis; D) Thyrotoxicosis; E) Aortic regurgitation V-23. Hepatic pulsation and ventricularization of the venous pulse are caused by: A) mitral regurgitation; B) aortic regurgitation; C) tricuspid regurgitation; D) mitral stenosis; E) myocardial infarction; V-24. The following is not found in case of mitral stenosis: A) Acrocyanosis B) redness of the cheeks C) apex beat displaced downwards and to the left D) epigastric pulsation V-25. Dysphagia in mitral stenosis is usually caused by: A) oesophageal blood vessel spasm B) oesophagus suppression due to enlarged right atrium C) oesophagus suppression due to enlarged left atrium D) oesophagus suppression due to left ventricle dilatation V-26. The following clinical feature is characteristic of mitral regurgitation: A) late manifestation B) early manifestation with shortness of breath C) early manifestation with blood spitting D) early manifestation with lightheadness V-27. Auscultative pattern in case of mitral regurgitation is: A) loud systolic murmur which radiates to blood vesels B) soft S1, systolic murmur C) loud S1, diastolic murmur D) soft S1 at the apex and fixed double S2 at the aorta E) diastolic murmur over the whole heart region V-28. The following could be found in case of aortic stenosis: A) skin paleness B) carotid dance C) ventricularization of the venous pulse D) “quail” rhythm V-29. The following is not found in case of aortic regurgitation: A) carotid dance B) decreased pulse pressure C) Musset symptom D) dilatation of the left ventricle E) Diroje’s double sound V-30. The following is not found in case of aortic regurgitation: A) Musset symptom B) the left border of the heart is displaced laterally (to the left) C) low systolic pressure D) carotid dance E) increased pulse pressure V-31. The following is usually found in case of aortic regurgitation: A) S1 intensification at the apex B) vertical heart axis on ECG C) skin and mucosa cyanosis D) increased pulse pressure V-32. Diastolic murmurs of aortic regurgitation are best audible when the patient is: A) Standing B) lying supine C) sitting leaning forward D) sitting E) lying in the left lateral decubitus position V-33. Diastolic murmur due to mitral stenosis is best audible when: A) the patient lies supine B) the patient is leaning forward C) the patient exhales lying in the left lateral decubitus position D) the patient inhales lying in the left lateral decubitus position V-34. Systolic click of mitral valve prolapse is best audible when patient is: A) Sitting B) Standing C) lying supine D) lying in the left lateral decubitus position V-35. What is classic symptom triad for patients with critical aortic valve stenosis? (select one or more) A) Syncope B) Angina C) Dyspnoe D) Stabbing chest pain E) Arrhythmia F) Peripheral oedema V-36. Anticoagulant treatment is indicated for patient after implantation of biological prosthetic valve? A) Yes B) No C) No, anticoagulation is not indicated if doesn`t exist other indications. V-37. What are symptoms for patient with tricuspid valve regurgitation? (select one or more) A) Peripheral oedema B) Ascites C) Hepatomegaly D) Angina E) Stabbing chests pain V-38. Hemoptysis is seen in: A) Aortic stenosis B) Pulmonary stenosis C) Mitral stenosis D) Tricuspid stenosis V-39. The area of mitral valve orifice in mitral stenosis not compatible with life is A) < 0.5 cm² B) 1.0 cm² C) 1.5 cm² D) 3.0 cm² V-40. In rheumatic heart disease most common cause of embolism is A) Mitral stenosis with atrial fibrillation B) Aortic stenosis C) Tricuspid regurgitation D) Atrial septal defect V-41. What valve area is associated with development of clinical symptoms in mitral stenosis? A) 3.5 cm2 B) 3 cm2 C) 2.5 cm2 D) < 2.5 cm2 V-42. Which of the following is usually absent in the mitral stenosis? A) Opening snap B) Middiastolic murmur C) S3 D) Right ventricular enlargemen V-43. Earliest ECG change in mitral stenosis is: A) Right axis deviation B) Left atrial enlargement C) R/S > 1 in V1 D) Right atrial enlargement V-44. Acute severe aortic regurgitation is characterized by all, except A) Increase ejection fraction B) Increase heart rate C) Increase peripheral vascular resistance D) Increase left ventricle end diastolic pressure V-45. Which hemodynamic component decreases during exercise in severe mitral stenosis? A) Pulmonary vein pressure B) Left atrial pressure C) Pulmonary artery pressure D) Cardiac output V-46. The most common arrhythmia in mitral stenosis is A) Ventricular extrasystole B) Atrial extrasystoly C) Atrial fibrillation D) 1 degree AV block V-47. Which heart chamber is normal in mitral stenosis? A) Right atrium B) Left atrium C) Left ventricle D) Right ventricle V-48. What valve is more common affected by calcification? A) Mitral B) Aortic C) Pulmonary D) Tricuspid V-49. Where doesn`t embolize the thrombi from left atrium? A) Brain B) Kidney C) Spleen D) Liver V-50. Which valve is rarely calcified? A) Aortic B) Mitral C) Pulmonary D) Tricuspid V-51. Normal Aortic valve orifice size is A) 2–3 cm² B) 3–4 cm² C) 4–5 cm² V-52. Syncope is more characteristic for: A) Aortic stenosis B) Mitral stenosis C) Aortic regurgitation D) Mitral regurgitation V-53. Right ventricular hypertrophy is more characteristic for: A) Mitral stenosis B) Mitral regurgitation C) Aortic regurgitation D) Aortic stenosis V-54. What is gold standard of treatment in patients with severe aortic stenosis: A) TAVI B) Medical therapy C) Surgical valve implantation D) Annuloplasty V-55. Which one, of below mentioned, is the rarest cause of tricuspid regurgitation in developed countries? A) Pulmonary hypertension B) Severe primary mitral regurgitation C) Chronic obstructive pulmonary disease D) Dilated cardiomyopathy E) Rheumatic heart disease V-56. Which one, of below mention, is the most common valvular pathology secondary to left ventricular remodelling? A) Secondary mitral regurgitation B) Secondary aortic stenosis C) Secondary aortic regurgitation D) Secondary pulmonary regurgitation V-57. Secondary mitral regurgitation is: A) Leakage of blood through mitral valve during systole due to remodelling of left atrium/ventricle B) Leakage of blood through mitral valve during diastole due to remodelling of left atrium/ventricle C) Leakage of blood through mitral valve during systole due to infectious endocarditis D) Leakage of blood through mitral valve during diastole due to infectious endocarditis V-58. Which of below mentioned is unlikely cause of pulmonary oedema? A) Severe mitral regurgitation B) Severe mitral stenosis C) Severe aortic regurgitation D) Severe tricuspid regurgitation V-59. What is characteristic for mitral stenosis? A) Impaired left atrial filling B) Arterial hypertension C) Impaired left ventricular filling D) Developt left ventricular dilatation V-60. What is characteristic for aortic valve insufficiency (regurgitation)? A) Diastolic murmur in the 2nd intercostal space to the right of sternum B) Systolic murmur in the 2nd intercostal space to the right of sternum C) Systolic murmur on apex cordis D) Diastolic murmur on apex cordis V-61. What is the mean pressure gradient for moderate mitral stenosis? A) 20-40 mmHg B) 10-15 mmHg C) 5-10 mmHg D) 30-50 mmHg V-62. Mean pressure gradient between left atria and left ventricle 11 mmHg. What is diagnosis? A) Mild mitral stenosis B) Severe mitral stenosis C) Mild mitral regurgitation D) Severe mitral regurgitation V-63. Incomplete mitral valve closure due to left chamber dilatation is: A) Mitral valve prolapse with mitral regurgitation B) Papillary muscle ischaemia with mitral regurgitation C) Secondary (functional) mitral regurgitation D) Constrictive mitral regurgitation V-64. Pressure like chest pain provoked by physical activity is typical for: A)Coronary artery stenosis B)Mitral stenosis C)Tricuspid stenosis D) Aortic stenosis 1)A+D 2)A+C 3)D+B 4)B+A V-65. ECG: Sv1 + R v5 = 40 mm. It is not typical for: A) Aortic stenosis B) Aortic regurgitation C) Mitral stenosis D) Left chamber hypertrophy V-66. Deviation of apical impulse to the left is typical for: (select one or more) A) Tricuspid regurgitation B) Aortic regurgitation C) Mitral regurgitation D) Mitral stenosis V-67. A 55-year-old male was admitted to the hospital due to complaints breathlessness and retrosternal chest pain during exertion. No prior health issues are known (e.g. does not have hypertension, non-smoker). Upon examination a systolic murmur can be heard, which is most prominent in the 2nd intercostal space to the right side of the sternum. The patient admits that his mother had cardiac surgery due to “a valve pathology” at about 42 years of age. The ECG is as follows: What is the most probable cause of the patient’s complaints? A) A bicuspid aortic valve with severe stenosis B) Acute mitral regurgitation due to chordae rupture C) Severe coronary artery disease D) Severe pulmonary hypertension due to secondary mitral regurgitation V-68. An 82-year-old male was admitted to the emergency department due to progressive dyspnoea during minimal exertion and head spinning upon getting up. BP at admission 155/90 mmHg. It is known that the patient has been using medications for hypertension for approximately 20 years. Renal disease stage IV is present with GFR at 25ml/min. No other health issues are known. Upon auscultation a systolic murmur can be heard (on all auscultation sites). What is the most probable cause of the patient’s complaints? A) A bicuspid aortic valve with severe stenosis B) Severe aortic stenosis due to degenerative aortic valve disease C) Aortic regurgitation due to aortic dissection D) Severe pulmonary hypertension due to secondary mitral regurgitation V-69. The patient was hospitalized with complaints of progressive shortness of breath on exertion, heaviness in the chest and right border. Weight has increased unmotivated by 6 kg in recent months. Objectives: Cyanosis of the lips. TA- 110/70 mm HG. Cor 80 x min, rhythmic, Audible noise to the left of the sternum 4 between the ribs. There is hepatomegaly 3 cm, edema of the lower legs. Echo is planned, ECG and X-ray Thoracis are marked. It is performed in the US abdominal cavity where hepatomegaly and ascites are detected. What kind of heart disease might the patient have? A) Mitral valve stenosis; B) Mitral valve insuficiency (regurgitation); C) Aortic valve insufficiency (regurgitation); D) Aortic valve stenosis; E) Tricuspidal regurgitation. V-70. What valvular heart diseases are most common in the practice of a general practitioners / family doctor for adults today? Several answers are possible. A) Mitral valve stenosis; B) Mitral valve insuficiency (regurgitation); C) Intraventricular septal defect D) Aortic valve insufficiency (regurgitation); E) Aortic valve stenosis; F) Tricuspidal regurgitation. V-71. Which valvular heart disease has the highest risk of systemic thromboembolism? A) Mitral valve stenosis; B) Mitral valve insuficiency (regurgitation); C) Aortic valve insufficiency (regurgitation); D) Aortic valve stenosis; E) Tricuspidal regurgitation. V-72. Severe aortic stenosis is characterized by the following Ehocardiography parameters A) Surface area < 2.5 cm 2, average pressure gradient ( PG Mean) >10 mm Hg; B) Surface area < 1 cm 2, average pressure gradient ( PG Mean) >40 mm Hg; C) Surface area >2.0 cm 2, average pressure gradient ( PG Mean) 0.12″) QRS complexes C) regular R-R intervāls D) irregular R-R intervāls E) heart rate is 100–130 min-1 F) heart rate is 120–200 min-1 The right answer is: 1) A, D, E 2) A, C, F 3) B, C, E 4) B, C E-38. Paroxysmal ventricular tachycardia is characterized by: A) narrow (< 100 ms) QRS complexes B) wide (> 120 ms) QRS complexes C) regular R-R interval D) irregular R-R interval E) heart rate is 100–130 min-1 F) heart rate is 120–200 min-1 The right answer is: 1) A, D, E 2) A, C, F 3) B, C, E 4) B, C, F E-39. The following criteria are strongly necessary to diagnose atrial fibrillation: A) all R-R intervals are different B) P waves are not registered C) fibrillation (f) waves are present The right answer is: 1) A, B 2) B, C 3) A, C 4) A, B, C E-40. In diagnostics of atrial flutter the following is considered: A) regular saw-like waves of rate 180–280 min-1 in leads II, III, avf B) regular saw-like waves of rate 250–350 min-1 in leads II, III, avf C) regular saw-like waves of rate 200–300 min-1 in leads V1–V6 D) R-R intervals (regular or irregular) The right answer is: 1) A, D, 2) A, B 3)A, C 4) B, D 5) C, D E-41. Sinoatrial block of II degree is characterized by: A) periods of PQRS absence B) periods of P wave absence, followed by timely QRS presence C) periods of QRS absence, P wave is present timely E-42. AV block of I degree is characterized by: A) stable prolonged PQ interval B) stable normal PQ interval C) each P wave is followed by QRS complex D) P-Q progressively increases E) Certain QRS are absent The right answer is: 1) A 2) A, B 3) A, C 4) C, D, E E-43. II degree AV block type I (Mobitz I) is characterized by: A) progressively prolonged PQ interval B) some P waves are not followed by QRS C) PQ interval remains stable The right answer is: 1) A 2) B 3) A, B 4) B, C 5) C E-44. II degree AV block, type II (Mobitz II) is characterized by: A) progressively prolonged PQ interval B) some P waves not followed by QRS C) PQ interval remains stable The right answer is: 1) A 2) B 3) A, B 4) B, C 5) C E-45. Complete AV block is characterized by: A) no electrical communication between QRS complex and P waves B) PQ interval remaining stable C) QRS complexes could be narrow D) QRS complexes could be wide The right answer is: 1) A 2) B, C 3) B, D 4) A, C, D E-46. The block of left anterior hemifascicle left is characterized by QRS axis: A) > +45° B) 0° C) > -45° E-47. The following is typical for the block of the left posterior hemifascicle: A) sinistrogram > -30° B) dextrogram > + 120° C) narrow (< 0.1″) QRS complex D) other causes of dextrogram are excluded The right answer is: 1) A 2) B 3) A, C 4) B, C 5) A, C, D 6) B, C, D E-48. The following signs are typical for the complete Left bundle branch block (LBBB): A) QRS < 0.12″ B) QRS > 0.12″ C) absent QI, QV5, QV6 D) QRS complex of M shape in V1 and V2 leads E) in I, avl, V5 or V6 leads QRS complex is wide with a plateau The right answer is: 1) A, C, D 2) B, C, E 3) C, D, E 4) A, C, D, E 5) B, C, D, E E-49. The following signs are characteristic for the complete right bundle branch block: A) QRS < 0.12″ B) QRS > 0.12″ C) Double R wave in leads V1 or (and) V2 D) Wide S1, SV5, SV6 The right answer is: 1) A, C 2) B, C 3) A, C, D 4) B, C, D E-50. Manifestation of the Wolff-Parkinson-White syndrome depends on: A) functioning of Kent’s bundle B) functioning of James’ bundle C) functioning of Bachman’s bundle D) functioning of Wenkebach’s bundle E-51. The following is present in ECG in case of Wolff-Parkinson-White syndrome: A) delta-wave B) short PQ C) wide QRS D) PQ of normal prolongation E) QRS of normal width The right answer is: 1) A, B, C 2) A, C, D 3) D, E 4) A, D, E E-52. ECG changes due to myocardial infarction of the left ventricle of anterior-septal localization are registered in: A) I, aVL B) V1–V2 C) V3–V4 D) V5–V6 E) III, aVF E-53. ECG changes due to myocardial infarction of the left ventricle of inferior localization are registered in: A) aVL B) V1–V2 C) V3–V4 D) V5–V6 E) III, aVF E-54. ECG changes due to myocardial infarction of the left ventricle of latero-inferior localization are registered in : A) V1–V2 B) V3–V4 C) V5–V6 D) I, aVL E) III, aVF The right answer is: 1) A, B,D 2) A,C, E 3) C,D, E 4) A, B, E Arterial hypertension_AH AH-1. Pathological urinalysis is typical in all of these secondary hypertension causes, except: a. Chronic glomerulonephritis b. Renal amyloidosis c. Renal artery stenosis d. Chronic pyelonephritis AH-2. What is the most unfavorable prognostic risk factor in case of primary arterial hypertension? a. Frequent headaches b. Smoking c. Excessive use of alcohol d. Overweight e. Left ventricle hypertrophy AH-3 What secondary hypertension cause also induces severe electrolyte disbalance? a. Thyrotoxicosis b. Glomerulonephritis c. Conn's syndrome d. Primary arterial hypertension e. Pheochromocytoma AH-4. What statement is incorrect? The following symptoms can be observed in a patient with coarctation of aorta: a. Arterial hypertension, when measuring arterial blood pressure on arms. b. Systolic murmur in the paravertebral area at the back. c. Palpable arterial pulsation in the intercostal spaces. d. Blood pressure on the feet higher than on the arms. e. ECG - left ventricular hypertrophy. AH-5. Pathogenesis of primary arterial hypertension includes all of mentioned, except: a. Sodium transport and excretion inhibition; b. Renin-angiotensin-aldosterone system activation and increased SNS activity; c. Increased vascular wall sensitivity to angiotensin and noradrenaline; d. Reduced output of angiotensin converting enzyme; e. Reduced output of kallikrein and prostacyclin (vasodilator). AH-6. Which statment is incorect? The important role in the pathogenesis of primary arterial hypertension is: a. Genetic factors b. Activiation of the sympathetic system c. Decreased activiation of the renin-angiotensin-aldosteron system AH-7. What is incorrect? The assessment of cardiovascular risk depends on: a. Blood pressure categories b. Cardiovascular risk factors c. Asymptomatic Hypertension mediated organ damages (HMOD) d. Symptomatic cardiovascular diseases and renal diseases e. Efficacy of antihypertensive treatment AH-8. Which factor does increase the cardiovascular risk for the general population? (select one or more): a. Smoking b. Female gender c. Total cholesterol (TC) 4,2 mmol/l d. Fasting plasma glucosae level 5,6 - 6,9 mmol/l e. Waist circumference 89 cm in male AH-9. The normal upper range of total cholesterol for the general population is: a. 4,9 mmol/l b. 4,2 mmol/l c. 4,6 mmol/l d. 5,5 mmol/l e. 5,2 mmol/l AH-10. The normal upper range of Low density cholesterol (LDL-C) for the general population is: a. 3,0 mmol/l b. 2,6 mmol/l c. 3,5 mmol/l d. 4,9 mmol/l e. 4,1 mmol/l AH-11. The normal value of High density cholesterol (HDL-C) in men is: a. ≥ 1,0 mmol/l b. ≤ 1,0 mmol/l c. ≥ 1,2 mmol/l d. ≤ 1,2 mmol/l e. ≥ 1,5 mmol/l f. ≤ 1,5 mmol/l AH-12. The normal value of High density cholesterol (HDL-C) in women is: a. ≥ 1,0 mmol/l b. ≤ 1,0 mmol/l c. ≥ 1,2 mmol/l d. ≤ 1,2 mmol/l e. ≥ 1,5 mmol/l AH-13. The normal fasting glucosae level is: a. < 5,6 mmol/l b. < 6,0 mmol/l c. < 6,2 mmol/l d. < 5,8 mmol/l e. < 6,5 mmol/l AH-14. Asymptomatic Hypertension mediated organ damage is: (select one or more) a. Left ventricular hypertrophy b. Heart failure c. Retinal aneurysms and papilloedema d. Microalbuminuria and reduction of GFR e. Peripheral artery disease AH-15. Grade 1 arterial hypertension is: a. SBP 140-159 mmHg and/or DBP 90-99 mmHg b. SBP 160-179 mmHg and/or DBP 100-109 mmHg c. SBP >180 mmHg and/or DBP 110 mmHg d. SBP 140mmHg and/or DBP 180 mmHg and/or DBP 110 mmHg d. SBP 140mmHg and/or DBP 180 mmHg and/or DBP 110 mmHg d. SBP 140mmHg and/or DBP 55 in women and > 65 yo in men b. Total cholesterol > 4,9 mmol/l c. Diabetes d. Fasting glycemia 5,6 - 6,9 mmol/l AH-29. BP 168/95mm/Hg was found for a first time for a patient. What is the grade of arterial hypertension in this case? a. 1. grade b. 2. grade c. 3. grade d. Isolated systolic hypertension AH-30. What level of GFR should be considered as a sign of HMOD in case of hypertension? a. < 60 ml/min b. < 50 ml/min c. < 40 ml/min d. < 30 ml/min AH-31. Which antihypertensive agents belong to the first-line drugs? (select on or more) a. Candesartan; b. Amlodipin; c. Hydrochlorthiazide; d. Ramipril; e. Doxazosin AH-32. Which antihypertensive agents belong to the first-line drugs? (select on or more) a. Angiotensin II Receptor Blockers; b. Clonidine c. Calcium antagonists (DHP) d. Thiazide diuretics e. Angiotensin-converting-enzyme inhibitors AH-33. Which antihypertensive agents have sedative effects? (select on or more) a. Clonidine b. Prazosin c. Methyldopa d. Enalapril e. Amlodipine AH-34. What are side effects of hydrochlorothiazide? 1. Uric acid level increase in the blood 2. Hypokalemia 3. Increased sensitivity to cardiac glycosides 4. Impaired glucose tolerance a. Only 1 is correct b. Only 1 and 3 are correct c. Only 2 and 4 are correct d. Only 1, 2 and 3 are correct e. All 1 - 4 are correct AH-35. Which of the drugs is preferable, if the patient has stable angina and hypertension? a. Hydrochlorothiazide b. Bisoprolol c. Prazosin d. Enalapril e. Telmisartan AH-36. Which of the following agents are not the first line medications for primary arterial hypertension treatment? 1. Nitrates 2. Telmisartan 3. Clonidine 4. Perindopril 5. Lacidipine a. Only 1 is correct b. Only 1, 2 and 3 are correct c. Only 2, 4 and 5 are correct d. Only 1 and 3 are correct e. Only 1, 3 and 4 are correct AH-37. The following drugs belong to the angiotensin-converting-enzyme inhibitors, except: a. Lisinopril b. Perindopril c. Lacidipine d. Enalapril e. Ramipril AH-38. Which antihypertensive agents may induce hyperuricemia and hypokalemia? a. Beta-adrenoblockers. b. Thiazide diuretics. c. Calcium antagonists. d. Angiotensin-converting-enzyme inhibitors. e. Angiotensin II receptor blockers. AH-39. The following antihypertensive agents are used for treatment of hypertensive crisis, except: a. Labetolol b. Nifedipine c. Hydrochlorothiazide d. Captopril c. Sodium nitroprusside AH-40. Which drugs belong to the calcium antagonist group? 1. Felodipine 2. Diltiazem 3. Amlodipine 4. Nifendipine a. Only 2 is correct b. Only 4 is correct c. Only 2 and 4 are correct d. Only 1, 3 and 4 are correct e. Only 1, 2 and 3 are correct f. All 1 - 4 are correct i. None of the above AH-41. First-line treatment of primary arterial hypertension: 1. Ramipril 2. Telmisartan 3. Hydrochlorothiazide 4. Clonidine 5. Felodipin a. Only 1 and 2 are correct b. Only , 2 and 3 are correct c. Only 2, 3,4 and 5 are correct d. Only 1,2, 3 and 5 are correct e. All 1 - 5 are correct AH-42. Male (55 years old) suffering from a long-term arterial hypertension; sudden appearance of chest pain. The pain has further spread to the upper abdomen and back. Investigating the patient: blood pressure - 190/105 mmHg, oliguria, electrocardiogram - left ventricular hypertrophy. Normal troponin levels. What is the most possible diagnosis? a. Pulmonary thromboembolism b. Hypertensive crisis c. Myocardial infarction d. Aortic aneurysms dissection e. Acute pericarditis AH-43. The high nephroprotective and metabolic effect is demonstrated by: a. Telmisartan; b. Eprosartan; c. Azilsartan; d. Valsartan. AH-44. Which of the following are first-choice medicines for primary prophylaxis of coronary heart disease? a. Ramipril, Perindopril; b. Enalapril, Captopril; c. Cilazapril, Benazepril AH-45. The possible side effect of treatment with ACE-inhibitors are : a. Angioedema b. Hyperkalaemia c. Cough d. Mental retardation e. a+b+c f. All of the above AH-46. Possible side effect of treatment with calcium channel blockers: a. Bradycardia b. Hypocalcemia c. LV dysfunction with reduced inotropy d. Periferal edema e. Hyperkalaemia 1. a+c+d+e 2. a+b+e 3. a+c+d 4. a+d AH-47. Contraindication for treatment with ARBs are: a. Hypokalemia b. Hyperkalemia c. Bilateral renal artery stenosis d. Gout e. Pregnancy 1. b+c+e 2. a+c+e 3. b+c+d+e 4. a+b AH-48. What is initial preferred drug treatment strategy in patient with grade 2 arterial hypertension and no concomitant cardiovascular diseases (uncomplicated arterial hypertension): a. Beta blocker and ACE-i b. ACE-I and ARB c. ARB and CCB d. Beta blocker and CCB AH-49. What combination of the hypertensive drug classes is contraindicated? a. ACE-I + ARB b. ARB + Beta-blockers c. CCB + Thiazides d. Thiazides + Beta blockers e. ACE-I + CCB AH-50. Which medications could be used to treat arterial hypertension in pregnant woman? a. Methyldopa, labetalol, perindopril b. Labetalol, telmisartan, nifedipine, magnesium c. Labetalol, magnesium, nifedipine, methyldopa d. Magnesium, nifedipine, perindopril, telmisartan, labetalol AH-51. The following non pharmacological methods have been shown to reduce the blood pressure in subjects with hypertension: (select one or more) a. Weight reduction b. Increased vegetables and fruit intake c. Regular aerobic exercise d. Cessation of smoking e. Reduced alcohol consumption AH-52. A 45 years old man is found to have a blood pressure of 145/85 mmHg. He is overweight, and smokes a pack of cigarettes a day, but has no other risk factors. The following are true: (select one or more) a. He should be started on thiazides diuretics immediately b. He should be adviced to reduce weight c. Mediatation is an effective method of reducing blood pressure d. He should stop smoking e. He should reduce the amount of salt in his diet AH-53. What is recommended systolic blood pressure in most patient < 65 years old? a. 130 - 139 mmHg b. 120 - 129 mmHg c. 110 - 119 mmHg d. 140 - 149 mmHg AH-54. What is recommended systolic blood pressure in most patient ≥ 65 years old? a. 130 - 139 mmHg b. 120 - 129 mmHg c. 150 - 155 mmHg d. 140 - 149 mmHg AH-55. What is recommended diastolic blood pressure for all hypertensive patient? a. 65 - 69 mmHg b. 70 - 79 mmHg c. 80 - 89 mmHg d. 90 - 99 mmHg AH-56. The monotherapy can be considered in treatment of hypertension for: a. Diabetic patients b. Patients with kidney failure c. Patients with 1st grade arterial hypertesion and low cardiovascular risk d. All patients e. Patients with 2nd grade arterial hypertension AH-57. The addition of Beta- blockers in treatment of arterial hypertension should be considered in all cases except: a. Chronic heart failure b. Dyslipidemia c. Angina d. After myocardial infarction AH-58. Which group of CCB is more often used in the treatment of arterial hypertension? a. Dihydropiridine b. Non - dihydropiridine AH-59. Contraindications of ACE-I are all from following, except: a. Pregnancy b. Severe heart failure (EF < 40%) c. Hyperkalaemia ( K > 5,5 mmol/l) d. Bilateral renal artery stenosis AH-60. Choose blood pressure levels related to diagnosis of hypertension. ( select one or more) a. 130/85 b. 190/70 c. 140/95 d. 135/100 e. 150/90 f. 140/80 g. 120/85 AH-61. Define hypertension grade in patient with arterial blood pressure of 129/84 mm/Hg. a. Normal; b. Grade 1 hypertension; c. Grade 2 hypertension; d. Grade 3 hypertension; e. Isolated systolic blood pressure. AH-62. Define hypertension grade in patient with arterial blood pressure of 150/95 mm/Hg. a. Normal; b. Grade 1 hypertension; c. Grade 2 hypertension; d. Grade 3 hypertension; e. Isolated systolic blood pressure. AH-63. Define hypertension grade in patient with arterial blood pressure of 160/100 mm/Hg. a. Normal; b. Grade 1 hypertension; c. Grade 2 hypertension; d. Grade 3 hypertension; e. Isolated systolic blood pressure. AH-64. Define hypertension grade in patient with arterial blood pressure of 185/115 mm/Hg. a. Normal; b. Grade 1 hypertension c. Grade 2 hypertension d. Grade 3 hypertension e. Isolated systolic blood pressure AH-65. Define hypertension grade in patient with arterial blood pressure of 189/75 mm/Hg a. Normal; b. Grade 1 hypertension c. Grade 2 hypertension d. Grade 3 hypertension e. Isolated systolic blood pressure AH-66. Define total cardiovascular risk for patient with either one of the following features: grade 3 hypertension/diabetes mellitus with proteinuria and chronic kidney injury (eGFR 180/ 110 mmHg b. Blood pressure > 200/ 105 mmHg c. High blood pressure with complaints regarding dizziness, nausea vomiting d. High blood pressure associated with clinical presentation of pulmonary oedema. AH-76. Hypertensive urgency is charecterised by: a. Blood pressure > 160/ 105 mmHg b. Blood pressure > 200/ 105 mmHg c. High blood pressure with complaints regarding dizziness, nausea d. High blood pressure associated with symptoms of cerebral infarction AH-77. Antihypertensive agents for treatment of Hypertensive emergency are: (select one or more) a. Nifedipine p/o b. Nitropruside i/v c. Nitroglycerine s/l d. Labetolol i/v e. Captopril p/o AH-78. What of the following belong to the non-pharmacological treatment of primary arterial hypertension? a. Weight normalization b. Dietary salt restriction c. Dynamic exercise d. Limited alcohol intake e. All of the above AH-79. White-coat hypertension associates with (several answers possible): a. Female sex b. Male sex c. Smoking d. Non-smoking e. Age AH-80. Which medications and substances can increase blood pressure? (select one or more) a. Anabplic steroids b. Erythropoietin c. Corticosteroids d. Oestrogen containing oral contraceptives AH-81. Clinical presentation of hypertensive emergency could be: a. Chest pain due to aortic dissection b. Dyspnoe due to pulmonary oedema c. Chest pain due to acute coronary syndrome d. Chest pain due to pneumothorax e. a+b+c f. a+b+c+d AH-82. Secondary Hypertension is caused by: (select one or more) a. Renal artery stenosis b. Coarctation of aorta c. Oral contraception d. Renin secreting tumor e. Rheumatoid arthritis AH-83. Regarding hypertensive emergency: (select one or more) a. The blood pressure must be reduced immediately to prevent hypertensive encephalopathy in most cases b. Intravenous labetolol is the drug of choice c. Sublingual nifedipine is indicated d. Mannitol is indicated to reduce cerebral oedema e. Aortic dissection is a complication AH-84. What is reason of true resistant hypertension? (select one or more) a. Undetected secondary forms of hypertension b. Advanced an irreversible organ damages c. Marked brachial artery calcification d. White-coat phenomenon e. Poor adherence to prescribed medicines AH-85. What is reason of pseudo resistant hypertension? (select on or more) a. Undetected secondary forms of hypertension b. Advanced an irreversible organ damages c. Marked brachial artery calcification d. White-coat phenomenon e. Poor adherence to prescribed medicines AH-86. What drug is recommended add to hypertensive therapy as the first choice in case of resistant hypertension? a. Spiranolacton b. Furosemide c. Metaprolol succinate d. Telmisartan e. Clonidine AH-87. What IS NOT cause of secondary hypertension: a. Chronic pyelonephritis b. Hypothyroidism c. Cirrhosis of liver d. Pheochromocytoma e. Hormonal contraceptives AH-88. What IS cause of secondary hypertension: (select one or more) a. Chronic obstructive pulmonary disease b. Sleep apnoe c. Generalized atherosclerosis d. Antibiotics e. Nonsteroidal anti-inflammatory drugs AH-89. 35 year old male complains about episodes with high blood pressure up to 200/120 mmHg, severe headache, pallor and palpitation. Previous treatment with a combination of beta blockers, ACE-I, CCB and thiazide diuretic was ineffective. What is most likely cause of paroxysms? a. Pheochromocitoma b. Cushing`s disease c. Primary aldosteronism d. Thyroid disease e. Innapropriate drug use Coronary artery disease - CAD. CAD-1. All of below mentioned pathologies are significant in development of chronic coronary syndrome, except: a. Endothelial dysfunction b. Epicardial artery atherosclerosis c. Rupture of atherosclerotic plaque in coronary arteries d. Coronary spasm e. Microvascular pathology CAD-2. Chronic coronary syndrome clinical scenarios are all except: a. Suspected coronary artery disease and stable angina symptoms b. Asymptomatic coronary artery disease less than one year after acute coronary syndrome c. Stable angina less than one year after acute coronary syndrome d. Angina and suspected vasospastic disease e. Atrial fibrillation CAD-3. Typical anginal pain in chronic coronary syndrome: a. Pressure/tightness in chest irradiating to neck, mandibula, left arm for 2-5 minutes. b. Burning pain left from sternum, irradiating to all thorax, between scapulae, 5-10 minutes duration. c. Stabbing pain at apex cordis irradiating to stomach, duration 30 seconds. d. Intense tightness in chest irradiating to left arm, cold sweat, nausea. Duration more than 30 minutes. CAD-4. Typical angina provoking factors: (more than one correct answer possible) a. Exercise b. Lifting weights c. Heat d. Cold air e. Change of body position f. Eating CAD-5. Typical angina relieving factors (more than one correct answer possible): a. Exercise b. Rest c. Leaning forward d. Nitroglycerin e. Sedatives f. Eating CAD-6. Which of below mentioned are not major CAD risk factors? a. Arterial hypertension b. Sedentary lifestyle c. Smoking d. Hypercholesterolemia. e. Alcohol abuse CAD-7. Stable angina class determining criteria? a. Duration of pain b. ECG changes c. Physical exercise tolerance d. Regularity of symptoms CAD-8. What angina functional class characterizes symptom appearance on climbing 3 rd floor or walking 600-700 meters? a. I b. II c. III d. IV CAD-9. Which of below mentioned is not first line examination in a patient with suspected stable coronary artery disease: a. Blood biochemistry, cardiovascular risk factors, liver function, renal function b. Rest ECG c. CT angiography for coronary arteries d. Rest echocardiography e. Chest Xray CAD-10. Which of below mentioned drugs are recommended for relieving and prevention of anginal pain in chronic coronary syndrome? (select one or more) a. Beta-blockers b. Aspirin c. Short acting nitrates d. Statins e. ACEI f. Ranolasine CAD-11. Which of below mentioned drugs are recommended for prevention of cardiovascular reccurent events ( as myocardial infarction) in chronic coronary syndrome? (select one or more) a. Beta-blockers b. Statins c. Ivabradine d. Long acting nitrates e. Aspirin f. Ca chanal blockers (DHP) CAD-12. What is the target low -density cholesterol level in a patient with established cardiovascular disease? a. < 3 mmol/L; b. < 1,4 mmol/L; c. < 2,8 mmol/L; d. < 1,8 mmol/L e. The most important is reduction by 30% CAD-13. Which statement is incorrect? If there is a suspicion of coronary artery disease, stress ECG test (veloergometry) must be stopped: a. In case of cardiac pain or shortness of breath b. Heart rate 115 per minute c. ECG, ST segment deviation more than 2 mm d. Systolic arterial pressure increases to 190 mmHg e. Frequent extrasystoles, and appearance of polymorphic extrasystoles CAD-14. Patient, who previously suffered from a myocardial infarction, complains about the angina type of pain. What questions to ask the patient to diagnose unstable angina? 1. Does the pain occur at rest? 2. Since when the pain got more intense? 3. Did the distance that the patient can walk without pain, decrease? 4. Did the pain intensity increase? 5. Did the frequency of pain occurrence increase? a. Only 3 and 4 are correct b. 1, 3 and 5 are correct c. Only 2, 3 and 5 are correct d. Only 1, 2, 4 and 5 are correct e. All 1 - 5 are correct CAD-15. Which CAD form more often causes chronic cardiac failure? a. Unstable angina b. Progressive angina pectoris c. Silent ischemia d. Old myocardial infarction CAD-16. What type of chronic coronary syndrome is divided into four classes? a. Unstable angina b. Spontaneous (special) angina c. Progressive angina pectoris d. Stable angina e. Angina - occurring for the first time CAD-17. What angina can be treated ambulatory (in out-patient setting)? a. First-time angina (in III FK level) b. Progressing rest angina and stable angina c. Stable angina CAD-18. The coronary artery spasm is the main mechanism for the development of: a. Classic angina. b. Prinzmetal's angina. c. Acute myocardial infarction d. Sudden coronary death. e. In all cases. CAD-19. What characteristic of the pain is less typical for myocardial ischemia. a. Burning type b. Irradiating on both hands c. Short, stabbing d. More intensive when walking e. Provocated by emotions CAD-20. Stable angina attacks most often last: a. 2-3 min b. 15-20 min c. 20-30 min d. 3-5 seconds e. 10-20 seconds CAD-21. The most common pain localization in angina pectoris attack is: a. Retrosternal b. in the heart region c. in the heart region and radiating to the left arm d. in epigastrium CAD-22. All the following is typical for angina pectoris, except: a. pain occurs during physical exercise b. retrosternal pain c. pain is relieved by nitroglycerine d. attack occurs mostly during cold and windy weather e. pain often occurs on empty stomach CAD-23. What statement is correct? To diagnose of painless myocardial ischemia, the main methodes are : a. Echocardiogramm b. Anamnesis c. ECG at rest d. Holter monitoring and stress ECG test (veloergometry) e. All above are correct CAD-24. The main effect of nitroglycerin for anginal pain is connected with: a. Hypotension b. Peripheral arterial dilatation c. Peripheral venous system dilatation d. Increase in coronary blood flow due to heart rate acceleration e. Heart rate increase and decrease of oxygen demand CAD-25. The most significant in acute coronary syndrome pathogenesis is: a. Plaque instability and rupture. b. Endothelial dysfunction. c. Plaque size. CAD-26. Diagnostic marker of myocardial necrosis is: a. AST b. ALT c. Troponin test d. Total CK e. alkaline phosphatase CAD-27. How long is recommended maximum time from the first medical contact to performing and analysing of ECG for the patient with suspected acute coronary syndrome? a. 5 min. b. 10 min. c. 20 min. d. 30 min. e. 40 min. CAD-28. The most effective treatment methode for a patient with acute coronary syndrome with ST segment elevations is: a. Percutaneous coronary intervention (PCI); b. Thrombolysis; c. Nitroglycerin and Morphine; d. Anticoagulants CAD-29. The absolute contraindications to Fibrinolysis are: (select one or more) a. Gastrointestinal bleeding within past month; b. Resection of the stomach one year ago c. Pulmonary oedema d. Reccurent myocardial infarction after 14 month e. Ischaemic stroke in the preceding 6 month CAD-30. What does mean “door-to-balloon” time? a. The time from the first medical contact to catheter guidewire insertion in the coronary blood vessel; b. The time from symptom onset to admission to a department; c. Time from the patients admission to the hospital until catheter guidewire insertion in the coronary blood vessel; d. Time from the patient transferring to the catheterization laboratory until the end of the procedure; CAD-31. Patient with acute coronary syndrome with ST segment elevation. The time of symptoms onset is 3 hours. What is maximum expected delay from STEMI diagnosis to primary PCI to choose primary PCI strategy over fibrinolysis? a. < 45min. b. < 60 min. c. < 120 min. d. < 150 min. e. time delay is not important CAD-32. Which statement(-s) is (are) correct regarding fibrinolytic (select one or more) a. Fibrionlysis is indicated for all patients with STEMI; b. Fibrinolytic therapy is recommended if timely primary PCI can not be performed; c. It is recommended to use any fibrinolytic agent; d. It is recommended to use fibrin-specific agents; e. It is recommended to performe fibrinolysis during 30 min from STEMI diagnosis. CAD-33. Most typical criteria of myocardial infarction: a. Leukocytosis b. Erythrocyte sedimentation rate increase c. Increased Troponin level d. Hypercholesterolemia e. Appearance of C - reactive protein CAD-34. High risk criteria of reccurent ischemia un cardiovascular death for Acute coronary syndrome without ST segment elevation are: (select one or more) a. Duration of the pain more than 10 min; b. GRACE score > 140 c. ECG: Dynamic ST segment depressions; d. Primary arterial hypertension; e. Established NSTEMI diagnosis f. PCI within last year CAD-35. The first choice treatment method of patient with very high risk Acute coronary syndrome without ST segment elevation is: a. Fibrinolysis; b. Percutaneous coronary intervention; c. Administration of Unfractioned heparin without Aspirin d. Aspirin without administration of heparin CAD-36. Which P2Y12 inhibitor is prefered for Acute coronary syndrome with ST segment elevation undergoing primary PCI strategy? a. Clopidogrel b. Ticagrelor c. Prasugrel d. Cangrelor e. Eptifibatide CAD-37. What is maximum recommended time from successful Fibrinolysis to coronary angiography with secondary PCI for stable patients? a. within 12 hours b. within 24 hours c. within 48 hours d. within 1 week e. within 1 month CAD-38. Which antithrombotic agents are not indicated for treatmen of unstable angina? (select one or more) a. Aspirin b. Ticagrelor c. Fondaparinux d. Warfarin e. Alteplase CAD-39. How long time is recommended to use dual antithrombotic therapy after the acute myocardial infartion for patient with sinus rrhythm? a. 3 month b. 6 month c. 6 – 12 month d. 12 month e. Depends on is stent implanted or not CAD-40. Which drug is recommended to use after acute anterior STEMI for the secondary prevention of recurrent cardiovascular events? a. Aspirin b. Beta-blockers c. Statins d. ACEI e. All above CAD-41. When is recommended to repeat Troponin test, if the first one is negative for the patient with suspected Acute coronary sindrome without ST segment elevation? a. It is not necessary to repeat it; b. After 1 hours c. After 3 hours d. After 9 hours CAD-42. Which score is used for assessment of intrahospital mortality risk for the patients with Acute coronary syndrome without ST segment elevation? a. Euroscore 2 b. CRUSADE c. PESI d. TIMI e. GRACE CAD-43. The very high risk criteria of reccurent ischemia in Acute coronary syndrome without ST segment elevation are: a. Cardiogenic shock or Haemodynamic instabillity b. GRACE score >140 punktiem c. Recurrent or ongoing chest pain refractory to medical treatment d. Positive Troponin test e. Percutaneous coronary intervention within 2 month CAD-44. The patient has acute coronary syndrome without ST segment elevation with stable haemodnyamic, ST segment depression in ECG and positive Troponin test. How fast is recommended to perform coronary angiography? a. within 2 hours b. within 12 hours c. within 24 hours d. within 48 hours e. within 72 hours CAD-45. The __________ branches into Circumflex artery and left anterior descendant artery: a. Left main coronary artery b. right marginal artery c. Posterior descendant artery d. None of these CAD-46. Which of the following describes a patient with a non-ST elevation myocardial infarction? a. Exertional angina that is new onset with 1 mm ST depression in leads V5 and V6. Normal cardiac biomarkers b. Rest angina with 2 mm ST depression in the inferior leads and normal cardiac biomarkers c. Rest angina with 2 mm ST elevation in leads V1-V4 and elevated cardiac biomarkers d. Acute onset rest angina with a normal ECG and elevated cardiac biomarkers e. Acute onset rest angina with 1 mm ST elevation in the inferior leads and normal cardiac biomarkers CAD-47. Which of the following ECG patterns is consistent with those seen in the setting of unstable angina or non-ST elevation myocardial infarction? a. Wellen’s phenomenon (biphasic or deeply inverted T waves in the anterior precordial leads) b. Isolated T wave flattening or inversion c. Horizontal ST segment depression d. Normal ST segments and T waves e. All of the above CAD-48. Which of the following best describes the most common pathophysiologic mechanism present during ST segment elevation myocardial infarction: a. Coronary plaque erosion b. Coronary plaque rupture c. Coronary plaque progression causing progressive stenosis d. Coronary vasospasm CAD-49. Diagnosis of non-ST elevation Acute coronary syndrome should be based on: a. 12 leads ECG, obtained following the 0h/1h algorithm b. A combination of clinical history, symptoms, ECG and high-sensitivity cardiac troponin c. ECG and dosage of CK-MB at 3h d. High-sensitivity cardiac troponin and echocardiography e. Symptoms and clinical history CAD-50. Which ESC algorithm is recommended to measure high-sensitivity cardiac troponin? a. 0h/2h in case CK-MB is not available b. 0h/1h or as an alternative, 0h/2h c. 0h/2h d. 0h/3h e. 0h/2h in case h-FABP and copeptin as marker are not available CAD-51. Which of following scores should be considered or prognosis estimation? a. GRACE b. CRUSADE c. DAPT d. EUROSCORE e. ACUITY CAD-52. Routine antithrombotic pretreatment with P2Y12 inhibitor in non-ST elevation Acute coronary syndrome patients: a. May be used when established CAD and prior history of PCI b. Is always indicated in high risk patients c. Should be avoided only in patients with advanced age due to increased bleeding risk d. Is not indicated if the symptom onset is > 6 hours e. It is not recommended to administer routine pre-treatment with a P2Y12 receptor inhibitor in patients in whom coronary anatomy is not known and an early invasive management is planned CAD-53. An immediate invasive strategy (i.e. < 2 h from hospital admission) in NSTE-ACS is indicated in: a. Stabilized resuscitated out-of-hospital cardiac arrest b. Very high risk NSTE-ACS patient irrespective of ECG or biomarker finding c. NSTE-ACS patients who have not contraindication to invasive treatment d. NSTE-ACS with ST depressions at the ECG e. NSTE-ACS patients who will not be able to undergo imaging or stress tests CAD-54. An early invasive strategy ( < 24 h of hospital admission) in NSTE-ACS is indicated in: a. Very high risk NSTE-ACS patients irrespective of ECG or biomarker finding b. NSTE-ACS patients with persistent chest pain c. NSTE-ACS patients with life-threatening arrythmias d. Patient with dynamic ST segment changes and/or GRACE risk score > 140 e. NSTE-ACS patients who prefer not to undergo imaging or stress tests CAD-55. Low-risk NSTE-ACS patients should: a. Be discharged without additional diagnostic tests b. Be selectively scheduled for coronary angiography after a positive non-invasive test c. Be routinely scheduled for coronary angiography within 24 h of hospital admission d. Always follow a conservative strategy e. Undergo cardiac computer tomography angiography or coronary angiography according to their preferences CAD-56. An immediate invasive strategy ( 140 f. Presence of ST-segment depression >1 mm in >_6 leads additional to ST-segment elevation in aVR and/or V1 CAD-57. An early invasive strategy within 24 h is recommended in NSTE-ACS patients with any of the following high risk criteria: (select one or more) a. Diagnosis of NSTEMI suggested by the diagnostic algorithm b. Recurrent or refractory chest pain despite medical treatment c. Dynamic or presumably new contiguous ST/T-segment changes suggesting ongoing ischaemia d. Transient ST-segment elevation e. Heart failure clearly related to NSTE-ACS CAD-58. What IS NOT included in universal definition of 1st type myocardial infarction: a. The detection of an increase and/or decrease of a cardiac biomarker, preferably high- sensitivity cardiac troponin (hs-cTn) T or I Symptoms of myocardial ischaemia b. New ischaemic ECG changes c. Development of pathological Q waves on ECG d. Imaging evidence of loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischaemic aetiology e. Intracoronary thrombus detected on angiography or autopsy f. Positive stress ECG test CAD-59. Medical treatment of coronary artery disease includes which of the following procedures? a. Cardiac catheterization b. Coronary artery bypass surgery c. Oral medication administration d. Percutaneous transluminal coronary angioplasty CAD-60. Which of the following diagnostic tools is not used to determine the location of myocardial damage? a. Cardiac catheterization b. Cardiac enzymes c. Echocardiogram d. Electrocardiogram CAD-61. Which procedure or test is used to diagnose CAD? a. Electrocardiogram b. Treadmill stress test c. Cardiac catheterization d. All of the above CAD-62. A 45-year-old man had a myocardial infarction (MI) 4 days ago and is recovering in the cardiac intensive care unit. Which complication is the MOST AT RISK for developing at this time? a. Aortic aneurysm b. Hidropericardium c. Atrial myxoma d. Left atrial thrombus e. Free wall rupture CAD-63. What is the exclusion criteria that a patient must meet for the Fibrinolytic Therapy Checklist for STEMI? a. Active internal bleeding within the last 21 days b. Known bleeding disorder c. Within 3 months of intracranial surgery, serious head trauma, or stroke d. Within 14 days of major surgery or serious trauma e. History of cancer of the brain f. Witnessed seizure at onset g. History of intracranial hemorrhage CAD-64. A 49-year-old white man who presented to the emergency department with an ST- segment elevation myocardial infarction was given thrombolytics, oxygen, and aspirin. He is now free of chest pain and will be admitted to the coronary care unit for further monitoring. Which of the following statements regarding adjuvant medical therapy for acute myocardial infarction is false? a. Early administration of beta blockers reduces the mortality and the reinfarction rate b. Unless contraindicated, angiotensin-converting enzyme (ACE) inhibitors are indicated in patients with significant ventricular dysfunction after acute myocardial infarction c. When given within 6 hours after presentation to the hospital, I.V. nitroglycerin reduces mortality in patients with myocardial infarction d. Prophylactic therapy with lidocaine does not reduce and may actually increase mortality because of an increase in the occurrence of fatal bradyarrhythmia and asystole CAD-65. A 50-year-old woman is hospitalized for an acute inferior myocardial infarction for which she has undergone angioplasty to the right coronary artery. On day 4, she develops acute shortness of breath and hypotension. She does not have any chest pain. On examination, she is tachycardic with a 3/6 holosystolic murmur at the apex and bibasilar crackles. An electrocardiogram shows sinus tachycardia, and a chest x-ray shows pulmonary edema. Which of the following is the most appropriate management for this patient’s problem? a. Prompt surgical repair b. Left heart catheterization c. Right heart catheterization d. Anticoagulation CAD-66. A 60-year-old female with a history of coronary artery disease presents to a rural emergency department with chest pain for 1 hour. Her pain is similar to the symptoms that she experienced last year when she was diagnosed with a non–ST elevation myocardial infarction. She has been taking her medications as instructed. The electrocardiogram shows anterior ST segment elevations. The nearest catheterization laboratory is 3 hours away. Which of the following is the most appropriate next step in the management of this patient? a. Transfer the patient for PCI b. Consult Cardiovascular Surgery for coronary bypass surgery c. Administer thrombolytics if there are no contraindications d. Medical management CAD-67. A 40-year-old male has been in the hospital for 5 days following an acute myocardial infarction. His catheterization revealed 99% stenosis of the left circumfl ex, and he received one drug-eluting stent without complications. An echocardiogram showed an ejection fraction of 45%. His current medications include aspirin, parasugrel, and metoprolol. Which of the following medications should be added to this patient’s regimen prior to discharge? a. An angiotensin receptor blocker b. Warfarin c. Furosemide d. Digoxin CAD-68. Which of the following describes a patient with a myocardial infarction and acute heart failure that is Killip Class II? a. Findings of mild to moderate heart failure (S3 gallop, rales < half-way up lung fields or elevated jugular venous pressure) b. Pulmonary edema c. Cardiogenic shock defined as systolic blood pressure < 90 mmHg and signs of hypoperfusion such as oliguria, cyanosis and sweating d. No evidence of heart failure CAD-69. Which of the following describes a patient with a myocardial infarction and acute heart failure that is Killip Class III? a. Findings of mild to moderate heart failure (S3 gallop, rales < half-way up lung fields or elevated jugular venous pressure) b. Pulmonary edema c. Cardiogenic shock defined as systolic blood pressure < 90 mmHg and signs of hypoperfusion such as oliguria, cyanosis and sweating d. No evidence of heart failure CAD-70. Which of the following describes a patient with a myocardial infarction and acute heart failure that is Killip Class IV? a. Findings of mild to moderate heart failure (S3 gallop, rales < half-way up lung fields or elevated jugular venous pressure) b. Pulmonary edema c. Cardiogenic shock defined as systolic blood pressure < 90 mmHg and signs of hypoperfusion such as oliguria, cyanosis and sweating d. No evidence of heart failure CAD-71. Which of the following describes a patient with a myocardial infarction and acute heart failure that is Killip Class I? a. Findings of mild to moderate heart failure (S3 gallop, rales < half-way up lung fields or elevated jugular venous pressure) b. Pulmonary edema c. Cardiogenic shock defined as systolic blood pressure < 90 mmHg and signs of hypoperfusion such as oliguria, cyanosis and sweating d. No evidence of heart failure CAD-72. When is fibrinolytic therapy NOT indicated in a facility not capable of PCI?: a. A 74 year old female with a blood pressure of 170/100 during an inferior ST elevation myocardial infarction b. A 68 year old male with an anterior STEMI and a prior intracranial hemorrhage 8 years ago c. A 45 year old male with 3 mm of ST depression in leads V1-V3 with an R:S ratio of > 1 in lead V1 and peptic ulcer 2 years ago d. An 88 year old male with an anterior ST elevation myocardial infarction and a prior ischemic stroke 5 years ago CAD-73. Which of the following best describes rescue percutaneous coronary intervention? a. Percutaneous coronary intervention after a ST segment elevation myocardial infarction patient was rapidly transferred from a non-PCI facility for coronary intervention b. The use of fibrinolytic therapy to stabilize a patient prior to transfer to a facility capable of percutaneous coronary intervention c. The use of percutaneous coronary intervention when fibrinolytic therapy fails d. The use of percutaneous coronary intervention when fibrinolytic therapy is initially successful, then non-invasive testing shows a large area of ischemia e. Fibrinolytic therapy given in the field prior to hospital arrival CAD-74. Which of the following situations should a beta-blocker NOT be used during a ST elevation myocardial infarction? a. Pulmonary edema b. Heart rate of 75 beats per minute c. Blood pressure of 110/70 d. Ejection fraction of 40% e. Beta-blockers are safe in all of the above situations CAD-75. Most common complication after acute myocardial infarction is: a. Pericarditis b. Arrhythimias c. Mitral regurgitation d. Formation of a scar CAD-76. Definition for typical anginal pain is: a. Substernal chest discomfort of characteristic quality (pressure-like, dull), provoked by physical exertion and relieved by rest and/or nitrates within minutes b. Substernal chest discomfort of characteristic quality (pressure-like, dull), provoked by physical exertion or emotional stress and not relieved by rest and/or nitrates within minutes c. Chest discomfort of characteristic quality (pressure-like, dull) at rest, relieved by administration of nitrates d. Substernal chest discomfort of characteristic quality (sharp, pleuritic-type), provoked by physical exertion or emotional stress and not relieved by rest and/or nitrates within minutes CAD-77. Signs of unstable angina are: a. Rest angina for prolonged period (>20 min) b. New-onset angina CCVS (Canadian. Cardiovascular Society) class II or III c. Crescendo angina d. All of the above CAD-78. Non-invasive techniques to assess coronary anatomy are: (multiple answers are correct): a. Computed tomography angiography b. Stress echocardiography c. Computed tomography with coronary calcium scoring d. Myocardioal perfusion scintigraphy e. Coronary angiography CAD-79. ECG criteria of posterior myocardial infarction is (standard 12 lead ECG): a. ST segment elevation >2 mm in leads V1-V3 b. Reciprocal ST segment depression in leads II, III, aVF c. Isolated ST depression >0.5 mm in leads V1-V3 d. ST segment elevation in leads V7-V8 CAD-80. Conditions other than acute myocardial infarction associated with troponin level elevation: (multiple answers are correct): a. Heart failure b. Myocarditis c. Aortic dissection d. Critical illness (shock, sepsis) e. Tachyarrhythmias f. Acute neurological event CAD-81. A P2Y12 inhibitors used to treat acute coronary syndrome are: (multiple answers are correct): a. Aspirin b. Clopidogrel c. Tirofiban d. Prasugrel e. Heparin f. Ticagrelor CAD-82. Contrindications for fibrinolysis are: a. Aortic dissection b. Known bleeding disorder c. Central nervous system neoplasm d. Time from chest pain onset >12 hours e. All of the above CAD-83. Dual anti-platelet treatment after acute myocardial infarction is used: a. For 12 months b. For pre-hospital management only c. For one week d. For one month e. During PCI only CAD-84. Mechanical complications after acute myocardial infarction are: a. Rupture of papillary muscle b. Pericarditis c. Free wall rupture d. Electro-mechanical dissociation e. Interventricular septum rupture f. All of the above g. a+c+d+e h. a+c+e CAD-85. The patient has reduced left ventricular ejection fraction ( EF < 35%) 90 days after the myocardial infarction despite optimal medical therapy. ECG finding – QRS duration > 130 ms due to left bundle branch block. What is the treatment strategy? a. Increase ACEI dose; b. Exertions restriction; c. Digoxin d. Intracardiac defibrillator implantation e. Cardiac resynchronization therapy with defibrillator (CRT-D) CAD-86. What is the most common myocardial infarction complication? a. Sudden death b. Rhythm disorder c. Acute cardiac failure d. Acute cardiovascular insufficiency e. Thromboembolism CAD-87. If one month after myocardial infarction ST elevation persists in patients ECG, then must think about: a. Dressler's syndrome b. Ventricular septal rupture c. Development of heart aneurysm d. Cardiac failure progression e. Threatening heart rhythm disorders CAD-88. The sudden death at the 3th – 4th day of acute myocardial infartion more often can be related with: a. Pulmonary embolism; b. Heart free wall rupture ; c. Pericarditis; d. Cerebral infarction; e. Acute aortic regurgitation. CAD-89. Which medication is less important for emergency treatment of myocardial infarction-induced pulmonary edema? a. Furosemide b. Morphine c. Digoxin d. Nitroglycerin (or isosorbide dinitrate) sublingually. CAD-90. What is indication for intra-aortic counterpulsation in cardiology intensive care practice? a. The standard method for patients with severe acute left ventricular systolic dysfunction; b. The method to be used in some cases at large anterior wall myocardial infarction; c. The treatment method of acute renal failure; d. The standard method in case of cardiogenic shock; e. The methode in case of myocardial infarction mechanical complications Heart failure - HF HF-1. The following are used for treatment of chronic heart failure with reduced ejection fraction: 1. Treatment of the underlying disease. 2. Beta-blockers. 3. Sacubitril/valsartan 4. Diuretics. 5. ACE inhibitors. a. 1, 2 and 3 are correct b. 1, 2 and 4 are correct c. 2, 3, 4 and 5 are correct d. 1, 2, 4 and 5 are correct e. All 1 - 5 are correct HF-2. Chronic heart failure patient suffers from fatigue, shortness of breath and palpitations on less than daily physical activities. Which chronic heart failure functional class by NYHA is it? a. I b. II c. III d. IV HF-3. Chronic heart failure patient suffers from fatigue, shortness of breath and palpitations on rest. Which chronic heart failure functional class by NYHA is it? a. I b. II c. III d. IV HF-4. Chronic heart failure patient suffers from fatigue, shortness of breath and palpitations on daily exercise. Which chronic heart failure functional class by NYHA is it? a. I b. II c. III d. IV HF-5. Chronic heart failure patient suffers from fatigue, shortness of breath and palpitations on unusually extreme exercise. Which chronic heart failure functional class by NYHA is it? a. I b. II c. III d. IV HF-6. The following is not found in case of isolated right ventricle failure: a. Ascitis b. Hepatomegaly c. overfilled neck veins d. coarse crackles in the basal part of the lung HF-7. Left ventricle failure usually manifestates with: a. overfilled neck viens b. ascitis c. anorexia d. orthopnoea e. hepatomegaly HF-8. The most typical and earliest symptom of the left ventricular failure is: a. Shortness of breath during physical activity b. Hepatomegaly c. Peripheral oedemas d. Cyanosis e. Jugular venous dilatation HF-9. Which of the following heart pathologies can not primary cause chronic left ventricle failure? a. primary hypertension b. lung emphysema c. coronary artery disease d. dialted cardiomyopathy HF-10. Chronic right ventricle failure can be caused by one of the following pathologies: a. lung emphysema b. primary hypertension c. aortic stenosis d. aortic regurgitation HF-11. The following symptom is not observed in case of lung oedema: a. foamy sputum b. cyanosis c. coarse crackles in the lung d. Kussmaul breathing HF-12. The functional class (NYHA) of chronic heart failure is assessed according: a. Breathlessness during physical activity b. Hepatomegaly c. Peripheral oedeam d. Cardiomegaly HF-13. The indication of cardiac resynchronisation therapy (CRT) for symptomatic heart failure patient IS NOT: a. Left ventricular ejection fraction < 35% b. QRS duration ≥ 120 ms c. Left bundle branch block at the ECG d. End diastolic diameter of left ventricle > 58 mm HF-14. Which drug has to be considered for a patient with chronic heart failure and preserved sinus rhythm who receive optimal dose of beta-blockers, but still has heart rate > 90 beats per min.? a. Digoxin b. Verapamil c. Ivabradine d. Ranolazine HF-15. The following are important in chronic heart failure pathogenesis: 1. Ejection fraction reduction 2. Peripheral vasoconstriction 3. Deterioration of renal perfusion 4. SNS suppression 5. RAAS activation a. Only 1 is correct b. Only 1 and 2 are correct c. Only 1, 2, 3 and 4 are correct d. Only 1, 2, 3 and 5 are correct e. All 1 - 5 are correct HF-16. What is incorrect regarding natriuretic peptide: a. It increases diuresis b. It acts as a vasodilator c. It activates renin-angiotensin-aldosteron system d. It is produced due to the extension of the walls of the heart HF-17. 52. years old women with symptomatic heart failure (NYHA III) has received Bisoprolol 10 mg, Valsartan/sacubitril 97/103 mg twice per day, Torasemide 20 mg once per day, Eplerenone 25 mg per day daily. The control Echo was performed, where dilatation of all chambers with LV ejection fraction 25% was observed. ECG data – sinus rhythm, 72 times per min., complete left bundle branch block. What is the next treatmen option? a. Heart transplantation; b. CRT implantation; c. CRT-D implantation; d. ICD implantation; e. Left ventricular mechanical assist device implantation. HF-18. What IS NOT an indication of cardiac resynchronisation therapy? a. QRS duration > 120 ms b. Symptomatic chronic heart failure ( NYHA II-IV) refractor to optimal medical therapy c. Complete Left bundle branch block in ECG d. Paroxysmal, reccurent atrial fibrillation e. Ejection fraction of the left ventricle < 35% HF-19. The diagnosis of chronic heart failure is based on: a. Transoesophageal Echo and natriuretic peptide b. Chest X-ray and transthoracic Echo c. Natriuretic peptide and transthoracic Echo d. Natriuretic peptide and chest Xray HF-20. What are the first-line drugs in the treatment of chronic heart failure? a. Ramipril and Nebivolol b. Perindopril and Verapamil c. Ramipril and Ivabradine d. Nebivolol and Digoxin e. Torasemide and Ivabradine HF-21. Which classification is used for Acute heart failure due to acute myocardial infarction? a. NYHA b. Killip c. PESI d. Forester HF-22. Which clinical presentation does describe Acute heart failure Killp II: a. Systolic arterial pressure < 90 mmHg; wet cold skin, decreased diuresis b. No signs of heart failure c. Coarse crackles over basal fields of the lungs, S3 d. Coarse crackles over all fields of the lungs HF-23. Which clinical profile does describe cardiogenic shock? a. Warm - dry b. Warm - wet c. Cold - dry d. Cold – wet HF-24. Which clinical profile does describe Acute hypertensive heart failure? a. Warm - dry b. Warm - wet c. Cold - dry d. Cold – wet HF-25. What is not hypoperfusion signa. a. Oliguria b. Cold sweated extremities c. Pulmonary congestion d. Mental confusion HF-26. The clinical signs of congestion are: (select one or more) a. Mental confusion b. Hepatomegaly c. Jugular venous dilatation d. Oliguria e. Orthopnoea f. Ascites HF-27. The main use of cardiac resynchronization therapy (CRT) is: a. Same as the standard pacemaker only in younger patients; b. Same as the standard pacemaker only in elderly patients; c. Is only applied at atrial fibrillation in the presence of bradysystole; d. Heart failure treatment method. HF-28. The patient is admitted with complaints regarding breathlessness during minimal physical activity. Which laboratory test can help to differentiate the reason for it - heart or lungs? a. Troponin b. Creatinine c. Natriuretic peptide d. C reactive protein e. Leucocytes HF-29. Female is admitted due to severe breathlessness. She has arterial hypertension in medical history. Objective status: Orthopnea, tachypnea, coarse crackles over all fields of the lungs, pulse oxymetry 88% with oxygen supply. Heart rhythm regular, 110 times per min. Blood pressure 210/120 mmHg. Which clinical profile (condition) of Acute heart failure is it? a. Acute decompensated heart failure b. Pulmonary oedema c. Acute hypertensive heart failure d. Cardiogenic shock e. Right heart failure HF-30. When are indicated oxygen therapy in case of Acute heart failure? Select one or more a. Pulse oxymetry < 94% b. Pulse oxymetry < 92% c. Pulse oxymetry < 90% d. PaO2 ( partial O2 pressure in arterial blood) 70 mmHg e. PaO2 ( partial O2 pressure in arterial blood) 58 mmHg HF-31. What is the indication of inotropes? a. Pulmonary oedema with preserved blood pressure, without signs of hypoperfusion b. All patients with Acute heart failure c. Arterial blood pressure 85/55 mmHg, warm skin and preserved diuresis d. Symptomatic hypotension with signs of hypoperfusion HF-32. What is not indicated for treatment of cardiogenic pulmonary edema? a. Half sitting position with the legs lowered down. b. Furosemide intravenous. c. Norepinephrine intravenous. d. Morphine intravenous. Inflammatory heart diseases - I I-1. Most common cause of acute myocarditis is: a. Allergies b. Viral infection c. Bacterial infection d. Unknown cause (idiopathic myocarditis) I-2. What from the following can be the reason for myocarditis? Select one or more a. Alcohol b. Systemic lupus erythematosus c. Viral infection d. Streptococcus infection e. B1 vitamin deficiency I-3. What is not the characteristic clinical presentation of myocarditis? a. Progression of heart failure symptoms b. Sharp chest pain relieved by leaning forward c. Discomfort behind the sternum d. Non-sustained ventricular tachycardia I-4. The "gold standard" diagnostic method for myocarditis is: a. Endomyocardial biopsy b. Echocardiography c. Computer tomography d. Cardiovascular magnetic resonance I-5. The treatment options of myocarditis are Select one or more a. Heart failure therapy b. Antiinflammatory therapy c. Antiarrhythmic therapy d. Immunomodulatory therapies e. Antihypertensive therapy I-6. The most common reason for pericarditis is: a. Systemic autoimmune diseases b. Tuberculosis c. Viral infection d. Flu vaccine I-7. Forced position of a patient sitting leaning forward is due to: a. Myocarditis; b. Aortic stenosis; c. Fibrinous pericarditis; d. Cardiac asthma attack; I-8. What is not a typical symptom or finding of pericarditis? a. ECG changes b. Chest pain c. Ventricular arrthymia d. Pericardial friction rub e. Pericardial effusion I-9. In case of acute pericarditis the pain can be relieved: a. by the patient leaning forward b. by lying supine c. by lying in the left lateral decubitus position d. by lying in the right lateral decubitus position I-10. The best method to diagnose pericardial effusion is: a. x-ray examination b. echocardiography c. pericardial cavity puncture I-11. The signs of cardiac tamponade are: (select one or more)

Cardiology Exam Questions 2022 PDF

Document Details

Tags

Related

Summary

Full Transcript

Upgrade to continue