Directions: Each question below contains five suggested answers.

Choose the one best response

to each question.

1. Which of the following coronary arteries supplies blood to the posterior portion of the
interventricular septum?
A. Left main coronary artery
B. Left anterior descending coronary artery
C. Left circumflex coronary artery
D. Proximal marginal coronary artery
E. Right coronary artery The answer is E

2. Which of the following statements regarding heart failure is true?

A. Forward failure refers to the motion of the heart pushing against the chest wall when
the ventricular chambers are dilated
B. Dyspnea is a result of stasis of blood in the extremities
C. Right-sided failure may result in hepatomegaly
D. Cor pulmonale usually is due to severe pulmonic stenosis
E. The clinical manifestations of heart failure most commonly reflect right-sided failure
The answer is C

3. All of the following statements regarding acute myocardial infarction are true EXCEPT
A. Most myocardial infarctions are transmural
B. Myocardial infarctions usually involve the left ventricle
C. Subendocardial infarctions usually are circumferential
D. Histologic evidence is seen first at about 24 hours postinfarction
E. The most sensitive marker within 48 to 72 hours postinfarction is an elevation of the MB
isoenzyme of creatine kinase
The answer is D

4. The modified Jones criteria are employed for the diagnosis of which of the following cardiac
diseases?
A. Secondary hypertension
B. Secondary cardiomyopathy
C. Acute rheumatic fever
D. Cyanotic heart disease
E. Syphilitic carditis
The answer is C

5. All of the following statements regarding infective endocarditis are correct EXCEPT
A. It is most commonly caused by gram-negative bacilli
B. It most often involves a previously damaged valve
C. Valve perforation may occur
D. It is fatal if not treated
E. The mitral and aortic valves are involved more commonly than the tricuspid and
pulmonic valves
The answer is A
 6. Cor bovinum is a Latin term that describes the appearance of a heart affected by which of
the following diseases?
A. Viral myocarditis
B. Long-standing hypertension
C. Syphilitic carditis
D. Alcoholic cardiomyopathy
E. Atherosclerosis
The answer is C

7. The most common cause of myocarditis in the United States is

A. Trypanosomiasis
B. Echinococcal infection
C. Trichinosis
D. Viral infection
E. Fiedlers myocarditis
The answer is D

8. A patient who suffers from dizziness, occasional dyspnea, and intermittent claudication of the
legs when running most likely has which of the following congenital heart defects?
A. Tetralogy of Fallot
B. Coarctation of the aorta
C. Eisenmengers complex
D. Ventricular septal defect
E. Atrial septal defect
The answer is B

Directions: Each question below contains four suggested answers of which one or more is correct.
A. if 1, 2, and 3 are correct
B. if 1 and 3 are correct
C. if 2 and 4 are correct
D. if 4 is correct
E. if 1, 2, 3, and 4 are correct

9. True statements regarding nonbacterial thrombotic endocarditis include which of the

following?
1. There is a common association with a hypercoagulable state
2. The inflammation frequently, but not always, is due to viral infection
3. It may contribute to the formation of bacterial endocarditis
4. The tricuspid valve is involved most commonly
The answer is B

10. Histologic findings produced by chronic ischemic heart disease include

1. Diffuse myocardial fibrosis
2. Fibrocalcific valvular changes
3. Small patchy myocardial scars
4. Endocardial fibroelastosis
The answer is A

11. Ventricular aneurysm following acute myocardial infarction may lead to

 1. Enlarged cardiac silhouette on chest radiograph
2. Renal infarction
3. Formation of mural thrombi
4. Hemorrhagic pneumonia
The answer is A

12. Morphologic examination of a heart diseased bypericarditis may reveal

1. Fibrinous exudate
2. Calcification
3. Fibrosis
4. Malignant cells
The answer is E

13. Congenital heart defects that initially cause cyanosis include

1. Patent ductus arteriosus
2. Coarctation of the aorta
3. Atrial septal defect
4. Tetralogy of Fallot
The answer is D

14. Mitral valve prolapse (floppy mitral valve) is characterized by

1. Prolapse of the mitral valve leaflets into the left ventricular cavity
2. An excess of mucopolysaccharide, which replaces a portion of the valve
3. Marked thickening of the mitral valve leaflets with commissural fusion
4. A systolic click or murmur
The answer is C

15. True statements regarding cardiomyopathy include which of the following?

1. The most common type is idiopathic congestive cardiomyopathy
2. Hypertrophic cardiomyopathy is characterized by very large ventricular cavities
3. Cardiac transplantation is an important treatment option
4. Restrictive cardiomyopathy typically results from viral infection or alcohol abuse
The answer is B

Directions: The group of questions below consists of lettered choices followed by several
numbered items. For each numbered item select the one lettered choice with which it is most
closely associated. Each lettered choice may be used once, more then once, or not at all.

Questions 16-20
Match each phrase describing a feature of inflammatory heart disease with the disease it
characterizes.
A. Acute rheumatic fever
B. Chronic rheumatic heart disease
C. Acute bacterial endocarditis
D. Subacute bacterial endocarditis
E. Libman-Sacks endocarditis

16. Fusion of the commissures

17. Infection by group A - hemolytic streptococci
18. Infection by -hemolytic (viridans) streptococci
19. Infection by Staphylococcus aureus
20. Warty vegetations on the undersurface of the mitral valve
The answers are: 16-B, 17-A, 18-D, 19-C, 20-E.