CARDIOLOGY

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DR. PAYAWAL
Cardio Recalls Midterm Exam Dr. Payawal
Sept. 3, 2013
1. Sinus Bradycardia
2. Atrial Flutter
3. Premature Atrial Contraction
4. Normal ECG
5. Premature Junction Contraction
6. Mobitz I
7. Atrial Fibrillation
8. Atrial systole
9. Ventricular tachycardia, monomorphic
10. Mobitz II A. Ventricular fibrillation B. Fragments of shivering C. Atrial
11. Torsades de pointes fibrillation
12. First degree heart block D. Ventricular tachycardia
13. Premature Ventricular complex
14. Third degree heart block 29. A 60 y/o male, bus driver, hypertensive, 45 pack years of
15. Sinus Tachycardia smoking complained of left caudal pain after walking..: ANS:
16. Lateral wall: lead I clopidogrel + B blocker + stop smoking
17. Placement of V5: ANS: 5th ICS anterior
axillary line
30. What antiarrhythmic agent would you give if the patient is
18. thecellmembraneis impermeable to entry of sodium ions
successfully resuscitated with BP of 120/90 mmHg?
during which phase of the action potential?
A. Verapamil B. Nifedipine C. Diltiazem D. Metoprolol
20. Electrial axis 12 lead = Left Axis Deviation

21. Her 12 ECG shows
1. Right BBB 31: Most common location of PAD:
2. Right Ventricular hypertrophy
3. Left Ventricular hypertrophy 1. Abd. aorta and iliac arteries
4. Left posterior hemiblock 2. Femoral and Popliteal Arteries
5. None of the above 3. Tibial and Peroneal
21. Case: Diagnosis: 4. Radial and Brachial

A. dilated cardiomyopathy 32. Case: 57 year old female, hypertensive, with diabetes, felt
B. TOF claudication with walking of a distance of >200m, relieved with rest.
Based on history alone, what is the probable location?
22. To confirm your clinical impression you will request A. B. C. D.
1. TPCK MB Abd. aorta and iliac arteries
2. ASO TITER Femoral and Popliteal Arteries
3. Serum cholesterol Tibial and Peroneal
4. ECG Radial and Brachial
5. ABG 33. ABI result: Right Tibial 1.4, Right Dorsalis Pedis = 1.3; Left Tibial =
24. What will you advise the patient: 1.1 Left Dorsalis Pedis = 1.0. Interpretation:
1. Avoid salt intake ANS = Incompressible right lower Ext & Normal Left Lower Ext
2. Undergo open commisurotomy 34. 35.
3. Undergo patch closure 1. SINUS BRADYCARDIA
4. Undergo PTCA F Regularly occurring PQRST
5. NOTA F Rate <60/min

25. prognosis of heart disease(LVH) - 50%mortality rate in 5years 2. ATRIAL FLUTTER
F Atrial rate= 220-300/min
F (P as flutter wave)
26. chest xray finding of this pt A. normal heart
F Variable degree of AV block
B. interstitial edema
F (irregular RR interval)
C. Boot shaped heart

D. Cut off sign pulmonary artery
PREMATURE ATRIAL CONTRACTION

F Prematurely occurring PQRST complex
F P wave different in configuration from the sinus
beat
F PR interval often long
F QRS narrow

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3. NORMAL ECG T wave opposite in deflection to the QRS
F
complex
Look at the P waves
F F Complete compensatory pause following every
Rate is 60-100/min
F premature beat
Cycle length does not vary by 10%
F
PR interval is 0.12 sec. or more
F 13. THIRD DEGREE HEART BLOCK
F No recognizable consistent or meaningful
4. PREMATURE JUNCTION CONTRACTION relationship between atrial and ventricular
F Prematurely occurring PQRST activity
F Inverted P wave that may precede, be F QRS complexes often abnormal in shape,
incorporated within or may follow the QRS duration and axis (occasionally normal)
complex F QRS morphology is constant
F QRS narrow F QRS rate is constant (15-60 beats/min)
F Any form of atrial activity seen (most commonly
5. MOBITZ I sinus initiated)
F Progressive lengthening of PR interval with
intermittent drop beats 14. SINUS TACHYCARDIA
F Regularly occurring tachycardia
6. ATRIAL FIBRILLATION F Rate >100/min
F No discernible P waves
F Irregular RR interval 15. LATERAL WALL
F Lead I
7. ASYSTOLE
F Note:
8. VENTRICULAR TACHYCARDIA Lateral wall- Lead I, AVL, V5, V6
F Atleast 3 consecutive PVCs Inferior wall- Lead II, III, AVF
F Rapid, bizarre, wide QRS complexes
Anterior wall- V3, V$
F (.0.10 sec.)
F No P wave (ventricular impulse origin) Anterior septal wall- VI, V2
No specific view- AVR
9. MOBITZ II
F Within period of observation, one P wave is not
followed by a QRS complex 16. Placement of V5
th
F No change in P-R interval before the transient F 5 ICS anterior axillary line
failure of atrio-ventricular conduction F Note:
th
F n: P waves to n-1 QRS complexes for each V1- 4 ICS Right sterna margin
example of transient type II block (n will be 3
th
V2- 4 ICS Left sterna margin
or more) V3- Midway between V2 and V4
F Fixed PR interval with intermittent drop beats th
V4- 5 ICS Midclavicular line (MCL)
th
V5- 5 ICS Anterior axillary line (AAL)
10. TORSADES DE POINTES th
V6- 5 ICS Midaxillary line (MAL)
11. FIRST DEGREE HEART BLOCK
F P waves present 17. The cell membrane is impermeable to entry of sodium ions
F QRS complex present during which phase of the action potential?
F Phase 4 Resting Membrane Potential
P waves morphology and axis usual for the
F F Note:
subject F Phase 0 -Rapid Repolarization
F QRS complexes morphology and axis usual for F -Sodium moves rapidly into the cell
the subject F -Calcium moves slowly into the cell
F One P wave to each QRS complex F Phase 1- Early Repolarization
F P-R interval constant F -Sodium channels close
F P-R interval must be prolonged (i.e. .21 sec.)
F -Transient Potassium efflux

F Phase 2-Plateau Phase
12. PREMATURE VENTRICULAR COMPLEX
F -Calcium continue to flow in

F -Potassium continue to flow out
F Prematurely occurring complex
F Wide, bizarre looking QRS complex F Phase 3-Rapid Repolarization
F Usually no preceding P wave F -Large amount of Potassium diffuse out as the
Potassium channels open

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F -Inactivation of Calcium channels e.
NOTA

18. A 35 y/o F, came in at the ER complaining of progressive 25. What is the prognosis for this type of heart disease?
SOB and DOB for the past month. She is non diabetic and a. 75% mortality in 5 years
non smoker, non alcoholic. On PE she had a BP of b. No improvement if PMC is not done
130/95mmHg, HR 110/min and RR of 30/min. her apex c. Coronary artery bypass grafting should be performed
th to prolong life
beat is displaced at 6 ICS LAAL with a loud S3, no
murmurs were appreciated. She had crackles mid to base d. Patch closure cannot be done because of
in both lung fields with a +1bipedal edema. Her ECG Eisenmenger syndrome
showed ( sorry no images but PE correlates well with e. NOTA
DCMP and Heart failure)
Basis: S3 (indicative of fluid overload) 26. What are the expected chest X-ray findings in this patient?
Crackles, peripheral edema, displaced apex beat point to a. Normal sided heart
DCMP b. Interstitial edema
c. Boot shaped heart

d. Cut off sign of the pulmonary artery
19. The electrical axis on her 12 lead ECG is
a. Right Axis Deviation
27. ECG monitoring shows
Left Axis Deviation ?
a. Ventricular fibrillation
b. Normal b. Fragments of shivering
c. Extreme Right Axis Deviation c. Atrial fibrillation
Note:
d. Ventricular Tachycardia
Lead I (+), AVF (-) = Left axis deviation
Lead I (-), AVF (+) = Right axis deviation 28.
Lead I (-), AVF (-) = Right axis deviation
29. A 60 y/o M, bus driver, hypertensive, 45 pack years
20. Her 12 lead ECG shows smoker, complained of left caudal pain after walking.
a. Right BBB Answer: Clopidogrel + B blocker + stop smoking
b. Right Ventricular Hypertrophy
c. Left Ventricular Hypertrophy ? 30. What anti-arrhythmic agent would you give if the patient
d. Left Posterior Hemiblock is successfully resuscitated with BP of 120/90 mmHg?
e. None of the above a. Verapamil
b. Nifedipine
21. Her clinical findings are compatible with a diagnosis c. Diltiazem
a. Dilated Cardiomyopathy d. Metoprolol
b. Rheumatic Mitral Stenosis
c. Inferior Wall Myocardial Infarction 31. Most common location of PAD
d. TOF a. Abdominal aorta and iliac arteries
e. Atrial Septal Defect b. Femoral and Popliteal arteries
c. Tibial and peroneal
22. To confirm your clinical impression you will request d. Radial and brachial
a. TPCK MB
b. ASO Titer 32. Case: A 57 y/o F, hypertensive, with diabetes, felt
claudication with walking of a distance of >200m, relieved
c. Serum Cholesterol with rest. Based on history alone, what is the probable
d. ECG location?
e. ABG a. Abdominal aorta and iliac arteries
b. Femoral and Popliteal arteries
23. Management would consist of the following except c. Tibial and peroneal
a. Streptokinase d. Radial and brachial
b. Captopril
c. PTCA ? 33. ABI result: Right tibial =1.4
d. Digoxin Right dorsalis pedis =1.3
e. A &C Left tibial =1.1
Left dorsalis pedis =1.0
24. You would advise the patient to Interpretation: Answer- Incompressible right lower extremity and
a. Avoid excessive salt intake
normal left lower extremity
b. Undergo open mitral commissurotomy
c. Undergo patch closure Note: ABI Classification
d. Undergo PTCA >1.3-incompressible

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1.0-1.3-normal d. STEMI
0.90-0.99-equivocal/borderline
0.51-0.89-mild to moderate 8. 70 y/o male, (+) DM, (+) HPN, continuous? Severe chest
0.41-0.50-moderate to severe pain, ST depression at lead II, III, V3, V4, V5, AVL?, (+)
Troponin after 6 hours.
<0.40-severe
a. Stable angina
b. Unstable angina
DR. DEDUYO c. NSTEMI
1. Best antihypertensive with 30 year old patient with d. STEMI
asthma and heart rate of 110-120 bpm
a. ND CCB 9. Which is a contraindication for a thrombolytic therapy in
b. D CCB ACS?
c. B Blocker a. CVA hemorrhage
d. ACEI
b. 180/100mmHg

c. ST elevation ..
2. Female hypertensive, bilateral kidney palpable, abdominal d. ST elevation ..
bruit
a. Renal artery stenosis
10. This is the common cause of death in acute coronary
b. Polycystic kidney disease syndrome.
c. Hyperaldosteronism a. Heart failure
d. Pheochromocytoma b. Pneumonia

c. Ventricular Fibrillation
3. The patient had ECG and cardiac biomarkers, what other d. Sinus tachycardia
test the patient need immediately to detect CAD?
a. 2D echo 11. A 40 y/o male, athletic, hypertensive, but can do regular
b. Coronary angiography
gym activities without any cardiac symptoms
c. Chest X-ray
a. Stage A
d. ____ b. Stage B
c. Stage C
4. A 28 year old female is hypertensive with a bp of 140/100- d. Stage D
160/100. The hypertension had been diagnosed 4 years
ago. Which antihypertensive drug is best for a 28 year old 12. 61 y/o male with orthopnea, fatigue and dyspnea, diabetic
fertile female? with insulin treatment. With dilated ischemic
a. CCB cardiomyopathy.
b. B blocker
a. Stage A
c. ACEI b. Stage B
d. ARBs c. Stage C
d. Stage D
5. 36 y/o male, non HPN, 5cm ST elevation at lead I,AVL,
(sorry di ko maalala masyado) troponin of 150ug/L 13. Gold standard for the diagnosis of heart failure
a. Stable angina a. ECG
b. Unstable angina b. CXR
c. NSTEMI
c. 2D echo Doppler
d. STEMI d. Pro BNP

6. A 62 y/o male was admitted due to severe progressive 14. NC 30 y/o, call center agent, with no previous medical
chest pain. He is hypertensive with COPD because of
illness complained of daily bilateral leg heaviness while at
chronic smoking. BP is 160/100. ECG revealed sinus work. Elevating the legs or walking would temporarily
tachycardia with tall and peaked T wave. Troponin T is relieve the symptoms. While playing basketball, he tripped
negative. and fell landing on his leg. He was brought to the hospital
a. Chronic stable angina pectoris
for treatment. The leg X-ray was negative for fracture. He
b. Unstable angina pectoris
was sent home with NSAIDs. 3 days later the patient
c. NSTEMI noticed the entire left leg is swollen. He was brought to ER
d. STEMI for evaluation and treatment. On measurement, the right
ankle is 21 cm, calf is 38 cm and thigh is 50 cm. on the left
7. A 60y/o patient complained of severe progressive chest lower extremity the ankle measures 25 cm, calf is 44 cm,
pain. BP is 180/110mmHg. ECG revealed LBBB, (+) thigh is 54 cm. Wells score is 4. Your working impression is
Troponin T. DVT. What initial test will you do next?
a. Chronic stable angina a. Venograph
b. Unstable angina b. D-dimer
c. NSTEMI c. Venous duplex scan of LE

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d. CT scan of LE A. Diuretic
D. Angiotensin receptor blocker agent
15. Non invasive procedure to rule in pulmonary embolism B. Calcium channel blocker
Answer: VQ scan E. Beta blocker
C. ACE inhibitor

16. Confirmed pulmonary embolism in left lung, what is the
6. A 56 year old admitted because of acute coronary syndrome
best treatment of choice?
with BP of 160/90 mmHg and a rate of 110 / min.
a. Direct catheter thrombolytics
7. A 76 year old male known diabetic and hypertensive with COPD
b. Systemic thrombolytics
and chronic cough. He is here because of chronic renal failure
c. --------
and scheduled for regular hemodialysis program. His BP is [cut
d. LMWH and dabigatran
off but Im guessing its high?] mmHg.

8. A 42 year old female admitted because of severe difficulty of
1. Endocarditis prophylaxis is indicated in the following: breathing with bilateral crackles occupying (1/2) of the lung
a. Prosthetic heart valves
field. She is regularly receiving ACE inhibitor as maintenance.
b. Previous infective endocarditis
What additional medication is needed for the patient?
c. VSD 9. A 50 year old female obese with family history of diabetes
d. HOCM mellitus. Her lipid profile is [cut off]. She is married and she
e. All of the above wants to have a child but her BP is 140 / 100.

10. A 60 year old female known hypertensive admitted because of
2. Most common site of metastasis in the heart CVA. She is diabetic with BP of 180 / 100 mm Hg.
a. Pericardium
b. Myocardium *******************
c. Endocardium
d. Patients with chest pain.
A. Chronic stable angina pectoris
3. Treatment of choice for ACS C. Non STEMI (MI)
Answer: CABG B. Unstable angina pectoris
D. STEM (MI)

CARDIOLOGY: DR. R. Deduyo 11. A 40 year old male works as an office clerk in manila city hall.
Matching Type: On his way to work he usually climbs the stairs of LRT since age
Patients with problems of hypertension 24. Lately he noticed that he suffers from chest pain every time
A. Pre-hypertension he reaches the top floor, but relieved every time he stops for a
D. Chronic uncontrolled hypertension minute or 2. He is hypertensive but with a good control of his
B. Stage I hypertension BP elevation.
E. Controlled hypertension 12. A 36 year old male with a previous history of DVT and is using
C. Stage II hypertension warfarin sodium regularly while playing basketball in a nearby
court suddenly suffered from severe chest pain with cold
1. A 32 year old call center agent reported to my clinic because of sweating. He was immediately brought to Fatima Medical
problems of elevated BP as detected in their company clinic. Center E.R. and ECG revealed ST elevation at V1. V2 TROP T
On PE BP was 156 / 92 mmHg left arm & right arm in a sitting revealed 600 ng/L. He was immediately transferred to Phil.
position. Cardiovascular PE are all normal 24 hours ambulatory Heart Center for ASIA.
BP confirmed the presence of hypertension of the same level. 13. A 56 year old male NOT known hypertensive but smoker
2. A 60 year old female known to be hypertensive for the last 10 suddenly suffered from severe progressive chest pain with cold
years with a BP ranging from 170 / 110 mmHg to 180 / 120 sweating. He was brought to the E.R. and ECG revealed LBBB
mmHg in spite of 2 medications. with H.S. TROP T revealed 1000ng/L.
3. A 36 year old is worried about a BP of 120 / 80 mm to a highest 14. A market vendor, 46 year old was brought to Fatima ER
BP of 130 / 88 mmHg without any evidence of target organ because of severe chest pain. His BP is 130/90, ECG revealed ST
damage. depression with symmetrical T wave inversion in I & AVL, V5 &
4. A 42 year old, smoker, obese was first seen in my clinic with a V6. TROP is 400 ng/L.
BP of 170 / 100 mmHg without any evidence of target organ 15. If the above patient showed the same ECG findings but the
damage. TROP T is less than 50 mg/L, what then will be your diagnosis?
5. A 50 year old male known hypertensive for the last 10 years.
He is receiving 2 medications to control his BP elevation. BP on
examination is 130 / 80 mm Hg. DIAGNOSTIC TESTS FOR CV DISEASE
A. ECG
************************* D. Cardiac nuclear imaging
B. Treadmill exercise test
Management of hyperetension. This is based on the JNC VII criteria E. Coronary angiogram
of the AHA / ACC. C. 2-D-Echo Doppler

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16. A 36 year old male reported to my clinic because of chest pain. D. Hydrocortisone IV
He described the chest pain to be precipitated by walking for 6 27. All of the following can reduce hospitalization days and
minutes and relieved by rest. He had been hypertensive since rehospitalization of patients with CHF EXCEPT
age 30 with irregular intake of medications to control his BP. A. ACE I B. ARD
The first diagnostic test is which of the above? B. C. Beta Blocker D. Digitalis
17. A 42 year old always complains of chest pain precipitated by 28. Which of the following drugs used for heart failure can make
activity and relieved by rest. His BP is 120/80 to 130/80 mm Hg the patient comfortable but it cannot prolong life nor reduce
with a HR of 66/mins. The first diagnostic test was normal the rate of hospitalization
which was done 3 times. The next test to request is what? A. Furosemide and Digitalis
18. A 46 year old male, known hypertensive diabetic with severe B. Carvedilol
chest pain and diagnosed to have STEMI with TROP T of 600 C. Perindropil
ng/L. To save the life of this patient the best diagnostic test is D. Valsartan
what? 29. Which of the following diuretics can prolong life and reduce
19. A 52 year old diabetic with chronic chest pain even on rest. He rate of hospitalization of patients with heart failure?
is diabetic and with dyslipidemia. Initial test done such as ECG, A. Hydrochlorothiazide
TET and 2-D-echo Doppler revealed to be normal what is the B. Furosemide
best diagnostic test to request? C. Spirinolactone
20. A 62 year old in congestive heart failure with a markedly D. Bumetamide
enlarged heart and crackles all over. What is the gold standard 30. Based on the above data presented in the case presented, what
test to request? do you think is the prognosis of the case with medical
treatment?
******************* A. Good the patient will recover completely
B. Poor the patient will improve in her symptoms
CASE ANALYSIS C. Poor the patient will not improve
A 72 year old female who had undergone CABGS at the D. Very poor, the condition is fatal
USA 15 years ago. She is now admitted at the ICU of Fatima because
of fatiguability, dyspnea, orthopnea and bilateral pedal edema. P.E. DR BARTOLOME
th
revealed markedly displaced apical beat at 6 ICS left mid axillary 2) Most common site cardiac metastasis
line which is fairly audible. The heart sounds are fairly audible. a. Pericardium
There is (+) hepatojugular reflux and (+) jugular venous
engorgement. 2-D-echo Doppler revealed LV dilated with global
3.) DM in CVS
hypokinesia and akinesis with EF of 40%.
a. CAD leading cause of death in DM

21. The underlying cause of the heart failure of this patient is b. MI tend to be larger
A. Chronic uncontrolled hypertension c. abdominal pain in response to MI
B. Dilated ischemic cardiomyopathy d. all
C. Chronic uncontrolled DM e.b & c
D. Pneumonia
22. Which of the following will be the best classification of heart
5.) A holosystolic murmur in left sternal border radiating to the
failure of this patient according to ACC/AHA guidelines.
A. Stage A B. Stage B right.
B. C. Stage C D. Stage D a. Tricuspid regurgitation
23. Which of the following is considered to be the gold standard in b. VSD
the diagnosis of CHF? c. both
A. Chest x-ray d. neither
B. B. ECG
C. C. 2-D echo Doppler
7.) 68 y/o male patient was noted to have systolic murmur at the
D. D. NT-PRO-BNP
24. Which of the following diagnostic test can confirm the diagnosis apex of the heart which radiates to the carotids. Which of the
of CHF as well as the [cut off]? following is unusual in severe aortic stenosis?
A. Dyspnea
25. Which of the following treatment is a marker of inflammation B. Exertional syncope
in atherosclerosis? C. Angina
A. [something INP]
D. Hypertension
B. B. ESR
8.) 28 year old female; bp of 140/40
C. C. HS CRP
D. D. ASO a. pulsus parvus et tardus
26. Which of the following treatment can relieved the dyspnea of b. head bobbing
patients in heart failure?
A. Spirinolactone per orem 9.) 35 year old, female, with dyspnea and orthopnea, RV heave,
B. Furosemide IV . diastolic rumbling murmur at 5th ICS MCL
C. Salbutamol nebulization

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A. Tricuspid Stenosis a. abdominal and arch of aorta
B. Mitral Stenosis
. Aortic regurgitation b. descending thoracic aorta
D. Pulmonary Stenosis
c. supra renal aorta
10) Graham Steel murmur high pitch decrescendo diastolic blowing
murmur noted @ Left upper sternal border due to: d. infra renal aorta
a. Aortic Regurgitation
b. Aortic Stenosis e. entire abdominal aorta
c. Pulmonic Stenosis
d. Pulmonic Regurgitation 1. Most common site of acute aortic dissection
a. ascending aorta
14) Definition of pulsus paradoxus a.inspiratory decline in systolic b. aortic arch
arterial pressure c. infra abdominal aorta
a..a patch of dullness above the left scapular space d. descending aorta
b.delayed carotid upstroke e. supra abdominal aorta

15.) A 45 y/o female patient was brought to the ER due to dyspnea. 5. Clinical criteria takayasu arteritis
She is known to be diagnosed with breast malignancy. Cardiac a. age < 40
Tamponade is suspected. Which is not a manifestation of Cardiac b. systolic BP? >40
Tamponade? c. Brachial artery...
A. Increased arterial pressure d. Carotid pulse....
B. Neck vein engorgement
C. Faint heart sounds 8. Dynamic maneuver to make MVP murmur click sound earlier?
D. Pulsus paradoxus A. Standing (early)
b. Squatting (late)
18.) PDA except? C.Isometric (late)
A. Loud S1 & S2 D. Valsalva's (late)
B. Differential Cyanosis
C. Machinery Murmur 9. Valvular murmur that increases during inspiration?
D. AOTA A. Standing (early)
B. Squatting (late)
19.) A 35 year old male - pleuritic chest pain radiating to the C. Isometric (late)
trapezius ridge on auscultation, grating sound. What is the ECG D. Valsalva's (late)
finding?
A. Widespread ST elevation with concavity 15. Routine anti microbial prophylaxis needed in.....except
b. (something about sa QRS) A. AR
Cc. (something about sa Q wave) B. MVP
C. PDA
21.) A 53 year old male in the ER presented with neck vein D. VSD
distention, ascites, bipedal edema. No S3 no murmur with
Kussmaul's sign. The patient most likely has: 18. true of pda
a. cardiac tamponade a. murmur s1 to after s2 upper sternal boarder
b. acute pericarditis b. machinery like murmur
c. constrictive pericarditis c. differentila cyanosis maybe present
d. tricuspud regurgitation d. aota
e. b%c
23) Radiologic finding of mitral stenosis?
A.bottle shaped 1. Most common site of cardiac metastasis
B. "3 sign" Pericardium
C. boot shaped, normal sized heart
D.dilated left atrium, normal sized ventricle 2. DM in CVS
a. CAD leading cause of death in DM
b. MI tend to be larger
26.) What is the most common location of syphilitic aneurysm?

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c. Abnormal pain response to MI 11. A 35 y/o male with pleuritic chest pain radiating to the
d. All of the above trapezius ridge on auscultation, with grating sound. What is
e. B & C the ECG finding?
a. Widespread ST elevation with concavity
3. A holosystolic murmur in left sterna border radiating to the b. (something about QRS)
righ c. (something about Q wave)
a. Tricuspid Regurgitation 12. A 53 y/o male in the ER presented with nexk vein
b. VSD distention, ascites, bipedal edema. No S3, no murmur with
c. Both Kussmauls sign. The patient most likely has:
d. Neither a. Cardiac tamponade
b. Acute pericarditis
4. 68 y/o male patient was noted to have systolic murmur at c. Constrictive pericarditis
the apex of the heart which radiates to the carotids. Which d. Tricuspid regurgitation
of the following is unusual in severe Aortic Stenosis?
a. Dyspnea 13. Radiologic finding for Mitral Stenosis?
b. Exertional syncope a. Water bottle shaped (Pericardial Effusion)
c. Angina b. 3 sign (Coarctation of the Aorta)
d. Hypertension c. Boot shaped, normal sized heart (Tetralogy of Fallot)
d. Dilated left atrium, normal sized ventricle
5. 28 y/o female, BP of 140/40 mmHg (kulang ata itong given
sa Q) aortic regurgitation
a. Pulsus parvus tardus 14. What is the most common location of syphilitic aneurysm?
b. Head bobbing Answer: Ascending Aorta

6. 35 y/o female, with dyspnea and orthopnea, RV heave, 1. Most common site of acute aortic dissection
th
diastolic rumbling murmur at 5 ICS MCL a. Ascending aorta
a. Tricuspid stenosis b. Infra abdominal aorta
b. Mitral stenosis c. Descending aorta
c. Aortic regurgitation d. Supra abdominal aorta
d. Pulmonary stenosis
2. Clinical criteria of Takayasu arteritis
7. Graham Steell murmur high pitch decrescendo diastolic a. Age <40
blowing murmur noted at left sterna border due to
a. Aortic regurgitation b. Systolic BP >40
b. Aortic stenosis c. Brachial artery
c. Pulmonic stenosis d. Carotid pulse

d. Pulmonic regurgitation 3. Dynamic maneuver to make MVP murmur click sound
earlier?
8. Definition of Pulsus paradoxus is a. Standing (early)
a. Inspiratory decline in systolic arterial pressure b. Squatting (late)
b. Patch of dullness above the left scapular space c. Isometric (late)
c. Delayed carotid upstroke d. Valsalvas (late)

9. A 45 y/o female patient was brought to the ER due to 4. Valvular murmur that increases during insipiration?
dyspnea. She is known to be diagnosed with breast Answer: Caravallos sign
malignancy. Cardiac tamponade is suspected. Which is not a
manifestation of cardiac tamponade?
5. Routine antimicrobial prophylaxis needed, except
a. Increased arterial pressure
a. AR
b. Neck vein engorgement
b. MVP
c. Faint heart sounds
c. PDA
d. Pulsus paradoxus
d. VSD


10. PDA except
6. True of PDA
a. Loud S1 and S2
a. Murmur S1 to after S2 upper sterna border
b. Differential cyanosis
b. Machinery like murmur
c. Machinery murmur
c. Differential cyanosis may be present
d. All of the above
d. All of the above

e. B & C

FC DC JC CC ADJ JPDM 8

 CARDIOLOGY COMPILED SAMPLEX 2015
PLEASE DONT RELY SOLELY ON THIS SAMPLEX. STUDY THE TOPICS AND PREFERRABLY STUDY HARRISONS!
7. ECG in acute pericarditis e. supra abdominal aorta
Answer: widespread ST segment elevation

8. Radiologic finding in mitral stenosis 5. Clinical criteria takayasu arteritis
a. Water bottle a. age < 40
b. 3 sign b. systolic BP? >40
c. Boot shaped c. Brachial artery...
d. Large atrium and normal ventricle d. Carotid pulse....

8. Dynamic maneuver to make MVP murmur click sound earlier?
9. 45 y/o F, history of breast cancer with cardiac tamponade.
A. Standing (early)
Features of cardiac tamponade except:
b. Squatting (late)
a. Increased arterial pressure
C.Isometric (late)
b. Neck vein distention
D. Valsalva's (late)
c. Faint heart sounds

d. Pulsus paradoxus
9. Valvular murmur that increases during inspiration?

A. Standing (early)
10. Relationship of DM and cardiovascular disease B. Squatting (late)
a. Most common cause of death in DM is coronary C. Isometric (late)
artery disease
D. Valsalva's (late)
b. In DM, MI is larger
c. Abnormal pain response to myocardial ischemia 15. Routine anti microbial prophylaxis needed in.....except
d. All of the above A. AR

B. MVP
11. Loud S1 diastolic rumbling murmur C. PDA
a. AS D. VSD
b. MS
c. MR 18. true of pda
d. AR a. murmur s1 to after s2 upper sternal boarder
12. Systolic murmur radiating to axilla: b. machinery like murmur
a. AS c. differentila cyanosis maybe present
b. MS d. aota
e. b%c
c. MR
d. AR 18. True of PDA:
a. murmur from S1 up to before S2 @ upper sternal border
13. Normal LV, dilated LA: b. machinery like murmur at the upper sternal border
a. AS c. differential of chanosis may be present
b. MS d. all of the above
c. MR e. B&C
d. AR
Ecg in acute pericarditis - widespread st segment elevation
14. Most common organism found in the blood culture after
dental procedure 20. Radiologic finding in mitral stenosis
a. S. viridians a. water bottle
b. S. pneumonia b. 3 sign
c. Chlamydia c. boot shaped
d. S. aureus d. Large atrium and normal ventricle

15. Common sign to LV diastolic dysfunction 26. 45 yo F, hx of breast ca w/ cardiac tamponade. Features of
a. Dyspnea on exertion cardiac tamponade EXCEPT:
b. Chest pain exertion a. Increased arterial pressure
c. Easy fatigability b. Neck vein distention
d. Palpitation c. Faint heart sounds
d. Pulsus paradoxus


30 relationship of DM and cardiovascular disease
Most common site of acute aortic dissection
A. Most common cause of death in DM is coronary artery disease
a. ascending aorta
B. In DM, MI is larger in size
b. aortic arch
C. Abnormal pain response to myocardial ischemia
c. infra abdominal aorta
D. All of the above
d. descending aorta

FC DC JC CC ADJ JPDM 9