PATHOLOGY B: Samplex Compilation DEE1

1.1 Heart

Plating Exam SY 2011-2012 Second Semester 10. Two hours after the onset of chest pain, the best lab exam
to request to verify the clinical impression of heart attack
is:
1. The posterobasal wall of the left ventricle is supplied by A. Troponon T
the: B. Myoglobin
A. Left anterior descending C. CRP
B. Left circumflex D. CK-MB
C. Right coronary
D. A & C only 11. In cardiac rupture syndrome, cardiac tamponade is
E. A, B & C common in ___ rupture:
A. Ventricular septum
2. Cardiac cycle is initiated by: B. Ventricular free wall
A. AV node C. Papillary muscles
B. SA node
C. Bundle of His 12. Chronic ischemic hear disease is commonly associated
D. Right and Left bundle branches with:
A. Angina attacks
3. Patients with pure LSHF presents with the following B. Previous MI
EXCEPT: C. Both
A. Ascites D. Neither
B. Orthopnea
C. Cough 13. Sudden cardiac death is caused by the following EXCEPT:
D. Dyspnea A. AMI
B. Myocarditis
4. Bipedal edema is a hallmark of: C. Amphetamine abuse
A. RSHF D. Mitral stenosis
B. LSHF
14. In mitral valve prolapsed, an important clinical
5. Vasospasm of the coronary is associated with this form of manifestation would be:
angina: A. Diastolic murmur, soft mitral area
A. Stable B. Harsh, machinery like murmur
B. Prinzmental variant C. mid-systolic click, mitral valve area
C. Crescendo D. chest pain
D. A & C E. none of the above

6. Which of the following left to right shunt is commonly 15. Which condition/s would a loud friction rub be most
associated with TOF: characteristic?
A. ASD A. Fibrinous pericarditis
B. VSD B. Caseous pericarditis
C. PDA C. Serous pericarditis
D. Patent foramen ovale D. Constrictive pericarditis
E. B & C only
7. Most ventricular septal defect are ___ type:
A. Muscular 16. Predisposition to development of chronic cor pulmonale
B. Membranous would be:
C. Infindibular A. Primary pulmonary hypertension
D. A & C B. Kyphoscoliosis
C. Metabolic acidosis
8. A transmural myocardial infarct may not be associated D. A & B only
with atheromatous plaque thrombosis in about 10% of E. A, B, C
cases:
A. True 17. Which type(s) of cardiomyopathy(ies) has(have) the
B. False pathogenesis associated with alcohol abuse,
hemochromatosis and myocarditis?
9. AMI affecting the anterior wall of the left ventricle near A. Hypertrophic
apex is due to occlusion of: B. Dilated
A. Left anterior descending C. Restrictive
B. Left circumflex D. A & B
C. Right coronary E. B & C
D. A & C only
E. A, B & C
PATHOLOGY B: Samplex Compilation DEE2
1.1 Heart

18. Cardiac myxoma is characterized by: 5. A 40 y/o female cosulted at the ER due to recurrent
A. 90% are located in the atria, more in the left attacks of substernal discomfort the occurs commonly
B. mobile tumors may exert a “wrecking-ball” when she is working or extremely happy but now even at
effect on valve leaflets rest. She noted that unlike before in which the discomfort
C. it can be identified by echocardiography is relieved by rest of nitroglycerin. The chest discomfort is
D. A & B only now persisted for 10 minutes. Your primary consideration
E. A, B, C is:
A. Typical angina pectoris
19. Which of the ff. conditions is characterized by impaired B. Prinzmental angina pectoris
ventricular filling during diastole? C. Crescendo angina pectoris
A. Dilated cardiomyopathy D. Myocardial infarction
B. Hypertrophic cardiomyopathy
C. Restrictive cardiomyopathy 6. The possible mechanism/s of chest discomfort in this
D. A & B only patient include/s:
E. B & C only A. Atherosclerotic plaque change
B. Vasospasm
C. Thrombosis
D. A & C only
Prelim Exam SY 2012-2013 Second Semester E. A, B & C

1. A 50 y/o male hypertensive, diagnosed case of left sided 7. The discomfort experienced by the patient persisted for 2
heart failure presented with 3 pillow orthopnea. PE hours even after giving nitrites and calcium channel
showed hepatosplenomegaly and pedal edema. The pedal blocker. Patient then developed weak rapid pulse
edema according to the patient was 6 months prior to associated with diaphoresis. ECG shows ST segment
consult. Morphologic feature/s seen in the patient elevation in leads V3-V6. The vessel most probably
include/s: obstructed is:
A. Pulmonary edema A. Left anterior descending coronary
B. Cardiac sclerosis B. Right coronary
C. Cardiomegaly C. Left circumflex
D. A & C only D. A & C
E. A, B & C E. A, B & C

2. A newborn baby boy was noted to be cyanotic upon birth 8. Laboratory examinations were requested. Which of the
but turns pink after several minutes. Auxcultation revealed following will be elevated?
a loud systolic murmur. Your primary diagnosis is: A. Troponin T or I
A. ASD B. CK-MB
B. VSD C. C-reactive protein
C. Coarctation of aorta D. A & B only
D. TOF E. A, B & C

3. His 30 y/o father was diagnosed of heart disease when he 9.
was 5 years old while her 46 y/o primigravid mother had
rubella infection at 38 weeks AOG. The risk factor/s
present in the above case is/are:
A. Rubella infection
B. Family history: heart-disease-father
C. Mother primigravid at 46 y/o
D. B & C only
E. A, B, & C
Patient was subsequently elevated in the coronary care
unit (CCU). Four days later, while recovering in the Ccu she
suddenly became hypotemsive and died within an hour.
What complication/s is the most probable cause of death?
A. Arrhythmia
B. Ventricular free wall rupture
C. Progressive heart failure
D. A & B only
E. A, B & C

4. A newborn baby girl was noted to be cyanotic since birth.
PE revealed murmur. Clinical assessment was TOF. Which
of the following is/are true?
A. ASD produces the murmur
B. Mixing of the oxygenated blood to the
unoxygenated blood causes the cyanosis
C. Oxygenation is decreased due to an obstruction
to the pulmonary outflow from the right
ventricle
D. B & C only
E. A, B & C
10. If autopsy was done, what morphologic feature/s would
you expect to see?
A. Coagulative necrosis of the cardiac myocytes
with neutrophilic infiltrates
B. Granulation tissue at the border of the lesion
C. Coronary obstructed by atherosclerosis with
thrombus
D. A & C only
E. A, B & C
PATHOLOGY B: Samplex Compilation DEE3
1.1 Heart

11. A 60 y/o hypertensive patient presented with anasarca. 18. A woman delivered her baby at 38th week of gestation,
Past medical history revealed CIHD. The above patient has: with history of hypertensive episodes during pregnancy.
A. LV hypertrophy &/or dilation Two weeks post partum developed cardiomyopathy.
B. RV hypertrophy &/or dilation Which of the following describes her condition?
C. Scars in the heart A. The heart chamber has banana shaped
D. A & C only configuration
E. A, B & C B. She has diastolic dysfunction
C. There is amyloid deposition in the heart
12. A 50 y/o patient presented with hypertension when BP D. None of the above
was taken in the right arm. PE revealed weak pulse in the E. A, B, C
pedal artery. Your primary diagnosis is?
A. Aortic stenosis 19. A 10 y/o male child frequently experiences documented
B. Pulmonary stenosis group A streptococcal pharyngitis, which of the ff. would
C. Coarctation of aorta be the most probable outcome if the heart in involved?
D. Aortic regurgitation A. Presence of bulky friable vegetation on the
mitral valve with bacterial colonies
13. CXR revealed notching of the undersurface of the ribs. The microscopically
above is due to enlarged ___ artery/arteries: B. Presence of activated macrophages admixed
A. Intercostals with lymphocytes on the different layers of the
B. Internal mammary heart
C. Coronary C. The ductus arteriosus stays patent
D. A & B only D. A & B
E. A, B & C E. NOTA

14. TRUE of cardiac myxomas: 20. Sudden cardiac death is usually the outcome of:
A. This is the most common metastatic tumor of A. Cardiac rupture
the heart in adults B. Vasospasm
B. Usually located in the atrium C. Letahal arrhythmia
C. Associated with Carney complex D. Ventricular tachycardia
D. B & C only
E. A, B, C ASSOCIATION TEST A-A, B-B, C- both, D – neither

15. Cardiac rhabdomyomas are often associated with this 21. Systemic hypertensive heart disease is characterized by:
disease: A. Concentric left ventricular hypertrophy
A. Cystic fibrosis B. Trigerred by lung emphysema
B. Tuberous sclerosis
C. Turner syndrome 22. Prosthetic valve endocarditis is caused by:
D. Retinoblastoma A. Coagulase positive staphylococcus
B. S. epidermidis
16. Cardiac tamponade is usually a consequence of:
A. Chronic increased of up tp 450 ml of fluid in the 23. Sterile vegetations are seen in:
pericardial space A. Marantic endocarditis
B. A sudden accumulation of 300 ml of fluid in the B. Libman Sacks endocarditis
pericardial space
C. Cardiac aneurysm post MI 24. In restrictive cardiomyopathy there is:
D. B & C A. Impaired ventricular filling
E. A, B, C B. Association with lipofuschin deposits

17. Hemorrhagic pericarditis is brought about by which of the 25. In the morphology of chronic ischemic heart disease the ff.
following? is found:
A. Presents of caseating granulomas A. Myocardial atrophy
B. Metastatic carcinoma to the heart B. Fibrosis
C. An open cardiac surgery for VSD
D. A & B
E. A, B, C LAB QUESTIONS

C 1. Congenital heart defect with left to right shunt A. RHD

A 2. Presence of fishmouth mitral stenosis B. TOF
B 3. Congenital heart defect with right to left shunt C. PDA
E 4. Commonly associated with myocardial infarction D. SBE
D 5. Strep. Viridans is a common etiologic agent
E. Hemorrhage, heart
PATHOLOGY B: Samplex Compilation DEE4
1.1 Heart

Plating Exam SY 2013-2014 First Semester 7. A 40 year old woman was diagnosed with SLE five years
ago. Laboratory exams revealed small vegetations on her
mitral valve, which of the ff. is true?
1. A 45 year old man complains of on and off headache. He A. She has big bulky vegetations on the valve
consulted an intermist, physical examination was normal B. She has marantic endocarditis
except for a blood pressure of 145/90mmHg. He was C. Associated with serofibrinous pericarditis
advised to monitor his blood pressure for a week. His BP D. A & C
ranges from 140-150/90-100 nnHg. Which of the ff. E. A, B, C
statements is/are TRUE?
A. Determination of CK-MB is warranted at this 8. A newborn has his aorta arising from the right ventricle
point and his pulmonary artery in the left ventricle which of the
B. ECG might reveal presence of left ventricular ff. is TRUE of his condition?
hypertrophy A. A concmitant PDA would provide stable shunt
C. There is increased total peripheral resistance B. This is a cyanotic hear disease
D. B & C C. There is discrepancy in the upper and lower
E. A, B, C extremities’ blood pressure
D. A & B
2. Chest x-ray of a 70 year old male patient reveals presence E. A, B, C
of atheromatous aorta, which of the ff is associated with
his condition? 9. An autopsy is done on a man who has lung carcinoma who
A. Left ventricular hypertrophy suddenly complained of chest pain, his heart is shown to
B. Elevated blood pressure have pale areas in the lateral posterobasal wall of the left
C. Right ventricular dilated hypertrophy ventricle. Which of the ff. coronary arteries is/are
D. A & B occluded?
E. A, B, C A. Left circumflex artery
B. Left anterior descending artery
3. Which of the ff. best describe the heart of an 80 year old C. Right artery
woman? D. A & C
A. There is thin pericardial fat E. B & C
B. Left ventricular chamber is smaller
C. There is mitral valve insufficiency 10. A patient who experiences chronic severe pulmonary
D. A & B hypertension has the ff:
E. A, B, C A. Right ventricualr hypertrophy
B. Hepatosplenomegaly
4. A 55 year old man who is a chronoc alcoholic developed C. Azotemia
cardiomyopathy, which of the ff, is associated with his D. A & B
condition? E. A, B, C
A. His heart chamber is banana like in configuration
B. His cardiac myocytes are hypertrophied ASSOCIATION TEST A-A, B-B, C- both, D – neither
C. He has systolic dysfunction
D. B & C 11. Incompatible with post natal life without shunt:
E. A, B, C A. Coarctation of aorta
B. Transposition of great arteries
5. On radiographic examination, a 45 year old male patient
was found to have enlarged right ventricle, which of the ff. 12. Disease with acute serous pericarditis
is attributed to this condition? A. Scleroderma
A. Presence of pulmonic stenosis B. Uremia
B. Insufficient mitral valve
C. Atheromatous plaque on the aorta 13. This is due to the atherosclerosis induced perfusion
D. B & C imbalance
E. A, B, C A. Prinzmental angina
B. Stable angina
6. A 55 year old patient complains of chest pain, upon
examination he was noted to have cold clammy 14. TRUE of Aschoff nodule:
perspiration, if he is suffering from transmural acute A. Composed of collagen
myocardial infarction which of the ff. is associated? B. Can be found in the myocardium
A. The CK-MB level will be elevated on the fifth day
post infarct 15. Disruption of atherosclerotic plaque can induce:
B. Granulation tissue is observed on the first week A. Crescendo angina
C. ECG shows ST segment elevation B. Prinzmental angina
D. B & C
E. A, B, C
PATHOLOGY B: Samplex Compilation DEE5
1.1 Heart

16. Staphylococcus aureus is associated with 3. Small, fibribous, sterile vegetations in either side of the
A. Acute infective endocarditis valve leaflets occur in:
B. Subacte infective endocarditis A. Non-bacterial, thrombotic endocarditis
B. Carcinoid heart disease
17. In persistent truncus arteriosus there is: C. Libman-Sack disease
A. A single great artery D. RHD
B. No separate superior vena cava E. Subacute infective endocarditis

18. Patient with myocarditis is infected with: 4. Due to toxicity in a male chronic alcoholic patient, the
A. An enterovirus heart condition that he would be prone to develop is:
B. Coxsackie A virus A. Hypertrophic cardiomyopathy
B. Restrictive cardiomyopathy
19. A left ventricular tumor in a 24 year old female may be: C. Dilated cardiomyopathy
A. Myxoma D. Acute myocarditis
B. Metastatic lymphoma cells E. Chronic pericarditis

20. On autopsy of a 50 year old male the right ventricle is 1.5 5. Limited diastolic expansion and low cardiac output is
cm encountered in:
A. He hs Eisenmenger syndrome A. Dilated cadiomyopathy
B. He has left ventricular failure B. Constrictive pericarditis
C. Mitral valve prolapse
LAB QUESTIONS: D. B & C only
E. A, B, C
1. Presence of hemorrhage in the heart indicates/ is present
in: 6. The most common primary tumor in adults associated
A. Myocardial infarction with:
B. Trauma A. 90% rise in the left atrium
B. pedunculated masses exert trauma to the AV
2. Characteristic/s of infective endocardities microscopically: valves
A. Bacterial colonies C. the stroma shows an acid mucopolysaccharide
B. Inflammatory infiltrates matrix
D. A & B
3. Component/s of TOF: E. A, B, C
A. ASD
B. Aortic stenosis 7. A 50 y/o male patient had an ECG and received the result
that he has left vetricular hypertrophy. His blood pressure
4. The gross specimen of RHD show: is 180/90. He also had a finding of aortic valve stenosis.
A. Fusion of chordae tendinae Which is TRUE of his condition?
B. Thickened chordae tendinae A. He can be diagnosed as having systemic
hypertensive heart disease
5. Found in RHD slide B. His cardiac change woukd be concentric type of
A. Hemorrhage hypertrophy
B. lymphocytes C. The problem with his cardiac change is a
decrease in cardiac output
D. A & B only
E. B & C only
Plating Exam SY 2013-2014 Second Semester
8. Auscultation of the mitral valve area of a 20 year old
female revealed a mid-systolic click, this finding is noted
1. Which is NOT a correct component of Aschoff bodies?
in:
A. Foci of fibrinous exudates
A. Chronic RHD with mitral stenosis
B. Caterpillar cells with wavy chromatin
B. Mitral valve prolapse
C. Surrounding mononuclear inflammatory cells
C. Infective endocarditis
D. Activated macrophages
D. Carcinoid heart disease
E. C & D
E. Libman-Sacks endocarditis
2. In acute infective endocarditis, which feature/s would be
9. Which produces serous type of pericarditis?
characteristic?
A. RHD
A. A 2cm vegetation s with valve destruction and
B. Uremia
abscess in adjacent myocardium
C. SLE
B. Distal emolization with septic infarcts
D. A & B only
C. 5 mm bland vegetations
E. A, B, C
D. A & B
PATHOLOGY B: Samplex Compilation DEE6
1.1 Heart

10. A 48 y/o female suffers from a pulmonary embolism, what 18. Eisengermenger syndrome is observed in patients with:
would be the cardiac effect of this condition? A. Left to right shunt at birth
A. Thickening of the left ventricle B. Right to left shunt at birth
B. Dilated right ventricle C. Obstructive congenital heart disease at birth
C. Right ventricular hypertrophy D. None of the above
D. Dilated left ventricle
E. B & D only 19. Separation of systemic from pulmonary circulation is
observed in:
11. Most cases of myocarditis in the US would be due: A. Terallogy of fallot
A. Coxsackie virus A & B B. Transposition of great arteries
B. AIDS C. Total anomalous pulmonary venous connection
C. Rheumatic fever D. None of the above
D. Toxins from C. diphtheria
E. None of the above 20. Valvular diseases can bring about which type of
hypertophy?
12. What feature/s is/are noted in a case of hypertrophic A. Dilated
cardiomyopathy? B. Hypertrophic
A. Left ventricular outflow tract obstruction C. Volume overload
B. Assymetric bulging of the ventricular septum D. A & C
C. Poor diastolic relaxation E. A, B, C
D. A & B only
E. A, B, C 21. A patient with pure left sided heart failure will manifest
the ff:
13. Patients with chronic ischemic heart disease is A. Peripheral edema
characterized by the ff: B. Orthopnea
A. On and off angina attacks C. Presence of 150 ml of fluid in the pleura
B. Usually are very young in age with familial D. B & C
tendency E. A, B, C
C. There is progressive heart failure
D. A & C 22. Brown atrophy of the heart is characterized by:
E. A, B, C A. Commonly seen in young individuals with
congenital heart anomaly
14. Vasospasm is part of the pathology of this/these type/s of B. Lipofuschin deposition
angina pectoris: C. Increased in sarcomeres
A. Prinzmental D. B & C
B. Stable E. A, B, C
C. Crescendo
D. A & B 23. The autonomic nervous system has the ff. function/s in the
E. A & C heart:
A. Controls SA node rate of firing
15. An autopsy is done on a patient who died of MI three B. Increase heart rate in response to exercise
hours ago. Which of the ff. microscopic findings is C. Responds in cases of increased oxygen demand
expected to be seen? D. B & C
A. Loss of nuclei E. A, B, C
B. Granulation tissue
C. Waviness of infarcted cells 24. Severity of symptoms in TOF is dependent on:
D. None of the above A. Pulmonic stenosis
E. A, B, C B. PDA
C. Aortic stenosis
16. Most of the genetic abnormalities causing congenital heart D. VSD
diseases affect the function of:
A. Transcription factors 25. In myocardial infarction associated with coronary artery
B. Cell cycle regulators atherosclerosis, the ff. contribute to the evolvement of
C. Translation factors infarction”
D. None of the above A. Disruption of atherosclerotic plaque
B. Formation of thrombus
17. Paradoxical embolism is brough about by which condition? C. Vasospasm
A. Coarctation of aorta D. All of the above
B. Terallogy of fallot
C. VSD
D. None of the above
PATHOLOGY B: Samplex Compilation DEE7
1.1 Heart

LAB QUESTIONS: 4. A 35 year old female complains of dyspnea, her doctor

noticed a grade 1 bipedal edema. Chest x-ray shows
1. Tetrallogy of fallot has presence of a globally enlarged heart, if the patient is
A. PDA suffering from heart failure, which of the following
B. ASD statement is/are true?
A. A physical examination would show a liver span
2. Gross RHD is characterized by: greater than normal.
A. elongated chorda tendinae B. The patient has biventricular heart failure
B. fusion of tendinae C. She has elevated BUN and createnine levels
D. A & B
3. Eosinophilic collagen material with lymphocytes in the E. A, B, C
myocardium are observed in:
A. SBE 5. A patient who is a known patient with cardiac pathology
B. RHD underwent chest thoracentesis, 600ml of serous fluid was
collected. The condition is attributed to:
4. Large vegetations are observed in: A. Left sided heart failure
A. SBE B. Right sided heart failure
B. RHD C. Cardiac tamponade
D. None of the above
5. Hemorrhage in the heart is brought about by:
A. A preceeding ischemia 6. A nineteen year old female patient has a congenital heart
B. Cardiac trauma disease since birth. ECG shows a connection between the
two ventricles. When complication/s must be watched out
in her condition?
Plating Exam SY 2014-2015 First Semester A. Thickening of the papillary muscles
B. Reversal of shunt from right to left to left to right
1. You are studying the slide of myocardial infarction and you C. Eissenmenger syndrome
see areas where the cardiac muscle cells are striated. D. B & C
Which of the ff. statement is TRUE?
A. The area that you see is the infarcted area 7. A newborn baby is noted to have episodic cyanosis after
B. This area is the initial change seen in myocardial birth. Through examination and laboratory work ups show
infarction presence of tetralogy of fallot. Which of the following is
C. This area will not take up triphenyl tetrazolium responsible for the severity of symptoms in this patient?
stain A. Aortic stenosis
D. None of the above B. Left ventricular hypertrophy
C. PDA
2. Electron microscopy of the heart shows gap junction, this D. None of the above
is involved in the following function/s:
A. Release of troponin during cell damage 8. An infant is noted by the mother to have cyanosis of the
B. Atrionaturetic peptide transfer from one cell to bilateral lower extremities, which of the ff. scenario is
another possible in this case?
C. Exchange of ions between cells A. Patient has narrowing of the aorta
D. All of the above B. Patient doesn’t have PDA
C. The aorta arises from the right ventricle
3. A 50 year old male patient who is diagnosed with right D. The patient has atrial septal defect
sided heart failure is expected to have the ff
characteristic/s: 9. A 50 year old male patient experiences fatigue and chest
A. Cardiac muscle cells on both ventricles exhibit discomfort when playing basketball, he consulted an
increase in the number of cellular mitochondria internist. ECG, chest x-ray and other laboratory exams
B. There is increased in the number of capillaries were required which revealed presence of an aortic
supplying the cardiac muscles atheromatous plaque. He was prescribed with
C. There is about 75% occlusion of one or more vasodilators. Which of the ff is TRUE in this patient?
coronary arteries A. Coronary spasm has somethis to do with the
D. There is chronic elevated pressure in the lungs symptoms
E. All of the above B. The plaque is distributed leading to the
symptoms
C. He has stable angina
D. His condition may immediately lead to infarction
PATHOLOGY B: Samplex Compilation DEE8
1.1 Heart

10. An eighty year old female patient admitted in the ICU has 17. Patients with uremia had pericardial effusion:
an ECG traciong showing ST elevation, this finding may A. Fluid has fibrin
mean: B. Fluid is serous
A. Full thickness infarction C. Both
B. Presence of thrombus in major coronary artery D. Neither
for about 45 minutes
C. Risk of arrhythmia in the first 24 hours of injury 18. Which of the ff. is a primary tumor commonly seen in the
D. B & C heart of individual in older age group?
E. A, B, C A. Lymphoma
B. Myxoma
11. The above patient (in #10) has the ff. laboratory features: C. Rhabdomyoma
A. Elevated troponin I on the first day D. Lipoma
B. Normal CK MB on the second day after the injury
C. Elevated ASO titer 19. A 75 year old male patient have the ff. cardiac profile:
D. All of the above A. Small left ventricular chamber
B. Increased number of cardiac muscle cells
12. A 37 year old female patient is know SLE patient, over the C. Numerous hemosiderin pigments
years she develop a valvular disease. Which of the ff is an D. All of the above
anatomic finding:
A. A bulky friable vegetation is seen in the valve 20. On physical examination a patient is noted to have
B. Gram stain of the smear taken from the valvular irregular heart rate and rhythm, which of the ff hear
lesion shows presence of gram positive component is most probably deranged?
microorganism A. Gap junctions
C. Vegetations both side of the valves is seen B. Sarcomere
D. None of the above C. SA node
D. Left anterior descending artery
13. Presence of Anitskow cells on microscopic examination of
the myocardium is correlated with: LAB QUESTIONS:
A. It is a result of a hypersensitivity reaction
B. Migratory polyarthritis 1. Component/s of tetrallogy of Fallot:
C. Normal ESR A. Right ventricular hypertrophy
D. All of the above B. Pulmonic stenosis

14. A patient with an existing cardiac problem has fever, blood 2. In the gross picture of RHD, there is:
culture reveals presence of Streptococcus viridans. The A. A big vegetation in the valve
patient has increased risk of developing which of the ff.? B. The chorda tendinae are normal
A. Myocarditis
B. Restrictive cardiomyopathy 3. The cardiac hemorrhage can be caused by:
C. Acute endocarditis A. Myocardial infarction
D. Suppurative pericarditis B. Penetrating injury
E. None of the above
4. In RHD, the ff. microscopic feature is/are seen:
15. Which of the ff. conditions is expected to have dysfunction A. Collagen material
during diastole? B. Lymphocytes
A. Massive infiltration of amyloid in the heart
B. Cardiomyopathy developing in a 25 year old 5. Bacterial colonies are found in which heart lesion?
female who just gave birth 3 weeks ago A. SBE
C. Presence of metastatic malignant lymphoid B. RHD
infiltration in a small portion of the anterior LV
wall
D. All of the above

16. A patient with malignant sarcomatous lesion in the heart is

noted to have 100 ml of pericardial fluid. The ff. statement
is TRUE:
A. The fluid is characterized as bloody
B. The fluid has numerous neutrophils
C. The patient has risk of cardiac tamponade
D. None of the above because the fluid amount is
normal
PATHOLOGY B: Samplex Compilation DEE9
1.1 Heart

Prelim Exam SY 2014-2015 Second Semester 10. Which is NOT a component of the Aschoff nodule?
A. Mononuclear inflammatory cells
1. The conducting myocyte is found in the right atrium along B. Cells with wavy chromatin
the atrial septum: C. Fibrinous exudate
A. AV node D. Activated macrophages
B. Bundle of His
C. SA node 11. Seen as small, fibrinous, sterile vegetations on either side
D. Right bundle banch of the valve leaflets occurs in:
A. Marantic endocarditis
2. A patient has infarction in the anterior 2/3 of the IV B. Carcinoid heart disease
septum, which coronary is most probably blocked? C. RHD
A. Right coronary artery D. Endocarditis associated with SLE
B. Left circumflex artery E. Acute infective endocarditis
C. Left anterior descending
D. Aorta 12. Which of the ff. is characterized by limited diastolic
expansion and low cardiac output?
3. Concentric hypertrophy of the left ventricle is associated A. Dilated cardiomyopathy
with the ff: B. Tricuspid stenosis
A. Mitral valve insufficiency C. Mitral valve prolapse
B. Increased peripheral resistance D. Constructive pericarditis
C. Tricuspid valve stenosis
D. All of the above 13. A 58 y/o female patient is diagnosed with multiple
myeloma, amyloid deposition in organs is associated with
4. A hypertrophic cardiac muscle cell is characterized by: her condition. The heart disorder that she should be prone
A. Increase number of mitochondria to develop is:
B. Increase in sarcomeres A. Hypertrophic cardiomyopathy
C. Increase protein synthesis B. Restrictive cardiomyopathy
D. All of the above C. Dilated cardiomyopathy
D. Acute myocarditis
5. Renal changes in left-sided heart failure contributes to: E. Chronic pericarditis
A. Peripheral edema
B. Anasarca 14. Which of the ff. is associated with the most common
C. Pulmonary edema primary tumor in adults:
D. Pleural effusion A. 90% arise in the left ventricle
B. pedunculated masses leads to trauma to the AV
6. Which of the ff. is NOT an obstructive congenital anomaly? node
A. Pulmonary atresia C. acid mucopolysaccharide matrix
B. TOF D. A & B
C. Coarctation of aorta E. B & C
D. Aortic stenosis
15. A 45 y/o male patient had an ECG which revealed presence
7. Acute plaque change has the ff. consequence/s: of aortic valve stenosis and left ventricular hypertrophy.
A. Thrombosis His blood pressure is 160/90. Which of the ff is TRUE?
B. Vasoconstriction A. He has systemic hypertensive heart disease
C. Inflammation B. There is dilated type of hypertrophy
D. All of the above C. There is a decrease in cardiac output
D. None of the above
8. If the heart chamber has inability to expand and fill up
sufficiently there is: 16. Cardiac auscultation of a 5 year old female revealed a
A. Systolic dysfunction machinery-like murmur, which of the ff statements is
B. Diastolic dysfunction associated?
C. Both A. She is suffering from chronic RHD with mitral
D. Neither stenosis
B. The patient has mitral valve prolaps
9. What makes a hypertrophied cardiac muscle prone to C. The murmur is the complication of infective
decompensation? endocarditis
A. Increased workload D. There is a connection between the pulmonic
B. Calcified valves artery and the aorta
C. Inadequate blood supply
D. Stasis of blood
PATHOLOGY B: Samplex Compilation
1.1 Heart
17. A 37 y/o female suffers from a severe acute pulmonary
embolism, what is the expected outcome?
A. Right venticular dilatation
B. Concentric left ventricular hypertrophy
C. Hypoplastic left atrium
D. Pulmonary artery stenosis
18. A patient is suffering from chronic ischemic heart disease.
Which of the ff. characterize/s this patient?
A. Progressive heart failure
B. Recurrent angina attacks
C. Older age group
D. All of the above
19. A patient suffering from crescendo angina is immediately
at risk of:
A. Cardiac muscle rupture
B. Irreversible effect of ischemia
C. Mural thrombus formation
D. None because he’s going to be ok at rest
20. A patient with TOF has more severe symptoms which is
attributed to:
A. VSD
B. PDA
C. Subpulmonic stenosis
D. Right ventricular hypertrophy
21. Lipofuschin pigment deposition in the heart is:
A. Associated with cardiac muscle atrophy
B. Seen as brown pigments derived from RBC
destruction
C. Usually seen in very young patients
D. All of the above
22. TRUE of paradoxical embolism:
A. The embolus passes through the lungs
B. Emboli come from a mural thrombus
C. This is seen in left to right shunt anomalies
D. None of the above
23. A 30 y/o male patient with VSD recently experiences easy
fatiguability, difficulty of breathing, and bipedal edema.
Which of the ff. is associated?
A. His right ventricle is hypertrophied
B. He has elevated BUN
C. Chest radiograph shows pleural effusion
D. A & C
E. A, B, C
24. A 75 y/o female patient who suffered from acute MI 10
hours ago will have the ff. morphologic change/s:
A. Prominent infiltration of the heart with
macrophage
B. Coagulation necrosis
C. Very pale are of infarction grossly
D. All of the above
DEE10
25. The patient in #24 has the ff laboratory profile:
A. TnI is not yet elevated at this time
B. CK-MB is elevated on the first day but returns to
normal level of the following day
C. TnT level peaks on the second day
D. None of the above
26. A 35 y/o male patient with no evidence of coronary
atherosclerosis based on his executive check up a week
ago experiences chest heaviness and cold clammy
perspiration. Troponin I is elevated as well as CK-MB.
Which of the ff. statement is/are TRUE?
A. His condition ay be attributed to vasospasm
B. An embolus is a possible cause
C. He is not having MI because he doesn’t have
atherosclerosis
D. None of the abobe
E. A & B
27. A male patient succumbed to sudden cardiac death, the ff.
is/are found to be associated:
A. Marked coronary atherosclerosis is often not
seen
B. Arrhythmia caused the death of the patient
C. Cardiac rupture is often seen as complication
D. All of the above
28. A 38 y/o female patient diagnosed with breast CA
underwent chest radiation and chemotherapy. She is at
risk of developing which type of pericarditis
A. Hemorrhagic
B. Purulent
C. Serofibrinous
D. None, because pericarditis does not occur in her
face
29. A 25 y/o male patient had myocarditis, his heart is
enlarged associated with progressive systolic dysfunction.
The patient:
A. Is suffering from hypertrophic cardimyopathy
B. Has enlarged cardiac myocytes
C. Is infected by a parasite
D. None of the above
30. A patient consulted you complaining of diarrhea, nausea
and vomiting and skin flushes, the most probable gross
findings in his heart is:
A. A myxomatous tumor in the left ventricle
B. 90% atherosclerotic occlusion of RCA
C. inside surface fibrous thickening of the heart
chambers
D. none because his heart is not affected
PATHOLOGY B: Samplex Compilation DEE11
1.1 Heart

Plating Exam SY 2014-2015 Second Semester 10. Patient is 40 y/o male complained of severe precordial
chest pain lasting for the last 125 minutes. He was rushed
to the ER due to cold clammy perspiration associated with
1. An infarct affected the right atrium along the atrial dyspnea. The most sensitive and specific test to confirm
septum. The conducting myocyte involved causing your diagnosis is:
arrhythmia is the: A. ECG
A. SA node B. CK-MB
B. AV node C. CRP
C. Bundle of His D. None
D. Right and left bundle branches

2. The left anterior descending coronary artery supplies the 11. Patient in #10 was subsequently admitted in the ICU/CCU.
following, EXCEPT: ECG revealed extensive transmural infarct affecting the
A. Apex anterior wall of the left ventricle to the apex. On the 3rd
B. Anterior wall of LV hospital day, patient died due to cardiac tamponade. What
C. Posterobasal wall of LV complication occurred?
D. Anterior 1/3 of IV septum A. Extension
B. Expansion
3. Morphological feature/s associated with left sided heart C. Free wall rupture
failure: D. Aneurysm
A. LVH
B. Heart failure cells within the myocardium 12. Patients who die of sudden cardiac death die due to:
C. Cellular swelling, kidneys A. Arrhythmia
D. A & C only B. Acute cor pulmonale
E. None C. Chronic cor pulmonale
D. Tamponade
4. Morphologic feature/s associated with pure right sided
heart failure: 13. Patients suffering of pulmonary hypertensive heart disease
A. Lungs: brown induration following massive pulmonary embolism show this
B. Liver: nutmeg appearance morphologic feature/s:
C. Heart: “cardiac cirrhosis” A. RV dilation
D. Subcutaneous tissue: periorbital edema B. LV hypertrophy
C. RV hypertrophy
6. Most common among the late cyanotic heart disease: D. A & C only
A. ASD E. None
B. VSD
C. Coarctation of aorta 14. Valvular insufficiency is associated with the ff:
D. B & C only A. If the mitral valve is involved, the right ventricle
E. A, B & C will have concentric hypertrophy
B. If the tricuspid valve is affected, the right atrium
7. Patient’s CxR revealed a boot-shape heart shadow. will have concentric hypertrophy
Components of the classic heart condition include the C. If the pulmonic valve is insufficient, the right
following, EXCEPT: ventricle will hae dilated hypertophy
A. ASD D. If the aortic valve has insufficiency, the right
B. VSD ventricle will have concentric hypertrophy
C. RVH
D. RV outflow tract obstruction 15. The most common heart valve involved in rheumatic heart
disease is:
8. Patient is a 35 y/o male, company manager complaining of A. Left AV valve
recurrent substernal discomfort occuring even at rest B. Right AV valve
lasting for 5-10 minutes. He is probably suffering of: C. Pulmonic valve
A. Angina pectoris D. Aortic valve
B. Myocardial infarction
C. CIHD with heart failure 16. A patient diagnosed with systemic lupus erythematous is
D. Myocarditis at risk of developing this type of valvular disease:
A. Valvular disease associated with the formation
9. Type of angina primarily due to coronary artery spasm: of aschoff nodule
A. Stable B. Valvular disease caused by a highly virulent
B. Variant organism
C. Crescendo C. Valvular disease that has vegetations on the
D. A & C only undersurfaces of the valve
E. A, B & C D. None of the above
PATHOLOGY B: Samplex Compilation DEE12
1.1 Heart

17. A patient suffering from multiple myeloma has increased 25. Found in an Aschoff nodule:
risk of amyloid formation, he developed a cardiac problem A. Hemosiderin pigments
that is characterized by diastolic dysfunction. Which of the B. Lymphocytes
ff. is the most probable cardiac pathology? C. Bacterial colonies
A. Infiltrative cardiomyopathy D. None of the above
B. Libman Sack endocarditis
C. Dilated cardiomyopathy
D. Non-bacterial thrombotic endocarditis

18. Rapid percardial accumulation of fluid of this minimum Prelim Exam SY 2014-2015 Second Semester
amount can lead to cardia tamponade:
A. 80 mL 1. The pacemaker of the heart is located:
B. 100 mL A. Near the atrial appendage
C. 150 mL B. Along the atrial septum
D. 200mL C. Ventricular septum
D. Apex
19. A patient with the ff s/s: nabusea and vomitng, episodic
skin flushings, and diarrhea has the ff. cardiac morphology: 2. An infarct was noted in the apex and anterior wall of the
A. Stenotic mitral valve left ventricle. The coronary most probably occluded is:
B. Thickening of the inside surface of the cardiac A. Right
chambers B. Left circumflex
C. AV valve insufficiency C. Left anterior descending
D. “boot-shaped” heart D. B & C only

20. The condiiton/s that is/are probably associated with a 3. Patient is suffering of pure right sided heart failure. The
cardiomyopathy with systolic dysfunction is/are: most characteristic morphologic finding is seen in the:
A. Hemochromatosis A. Lungs
B. Pregnancy B. Liver
C. Chronic alcoholism C. Kidneys
D. B & C only D. None

21. A cardiac tumor that has a wrecking ball effect: 4. Patient is a 5 y/o boy with no note of cyanosis.
A. Metastatic from other sites Auscultation revealed murmur. Patient is most probably
B. Primary tumor to the heart suffering of:
C. Commonly seen in young children A. ASD
D. A & C B. VSD
E. B & C C. TOF
D. TGA
22. The most common organism associated with subacute
infective endocarditis is: 5. If the patient is #4 presents with cyanosis. The most
A. Staph aureus probably diagnosis is:
B. Strep viridans A. PDA
C. Haemophilus influenzae B. VSD
D. None of the above C. TOF
D. Tricusid atresia
23. in which combination of parameters will you make a
diagnosisof rheumatic heart disease/fever in patients? 6. Patients with TOF may vary in clinical manifestations
A. Positive serologic test for Strep., fever, elevated mainly depending on:
ESR, subcutaneous nodule A. Size of VSD
B. Sydenham chorea, carditis, fever, positive B. Degree of RVH
serologic test for Strep C. Degree of pulmonary outflow tract obstruction
C. Erythema marginatum, athralgia, fever, D. Location of aorta that overrides the defect
headache, positive serologic test for Strep
D. All of the above 7. Harsh machinery-like murmur is characteristic in:
A. ASD
24. Major clinical Duke criterion/a for infective criteria B. VSD
include/s: C. PDA
A. Positive blood culture D. TOF
B. New valvular regurgitation
C. Fever
D. A & B
E. A, B, C
PATHOLOGY B: Samplex Compilation DEE13
1.1 Heart

8. Patient complained of chest pain while lying in bed which
lasted for 20 minutes. ECG revealed ST segment elevation.
The pathogenesis of this lesion is:
A. Atherosclerosis causing coronary luminal
narrowing
B. Vasospasm
C. Thrombus causing coronary occlusion
D. A & C only
16. A 30 year old female patient has diastolic dysfunction and
one of her left ventricular heart chambers has banana-like
configuration, which of the ff. is the most probable heart
pathology?
A. Restrictive cardiomyopathy
B. Hyepretensive heart disease
C. Post MI
D. Hypertrophic cadiomyopathy

9. Patient suffered of massive MI and died 2 days after the 17. A patient has rhabdomyocarcoma and was noted to have
onset of chest pain. The morphologic change/s that you pericardial effusion what is the most probable
expect to see in the area affected include/s: descriptionof the pericardial fluid?
A. Fibroblasts with scattered monocytes A. Granular
B. Granulation tissue B. Fibrinous
C. Coagulated myocytes with neutrophils C. Bloody
D. Fibrosis D. Purulent

10. The most sensitive and specific laboratory test to confirm 18. Cardiac myxoma is charactierized by which of the ff.?
diagnosis of MI is: A. Benign
A. ECG B. Common metastatic tumor in the heart
B. CK-MD C. Both
C. Trop I & T D. Neither
D. LDH
19. A 15 y/o male child developed myocarditis, he has 2 weeks
11. Myocardial free wall rupture usually occurs in the ___ historu of cough accompanied by fever, what is the most
week after the infarct: probable etiology of his condition?
A. First A. Streptococcal infection
B. Third B. Coxsackie virus
C. Fifth C. Adenovirus
D. seventh D. Staph. Aureus

12. Most frequent site affected by an infarct is the areas 20. A 58 y/o female patient was diagnosed with SLE ten years
supplied by the: ago. Which of the ff. cardiac morphology can be seen in
A. LAD her heart?
B. LCX A. Fibrosis of the myocardium
C. RC B. Sterile vegetation underneath the valvular space
D. B & C C. Fish mouth stenosis
D. Aneurysm
13. In patients suffering of MI but without typical coronary
pathology, the pathogenesis could be due to: 21. An 80 y/o male patient has been suffering from
A. Emboli that has been lysed carcinomatosis and is confined to bed rest for the past 10
B. Vasospasm months, which of the ff. can be seen in this patient?
C. Ischemia dute to global hypotension A. Large vegetation on mitral valve with gram stain
D. A & B only positive organism
E. A, B & C B. Small valvular masses turned out negative on
culture
14. Morphologic feature/s seen in CIHD: C. Highly stenotic mitral valve
A. Enlarged heavy heart D. Highly incompetent tricuspid valve
B. LVH
C. Scars or fibrosis 22. What is the most consistent sign of infective endocarditis?
D. A & B only A. Murmur
E. A, B & C B. Fever
C. Body malaise
15. Patient died cute to sudden cardiac death. The most D. Tachycardia
common trigger for fatal arrhythmia is:
A. Acute myocardial infarction 23. The most common organism involved in subacute bacterial
B. Acute myocardia ischemia endocarditis:
C. Myocarditis A. Stahp aureus
D. Mitral valve prolapse B. Strep viridans
C. Haemophilus
D. None of the above
PATHOLOGY B: Samplex Compilation DEE14
1.1 Heart

24. A person with myxomatous degeneration of the mitral Plating Exam SY 2015-2016 First Semester
valve has the ff. characteristic/s:
A. Reversed blood flow 1. Which of the ff normal structures in the heart facilitate
B. Incomplete valvular closure synchronous myocyte contraction and which when
C. Forward flow impeded abnormally distributed leads to arrhythmia and/or heart
D. A & B failure?
E. B & C A. Cardiac myocyte
B. Sarcomeres
25. Aortic insufficiency may be associated with: C. Intercalated disk
A. Hypertension D. Gap junctions
B. Aging
C. Dilated ascending aorta 2. This segment of the conduction system serves as a
D. All of the above gatekeeper funtion delaying the transmission of signals
from the aorta to the ventricle:
26. Antibodies against protein cross react with self antigens in A. SA node
the heart of an RHD patient: B. AV node
A. A C. Bundle of His
B. S D. Right and Left ventricular branch
C. M
D. O Case 1: A 74 y/o male complained of severe chest pain of one day
duration which was not relieved by vasodilators. He sought
27. Component/s of aschoff bodies EXCEPT: admission to the hospital where he was wheeled directly to the ICU.
A. Collagen The patient died 24 hours later. Autopsy revealed reddish-black
B. Lymphocytes discoloration involving the posterobasal wall of the left ventricle, the
C. Caterpillar cells right ventricle, and the posterior third of the interventricular
D. None of the above septum.
28. Major clinical manifestation/s seen in rheumatic fever: 3. Which of the following branches of the coronary artery is
A. Fever most probably occluded?
B. Mitral stenosis A. Left anterior descending
C. Polyarhtritis of phalangeal joints B. Left circumflex artery
D. None of the above C. Right coronary artery
D. Right anterior descending branch
29. Cardiomyopathies are:
A. Primary cardiac problems 4. Histologic examination of this heart will show:
B. May be secondary to systemic disorder A. Coagulation necrosis
C. Presence of myocardial abnormalities B. Neutrophilic infiltrates
D. All of the above C. Phagocytosis of dead cells by macrophages
D. A, B, & C
30. Abnormal diatolic filling is observed in: E. A & B only
A. Hypertrophic cardiomyopathy
B. Dilated cardiomyopathy 5. If cardiac markers were requested upon admission of this
C. Restrictive cardiomyomathy patient, which would be elevated?
D. All of the above A. CK-MB
B. CTnT
C. cTnI
D. A, B & C
E. B & C only

6. Which of the following complications most commonly

cause the death of this patient?
A. Cardiogenic shock
B. Arrhythmia
C. Infarct expansion
D. Papillary muscle dysfunction

7. Which of the following is considered as preinfarction

angina?
A. Typical angina
B. Prinzmental angina
C. Crescendo angina
D. None of the above
PATHOLOGY B: Samplex Compilation DEE15
1.1 Heart

CASE 2: A 15 y/o female was admitted because of difficulty of 16. This type of endocarditis is associated with debilitated
breathing, paroxysmal nocturnal dyspnea, and easy fatigability of 2 patients with cancer:
months duration. She is a diagnosed case of rheumatic heart disease A. Acute infective endocarditis
since the age of 7 years. Pertinent physical examination findings B. Nonbacterial endocarditis
revealed displacement of the apex beat to the 6th intercostal space C. Libman Sacks endocarditis
lateral to the midclavicular line, rumbling diastolic murmur best D. Subacute bacterial endocarditis
heard over the mitral areas, rales on both lung fields, and spoon nail.
17. This type of cardiomyopathy is associated with banana-like
8. The patient has: configuration of the ventricular cavity:
A. Mitral stenosis A. Dilated
B. Mitral insufficiency B. Hypertrophic
C. Congestive heart failure C. Restrictive….cardiomyopathy
D. B & C D. None of these
E. A & C only

9. The pathognomonic histologic hallmark of this disease is 18. The most common cardiac tumor which is associated with
presence of: hemorrhagic pericarditis?
A. Anitschkow myocyte A. Fibroma
B. Fibrosis B. Lipoma
C. Bacterial colonies C. Myxoma
D. Increase circumference of the mitral valve D. Rhabdomyoma

10. The infective endocarditis develops in this patient (Case 2), 19. Which of the following conditions is associated with
the most probable organism would be: hemorrhagic pericarditis?
A. Staphylococcus aureus A. Systemic lupus erhythematous
B. Streptococcus viridans B. Acute myocardial infarction
C. Haemophillus influenza C. Tuberculosis
D. Staphylococcus epidermis D. Rheumatic fever

11. Hypoxic encephalopathy and anascara are findings seen in: 20. The most common cause of myocarditis is:
A. Right-sided heart failure A. Coxackie A & B virus
B. Left-sided heart failure B. HIV
C. Both C. Infulenza virus
D. Neither D. Cytomegalovorus

12. Left to right shunt is seen in the following congenital heart LAB QUESTIONS:
disease, EXCEPT:
A. Atrial septal defect 1. The gross findings seen in rheumatic heart disease include
B. Ventricular septal defect the following, EXCEPT:
C. Patent ductus arteriosus A. Mitral stenosis
D. Eisenmenger syndrome B. Hypertrophy of the papillary muscles
C. Fusion of chorda tendinae
13. The severity of Tetrallogy of Fallot is dependent on the D. Flattened trabeculae carnae
degree of:
A. Right ventricular hypertrophy 2. The major pathologi criteria for the diagnosis of infective
B. Subpulmonic stenosis endocarditis is:
C. Ventricular septal defect A. Demonstration of organism in the lesion
D. Overriding of the aorta B. Intracardiac abscess on microscopy
C. Both
14. Aortic stenosis and atresia will cause: D. Neither
A. Systolic murmur
B. Left ventricular hypertrophy 3. The most common pattern of ventricular septal defect:
C. Obstructive congenital anomaly A. Membranous
D. A, B & C B. Infundibular
E. A & B only C. Both
D. Neither
15. Right ventricular hypertrophy is seen in:
A. Acute cor pulmonale 4. Tetrallogy of Fallot is characterized by:
B. Chronic cor pulmonale A. Left to right shunt
C. Both B. Cyanosis
D. Neither C. Both
D. Neither
PATHOLOGY B: Samplex Compilation DEE16
1.1 Heart

5. Patent ductus arteriosus connects which blood vessels? 6. Hemopericardium can cause cardiac tamponade and death
A. Aorta and pulmonary vein due to:
B. Aorta and pulmonary artery A. Diastolic dysfunction
C. Aorta and carotid artery B. Systolic dysfunction
D. Aorta and superior vena cava C. Exsanguination
D. Arrhythima
E. None of there

Plating Exam SY 2015-2016 Second Semester 7. A 45 y/o male complained of severe chest pain of
increasing frequency, lasting for 30 mins, occuring even at
1. True of atrial natriuretic peptide: rest. The lesion is usually caused by:
A. Stored in an electron-dense cytoplasmic granules A. Coronary vasospasm
B. Causes vasoconstriction, diuresis and sodium B. Chronic stenosing coronary AS
excretion C. Disruption of an AS plaque
C. Benefits hypertensive and patients with heart D. Left ventricular hypertrophy
failure E. None of these
D. A, B & C
E. A & C only 8. A 28 y/o female was admitted because of difficulty of
breathing, paroxysmal nocturnal dyspnea, grade 2 pedal
2. Abnormal distribution of the gap junctions of the edema and easy fatigability of 2 months duration. She is
intercalated disks can lead to: diagnosed case of rheumatic heart disease since the age of
A. Arrhythmia 7 years. Pertinent physical examination findings revealed
B. Heart failure displacement of the apex beat to the 6th intercostal space
C. Myocardial infacrtion lateral to the midclavicular line, rumbling diastolic murmur
D. A, B & C best heard over the mitral area, and systolic murmur over
E. A & B only the aortic area, rales on both lung field, and spoon nail.
This patient has:
3. A 54 y/o male, hypertensive, smoker and diabetic, A. Mitral stenosis and aortic insufficiency
complained of severe chest pain of one hour duration B. Mitral and aortic insufficiency
which was not relieved by vasodilators. He sought C. Mitral and aortic stenosis
admission to the hospital where he was wheeled directly D. Left sided heart failure
to the intensive care unit. The patient died 12 hours later. E. Right sided heart failure
Autopsy revealed reddish-black discoloration involving the
apex, the anterior and lateral wall of the left ventricle, and 9. The pathognomonic histologic hallmark of Rheumatic
the entire interventricular septum. Which of the following heart disease is the presence of:
epicardial coronary artery is probably obstructed? A. Anitschkow myocyte
A. Left anterior descending B. Bacterial colonies
B. Left circumflex C. Fibrosis
C. Right coronary D. Increase circumference of the mitral valve
D. A, B & C
E. A & B only 10. Considered as the clinical hallmark of right-sided heart
failure:
4. Free wall rupture may occur in patients with myocardial A. Pulmonary edema
infarction. This most frequently occurs howmany days B. Peripheral edema
after the infarct? C. Paroxysmal nocturnal dyspnea
A. 24 – 48 hours D. Dyspnea and orthopnea
B. 2 – 4 days E. None of these
C. 5 – 6 days
D. 7 – 8 days 11. The pathologic criteria for the diagnosis of infective
endocarditis include/s:
5. A 94 year old female died from natural cause. The A. Positive culture of microorganism from the
following findings are seen in an aging heart, EXCEPT: vegetations
A. Dilated ascending aorta with rightward shift and B. Biopsy of active endocarditis in vegetations
tortour thoracic aorta C. Presence of valvular insufficiency
B. Mitral and aortic valve calcifications D. A, B & C
C. Decrease left atrial, increased left ventricular E. A & B only
cavity size
D. Brown atrophy, amyloid and lipofuschin
deposition in myocardium
E. Tortousity and theromatous plaque in the
epicardial coronary arteries
PATHOLOGY B: Samplex Compilation DEE17
1.1 Heart

12. Small erythematous or hemorrhagic macular, nontender 20. This type of endocarditis is associated with SLE:
lesions on the palms and soles which is seen in infective A. Acute infective endocarditis
endocarditis is known as: B. Nonbacterial thrombotic endocarditis
A. Janeway lesions C. Libman Sacks endocarditis
B. Osler nodes D. Subacute bacterial endocarditis
C. Roth spots
D. Erythema marginatum 21. This type of cardiomyopathy is associated with amyloidosis
E. Subcutaneous nodules and hemochromatosis:
A. Dilated
13. The major known cause of congenital heart disease is: B. Hypertrophic
A. Environmental factors C. Restrictive…..cardiomyopathy
B. Maternal age D. None of these
C. Multifactorial genetic factors 22. The most common cardiac tumor in children is:
D. Nutritional factors A. Fibroma
E. Sporadic genetic abnormalities B. Lipoma
C. Myxoma
14. True of secundum type of atrial septal defect, EXCEPT: D. Rhabdomyoma
A. Asymptomatic till adulthood
B. Associated with Tetrallogy fo Fallot 23. Which of the following conditions is associated with serous
C. Located at the oval fossa pericarditis?
D. Most common type A. SLE
E. None of these B. Acute MI
C. Tuberculosis
15. Eisenmenger syndrome is characterized by: D. RHD
A. Late cyanosis
B. Large atrial septal defect 24. The diagnosis of hypertensive heart disease is based on
C. Right ventricular hypertrophy the following criteria:
D. A, B & C A. History of hypertension
E. A & B only B. Left ventricular hypertrophy
C. Aortic insufficiency
16. A right to left shunt is seen in which of the following D. A, B & C
congenital heart defects? E. A & B only
A. Ventricular septal defect
B. Patent ductus arteriosus 25. The major criteria for diagnosis rheumatic fever include
C. Tricuspid atresia the ff., EXCEPT:
D. Patent foramen ovale A. Migratory polyarthritis
E. None of these B. Migratory thrombophlebitis
C. Subcutaneous nodules
17. Which of the following pair of heart disease and feature is D. Erythema marginatum
NOT correct? E. pericarditis
A. TOF – boot-shaped heart
B. Coarctation of the aorta – rib notchings
C. PDA – machinery-like murmur
D. RHD – bread and butter pericarditis
E. None of these

18. Hypertrophy can be caused by:

A. Cardiac overload
B. Pressure overload
C. Trophic signals
D. A, B & C
E. A & B only

19. Right ventricular dilation without hypertrophy is seen in:

A. Acute cor pulmonale
B. Chronic cor pulmonale
C. Left sided heart failure
D. A, B & C
E. B & C only
PATHOLOGY B: Samplex Compilation DEE18
1.1 Heart

Prelim Exam SY 2015-2016 Second Semester Case 2: A 15 y/o female was admitted because of difficulty of
breathing, paroxysmal nocturnal dyspnea, and easy fatigability of 2
1. The heart comprise 0.4 – 0.5% of the total body weight. months duration. She is s diagnosed case of RHD since the age of 7.
The following are normal measurements of the heart: Pertinent physical examination findings revealed displacement of
A. LV thickness – 1.0 – 1.3 cm the apex beat to the 6th intercostal space lateral to the midclavicular
B. RV thickness – 0.3 – 0.5 cm line, rumbling systolic murmur best heard over the mitral area, rales
C. Weight female – 200 – 250 gms on both lung fields and spoon nail.
D. A, B & C
E. A & B only 8. This patient has the following, EXCEPT:
A. Cardiomegaly
2. A 95 year old male died of natural death. The following are B. Pulmonary edema
changes expected in his heart, EXCEPT: C. Mitral stenosis
A. Amyloid deposits D. Chronic hypoxia
B. Aortic valve calcification E. None of these
C. Increased epicardial fats
D. Lambl excrescences 9. Considered the pathognomonic histologic hallmark of
E. Increase LV cavity Rheumatic fever:
A. Anitschkow myocyte
Case 1: A 55 y/o male complained of severe chest pain of one day B. Aschoff bodies
duration which was not relieved by vasodilators. He sought C. Bacterial colonies
admission to the hospital where he was wheeled directly to the ICU. D. Fibrosis
The patient died 5 days later. Autopsy revealed hyperemic borders
involving the apex, the lateral and anterior wall of the left ventricle 10. True of sudden cardiac death:
and anterior 2/3 of IVS with central yellow-tan softening A. Almost always with infarction
B. Due to lethal arrhythmia
3. Which of the following branches of the coronary artery is C. Both
most probably occluded? D. Neither
A. Left anterior descending
B. Left circumflex artery 11. A newborn baby was noted to be cyanotic at birth. Chest
C. Right coronary artery x-ray showed the aorta lies anterior and arises from the
D. A, B & C right ventricle while the pulmonary artery is posterior and
E. A & B only arises from the left ventricle. What is the most probable
4. If cardiac markers were requested on admission of this diagnosis?
patient, which would be elevated? A. Transposition of great vessels
A. CK-MB B. VSD
B. cTnT C. Tricuspid atresia
C. cTnI D. TOF
D. A, B & C
E. B & C only 12. Mitral insufficiency will cause:
A. Systolic murmur
5. What microscopic findings in the heart would be present B. LV hypertrophy
on autopsy? C. Obstructive congenital anomaly
A. Disintegration of dead myofibers D. A, B & C
B. Well-developed granulation tissue E. A & B only
C. Increased collagen deposition
D. Coagulation necrosis 13. This type of endocarditis is seen in patients with
hypercoagulability:
6. Cardiogenic shock may occur in patients with infarcts A. Acute infective endocarditis
involving more than __% of left ventricle: B. Nonbacterial thrombotic endocarditis
A. 20 C. Libman Sacks endocarditis
B. 30 D. Subacute bacterial endocarditis
C. 40
D. 50 14. The layer of the heart most vulnerable to ischemia is:
E. 60 A. Endocardium
B. Subendocardium
7. A 54 y/o patient showed 2nd degree heart block on ECG. C. Myocardium
This abnormality is usually caused by: D. Epicardium
A. Irritable atrial myocytes
B. SA node damage
C. Absent electrical activity
D. AV node dysfunction
PATHOLOGY B: Samplex Compilation DEE19
1.1 Heart

15. Among the nonviral causes of infectious myocarditis, this 23. This type of endocarditis is characterized by large, irregular
infective agent produces toxin as mechanism for the masses on the valve cusps that can extend to the chordae
disease: tendinae:
A. C. diphtheria A. Infective endocarditis
B. T. cruzi B. Nonbacterial thrombotic endocarditis
C. Cox A & B virus C. Libman Sacks endocarditis
D. HIV D. Subacute bacterial endocarditis

16. A 65 y/o female, known diabetic, 30 pack year smoker and 24. The most common cardia tumor which is associated with
hypertensive for 15 years with poor drug compliance the wrecking ball effect:
sought consult because of severe headache. Paertinent PE A. Lipoma
findings include BP=170/110mmHg, HR=95/min, T=37, PMI B. Leiomyoma
located at the 6th ICS AAL. Chest x-ray showed an enlarged C. Myxoma
heart. The most probable diagnosis is: D. Rhabdomyoma
A. Cor pulmonale
B. Hypertrophic cardiomyopathy 25. The clinical criteria for infective endocarditis include/s:
C. Ischemic heart disease A. Positive blood culture for a characteristic
D. Hypertensive heart disease organism
B. ECG finding of valve-related mass
17. The minimal pathologic criteria for the diagnosis of this C. Valvular stenosis
disorder (#16) includes: D. A, B & C
A. Coagulation necrosis E. A & B only
B. Concentric LV hypertrophy
C. Right ventricular hypertrophy 26. Virtually considered as the only cause of mitral stenosis is:
D. Banana-shaped LV chamber A. Rheumatic Heart Disease
B. Calcific stenosis
18. Outcomes of large VSD include the ff. EXCEPT: C. Healed infective endocarditis
A. Left to right shunt D. Mitral annular calcifications
B. Acute cor pulmonale
C. Pulmonary hypertension 27. Components of TOF include the ff. EXCEPT:
D. RV hypertrophy A. VSD
B. RV hypertrophy
19. PDA connects which blood vessels? C. Overriding of the aorta
A. Aorta and pulmonary vein D. PDA
B. Aorta and carotid artery E. Pulmonic stenosis
C. Aorta and pulmonary artery
D. Aorta and superior vena cava 28. Some atrial cells secrete ANP which has the following
physiologic effect/s:
20. This segment of the conduction system connects the right A. Diuresis
atrium to the ventricular septum: B. Sodium excretion
A. AV node C. Vasodilation
B. Bundle of His D. A, B & C
C. Right and left bundle branch E. A & B only
D. SA node
29. This cardiac stucture facilitates synchronize myocyte
21. If infective endocarditis occurs in normal valve, the most contraction and abnormal spatial distribution of which
probable organism would be: may cause arrhythmia:
A. Staphylococcus aureus A. Sarcomere
B. Streptococcus viridans B. Intercalated disc
C. Haemophilus influenza C. Gap junctions
D. Staphylococcus epidermidis D. Nuclei

22. Left to right shunt is seen in the ff. congenital heart 30. The most abundant cell type in the cardiac valves and
disease EXCEPT: synthesize ECM and MMPs:
A. ASD A. Endothelial cells
B. Tricuspid atresia B. Interstitial cells
C. PDA C. Fibroblasts
D. SBE D. Argentaffin cells
PATHOLOGY B: Samplex Compilation DEE20
1.1 Heart

31. This cardiac abnormality is associated with Marfan Plating Exam SY 2015-2016 First Semester
syndrome:
A. Mitral valve prolapse 1. A 60 year old male, diabetic died while undergoing
B. Myxoma treatment for myocardial infarction. Which of the ff
C. Ischemic heart disease measurements of the heart is normal?
D. Myocarditis A. Weight – 450 gms
B. RV thickness – 0.3cm
32. Considered as the hallmark of right-sided heart failure: C. LV thickness – 1.8 cm
A. Ascites D. LA thickness – 0.7 cm
B. Hepatomegaly
C. Pulmonary edema 2. True of the normal heart, EXCEPT:
D. Peripheral edema A. Overlapping actin and myosin give rise to the
striations
33. Eisenmenger syndrome is associated with: B. ANP causes vasodilation, natriuresis and diuresis
A. Pulmonary hypertension C. Gap junctions allow for rapid movement ions
B. RV hypertrophy D. Troponin and tropomyosin are enzyme proteins
C. VSD E. Coordinated beating of cardiac myocytes depends
D. A, B & C on the intercalated discs
E. A & B only
3. A 30 y/o drug dependent male developed acute infective
34. In total anomalous pulmonary venous return, all the endocarditis of the mitral valve. Which of the following
pulmonary veins connect to: valvular dysfunction do you expect to occur?
A. Aorta A. Mitral stenosis
B. Superior vena cava B. Mitral insufficiency
C. Inferior vena cava C. Both
D. Pulmonary artery D. Neither

35. A 5y/o girl was diagnosed to have heart disease. Chest x- 4. Which of the following sites in the conductio system
ray revealed notchings on the undersurface of the ribs. serves as a gatekeeper function?
This findings is usually seen in: A. SA node
A. TOF B. AV node
B. VSD C. Bundle of His
C. Coarctation of aorta D. Purkinjie fiber
D. ASD
5. A 70 y/o male on coronary angiogram showed 80%
36. Increasing chest pain lasting for more that 20 minutes, obstruction of the left anterior descending and right
occurs at rest and relieved by vasodilators is seen in coronary artery. Which area is/are at risk for myocardial
patient with: infarction in this patient?
A. Stable angina A. Apex
B. Prinzmetal angina B. Interventricular septum
C. Unstable angina C. Anterior and posterobasal wall of left ventricle
D. Myocardial infarction D. A, B & C
E. A & B only
37. This form of cardiomyopathy is caused by amyloidosis and
hemochromatosis: 6. A 93 y/o female died of natural death. The following
A. Dilated findings are expected in the heart, EXCEPT:
B. Hypertrophic A. Decreased left atrial cavity size
C. Restrictive….cardiomyopathy B. Fibrous thickening of leaflets
C. Tortous coronary arteries
38. Cardiac malignancies are usually associated with this type D. Amyloid deposits
of pericarditis:
A. Serous 7. Cardiomegaly can result from:
B. Fibrinous A. Pressure overload causing hypertrophy
C. Serofibrous B. Volume overload causing cardiac dilation
D. Hemorrhagic C. Both
D. Neither
PATHOLOGY B: Samplex Compilation DEE21
1.1 Heart

8. A 67 y/o make known hypertensive for 20 years sought 14. A 45 y/o executive had severe crushing chest pain while
admission because of dyspnea, nocturnal dyspnea and driving to his office one early morning. He drove straight
orthopnea of one week duration. The patient is most instead to the hospital and was there within 30 mins of
probably suffering from: onset of chest pain. At the ER, he was found to cold,
A. Right-sided heart failure clammy perspiration, with a BP of 80/60 mmHg. True of
B. Left-sided heart failure this patient:
C. Global heart failure A. He is sufeering from crescendo angina
D. Myocardial infarction B. He has irreversible cardiac damage
E. Angina pectoris C. He will benefit from perfusion procedure
D. cTnI is elevated
9. The mechanism of symptoms in this patient in #8 is due to: E. none of these
A. Systolic dyfunction
B. Diastolic dyfunction 15. Coronary arteriogram revealed 90% obstruction of the LAD
C. Both systolic and diastolic dysfunction artery. Which of the following could have precipitated the
D. Coronary insufficiency event in #14?
E. None of these A. Acute plaque change
B. Embolism
10. Patient #8 may develop which of the ff complications: C. Thrombosis
A. Ischemic encephalopathy D. Vasospasm
B. Pre-renal azotemia E. None of these
C. Cerebral hemorrhage
D. A, B & C 16. This type of endocarditis is usually seen in patients with
E. A & B only Rheumatic heart disease:
A. Acute infective endocarditis
11. Right to left shunt is seen in which of the ff congenital B. Nonbacterial throbotic endocarditis
heart disease? C. Libman Sacks endocarditis
A. ASD D. Subacute bacterial endocarditis
B. VSD
C. TOF 17. This type of cardiomyopathy is associated with
D. Eisenmenger syndrome enlargement of the individual muscle fiber with haphazard
configuration causing assymmetric interventricular septal
12. A 45 y/o female who was bed ridden for the last few hypertrophy:
months due to metastatic malignancy suddenly developed A. Dilated
severe dyspnea. Chest x-ray and chest CT scan revealed B. Hypetrophic
saddle embolus to yje pulmonary artery. Which of the ff C. Restrictive…..cardiomyopathy
is/are true of this patient: may develop D. None of these
A. Acute cor pulmonale
B. Pulmonary infarction 18. The pathologic criteria for the diagnosis of infective
C. RV hypertrophy endocarditis include/s:
D. A, B & C A. A positive culture of microorganism
E. A & B only B. Biopsy of active endocarditis in vegetations
C. Presence of embolus from vegetations
13. A 73 y/o male with chronic bronchitis due to chronic D. A, B & C
smoking was diagnosed to have emphysema since 10 yrs E. A & B only
ago and has been suffering from dyspnea even at rest.
Physical examination revealed hepatomegaly and grade 2 19. Which of the ff conditions is associated with hemorrhagic
pitting pedal edema. This patient is most probably pericarditis?
suffering from: A. SLE
A. Chronic cor pulmonale B. Acute MI
B. Right0sided heart failure C. Tuberculosis
C. RV hypertrophy with dilaton D. Rheumatic fever
D. A, B & C
E. A & B only 20. The most common cardiac tumor among infants and
children is:
A. Fibroma
B. Lipoma
C. Myxoma
D. Rhabdomyoma
PATHOLOGY B: Samplex Compilation DEE22
1.1 Heart

21. Which of the ff pair of heart disease and feature is not

correct?
A. RHD – McCallum’s plaque
B. Coarctation of the aorta – rib notchings
C. Transposition of great vessels – boot-shaped
heart
D. PDS – machinery-like murmur
E. None of these

LAB QUESTIONS:

1. The gross findings seen in RHD include the ff:

A. Fish-mouth deformity
B. Hypertrophy of the papillary muscles
C. Rupture chordae tendinae
D. A, B & C
E. A & B only

2. The causative organism usually isolated in patients with

SBE is:
A. S. aureus
B. S. viridans
C. H. influenzae
D. Cardiobacterium

3. True of VSD:
A. Most common congenital cardiac anomaly
B. Causes RV hypertrophy
C. Both
D. Neither

4. TOF is characterized by the presence of:

A. Subpulmonic stenosis
B. RV hypertrophy
C. VSD
D. A, B & C
E. A & B only

5. PDA connects which blood vessels?

A. Aorta and pulmonary artery
B. Aorta and pulmonary vein
C. Aorta and carotid artery
D. Aorta and superior vena cava