Davidson 6th-100
1. Complete heart block in a patient with infective endocarditis suggest?
Mitral valve abscess.
Aortic root abscess.
Pulmonic valve abscess.
Apical Myocarditis.
Tricuspid valve abscess.
2. Which of the Following is a common cause of valvular stenosis:
Aortitis.
Infective endocarditis.
Infective endocarditis.
Senile degeneration.
3. What is the treatment for AVNRT with hemodynamic compromise?
Carotid sinus massage.
Valsalva.
Adenosine.
Verapamil.
DC cardioversion.
4. The antibodies in rheumatic fever is directed to which cardiac protein?
Troponin I
Myosin.
Troponin C
Actin.
Calcium ATPase.
5. The Bundle of Kent in WPW does not lead to which of the following features?
A high risk of AF.
Wide QRS.
A PR <120 ms.
AVNRT.
Delta wave in QRS upstroke.
6. Which of the following is not a Jones major criteria of rheumatic fever?
Carditis.
Polyarthritis.
Polyarthralgia.
Chorea.
Erythema marginatum.
7. All of the following are evidence of carditis in rheumatic fever, except?
Cardiomegaly
First degree heart block.
T wave inversion.
Valvular regurgitation in echo.
Increased QRS voltage.
8. Which of the following drug is indicated in patients with WPW and Atrial fibrillation?
Bisoprolol.
Propafenone.
Diltiazem.
Adenosine.
Digoxin.
9. All of the following are feature of mitral stenosis auscultation, except:
Loud first heart sound.
Opening snap
Mid-diastolic murmur
Softening of second heart sound.
Pre-systolic accentuation.
10. Symptomatic patients with ventricular premature beats should receive which drug?
Digoxin.
Amiodarone.
Beta blockers.
Adenosine.
Verapamil.
11. Which of the following is NOT a typical investigation finding in mitral stenosis?
P mitrale.
Atrial fibrillation.
RVH
Kerley B line in CXR.
Increased valve area.
12. All of the following are features of Hemolytic uremic syndrome except?
A thrombotic microangiopathy.
Common cause is EHEC O157 H7 strain.
Can cause anemia.
Platelet count is normal.
Renal failure can occur.
13. Following are criteria for mitral valvuloplasty, except?
Significant symptoms.
Isolated mitral stenosis.
Significant mitral regurgitation.
Mobile valve.
Left atrium free of thrombus.
14. Which of the following is a cause of mitral regurgitation?
Left ventricular hypertrophy.
Coronary artery disease.
Senile degeneration.
Drug induced.
Cor pulmonale.
15. All of the following are features of mitral regurgitation, except?
Soft first heart sound.
Pansystolic murmur.
Radiation of murmur to axilla.
Fourth heart sound may be present
Third heart sound may be present.
16. Which of the following is an investigation finding in mitral regurgitation?
Multifocal atrial tachycardia.
Enlarged left ventricle.
Wandering atrial pacemaker.
Small left atrium.
Adynamic left ventricle.
17. Which of the following features is not suggestive of VT?
Broad QRS complexes
Extreme left axis deviation.
Response to intravenous adenosine.
Capture beat.
Fusion beat.
18. Which of the following is false regarding Torsades de pointes?
Main risk factor is prolonged QT.
Treated with IV magnesium.
Hypomagnesemia is the commonest trigger.
Erythromycine is a recognized cause.
Sotalol and amiodarone are very effective treatment.
19. All of the following regarding Brugada syndrome are true, except?
Coved ST elevation in V1 and V2.
Presence of LBBB.
Occurs due to a defect in sodium channel function.
Presents with polymorphic VT.
Implantable defibrillator is the only treatment.
20. What type of atheromatous lesion generally presents as stable angina?
Type I lesion
Type VI lesion
Type V lesion
Type II lesion
Type III lesion.
21. Which of the following is not a feature of vulnerable plaques?
Lipid rich core
Plentiful collagenous cross link.
Thin fibrocellular cap.
Speckled calcification
Increase in inflammatory cells.
22. How much energy should we have from saturated fat to prevent coronary artery disease?
Less than 10%
Less than 5%
Less than 20%
Less than 1%
Less than 25%
23. Which of the following can cause angina pectoris?
Aortic regurgitation.
Mitral stenosis.
Aortic stenosis.
Mitral regurgitation.
Tricuspid stenosis.
24. Which of the following is not true regarding variant angina?
Result from vasospasm of coronary arteries.
Angiogram is normal.
May have ST elevation during chest pain attack.
Angiogram shows spasmodic vessel.
May be called Prinzmetal angina.
25. Which of the following factors does not increase oxygen demand of heart?
Raised heart rate.
Low hemoglobin
Increased blood pressure.
High myocardial contractility.
Hypertrophy of left ventricle.
26. Which of the following is a feature of high risk stable angina?
Exertional angina.
Ischemia only at high workload.
Single vessel disease.
Poor left ventricular function.Poor left ventricular function.
Two vessel disease.
27. What is the which of the following is wrong regarding nitrates?
Reduction of preload.
Reduction of vasomotor tone.
Can cause hypertension.
Dilation of coronary arteries.
Increase myocardial oxygen supply.
28. Which of following is not diagnostic of Myocardial infarction?
Rise and fall of Troponin.
Symptoms of ischemia.
ST elevation in ECG
Raised troponin without dynamic change.
Angiogram revealing coronary thrombus.
29. What is the main acute complication of PCI?
Long hospital stay.
Recurrent angina.
Occlusion of target vessel by a thrombus.
Neurological complication.
Complete heart block due to AV damage.
30. Which of the following is a criterion for diagnosis of a prior myocardial infarction?
Imaging evidence of loss of viable myocardium without acute symptoms.
Symptoms of ischemia.
Dynamic change in Troponin I level.
New ST T changes.
New LBBB.
31. Which of the following is a not a dangerous rhythm in patients with Myocardial infarction?
Ventricular fibrillation.
Ventricular tachycardia.
Sinus bradycardia.
Accelerated Idioventricular rhythm (AIVR).
Third degree AV block.
32. Which marker should be used for diagnosing recurrent MI within a few days of primary event?
Troponin I
Troponin T
CK-MB
AST.
LDH.
33. A hospitalized patient with myocardial infarction develops chest pain in third day of admission. The pain is increased during inspiration and relieved somewhat during bending forward. What is the most likely diagnosis?
Acute heart failure.
Dressler syndrome.
Recurrent angina.
Acute pericarditis.
Recurrent MI.
34. A 50-year-old patient with history of MI 2 months back comes with the complaints of shortness of breath. ECG shows ST elevation in V1-V4. Patient does not have any current chest pain. What is the most likely diagnosis?
Ventricular septum rupture.
Ventricular aneurysm.
Brugada syndrome.
Pericarditis.
Hyperkalemia.
35. ST elevation in which of the following leads suggest anterolateral infarction?
V4-V6, I, aVL.
V1-V2.
V1-V4.
II, III, aVF.
AVL.
36. ST depression and tall R wave in leads V1-V4 suggest which infarction?
Posterior infarction.
Anterior infarction.
Anteroseptal infarction.
Septal infarction.
Lateral infarction.
37. Which of the following is not a feature of successful reperfusion after thrombolysis?
Rapid pain relief.
Resolution of Q waves.
Occasional transient arrhythmias such as AIVR.
Resolution of ST elevation.
Angiogram showing vessel free of thrombus.
38. Which of the following is not a contraindication to thrombolytic therapy?
Previous hemorrhagic stroke.
Blood pressure more than 185/110 mm Hg.
Active peptic ulcer disease.
Previous ischemic stroke.
Pregnancy.
39. Which of the following is not part of the definition of critical limb ischemia?
Rest pain requiring opioids.
Ulcer for more than 2 weeks.
Gangrene for more than 2 weeks.
Ankle BP less than 50 mm Hg.
Ankle BP more than 50 mm Hg.
40. Which of the following is not a presentation of abdominal aortic aneurysm?
Asymptomatic.
Abdominal pain.
Compression of mesenteric arteries. T
Acute limb ischemia.
Duodenal obstruction.
41. Which of the following is not an indication of AAA repair?
Size >5.5 cm.
Symptomatic.
Embolization.
Size > 7cm. T
Impending rupture.
42. Which of the following is a complication of aortic dissection?
Endocarditis.
Aortic stenosis.
Cardiac tamponade.
Mitral regurgitation.
Pulmonary regurgitation.
43. Which of the following is the most common risk factor for aortic dissection?
Atherosclerosis.
Marfan syndrome.
Pregnancy.
Fibromuscular dysplasia.
Hypertension. T
44. Which of the following suggest Type B aortic dissection?
Anterior chest pain.
Interscapular back pain. T
Stroke.
Mi.
Cardiac tamponade.
45. Which of the following is not a feature of Marfan syndrome?
Downward less dislocation. T
Aortic aneurysm.
Aortic dissection.
AR
Upward Lens dislocation.
46. Which of the following is false regarding the adverse effects of hypertension?
Thickened elastic lamina of arteries.
Large arteries have hyaline arteriosclerosis. T
Smooth muscle hypertrophy.
Tortuosity of vessel wall.
Widespread atheroma.
47. Which of the following clues to secondary hypertension does not match?
Radiofemoral delay > Coarctation of aorta.
Enlarged kidneys> Polycystic kidney disease.
Abdominal bruit: Renal artery stenosis.
Facial swelling: Conn’s syndrome. T
Weight loss, diarrhea: Hyperthyroidism.
48. Which of following disease cause only diastolic hypertension?
Obesity.
Alcohol.
Pregnancy.
Hyperthyroidism.
Hypothyroidism. T
49. Following are side effects of ACEI except?
Hyperglycemia. T
First dose hypotension.
Hyperkalemia.
Renal dysfunction.
Cough.
50. All of the following skin changes can occur in a renal patient, except?
Yellow complexion.
Bruising.
Palmar erythema.
Excoriation
Reduced skin turgor.
51. The amount of ultrafiltrate produced in 24 hours by kidneys is?
160L
180 L
200L
120ml
170L
52. How much of the cardiac output does kidney receive?
5-10%
10-15%
20-25%
15-20%
25-30%
53. How much of the glomerular filtrate is reabsorbed in the tubules?
More than 90%
More than 95%
More than 65%
More than 99%
More than 80%
54. Which of the Following acts a trigger for erythropoietin release?
High oxygen tension.
Anemia.
Polycythemia.
Heart failure.
Renal failure.
55. Which of the following is not an effect of angiotensin II?
Decreased aldosterone.
Constriction of efferent arteriole.
Raised filtration pressure
Raised GFR
Systemic vasoconstriction.
56. Which of the following is wrong regarding the nerve supply of bladder?
Sympathetic nerves relax detrusor.
Sympathetics contract blader neck.
Distal sphincter innervated by somatic motor nerves from S2-4
Parasympathetics from S2-4 stimulate detrusor contraction.
Sympathies help release of urine.
57. All of the following relax the corpus cavernosa smooth muscles except?
Nitric oxide.
GABA
Acetylcholine.
VIP
Prostacyclin
58. Which of the Following statement regarding eGFR is true?
Under-estimated in cachexic patients.
Over-estimated in amputees.
Over-estimated in people taking creatine supplements.
Overestimated in people taking trimethoprim.
Valid in assessing acute kidney injury.
59. Which of the following is not a contraindication of renal biopsy?
Disordered coagulation.
Kidneys <60% of predicted size
Uncontrolled hypertension.
Solitary transplant kidneys.
Thrombocytopenia.
60. Which of following is a pre-renal cause of anuria?
BPH
Aortic dissection
Urethral stenosis
Bilateral renal stone
Massive crystalluria.
61. Positive dipstick for RBC but not RBC found in Microscopy is suggestive of?
Pyelonephritis.
UTI
Renal tumor.
Rhabdomyolysis.
Glomerulonephritis.
62. All of the following test are done in rapidly progressive glomerulonephritis except?
ASO titre
Complement levels (C3,C4)
Anti-GBM antibody.
Anti-CCP.
ANA
63. Which of the following disease has nephritic presentation?
Minimal change disease.
Anti-GBM disease.
FSGS
Membranous nephropathy.
Diabetic nephropathy.
64. All of the following are features of nephrotic syndrome except?
Podocyte injury.
Hypertension
Overt proteinuria
Hypoalbuminemia.
Edema and generalized fluid retention.
65. Which of the following ACR value suggest microalbuminuria?
3.5- 30
<2.5
30-70
70-300
>300
66. Following are complications of nephrotic syndrome, except?
Hypoalbuminemia.
Sodium retention.
Hypercoagulability.
Infection.
Liver failure.
67. Which of following may cause edema due to lymphatic obstruction?
Congestive heart failure.
Malignancy.
Renal failure
Liver disease.
Malnutrition.
68. All of the following cause nephrogenic diabetes insipidus except?
Lithium
Diuretics
Interstitial nephritis.
Hypokalemia.
Hyperkalemia.
69. Which of the following is an association of membranous nephropathy?
HIV infection.
Heroin abuse
Hepatitis B infection.
Morbid obesity
Chronic hypertension.
70. Which of the following is not a feature of tubulo-interstitial disease?
Nephrotic range proteinuria.aves’ disease
Tubular dysfunction.
Electrolyte abnormalities.
Renal impairment.
Polyuria.
71. All of the following are cause of acute interstitial nephritis except?
Penicillins.
Fungal infection
NSAIDs
Acute bacterial pyelonephritis
Tuberculosis.
72. All of the following cause chronic interstitial nephritis, except:
Sarcoidosis.
Any cause of acute interstitial nephritis, if persistent.
Sjogren syndrome.
Rheumatoid arthritis
SLE
73. Following is wrong regarding papillary necrosis:
Best imaging study is USG.
DM is a common cause.
NSAIDs can also cause it.
Ureteric obstruction can occur.
Cause sterile pyuria.
74. Following is true regarding Alport syndrome:
Mutation in COL3A5 gene
Autosomal dominant disorder.
Patient have hematuria.
Never progress to ESRD.
Always limited to renal symptoms.
75. All of the following are features of Fanconi syndrome except:
Low calcium.
Proximal tubular dysfunction.
Low phosphate.
Low uric acid.
Loss of amino acid.
76. Which of the following is true regarding ADPKD:
Autosomal recessive disease.
Most commonly affected gene is PKD 2
All of the patients have hepatic cyst.
Never require dialysis.
Berry aneurysm is a rare feature.
77. Which of the following is true regarding renal manifestation of multiple myeloma?
Cast nephropathy is caused by heavy chain.
Fanconi syndrome occur due to light chain mediated proximal tubular injury.
Secondary amyloidosis is a common manifestation.
Can cause diffuse glomerulosclerosis.
Hypercalcemia can lead to anuria.
78. Which of the following cause of aortic stenosis is associated with Turner syndrome?
Senile degenerative aortic stenosis.
Congenital aortic stenosis.
Bicuspid aortic valve.
Rheumatic aortic stenosis.
Cogenital supravalvular aortic stenosis.
79. All of the following are features of aortic stenosis, except?
Angina.
Wide pulse pressure.
Syncope
Dyspnea.
Episodes of acute pulmonary edema.
80. Following are common investigation finding in aortic stenosis, except?
Left ventricular hypertrophy.
Left bundle branch block.
Right bundle branch block.
Calcified valve with restricted opening.
Dilated ascending aorta.
81. Which of the following is a congenital cause of aortic regurgitation?
Rheumatic disease.
Bicuspid aortic valve.
Infective endocarditis.
Aortic aneurysm.
Aortic dissection.
82. Which of the following rheumatologic condition cause aortic regurgitation?
Rheumatoid arthritis.
Ankylosing spondylitis.
SLE.
Systemic sclerosis.
JIA
83. Which of the following is a clinical sign in aortic regurgitation?
Low volume pulse.
Pulsus alternans.
Pulsus paradoxus.
Slow rising pulse.
Capillary pulsation in nail beds.
84. Which of the following is a primary cause of tricuspid regurgitation?
Right ventricular failure.
Right ventricular infarction.
Endocarditis in IV drug abusers.
Pulmonary hypertension.
Mitral stenosis.
85. Which of the following organism causing infective endocarditis is associated with large bowel malignancy?
Streptococcus mitis.
Streptococcus sanguis.
Staphylococci.
Streptococcus gallolyticus.
Enterococcus.
86. Which of the following is a Duke Major criterion for diagnosing infective endocarditis?
Predisposing valvular or cardiac abnormality.
New valvular regurgitation.
IV Drug abuse.
Typical organism from one culture.
Persistent positive blood cultures taken > 4 hours apart.
87. Which of the following is an indication for cardiac surgery in infective endocarditis?
Native valve infection.
MIC < .125mg/L
No evidence of thromboembolic disease.
Abscess formation.
No evidence of thromboembolic disease.
88. Which of the following is the primary issue in Tetralogy of Fallot?
VSD
Overriding aorta.
Pulmonary stenosis.
Right ventricular hypertrophy.
89. Which of the following congenital heart disease cause cyanosis?
ASD
VSD.
PDA.
Tricuspid atresia.
Coarctation of aorta.
90. All of the following drugs cause myocarditis except?
Alcohol.
Lithium
Cyclophosphamide.
Cocaine.
Clozapine.
91. Which of the following is not a clinical sign of hypertrophic cardiomyopathy?
Jerky pulse.
Palpable LVH.
Double apical impulse.
Mid systolic murmur augmented by increase in preload.
Mid systolic murmur augmented by reduction of preload.
92. Which of the following is a risk factor of sudden death in hypertrophic cardiomyopathy?
History of atrial fibrillation.
Favorable genotype.
Recurrent syncope.
Mild increase in left ventricular wall thickness.
Exercise induced hypertension.
93. All of the following are clinical features of chronic constrictive pericarditis, except?
Soft heart sound.
Fatigue.
Low volume pulse.
Kussmaul’s sign.
Elevated JVP with a rapid y descent.
94. All of the following are clinical features of cardiac tamponade, except?
Collapse.
Hypotension.
Elevation of JVP.
Ascites.
Pulsus paradoxus.
95. Which of the following is the specific treatment of purulent pericarditis?
Aspirin.
Indomethacin
Antibiotics and Pericardiocentesis.
Cochicine
Glucocorticoids.
96. Which of the following is true regarding Takotsubo cardiomyopathy?
Is a chronic left ventricular dysfunction.
Dilation of right ventricle.
Cholinergic coronary vasoconstriction.
Apical ballooning of the Left ventricle.
Mimics NSTEMI.
97. Which of the following is true regarding arrhythmogenic ventricular cardiomyopathy?
Predominantly affects the myocardium of left ventricle.
Involves mutation in desmosomal protein genes.
It is autosomal recessive.
Cause atrial arrhythmias.
Never require ICD.
98. All of the following are true regrading dilated cardiomyopathy, except?
Left ventricular mass is increased.
Wall thickness is normal or reduced.
Never develop chest pain.
Can have functional mitral incompetence
Alcohol is an important cause
99. Which of the following is true regarding VSD?
The second most common congenital heart disease.
Causes soft Pansystolic murmur radiating to axilla.
Small defect produces soft murmur.
Large defect produces loud murmur.
Most defects are perimembranous.
100. Which of the following is true regarding renal artery stenosis:
A rare cause of secondary hypertension.
Kidneys are asymmetrical in size.
Most common cause in young is atherosclerosis.
Fibromuscular dysplasia is a common cause in adult.
Older patients should be considered for intervention.
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