[MCQs] Cardiology

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Cardioly

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Question 1

Which of the following features of breathing define dyspnea ?

A	Abnormal
B	Uncomfortable
C	Awareness
D	All of the above

Question 1 Explanation:

Normally, at rest, one is unaware of the act of breathing. With exercise, though aware of breathing, discomfort is expected to be transient. Dyspnea is defined with prefixes before awareness of breathing i.e. abnormally uncomfortable.

Question 2

Sudden and unexpected dyspneic episodes at rest can be associated with all except ?

A	Pulmonary emboli
B	Spontaneous pneumothorax
C	Metabolic acidemia
D	Anxiety

Question 2 Explanation:

Laboured breathing is not synonymous with dyspnea. Hyperventilation with metabolic acidemia is rarely accompanied by dyspnea. Sudden & unexpected dyspnea at rest occur with pulmonary emboli, spontaneous pneumothorax, hypercapnea secondary to breath holding, or anxiety

Question 3

Which of the following is most characteristic of severe paroxysmal dyspnea of left ventricular failure ?

A	Nocturnal episodes
B	Nocturnal episodes
C	Orthopnea
D	All of the above

Question 3 Explanation:

Nocturnal episodes of dyspnea are a typical feature of left ventricular failure. Sudden & unexpected dyspneic episodes at rest is more typical of pulmonary embolization, spontaneous pneumothorax, anxiety. Orthopnea is characteristic of congestive heart failure

Question 4

Orthopnea is seen in ?

A	Congestive heart failure
B	Asthma & COPD
C	Bilateral diaphragmatic paralysis
D	All of the above

Question 4 Explanation:

Dyspnea occuring in supine posture is termed orthopnea. It points to the diagnosis of CHF, asthma, COPD, or bilateral diaphragmatic paralysis

Question 5

Platypnea is dyspnea that occurs in which position ?

A	Upright
B	Sitting
C	Supine
D	Lateral

Question 5 Explanation:

Platypnea is dyspnea that occurs only in upright position

Question 6

Trepopnea most often occurs in patients with ?

A	Asthma
B	COPD
C	Heart disease
D	Pleural effusion

Question 6 Explanation:

Trepopnea is dyspnea that occurs only in a lateral decubitus position, most often in patients with heart disease due to positional alterations in ventilation-perfusion relationships.

Question 7

The sense of air hunger arises from ?

A	Increased respiratory activity in brainstem
B	Stimulation of vagal-irritant receptors
C	Chemoreceptors in aortic and carotid bodies
D	Afferent fibers in the phrenic nerves

Question 8

The sensation of chest tightness probably results from ?

A	Increased respiratory activity in brainstem
B	Stimulation of vagal-irritant receptors
C	Chemoreceptors in aortic and carotid bodies
D	Afferent fibers in the phrenic nerves

Question 8 Explanation:

Dyspnea is characterized by an excessive or abnormal activation of respiratory centers in brainstem. This stimuli may come from intrathoracic receptors via vagal nerves, afferent somatic nerves from respiratory muscles & chest wall, chemoreceptors in brain, aortic & carotid bodies, cortical centers or afferent fibers in phrenic nerves. Sense of air hunger arises from increased respiratory activity within brainstem & sensation of chest tightness results from stimulation of vagal-irritant receptors.

Question 9

In chronic bronchitis, which of the following is the predominant sensory experience ?

A	Inability to take in a sufficiently deep breath
B	Difficulty in exhaling
C	Difficulty in inhaling and exhaling
D	Any of the above

Question 9 Explanation:

Despite the fact that severe limitation of expiratory flow & hyperinflation of lung are characteristic of chronic bronchitis, sensory experience is often that of an inability to take in a sufficiently deep breath rather than difficulty in exhaling.

Question 10

Obstruction of airways is an invariable finding in ?

A	Asthma
B	Chronic bronchitis
C	Emphysema
D	All of the above

Question 10 Explanation:

Emphysema is a parenchymal disease, it is invariably accompanied by obstruction of airways.

Question 11

Chronic cor pulmonale & respiratory failure is more common in which of the following diseases ?

A	Severe kyphoscoliosis
B	Pectus excavatum
C	Ankylosing spondylitis
D	Rheumatoid arthritis

Question 11 Explanation:

Severe kyphoscoliosis alters ventilation to produce chronic cor pulmonale & respiratory failure

Question 12

J (juxtacapillary) receptors are found in ?

A	Bronchi
B	Terminal brochiole
C	Alveolar interstitial space
D	All of the above

Question 13

Which of the following is called “cardiac asthma” ?

A	Paroxysmal nocturnal dyspnea (PND)
B	Orthopnea
C	Platypnea
D	Trepopnea

Question 13 Explanation:

PND is also called cardiac asthma. During night, with recumbency, total blood volume is increased due to fluid mobilization from edematous areas leading to pulmonary congestion.

Question 14

“Nocturnal dyspnea” is a feature of which of the following ?

A	Heart failure
B	Chronic bronchitis
C	Asthma
D	All of the above

Question 14 Explanation:

Chronic bronchitis causes nocturnal dyspnea due to bronchial mucus hypersecretion leading to airway obstruction. It is relieved by cough & expectoration. Circadian variations increase bronchial sensitivity between 2 AM & 4 AM in asthma patients leading to episodes of nocturnal dyspnea.

Question 15

Echocardiographically, which of the following is not a feature of left ventricular failure ?

A	Left atrial dilatation
B	Left ventricular hypertrophy
C	Reduced left ventricular ejection fraction
D	Reduced right ventricular ejection fraction

Question 15 Explanation:

Left atrial &/or left ventricular dilatation, LVH, reduced LV ejection fraction & disorders of LV wall motion are clues to a left ventricular cardiac etiology. Right ventricular ejection fraction may be low at rest or may decline during exercise in patients with severe lung disease.

Question 16

In neurocirculatory asthenia, the electrocardiographic changes are most often seen during ?

A	Depolarization
B	Repolarization
C	Depolarization + Repolarization
D	Any of the above

Question 16 Explanation:

D. Any of the above In neurocirculatory asthenia, ECG changes are most often seen during repolarization.

Question 17

Frequent sighing respirations & irregular breathing pattern suggest which cause of dyspnea ?

A	Psychogenic
B	Cardiac
C	Pulmonary
D	Diseases of chest wall or respiratory muscles

Question 17 Explanation:

Frequent sighing respirations & irregular breathing point to a psychogenic origin of dyspnea.

Question 18

Pulmonary edema due to “imbalance of Starling forces” includes all of the following except ?

A	Increased pulmonary capillary pressure
B	Decreased plasma oncotic pressure
C	Endogenous vasoactive substances
D	Increased negativity of interstitial pressure

Question 18 Explanation:

Imbalance of Starling forces leading to pulmonary edema can be produced by increased pulmonary capillary pressure, decreased plasma oncotic pressure or by increased negativity of interstitial pressure. Endogenous vasoactive substances (histamine, kinins) alter alveolar- capillary membrane permeability (acute respiratory distress syndrome).

Question 19

Which of the following is termed “overperfusion pulmonary edema” ?

A	Increased pulmonary venous pressure without LVF
B	Increased pulmonary venous pressure secondary to LVF
C	Increased pulmonary capillary pressure secondary to increased pulmonary arterial pressure
D	All of the above

Question 19 Explanation:

Increased pulmonary capillary pressure secondary to increased pulmonary arterial pressure is called overperfusion pulmonary edema.

Question 20

High-altitude pulmonary edema (HAPE) is more common in persons of which age ?

A	Infants
B	< 25 years
C	30 to 60 years
D	D. > 75 years

Question 21

Which of the following diffuse pulmonary edema does not have a hemodynamic origin ?

A	Shock due to sepsis
B	Shock due to hemorrhagic pancreatitis
C	Shock following cardiopulmonary bypass
D	All of the above

Question 21 Explanation:

Toxic insult to lungs, diffuse pulmonary infections, aspiration & shock, particularly due to sepsis, hemorrhagic pancreatitis & following cardiopulmonary bypass, are associated with diffuse pulmonary edema that clearly does not have a hemodynamic origin

Question 22

Prophylactic inhalation of which of the following reduces the incidence of high-altitude pulmonary edema (HAPE) ?

A	P2 agonist salmeterol
B	Steroid
C	Ipratropium bromide
D	Chromolyn

Question 22 Explanation:

Prophylactic inhalation of agonist salmeterol, administration of oxygen and/or return to lower altitudes reduces the incidence of high-altitude pulmonary edema (HAPE).

Question 23

Neurogenic pulmonary edema has been described in ?

A	Central nervous system disorders
B	Peripheral nervous system disorders
C	Central + peripheral nervous system disorders
D	Any of the above

Question 23 Explanation:

Neurogenic pulmonary edema has been described in patients with CNS disorders and without apparent preexisting left ventricular dysfunction

Question 24

Overdoses of which of the following heroin preparations is associated with pulmonary edema ?

A	Morphine
B	Methadone
C	Dextropropoxyphene
D	All of the above

Question 24 Explanation:

Parenteral & oral overdoses of legitimate preparations of morphine, methadone and dextropropoxyphene can produce pulmonary edema

Question 25

Which of the following leads to the development of interstitial edema ?

A	Rapid evacuation of a large pneumothorax
B	Acute severe asthma
C	Lymphangitic carcinomatosis
D	All of the above

Question 25 Explanation:

Rapid evacuation of a large pneumothorax causes increased negativity of interstitial pressure. Large negative intrapleural pressures during acute severe asthma may cause interstitial edema. Lymphatic blockade due to lymphangitic carcinomatosis may lead to interstitial edema.

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II. Preview all questions the Cardiology below:

1.Which of the following features of breathing define dyspnea ?A. Abnormal
B. Uncomfortable
C. Awareness
D. All of the above

2.Sudden and unexpected dyspneic episodes at rest can be associated with all except ?
A. Pulmonary emboli
B. Spontaneous pneumothorax
C. Metabolic acidemia
D. Anxiety

3 .Which of the following is most characteristic of severe paroxysmal dyspnea of left ventricular failure ?
A. Nocturnal episodes
B. Sudden and unexpected
C. Orthopnea
D. All of the above

4 .Orthopnea is seen in ?
A. Congestive heart failure
B. Asthma & COPD
C. Bilateral diaphragmatic paralysis
D. All of the above

5. Platypnea is dyspnea that occurs in which position ?
A. Upright
B. Sitting
C. Supine
D. Lateral

6 .Trepopnea most often occurs in patients with ?
A. Asthma
B. COPD
C. Heart disease
D. Pleural effusion

7. The sense of air hunger arises from ?
A. Increased respiratory activity in brainstem
B. Stimulation of vagal-irritant receptors
C. Chemoreceptors in aortic and carotid bodies
D. Afferent fibers in the phrenic nerves

8. The sensation of chest tightness probably results from ?
A. Increased respiratory activity in brainstem
B. Stimulation of vagal-irritant receptors
C. Chemoreceptors in aortic and carotid bodies
D. Afferent fibers in the phrenic nerves

9. In chronic bronchitis, which of the following is the predominant sensory experience ?
A. Inability to take in a sufficiently deep breath
B. Difficulty in exhaling
C. Difficulty in inhaling and exhaling
D. Any of the above

10. Obstruction of airways is an invariable finding in ?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. All of the above

11. Chronic cor pulmonale & respiratory failure is more common in which of the following diseases ?
A. Severe kyphoscoliosis
B. Pectus excavatum
C. Ankylosing spondylitis
D. Rheumatoid arthritis

12 J (juxtacapillary) receptors are found in ?
A. Bronchi
B. Terminal brochiole
C. Alveolar interstitial space
D. All of the above

13 . Which of the following is called “cardiac asthma” ?
A. Paroxysmal nocturnal dyspnea (PND)

B. Orthopnea
C. Platypnea
D. Trepopnea

14. “Nocturnal dyspnea” is a feature of which of the following ?
A. Heart failure
B. Chronic bronchitis
C. Asthma
D. All of the above

15. Echocardiographically, which of the following is not a feature of left ventricular failure ?
A. Left atrial dilatation
B. Left ventricular hypertrophy
C. Reduced left ventricular ejection fraction
D. Reduced right ventricular ejection fraction

16 In neurocirculatory asthenia, the electrocardiographic changes are most often seen during ?
A. Depolarization
B. Repolarization
C. Depolarization + Repolarization
D. Any of the above

17. Frequent sighing respirations & irregular breathing pattern suggest which cause of dyspnea ?
A. Psychogenic
B. Cardiac
C. Pulmonary
D. Diseases of chest wall or respiratory muscles

18. Pulmonary edema due to “imbalance of Starling forces” includes all of the following except ?
A. Increased pulmonary capillary pressure
B. Decreased plasma oncotic pressure
C. Endogenous vasoactive substances
D. Increased negativity of interstitial pressure

19 .Which of the following is termed “overperfusion pulmonary edema” ?
A. Increased pulmonary venous pressure without LVF
B. Increased pulmonary venous pressure secondary to LVF
C. Increased pulmonary capillary pressure secondary to
increased pulmonary arterial pressure
D. All of the above

20. High-altitude pulmonary edema (HAPE) is more common in persons of which age ?
A. Infants
B. < 25 years
C. 30 to 60 years
D. > 75 years

21. Which of the following diffuse pulmonary edema does not have a hemodynamic origin ?
A. Shock due to sepsis
B. Shock due to hemorrhagic pancreatitis
C. Shock following cardiopulmonary bypass
D. All of the above

22 . Prophylactic inhalation of which of the following reduces the incidence of high-altitude pulmonary edema (HAPE) ?
A. 2 agonist salmeterol
B. Steroid
C. Ipratropium bromide
D. Chromolyn

23. Neurogenic pulmonary edema has been described in ?
A. Central nervous system disorders
B. Peripheral nervous system disorders
C. Central + peripheral nervous system disorders
D. Any of the above

24. Overdoses of which of the following heroin preparations isassociated with pulmonary edema ?
A. Morphine
B. Methadone
C. Dextropropoxyphene

D. All of the above

25. Which of the following leads to the development of interstitial edema ?
A. Rapid evacuation of a large pneumothorax
B. Acute severe asthma
C. Lymphangitic carcinomatosis
D. All of the above

Cardiology

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Cardioly

II. Preview all questions the Cardiology below:

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