[MCQ] Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 1

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Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 1

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Congratulations - you have completed Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 1. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Wells diagnostic scoring system is used for ?

A	ILD
B	COPD
C	Pulmonary embolism
D	Cystic fibrosis

Question 1 Explanation:

Wells Diagnostic Scoring System is a semi-quantitative clinical scoring system for suspected pulmonary embolism (PE)

Question 2

Wells Scoring System has a maximum of ?

A	8.5 points
B	10.5 points
C	12.5 points
D	15.5 points

Question 2 Explanation:

The Wells Scoring System has a maximum of 12.5 points. If the score is <= 4 points, the likelihood of PE is only 8%.

Question 3

Frequency of occurrence of DVT is how many times more than PE ?

A	2
B	3
C	4
D	5

Question 3 Explanation:

Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) & pulmonary embolism (PE). DVT occurs about 3 times more often than PE.

Question 4

Which of the following is false about postphlebitic syndrome ?

A	Early adverse effect of DVT
B	Caused by permanent damage to venous valves of leg
C	Skin ulceration on medial malleolus of leg
D	No effective medical therapy

Question 4 Explanation:

Major adverse outcome of DVT alone, without PE, is postphlebitic syndrome, which occurs in more than half of DVT cases. It is a late adverse effect of DVT. It is also known as postthrombotic syndrome or chronic venous insufficiency.

Question 5

Which of the following medical conditions contribute to the likelihood of VTE ?

A	Antiphospholipid antibody syndrome
B	Systemic arterial hypertension
C	Chronic obstructive pulmonary disease
D	All of the above

Question 5 Explanation:

Acquired predispositions to VTE include long-haul air travel, obesity, cigarette smoking, oral contraceptives, pregnancy, postmenopausal hormone replacement, surgery, trauma. Medical conditions include APLA syndrome, cancer, systemic arterial hypertension & COPD

Question 6

Which of the following about pregnancy & DVT is false ?

A	DVT occurs in ~1 in 2000 pregnancies
B	DVT more common in left than right leg
C	~25% pregnancy with DVT carry factor V Leiden allele
D	None of the above

Question 7

Genetic mutations associated with DVT in pregnancy include ?

A	Factor V Leiden mutation
B	Prothrombin G20210A mutation
C	Methylenetetrahydrofolate reductase C677T mutation
D	All of the above

Question 7 Explanation:

Autosomal dominant genetic mutations that contribute to the likelihood of VTE are factor V Leiden and the prothrombin gene mutations

Question 8

In a case of pulmonary embolism, which of the following is false ?

A	Increased pulmonary vascular resistance
B	Impaired gas exchange
C	Alveolar hypoventilation
D	Increased airway resistance

Question 8 Explanation:

Effects of pulmonary embolism are : Increased pulmonary vascular resistance, impaired gas exchange, alveolar hyperventilation, increased airway resistance & decreased pulmonary compliance.

Question 9

Which of the following is the most common source of paradoxical embolism ?

A	Pelvic vein thrombosis
B	Proximal leg deep venous thrombosis
C	Isolated calf vein thrombi
D	Any of the above

Question 9 Explanation:

50% of patients with pelvic vein thrombosis or proximal leg deep venous thrombosis (DVT) have asymptomatic pulmonary thromboembolism (PTE). Isolated calf vein thrombi pose a lower risk of PE but they are the most common source of paradoxical embolism

Question 10

Eponym “The Great Masquerader” is used for ?

A	Deep venous thrombosis (DVT)
B	Pulmonary embolism (PE)
C	Venous thromboembolism (VTE)
D	All of the above

Question 10 Explanation:

Apart from PE, term masquerader has been used for acute appendicitis & pheochromocytoma.

Question 11

Which of the following is likely in massive DVT ?

A	Sudden, severe calf discomfort
B	Severe thigh swelling
C	Diffusely edematous leg
D	Any of the above
E	Sudden, severe calf discomfort suggests a ruptured Baker’s cyst. Severe thigh swelling & marked tenderness in inguinal area & common femoral vein occurs in massive DVT. If leg is diffusely edematous, DVT is unlikely, rather acute exacerbation of venous insufficiency due to postphlebitic syndrome is likely

Question 12

Which of the following suggests a small pulmonary embolism ?

A	Dyspnea
B	Pleuritic pain
C	Syncope
D	Hypotension

Question 13

Which of the following suggests a massive pulmonary embolism ?

A	Cough
B	Pleuritic pain
C	Dyspnea
D	Hemoptysis

Question 13 Explanation:

Dyspnea is the most frequent symptom of PE, and tachypnea is its most frequent sign. Dyspnea, syncope, hypotension or cyanosis indicates a massive PE. Pleuritic pain, cough or hemoptysis suggests a small embolism located distally near the pleura

Question 14

Levels of D-dimer increase in ?

A	Myocardial infarction
B	Sepsis
C	Second or third trimester of pregnancy
D	All of the above

Question 14 Explanation:

Levels of D-dimer increase in myocardial infarction, pneumonia, sepsis, cancer, postoperative state, and second or third trimester of pregnancy.

Question 15

ECG change in pulmonary embolism include ?

A	T wave inversion in V1-4
B	New onset atrial fibrillation
C	S1Q3T3 pattern
D	All of the above

Question 15 Explanation:

Classic ECG abnormalities in PE include sinus tachycardia, new-onset atrial fibrillation or flutter & an S wave in lead I, a Q wave in lead III & an inverted T wave in lead III. QRS axis is >90°

Question 16

Most frequent ECG finding in pulmonary embolism is ?

A	New-onset atrial fibrillation
B	S1Q3T3 pattern
C	QRS axis greater than 90º
D	T-wave inversion in leads V1 to V4

Question 16 Explanation:

In PE, T-wave inversion in leads V1 to V4 is the most frequent change (right ventricular strain).

Question 17

Which of the following is a feature of pulmonary embolism on chest X-Ray ?

A	Westermark’s sign
B	Hampton’s hump
C	Palla’s sign
D	All of the above

Question 18

Palla’s sign refers to ?

A	Focal oligemia
B	Peripheral wedged-shaped density above diaphragm
C	Peripheral wedged-shaped density above diaphragm
D	Peripheral wedged-shaped density above diaphragm

Question 19

Westermark’s sign refers to ?

A	Focal oligemia
B	Peripheral wedged-shaped density above diaphragm
C	Enlarged right descending pulmonary artery
D	Enlarged left descending pulmonary artery

Question 20

Hampton’s hump refers to ?

A	Hampton’s hump refers to ?
B	Peripheral wedged-shaped density above diaphragm
C	Enlarged right descending pulmonary artery
D	Enlarged left descending pulmonary artery

Question 20 Explanation:

In a dyspneic patient, a normal or near-normal chest x-ray suggests PE. Other abnormalities include focal oligemia (Westermark’s sign), a peripheral wedged-shaped density above the diaphragm (Hampton’s hump), or an enlarged right descending pulmonary artery (Palla’s sign).

Question 21

Pulmonary perfusion scan that has a high probability for PE should have how many segmental perfusion defects in the presence of normal ventilation scan ?

A	One or more
B	Two or more
C	Three or more
D	Three or more

Question 21 Explanation:

A high probability pulmonary perfusion scan for PE is defined as having two or more segmental perfusion defects in the presence of normal ventilation scan

Question 22

Echocardiography is the least useful diagnostic tool for ?

A	Acute myocardial infarction
B	Pulmonary embolism
C	Pericardial tamponade
D	Pericardial tamponade

Question 22 Explanation:

Echocardiography is not a reliable diagnostic imaging tool for acute PE because most patients with PE have normal echocardiograms

Question 23

In echocadiography, McConnell’s sign is specific for which of the following ?

A	HOCM
B	Pulmonary embolism
C	Acute rheumatic fever
D	Infective endocarditis

Question 23 Explanation:

Echocardiographic McConnell’s sign refers to right ventricular free wall hypokinesis with normal right ventricular apical motion and is specific for PE.

Question 24

Which of the following is the principal imaging test for the diagnosis of PE ?

A	Lung Scanning
B	Chest x-ray
C	Chest CT
D	Echocardiography

Question 24 Explanation:

Computed tomography of chest with intravenous contrast is the principal imaging test for diagnosis of PE. Multidetector-row spiral CT scanners can image small peripheral emboli. Sixth-order branches can be visualized with resolution superior to that of conventional invasive contrast pulmonary angiography

Question 25

Which of the following is false ?

A	Normal or nearly normal chest x-ray often occurs in PE
B	Normal venous ultrasound does not exclude PE
C	Lung scanning is the second-line diagnostic test for PE
D	None of the above

Question 25 Explanation:

None of the above

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Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 1 |Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 2

1.Wells diagnostic scoring system is used for ?
A. ILD
B. COPD
C. Pulmonary embolism
D. Cystic fibrosis

2. Wells Scoring System has a maximum of ?
A. 8.5 points
B. 10.5 points
C. 12.5 points
D. 15.5 points

3. Frequency of occurrence of DVT is how many times more than PE ?
A. 2

B. 3
C. 4
D. 5

4. Which of the following is false about postphlebitic syndrome ?
A. Early adverse effect of DVT
B. Caused by permanent damage to venous valves of leg
C. Skin ulceration on medial malleolus of leg
D. No effective medical therapy

5. Which of the following medical conditions contribute to thelikelihood of VTE ?
A. Antiphospholipid antibody syndrome
B. Systemic arterial hypertension
C. Chronic obstructive pulmonary disease
D. All of the above

6. Which of the following about pregnancy & DVT is false ?
A. DVT occurs in ~1 in 2000 pregnancies
B. DVT more common in left than right leg
C. ~25% pregnancy with DVT carry factor V Leiden allele
D. None of the above
7. Genetic mutations associated with DVT in pregnancy include ?
A. Factor V Leiden mutation
B. Prothrombin G20210A mutation
C. Methylenetetrahydrofolate reductase C677T mutation
D. All of the above

8. In a case of pulmonary embolism, which of the following is false ?
A. Increased pulmonary vascular resistance
B. Impaired gas exchange
C. Alveolar hypoventilation
D. Increased airway resistance
9. Which of the following is the most common source of paradoxical embolism ?
A. Pelvic vein thrombosis
B. Proximal leg deep venous thrombosis

C. Isolated calf vein thrombi
D. Any of the above

10. Eponym “The Great Masquerader” is used for ?
A. Deep venous thrombosis (DVT)
B. Pulmonary embolism (PE)
C. Venous thromboembolism (VTE)
D. All of the above

11. Which of the following is likely in massive DVT ?
A. Sudden, severe calf discomfort
B. Severe thigh swelling
C. Diffusely edematous leg
D. Any of the above

12. Which of the following suggests a small pulmonary embolism ?
A. Dyspnea
B. Pleuritic pain
C. Syncope
D. Hypotension
13. Which of the following suggests a massive pulmonary embolism ?
A. Cough
B. Pleuritic pain
C. Dyspnea
D. Hemoptysis

14. Levels of D-dimer increase in ?
A. Myocardial infarction
B. Sepsis
C. Second or third trimester of pregnancy
D. All of the above

15. ECG change in pulmonary embolism include ?
A. T wave inversion in V
1-4
B. New onset atrial fibrillation

C. S
1Q3T3 pattern
D. All of the above

16. Most frequent ECG finding in pulmonary embolism is ?
A. New-onset atrial fibrillation
B. S1Q3T3 pattern
C. QRS axis greater than 90º
D. T-wave inversion in leads V1 to V4

17. Which of the following is a feature of pulmonary embolism on chest X-Ray ?
A. Westermark’s sign
B. Hampton’s hump
C. Palla’s sign
D. All of the above
18. Palla’s sign refers to ?
A. Focal oligemia
B. Peripheral wedged-shaped density above diaphragm
C. Enlarged right descending pulmonary artery
D. Enlarged left descending pulmonary artery
19. Westermark’s sign refers to ?
A. Focal oligemia
B. Peripheral wedged-shaped density above diaphragm
C. Enlarged right descending pulmonary artery
D. Enlarged left descending pulmonary artery
20. Hampton’s hump refers to ?
A. Focal oligemia
B. Peripheral wedged-shaped density above diaphragm
C. Enlarged right descending pulmonary artery
D. Enlarged left descending pulmonary artery

21. Pulmonary perfusion scan that has a high probability for PE should have how many segmental perfusion defects in the presence of normal ventilation scan ?
A. One or more
B. Two or more
C. Three or more
D. Four or more

22. Echocardiography is the least useful diagnostic tool for ?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Pericardial tamponade
D. Aortic dissection

23. In echocadiography, McConnell’s sign is specific for which of the following ?
A. HOCM
B. Pulmonary embolism
C. Acute rheumatic fever
D. Infective endocarditis

24. Which of the following is the principal imaging test for thediagnosis of PE ?
A. Lung Scanning
B. Chest x-ray
C. Chest CT
D. Echocardiography

25. Which of the following is false ?
A. Normal or nearly normal chest x-ray often occurs in PE
B. Normal venous ultrasound does not exclude PE
C. Lung scanning is the second-line diagnostic test for PE
D. None of the above

Deep Venous Thrombosis and Pulmonary Thromboembolism

[MCQ] Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 1

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Deep Venous Thrombosis and Pulmonary Thromboembolism- Part 1

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