[MCQ] Pericardial Disease- Part 1

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Pericardial Disease- Part 1

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Question 1

Pericardial cavity normally contains how much fluid ?

A	5 to 10 ml of fluid
B	10 to 20 ml of fluid
C	15 to 50 ml of fluid
D	50 to 100 ml of fluid

Question 1 Explanation:

Normal pericardium is a double-layered sac. Visceral pericardium is a serous membrane that is separated by a small quantity (15 to 50 mL) of fluid, an ultrafiltrate of plasma, from the fibrous parietal pericardium.

Question 2

In partial left pericardial defects, which of the following may bulge through the defect ?

A	Aorta
B	Left atrium
C	Left ventricle
D	Pulmonary vein

Question 2 Explanation:

In partial left pericardial defects, main pulmonary artery & left atrium may bulge through the defect.

Question 3

Chest pain is often absent in which of the following ?

A	Postirradiation pericarditis
B	Postirradiation pericarditis
C	Uremic pericarditis
D	All of the above

Question 3 Explanation:

Chest pain is absent in slowly developing TB, postirradiation, neoplastic & uremic pericarditis.

Question 4

Which of the following statements about chest pain of acute pericarditis is false ?

A	Retrosternal and left precordial
B	Exacerbated by inspiration
C	Exacerbated by inspiration
D	Pain may radiate to one or both trapezius muscle ridges

Question 4 Explanation:

Pain of acute pericarditis is often severe, retrosternal & left precordial, referred to neck, arms, or left shoulder. Often pain is pleuritic, aggravated by inspiration, coughing & changes in body position. Pericardial pain is relieved by sitting up & leaning forward & is intensified by lying supine

Question 5

Pericardial friction rub is best heard at ?

A	Apex
B	Left lower sternal border
C	Right sternal border
D	Right sternal border

Question 5 Explanation:

Pericardial friction rub is high-pitched, elicited sometimes only at the left lower sternal border at end-expiration with the patient upright & leaning forward throughout the respiratory cycle

Question 6

“Triphasic” pericardial friction rub is heard in about ?

A	100% of patients
B	75% of patients
C	50% of patients
D	25% of patients

Question 7

PR-segment depression is seen in which stage of acute pericarditis ?

A	Stage I
B	Stage II
C	Stage III
D	Stage IV

Question 8

Widespread T-wave inversions are found in which stage of acute pericarditis ?

A	Stage I
B	Stage II
C	Stage III
D	.. Stage IV

Question 8 Explanation:

ECG in acute pericarditis evolves through 4 stages. In stage 1, there is widespread elevation of ST segments with upward concavity, involving two or three standard limb leads and V2 to V6, as well as PRsegment depression with no significant changes in QRS. In stage 2, ST segments return to normal and then T waves become inverted (stage 3). Weeks or months later, ECG returns to normal in stage 4

Question 9

In acute pericarditis, reciprocal depression is seen in ?

A	aVR
B	aVL
C	aVF
D	All of the above

Question 9 Explanation:

ECG in stage 1 of acute pericarditis shows widespread elevation of ST segments, with upward concavity, involving two or three standard limb leads and V2 to V6, with reciprocal depressions only in aVR and sometimes V 1, as well as depression of the PR segment below the TP segment reflecting atrial involvement without significant changes in QRS complexes

Question 10

The most reliable ECG distinguishing feature between acute pericarditis and acute myocardial infarction is ?

A	Ratio of ST segment elevation to T-wave height in V6 of > 0.16
B	Ratio of ST segment elevation to T-wave height in V6 of > 0.20+
C	Ratio of ST segment elevation to T-wave height in V6 of > 0.24
D	Ratio of ST segment elevation to T-wave height in V6 of > 0.28

Question 10 Explanation:

In early repolarization, T waves are usually tall and the ST/T ratio is <0.25, this ratio is higher in acute pericarditis.

Question 11

Patch of dullness on auscultation beneath angle of left scapula in pericardial effusion is called ?

A	Auenbrugger’s sign
B	Ewart’s Sign
C	Broadbent’s sign
D	Ebstein’s sign

Question 11 Explanation:

Patch of dullness on auscultation beneath angle of left scapula due to compressive atelectasis of left lung base by pericardial fluid is called Ewart’s Sign (William Ewart, UK). Also known as Bamberger-Pins-Ewart Sign or Pins’ Syndrome. Auenbrugger’s sign - epigastric prominence seen in marked pericardial effusion. Broadbent’s sign - retraction of thoracic wall, synchronous with cardiac systole, visible in left posterior axillary line is a sign of adherent pericardium. Ebstein’s sign - obtuseness of the cardiohepatic angle on percussion. Friedreich’s sign - In adherent pericardium, sudden collapse of the previously distended veins of neck at each diastole. Rotch’s sign - percussion dullness in fifth intercostal space on the right. Heim-Kreysig sign - In adherent pericardium, an indrawing of the intercostal spaces, synchronous with cardiac systole. Synonym: Kreysig’s sign.

Question 12

Which of the following is the name given to the configuration of the cardiac silhouette in pericardial effusion ?

A	Hour glass
B	Water bottle
C	Dust bin
D	Tear drop

Question 12 Explanation:

Chest roentgenogram in pericardial effusion may show a “water bottle” configuration of the cardiac silhouette but may be normal.

Question 13

Which out of the following is the less common cause of cardiac tamponade ?

A	Neoplastic disease
B	Tuberculosis
C	Idiopathic pericarditis
D	Renal failure

Question 14

In cardiac tamponade, Beck’s triad consists of all except ?

A	Hypotension
B	Soft or absent heart sounds
C	Pulsus paradoxus
D	Jugular venous distention with a prominent “x” descent but an absent “y” descent

Question 14 Explanation:

Three main features of cardiac tamponade (Beck’s triad) are hypotension, soft or absent heart sounds, and jugular venous distention with a prominent “x” descent but an absent “y” descent.

Question 15

Presence of which of the following should raise suspicion of cardiac tamponade ?

A	Reduction in amplitude of QRS complexes
B	Electrical alternans of P wave
C	Electrical alternans of QRS or T waves
D	All of the above

Question 16

In ECG, electrical alternans may be present in ?

A	Cardiac tamponade
B	Cardiac tamponade
C	Restrictive cardiomyopathy
D	RVMI

Question 17

Kussmaul’s sign is absent in which of the following ?

A	Cardiac tamponade
B	Constrictive pericarditis
C	Restrictive cardiomyopathy
D	Right ventricular myocardial infarction (RVMI)

Question 17 Explanation:

When jugular veins are distended and venous pressure fails to decline during inspiration is called Kussmaul’s sign. It is absent in cardiac tamponade and is seen in chronic pericarditis, tricuspid stenosis, right ventricular infarction, and restrictive cardiomyopathy

Question 18

Right ventricular size is small in which of the following ?

A	Cardiac tamponade
B	Constrictive pericarditis
C	Restrictive cardiomyopathy
D	Restrictive cardiomyopathy

Question 19

On echocardiography, right atrial collapse and right ventricular diastolic collapse (RVDC) is present in which of the following ?

A	Cardiac tamponade
B	Constrictive pericarditis
C	Restrictive cardiomyopathy
D	Right ventricular myocardial infarction (RVMI)

Question 20

Prominent “y” descent is usually present in which of the following condition ?

A	Cardiac tamponade
B	Constrictive pericarditis
C	Restrictive cardiomyopathy
D	RVMI

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See all quizzes of the Pericardial Disease at here:

Pericardial Disease- Part 1| Pericardial Disease- Part 2

1.Pericardial cavity normally contains how much fluid ?
A. 5 to 10 ml of fluid
B. 10 to 20 ml of fluid
C. 15 to 50 ml of fluid
D. 50 to 100 ml of fluid

2. In partial left pericardial defects, which of the following may bulge through the defect ?
A. Aorta
B. Left atrium
C. Left ventricle
D. Pulmonary vein

3. Chest pain is often absent in which of the following ?
A. Postirradiation pericarditis
B. Neoplastic pericarditis
C. Uremic pericarditis
D. All of the above

4. Which of the following statements about chest pain of acute pericarditis is false ?
A. Retrosternal and left precordial
B. Exacerbated by inspiration
C. Worse when the patient sits upright and leans forward and improves in supine position
D. Pain may radiate to one or both trapezius muscle ridges

5. Pericardial friction rub is best heard at ?
A. Apex
B. Left lower sternal border
C. Right sternal border
D. All of the above

6. “Triphasic” pericardial friction rub is heard in about ?
A. 100% of patients
B. 75% of patients
C. 50% of patients
D. 25% of patients
7. PR-segment depression is seen in which stage of acute pericarditis ?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
8. Widespread T-wave inversions are found in which stage of acute pericarditis ?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV

9. In acute pericarditis, reciprocal depression is seen in ?
A. aVR
B. aVL
C. aVF
D. All of the above

10. The most reliable ECG distinguishing feature between acute pericarditis and acute myocardial infarction is ?
A. Ratio of ST segment elevation to T-wave height in V6 of > 0.16
B. Ratio of ST segment elevation to T-wave height in V6 of > 0.20
C. Ratio of ST segment elevation to T-wave height in V6 of > 0.24
D. Ratio of ST segment elevation to T-wave height in V6 of > 0.28

11.Patch of dullness on auscultation beneath angle of left scapula in pericardial effusion is called ?
A. Auenbrugger’s sign
B. Ewart’s Sign
C. Broadbent’s sign
D. Ebstein’s sign

12. Which of the following is the name given to the configuration of the cardiac silhouette in pericardial effusion ?
A. Hour glass
B. Water bottle
C. Dust bin
D. Tear drop

13. Which out of the following is the less common cause of cardiac tamponade ?
A. Neoplastic disease
B. Tuberculosis
C. Idiopathic pericarditis
D. Renal failure

14. In cardiac tamponade, Beck’s triad consists of all except ?
A. Hypotension
B. Soft or absent heart sounds
C. Pulsus paradoxus
D. Jugular venous distention with a prominent “x” descent but an absent “y” descent

15. Presence of which of the following should raise suspicion of cardiac tamponade ?

A. Reduction in amplitude of QRS complexes
B. Electrical alternans of P wave
C. Electrical alternans of QRS or T waves
D. All of the above
16. In ECG, electrical alternans may be present in ?
A. Cardiac tamponade
B. Constrictive pericarditis
C. Restrictive cardiomyopathy
D. RVMI
17. Kussmaul’s sign is absent in which of the following ?
A. Cardiac tamponade
B. Constrictive pericarditis
C. Restrictive cardiomyopathy
D. Right ventricular myocardial infarction (RVMI)

18. Right ventricular size is small in which of the following ?
A. Cardiac tamponade
B. Constrictive pericarditis
C. Restrictive cardiomyopathy
D. Right ventricular myocardial infarction (RVMI)
19. On echocardiography, right atrial collapse and right ventricular diastolic collapse (RVDC) is present in which of the following ?
A. Cardiac tamponade
B. Constrictive pericarditis
C. Restrictive cardiomyopathy
D. Right ventricular myocardial infarction (RVMI)
20. Prominent “y” descent is usually present in which of the following condition ?
A. Cardiac tamponade
B. Constrictive pericarditis
C. Restrictive cardiomyopathy
D. RVM

Pericardial Disease

[MCQ] Pericardial Disease- Part 1

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Pericardial Disease- Part 1

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