[MCQs] Physical Examination of the Cardiovascular System- Part 1

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Physical Examination of the Cardiovascular System- Part 1

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Congratulations - you have completed Physical Examination of the Cardiovascular System- Part 1. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Stethoscope was first introduced by ?

A	Austin Flint
B	Barlow
C	René Laennec
D	Richard Cabot

Question 1 Explanation:

Stethoscope was first introduced by René Laennec in 1819.

Question 2

Which of the following is not related to infective endocarditis ?

A	Subungual hemorrhages
B	Osler's nodes
C	Nikolsky's sign
D	Janeway lesions

Question 2 Explanation:

Infective endocarditis may present as petechiae, Osler’s nodes and Janeway lesions. Staphylococcal scalded-skin syndrome is seen in children and in immunocompromised adults. Generalized erythema is often evident during the prodrome of fever and malaise; profound tenderness of the skin is distinctive. In the exfoliative stage, the skin can be induced to form bullae with light lateral pressure (Nikolsky’s sign).

Question 3

Which of the following is false about diabetic retinopathy ?

A	Microaneurysms just temporal to fovea
B	Cotton-wool infarcts circularly around the disc
C	Yellow exudates
D	Nonproliferative retinopathy found in almost all individuals with DM for >10 years

Question 3 Explanation:

Early diabetic microaneurysms are found just temporal to fovea, along horizontal raphe & cotton¬wool infarcts are found circularly around disc. Nonproliferative retinopathy is found in almost all individuals who have had DM for >20 years.

Question 4

Which of the following retinal emboli is most common ?

A	Platelet emboli
B	Hollenhorst plaques
C	Calcium emboli
D	Uric acid emboli

Question 4 Explanation:

Platelet emboli in retinal artery is most common

Question 5

When ascites is out of proportion to peripheral edema, which of the following should be suspected ?

A	Tricuspid regurgitation
B	Budd Chiari Syndrome
C	Constrictive pericarditis
D	Cirrhosis liver

Question 5 Explanation:

Constrictive pericarditis is a possibility when ascites is out of proportion to peripheral edema

Question 6

Atherosclerosis of the peripheral arteries may produce intermittent claudication of ?

A	Buttock
B	Calf
C	Calf
D	Any of the above

Question 6 Explanation:

Atherosclerosis of peripheral arteries of lower extremities produces intermittent claudication of buttock, calf, thigh, or foot.

Question 7

What resting ankle-brachial index is consistent with critical ischemia, rest pain & tissue loss ?

A	< 0.3
B	< 0.5
C	< 0.7
D	< 0.9

Question 7 Explanation:

Resting ABI < 0.9 is considered abnormal. ABI <0.3 is consistent with critical ischemia, rest pain, and tissue loss.

Question 8

Which of the following statements is false ?

A	Anacrotic shoulder is present on ascending limb
B	Incisura coincides with the aortic valve closure
C	Incisura coincides with the aortic valve closure
D	None of the above

Question 8 Explanation:

In normal central aortic pulse wave, anacrotic shoulder is present on ascending limb. Descending limb has a sharp downward deflection called incisura coinciding with aortic valve closure. Peripherally, anacrotic shoulder is less apparent & incisura is replaced by dicrotic notch

Question 9

Pulse more evident in a peripheral artery is ?

A	Pulsus bigeminus
B	Pulsus bisferiens
C	Pulsus paradoxus
D	Dicrotic pulse

Question 10

Pulse more evident in a peripheral artery is ?

A	Pulsus bigeminus
B	Pulsus alternans
C	Pulsus paradoxus
D	Dicrotic pulse

Question 10 Explanation:

Bisferiens pulse (in AR) & pulsus alternans are more evident in peripheral arteries

Question 11

“Trisection” is a method for ?

A	Assessing chest expansion
B	Assessing character of arterial pulse
C	Assessing postural fall of blood pressure
D	Assessing pulse, BP and respiration

Question 11 Explanation:

Trisection is a method for assessing the sharpness of upstroke, systolic peak and diastolic slope of the arterial pulse

Question 12

Pulsus parvus is found in which of the following conditions ?

A	Diminished left ventricular stroke volume
B	Narrow pulse pressure
C	Increased peripheral vascular resistance
D	All of the above

Question 12 Explanation:

Pulsus parvus is seen in conditions with diminished left ventricular stroke volume, narrow pulse pressure & increased peripheral vascular resistance

Question 13

Pulsus tardus is found in ?

A	Mitral stenosis
B	Aortic valve stenosis
C	Aortic regurgitation
D	Mitral regurgitation

Question 13 Explanation:

Pulsus tardus is seen in aortic valve stenosis (delayed systolic peak due to obstruction to left ventricular ejection)

Question 14

Bounding or hyperkinetic pulse is associated with ?

A	Increased left ventricular stroke volume
B	Wide pulse pressure
C	Decrease in peripheral vascular resistance
D	All of the above

Question 14 Explanation:

Large, bounding or hyperkinetic pulse occurs in complete heart block, anxiety, anemia, exercise, fever, PDA, peripheral AV fistula, mitral regurgitation or ventricular septal defect & aortic regurgitation.

Question 15

Which of the following about bisferiens pulse is false ?

A	Has two systolic peaks
B	Characteristic of aortic regurgitation (AR)
C	Characteristic of hypertrophic cardiomyopathy (HOCM)
D	First systolic peak in HOCM is called “tidal wave”

Question 15 Explanation:

Bisferiens pulse has two systolic peaks is characteristic of AR (with or without stenosis) & HOCM. In HOCM, pulse wave upstroke rises rapidly and forcefully, producing the “first systolic peak called percussion wave”. Tidal wave is a smaller and slowly rising positive pulse wave produced by continued ventricular ejection and by reflected waves from the periphery.

Question 16

Which of the following about dicrotic pulse is false ?

A	Has 2 palpable waves, one each in systole & diastole
B	Usually denotes a very low stroke volume
C	Found in restrictive cardiomyopathy
D	Found in dilated cardiomyopathy

Question 16 Explanation:

Found in dilated cardiomyopathy

Question 17

Which of the following about pulsus alternans is false ?

A	Regular alteration of pressure pulse amplitude
B	Irregular rhythm
C	Indicates severe impairment of LV function
D	Indicates severe impairment of LV function

Question 17 Explanation:

In pulsus alternans, rhythm is regular, but regular alteration of pressure pulse amplitude. It is due to alternating LV contractile force indicating severe impairment of LV function. Loud S3 is frequently heard. It may occur during or following paroxysmal tachycardia or for several beats following a premature beat in patients without heart disease.

Question 18

Pulsus bigeminus is found in ?

A	Premature atrial contraction
B	Premature ventricular contraction
C	In ventricular tachycardia
D	In PSVT

Question 18 Explanation:

Regular alteration of pressure pulse amplitude occur in pulsus bigeminus, but caused by premature ventricular contraction that follows each regular beat.

Question 19

Pulsus paradoxus is found in ?

A	Pericardial tamponade
B	Airway obstruction
C	Superior vena cava obstruction
D	All of the above

Question 19 Explanation:

Pulsus paradoxus is found in patients with pericardial tamponade, airway obstruction, or superior vena cava obstruction.

Question 20

Pulsus paradoxus is defined as a decrease in systolic arterial pressure of ?

A	> 10 mm Hg with inspiration
B	> 20 mm Hg with inspiration
C	C. > 30 mm Hg with inspiration
D	D. > 40 mm Hg with inspiration

Question 20 Explanation:

Pulsus paradoxus is defined as a decrease in systolic arterial pressure of >10 mm Hg with inspiration.

Question 21

Radial & femoral arterial pulses are not coincident in ?

A	Aortic dissection
B	Aortic coarctation
C	HOCM
D	All of the above

Question 22

Which of the following statements is false ?

A	Peripheral atherosclerosis is a risk factor for IHD
B	Edema is a late sign of heart failure
C	Edema is a late sign of heart failure
D	None of the above

Question 22 Explanation:

Peripheral atherosclerosis is an important risk factor for coincident ischemic heart disease. Edema is a late sign of heart failure, it involves the right leg prior to the left.

Question 23

Pulsation of the internal jugular vein is greatest when the trunk is inclined by ?

A	< 15º
B	< 30º
C	< 45º
D	< 60º

Question 23 Explanation:

Right internal jugular vein is best for examination of neck veins for inspection of their waveform & estimation of CVP. Pulsation of internal jugular vein is greatest when trunk is inclined by < 30º.

Question 24

Which of the following waves in JVP is negative ?

A	a
B	y
C	c
D	v

Question 25

JVP waveforms reflect pressure changes in which of the following cardiac chambers ?

A	Right atrium
B	Right ventricle
C	Left atrium
D	Left ventricle

Question 25 Explanation:

JVP reflects phasic pressure changes in right atrium and consists of a, c and v positive waves and x and y negative waves

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See all quizzes of the Physical Examination of the Cardiovascular System at here:

Physical Examination of the Cardiovascular System Part 1 | Physical Examination of the Cardiovascular System Part 2 |Physical Examination of the Cardiovascular System Part 3 | Physical Examination of the Cardiovascular System Part 4 | Physical Examination of the Cardiovascular System Part 5

1. Stethoscope was first introduced by ?
A. Austin Flint
B. Barlow
C. René Laennec
D. Richard Cabot

2. Which of the following is not related to infective endocarditis ?
A. Subungual hemorrhages
B. Osler’s nodes
C. Nikolsky’s sign
D. Janeway lesions

3. Which of the following is false about diabetic retinopathy ?
A. Microaneurysms just temporal to fovea
B. Cotton-wool infarcts circularly around the disc
C. Yellow exudates
D. Nonproliferative retinopathy found in almost all individuals with DM for >10 years

4. Which of the following retinal emboli is most common ?
A. Platelet emboli
B. Hollenhorst plaques
C. Calcium emboli

D. Uric acid emboli

5. When ascites is out of proportion to peripheral edema, which of the following should be suspected ?
A. Tricuspid regurgitation
B. Budd Chiari Syndrome
C. Constrictive pericarditis
D. Cirrhosis liver

6. Atherosclerosis of the peripheral arteries may produce intermittent claudication of ?
A. Buttock
B. Calf
C. Thigh
D. Any of the above

7. What resting ankle-brachial index is consistent with critical ischemia, rest pain & tissue loss ?
A. < 0.3
B. < 0.5
C. < 0.7
D. < 0.9

8. Which of the following statements is false ?
A. Anacrotic shoulder is present on ascending limb
B. Incisura coincides with the aortic valve closure
C. Peripherally, incisura is replaced by dicrotic notch
D. None of the above

9. Pulse more evident in a peripheral artery is ?
A. Pulsus bigeminus
B. Pulsus bisferiens
C. Pulsus paradoxus
D. Dicrotic pulse

10. Pulse more evident in a peripheral artery is ?
A. Pulsus bigeminus
B. Pulsus alternans
C. Pulsus paradoxus
D. Dicrotic pulse

11. “Trisection” is a method for ?
A. Assessing chest expansion
B. Assessing character of arterial pulse
C. Assessing postural fall of blood pressure
D. Assessing pulse, BP and respiration

12. Pulsus parvus is found in which of the following conditions ?
A. Diminished left ventricular stroke volume
B. Narrow pulse pressure
C. Increased peripheral vascular resistance
D. All of the above

13. Pulsus tardus is found in ?
A. Mitral stenosis
B. Aortic valve stenosis
C. Aortic regurgitation
D. Mitral regurgitation

14. Bounding or hyperkinetic pulse is associated with ?
A. Increased left ventricular stroke volume
B. Wide pulse pressure
C. Decrease in peripheral vascular resistance
D. All of the above

15. Which of the following about bisferiens pulse is false ?
A. Has two systolic peaks
B. Characteristic of aortic regurgitation (AR)
C. Characteristic of hypertrophic cardiomyopathy (HOCM)
D. First systolic peak in HOCM is called “tidal wave”

16. Which of the following about dicrotic pulse is false ?
A. Has 2 palpable waves, one each in systole & diastole
B. Usually denotes a very low stroke volume
C. Found in restrictive cardiomyopathy
D. Found in dilated cardiomyopathy

17. Which of the following about pulsus alternans is false ?
A. Regular alteration of pressure pulse amplitude
B. Irregular rhythm
C. Indicates severe impairment of LV function
D. May occur during or following paroxysmal tachycardia

18. Pulsus bigeminus is found in ?
A. Premature atrial contraction
B. Premature ventricular contraction
C. In ventricular tachycardia
D. In PSVT

19. Pulsus paradoxus is found in ?4
A. Pericardial tamponade
B. Airway obstruction
C. Superior vena cava obstruction
D. All of the above

20. Pulsus paradoxus is defined as a decrease in systolic arterial pressure of ?
A. > 10 mm Hg with inspiration
B. > 20 mm Hg with inspiration
C. > 30 mm Hg with inspiration
D. > 40 mm Hg with inspiration

21. Radial & femoral arterial pulses are not coincident in ?
A. Aortic dissection
B. Aortic coarctation
C. HOCM
D. All of the above

22. Which of the following statements is false ?
A. Peripheral atherosclerosis is a risk factor for IHD
B. Edema is a late sign of heart failure
C. In CHF, edema involves right leg prior to left
D. None of the above

23. Pulsation of the internal jugular vein is greatest when the trunk is inclined by ?
A. < 15º
B. < 30º
C. < 45º
D. < 60º

24. Which of the following waves in JVP is negative ?
A. a
B. y
C. c
D. v

25. JVP waveforms reflect pressure changes in which of the following cardiac chambers ?
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle

Physical Examination of the Cardiovascular System

[MCQs] Physical Examination of the Cardiovascular System- Part 1

I. Start the exam by click the “Start” button

Physical Examination of the Cardiovascular System- Part 1

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