pathology test bank-

CVS final

Done by : Zeenah Al-

smady
Lecture 1

1-diminished oxygen-carrying capacity of the blood represents the most frequent

mechanism
of cardiac ischemia
a. True
b. False
Ans: B
2-angina pectoris is defined as ischemia that causes pain but is insufficient to lead
to death of
myocardium
a. True
b. False
Ans: A
3-Stable angina pectoris is also known as crescendo angina
a. True
b. False
Ans: B
4-the following statements conform with angina pectoris except:
a. Prinzmetal is usually associated with elevated ST segment of ECG
b. Stable angina is relieved by rest
c. Unstable angina is considered a pre-infarction
d. Typical angina is produced mainly on rest
e. Variant angina is due to vasospasm
Ans: D
5-stable angina has the following characters except:
a. Appears with increased demand for blood
b. Associated with depressed ST segment of ECG
c. Basically there is fixed coronary narrowing by atherosclerosis
d. Usually of a short period
e. Being the least common
Ans: E
6-angina pectoris that occurs more frequently and of progressively longer period
than other is:
a. Crescendo
b. Stable
c. Variant
d. Prinzmetal
e. Effort angina
Ans: A
7-a man who suffer from chest pain and breathlessness after climbing the stairs to
the 3rd
floor, he has:
a. Stable angina
b. Prinzmetal angina
c. Unstable angina
d. Myocardial infarction
Ans: A
8-all of the following regarding ischemic heart disease are correct EXCEPT:
a. Associated with a severe substernal pain that can radiate to the left arm
b. Variant angina is associated with coronary artery vasospasm
c. Stable angina is also known as pre-infarction angina
d. Chronic IHD is usually associated with arrhythmias
e. Typical angina can be relieved by rest and nitroglycerin
Ans: C

9-all of the following would mostly lead to unstable angina EXCEPT:

a. Partially occlusive thrombus
b. Complete coronary obstruction
c. Stenosis with superimposed spasm
d. Distal embolus formation
e. Atheromatous plaque rupture
Ans: B
10-Thrombosis of atheromatous plaque, the most common complication:
A. Stable angina
B. Effort angina
C. Unstable angina
D. Prinzmetal angina
E. Variant angina
Ans: C
*Which of the following mostly to proceed to MI?
Unstable angina
*Not one of the clinical forms of IHD:
Endarteritis obliterans
*Wrong pair:
Atherosclerotic plaque rupture/ prinzmetal angina

Lecture 2

1-36 hours following acute myocardial infarction, the infarct site reveals a dense
neutrophil
infiltrate
a. True
b. False
Ans: A
2-overall, non-atherosclerotic causes of sudden cardiac death are more frequent
than
atherosclerotic causes:
a. True
b. False
Ans: B
3-regarding myocardial infarction, all are correct EXCEPT:
a. Most cases of pre-hospital deaths are due to lethal arrhythmias
b. Troponin I and T are the best indicators for MI
c. 40-50% of cases are due to occlusion of the circumflex artery
d. Coagulative necrosis and wavy fibers are seen within 24 hours of injury
e. Most cases of in-hospital deaths are due cardiogenic shock
Ans: C
4-a 67 years old man with a history of hypertension was sent home 4 days after an
MI. he returned to his normal activities, but died suddenly the next day. We
expect to see:
a. Arrhythmia
b. Myocardial rupture
c. Ventricular aneurysm
Ans: B
5-all of these factors modify the location and extent of MI, except:
a. Patient’s cardiovascular status
b. Sex of the patient
c. Vasospasm
d. Duration of occlusion
e. Collaterals
Ans: B
6-in the right coronary dominant patients, the most frequent coronary artery
occlusion causing MI is:
a. Left main stem
b. Right main stem
c. Left circumflex
d. Left anterior descending
e. Right posterior descending
Ans: D
7-serum creatine kinase determination in cardiac infarction conforms with the
following,
except:
a. Appears in 2-4 hours
b. Does not elevate with angina pectoris
c. Peaks in 24 hours
d. Considered highly specific
e. Disappears in 3 days
Ans: D
8-the heart specific enzyme/ protein serum elevation indicative of myocardial
infarction is:
a. Lactic dehydrogenase
b. Creative kinase index
c. Troponin I
d. Troponin T
**Ans: C (according to our lecture c&d)
9-all of the following are complications of myocardial infarction EXCEPT:
a. Papillary muscle rupture causing acute mitral regurgitation
b. Free wall rupture
c. Early pericarditis
d. Cardiogenic shock
e. Acute aortic regurgitation
Ans: E
10-at the site of a myocardial infarction, phagocytic macrophages are most
abundant in which
of the following time zones from infarct onset:
a. After 6 weeks
b. Within the first 2 days
c. After 3 weeks
d. Within first 24 hours
e. By the end of first week
Ans: E
11-one of the following is considered a late complication that may occur months
after acute myocardial infarction:
a. Infarct expansion
b. Papillary muscle rupture
c. Fibrinous pericarditis
d. Ventricular aneurysm
e. Cardiogenic shock
Ans: D
12-papillary muscle rupture can lead to:
a. Aortic regurgitation
b. Mitral stenosis
c. Mitral regurgitation
d. Aortic stenosis
Ans: C
*Late complications of MI:
Ventricular aneurysm
*Masked MI in:
Peripheral neuropathy
*Up to 50% of all MI are due to occlusion of:
Left anterior descending artery
*Wrong complication of MI:
Papillary muscle rupture/ severe aortic regurgitation

*Wrong combination:
Post-MI pericarditis/ staph aureus infection
*Which of the following is a major risk factor of MI:
Smoking
Lecture 3

1- Rheumatic fever is an infection of the heart caused by bacteria, especially

Streptococci
a- True
b- False
Ans:B

2- Fever and painful tender joints are common signs and symptoms of Rheumatic
fever
a- True
b- False
Ans:A

3-The second most common valve to be affected by rheumatic after mitral is :

a. Aortic
b. Pulmonary
c. Tricuspid
d. Pulmonary and tricuspid
Ans:A
4-The microorganism responsible for rheumatic carditis is:
a. Alpha streptococcus hemolytic group A
b. Human papilloma virus
c. Staphylococcus aureus
d. All of the above
e. None of the above
Ans :E

5-The valve most commonly affected by rheumatic carditis is the :

a. Pulmonic
b. Tricuspid
c. Mitral
d. Foramen ovale
e. Aortic
Ans:C

6-All of the following regarding rheumatic heart fever are correct EXCEPT :
a. Aschoff bodies can be seen in acute rheumatic heart disease
b. Chronic form of rheumatic heart fever is associated with stenosis
c. Can affect the pericardium, myocardium or endocardium (including valves)
d. The most important cause of acquired post-inflammatory valves scarring
e. It’s an infection due to group A – β hemolytic streptococci
Ans:E
7-The following conform with rheumatic carditis except:
a. Incidence peaks during childhood
b. Death in acute rheumatic carditis is most commonly due to mitral stenosis
c. Considered of immunologic etiology
d. Antibiotic prevention is possible
e. All cardiac tissues can be involved
Ans:B
8- Which of the following is not one of JONES criteria?
a. Arthritis
b. Elevated ESR
c. Erythema marginatum
d. Syndrham chorea
e. carditis
Ans:B

9- Which of the following is true regarding aortic bicuspid valve ?

a. Forms stenosis later on
b. 50% of humans are diagnosed with it
c. It is acquired
Ans:A
10-Major cause of death in (acute) Rheumatic Carditis :
a. Acute Myocarditis
11-An 11 years old girl suffered from acute pharyngitis and died shortly after. Her
condition became worse before she died. What will we expect to see in a
postmortem sample?
a. Aschoff bodies (bcz its acute)

12-The most common congenital valve disease :

a. Bicuspid aortic valve

13-Not part of major Jones criteria :

a. Fever

14-Wrong combination :
a. Aschoff bodies & acute phase of infective endocarditis

Lecture 4
1-Influenza viruses represent the most important pathogens in infective
endocarditis
a- True
b- False
Ans:B
2- Prosthetic heart valves are considered risk factors for infective endocarditis
a- True
b- False
Ans:A
3- IV drug usage is a unique risk factor for infective endocarditis of the pulmonary
valve
a- True
b- False
Ans :B
4-Which of the following regarding infective endocarditis is TRUE:
a. No fever can be seen during infection
b. Is an auto-immune mediated disease
c. Acute endocarditis is due to infection with a low virulent microorganism
d. Can result in the formation of a septic infarct
e. Recovery is very difficult and most cases end in death
Ans:D
5-Subacute endocarditis is often developed by presence of:
a. Abnormal valves
b. Congenital deformities
c. Rheumatic lesions
d. A&B is correct
e. All are correct
Ans:E
6-The cardiac vegetations which fragment and embolize most are due to :
a. Infective endocarditis
b. Rheumatic carditis
c. Systemic lupus erythematosus
d. Non-bacterial thrombotic endocarditis
e. Marantic endocarditis
Ans:A
7-The cardiac valve vegetations most frequently embolizing are those of :
a. Limban sacks
b. Rheumatic carditis
c. Marantic
d. Infective endocarditis
e. Associated with cancer
Ans:D
8- What could be found as a result of infective endocarditis?s
a. Aschoff bodies
b. Bacteria on vegetation
Ans:B
‫الحمد لله رب العالمين‬

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