Question 1
Which of the following descriptions is consistent with pleuritic pain?
| A. | deep, dull and poorly localised chest pain | |
| B. | constant, severe, crushing, substernal pain | |
| C. | unilateral, sharp, stabbing pain worse on inspiration/coughing | |
| D. | tightness, heaviness or constriction in the chest | |
| E. | burning, scalding pain that radiates into the throat |
1 points
Question 2
The most common cause of death immediately following a myocardial infarction is
| A. | parasympathetic stimulation depresses the SA node | |
| B. | ventricular fibrillation develops | |
| C. | left ventricle ruptures | |
| D. | blocked coronary artery bursts | |
| E. | aortic valve fails permanently |
1 points
Question 3
The process responsible for development of oedema in acute inflammation is
| A. | chemotaxis | |
| B. | exudation | |
| C. | vasoconstriction | |
| D. | ischaemia | |
| E. | congestion |
1 points
Question 4
When stroke volume decreases (as in heart failure), which of the following processes could help maintain the cardiac output?
| A. | decreased peripheral resistance | |
| B. | decreased venous return | |
| C. | generalised vasodilation | |
| D. | increased perfusion of the kidneys | |
| E. | increased heart rate |
1 points
Question 5
What happens with intrapleural pressure in pneumothorax?
| A. | it becomes negative | |
| B. | it becomes lower than atmospheric pressure | |
| C. | it does not change from physiologic | |
| D. | it becomes lower than alveolar pressure | |
| E. | it becomes equal to/greater than alveolar pressure |
1 points
Question 6
Pericarditis could cause a reduction in cardiac output as a result of which of the following?
| A. | excess fluid in the pericardial cavity, which decreases ventricular filling | |
| B. | weak myocardial contractions due to friction | |
| C. | myocardial ischaemia due to widespread atherosclerosis | |
| D. | delays in the conduction system, interfering with normal cardiac rhythm | |
| E. | incompetent valves, which allow regurgitation of blood |
1 points
Question 7
Growth and development of a child with cystic fibrosis may be delayed because of
| A. | deficit of gastric enzymes for protein digestion | |
| B. | mucus plugs obstructing the flow of pancreatic enzymes | |
| C. | loss of too much electrolytes in sweat | |
| D. | increased production of protein-rich sputum | |
| E. | abnormal salivary secretions |
1 points
Question 8
Compensation mechanism for decreased cardiac output in cases of congestive heart failure includes
| A. | decreased coagulability of blood | |
| B. | reduced erythropoietin release | |
| C. | increased urinary output | |
| D. | increased production of renin and aldosterone | |
| E. | slow cardiac contractions |
1 points
Question 9
All of the following can produce restrictive lung condition except
| A. | idiopathic pulmonary fibrosis | |
| B. | muscular dystrophies | |
| C. | pneumoconiosis | |
| D. | restrictive cardiomyopathy | |
| E. | chronic extrinsic allergic alveolitis |
1 points
Question 10
Which of the following would be particularly characteristic of chronic bronchitis?
| A. | marked dilations of bronchi | |
| B. | decreased activity of the mucous glands | |
| C. | fibrosis of the bronchial wall | |
| D. | accumulation of IgE in airway walls | |
| E. | formation of bullae on the lung surface |
1 points
Question 11
Which of the following is unlikely to cause hypoxaemia and central cyanosis?
| A. | status asthmaticus | |
| B. | serious pulmonary embolism | |
| C. | pulmonary oedema | |
| D. | non-infective pericarditis | |
| E. | serious pneumonia |
1 points
Question 12
Varicose ulcers are generally slow to heal because of
| A. | stenotic venous valves block flow of venous blood | |
| B. | reduced oxygenation of blood in the lungs | |
| C. | arterial vasodilation in the area | |
| D. | arterial blood supply to the area is decreased | |
| E. | venous atherosclerosis reduces venous blood flow |
1 points
Question 13
What effect will chronic hypertension have on left ventricular muscle?
| A. | replacement of muscle cells with connective tissue cells | |
| B. | coagulative necrosis of cardiac muscle cells | |
| C. | development of hypertrophy | |
| D. | hyperplasia of cardiac muscle cells | |
| E. | development of reactive myocarditis |
1 points
Question 14
Which of the following statements about chronic bronchitis is not correct?
| A. | it is mediated by type I hypersensitivity reaction | |
| B. | it can coexist with emphysema | |
| C. | it is characterised by reduced FVC | |
| D. | it can lead to right ventricular failure | |
| E. | unlike asthma it does not respond well to bronchodilators |
1 points
Question 15
The presence of squamous epithelium in the respiratory airways of a person with a history of heavy smoking is consistent with
| A. | healing through regeneration | |
| B. | metaplastic change | |
| C. | type I hypersensitivity | |
| D. | chronic inflammation | |
| E. | coagulative necrosis |
1 points
Question 16
In which of the following locations atherosclerosis would not be expected?
| A. | arteries in lower extremities | |
| B. | cerebral arteries | |
| C. | femoral vein | |
| D. | renal arteries | |
| E. | descending aorta |
1 points
Question 17
Pulmonary oedema can cause hypoxaemia because of
| A. | leakage of oxygen into the pulmonary cavity | |
| B. | reduced concentration of haemoglobin in blood | |
| C. | reduced diffusion of oxygen into the blood | |
| D. | accumulation of carbon dioxide in the blood | |
| E. | widespread airway obstruction |
1 points
Question 18
What causes the expanded anteroposterior thoracic diameter (barrel chest) in patients with emphysema?
| A. | accumulation of air in the pleural cavity | |
| B. | compression on the lungs by the diaphragm | |
| C. | excessive air trapping in alveolar spaces | |
| D. | increased peak expiratory flow rate | |
| E. | loss of elasticity of the chest wall |
1 points
Question 19
_______________________ suggests that a neoplasm is malignant.
| A. | Cellular anaplasia | |
| B. | Hydropic change | |
| C. | Presence of connective tissue capsule | |
| D. | Cellular hyperplasia | |
| E. | Excessive cell proliferation |
1 points
Question 20
The normal delay in electrical conduction through the AV node in the heart is essential for
| A. | completing ventricular filling | |
| B. | limiting the time for a myocardial contraction | |
| C. | allowing AV valves to close | |
| D. | allowing the ventricles to contract before the atria | |
| E. | preventing an excessively rapid heart rate |
1 points
Question 21
Airway obstruction in asthma can be caused by all of the following except
| A. | increased airway wall thickness | |
| B. | increased mucus production in airways | |
| C. | presence of fluid in alveoli | |
| D. | contraction of bronchial smooth muscle | |
| E. | oedema of bronchial mucosa |
1 points
Question 22
_______________ develops as a consequence of pneumothorax.
| A. | extrinsic allergic alveolitis | |
| B. | bronchiectasis | |
| C. | pneumoconiosis | |
| D. | lung atelectasis | |
| E. | filling of alveolar spaces with fluid |
1 points
Question 23
Reduced ____________________ would not be expected in restrictive lung disorders.
| A. | SpO2 | |
| B. | VC | |
| C. | lung compliance | |
| D. | Tiffeneau-Pinelli Index | |
| E. | TLC |
1 points
Question 24
Rheumatic heart disease usually manifests in later years as
| A. | cardiac arrhythmias and heart murmurs | |
| B. | ventricular aneurysm | |
| C. | essential hypertension | |
| D. | mural thrombosis and systemic embolism | |
| E. | pericarditis and pericardial rub |
1 points
Question 25
Cyanosis of the affected leg can occur in DVT because of
| A. | increased filtration of fluid into interstitial space | |
| B. | decreased capillary pressure | |
| C. | accumulation of deoxygenated haemoglobin | |
| D. | increased inflow of arterial blood | |
| E. | decreased level of haemoglobin in blood |
1 points
Question 26
The biggest problem in ventricular fibrillation is
| A. | increase in systemic blood pressure | |
| B. | backflow of blood from LV to LA | |
| C. | absence of cardiac output | |
| D. | pulmonary congestion | |
| E. | increased risk for DVT/PE |
1 points
Question 27
Important finding supporting diagnosis of heart failure is
| A. | positive D-dimer blood test | |
| B. | reduced cardiac creatine kinase level in blood | |
| C. | increased pO2 in blood | |
| D. | presence of ventricular ectopic beats on ECG | |
| E. | reduced ejection fraction on ultrasonography |
1 points
Question 28
Which statement about cystic fibrosis is incorrect?
| A. | it is a multisystem disease | |
| B. | it is mediated by IgE antibodies | |
| C. | mucous produced in the airways is excessively thick | |
| D. | it is an inherited condition | |
| E. | it is often associated with bronchiectasis |
1 points
Question 29
Which factor usually causes metabolic acidosis to develop in association with hypoxia?
| A. | liver dysfunction | |
| B. | compensation by the kidneys | |
| C. | anaerobic metabolism | |
| D. | failure to excrete carbon dioxide | |
| E. | increased blood volume |
1 points
Question 30
Which of the following statements is correct?
| A. | tissue affected by congestion is warm and red | |
| B. | congestion leads to increased blood hydrostatic pressure | |
| C. | right sided heart failure typically causes pulmonary congestion | |
| D. | tissue affected by hyperaemia is cyanotic | |
| E. | hyperaemia results from vasoconstriction |
1 points
Question 31
Long-term hypertension is not a risk factor for
| A. | ischaemic heart disease | |
| B. | left ventricular failure | |
| C. | deep leg vein thrombosis | |
| D. | cerebral haemorrhage | |
| E. | chronic renal failure |
1 points
Question 32
The main contributing factor in airway obstruction in emphysema is
| A. | fibrosis and thickening of the airways | |
| B. | persistent contraction of airway smooth muscle | |
| C. | collapse of small airways due to loss of alveoli | |
| D. | presence of fluid in alveolar spaces | |
| E. | presence of air in the pleural cavity |
1 points
Question 33
Why does cor pulmonale develop with chronic pulmonary disease?
| A. | thrombosis occurs in pulmonary circulation | |
| B. | pulmonary fibrosis and vasoconstriction increase vascular resistance | |
| C. | the right ventricle pumps more blood than the left ventricle | |
| D. | too much blood comes back from the lungs | |
| E. | demands on the left ventricle are excessive |
1 points
Question 34
Underfilling of the systemic circulation is not a main mechanism in ____________ shock.
| A. | hypovolaemic | |
| B. | haemorrhagic | |
| C. | anaphylactic | |
| D. | neurogenic | |
| E. | cardiogenic |
1 points
Question 35
Which if the following would indicate that pulmonary infarction has occurred during pulmonary embolism?
| A. | positive D-dimer in blood | |
| B. | pulmonary hypertension | |
| C. | hypoxaemia | |
| D. | sharp pleuritic pain | |
| E. | distended neck veins |
1 points
Question 36
Chronic heart failure that develops as a result of long standing systemic hypertension is generally results from
| A. | large coagulative necrosis | |
| B. | ventricular outflow obstruction | |
| C. | atrial inflow obstruction | |
| D. | ventricular volume overload | |
| E. | decreased systemic vascular resistance |
1 points
Question 37
Which of the following would not be expected in right heart failure?
| A. | liver congestion | |
| B. | paroxysmal nocturnal dyspnoea | |
| C. | peripheral dependant oedema | |
| D. | ascites | |
| E. | distended neck veins |
1 points
Question 38
Pulmonary embolism can produce all of the following except
| A. | pulmonary hypertension | |
| B. | right ventricular strain | |
| C. | acute airway obstruction | |
| D. | lung infarction | |
| E. | hypoxaemia |
1 points
Question 39
Hypertrophic cardyomyopathy would be suggested when
| A. | ventricular chambers enlarge for no clear reason | |
| B. | there is increased thickness of atrial and not ventricular muscle | |
| C. | there is concentric hypertrophy of the LV | |
| D. | LV hypertrophy occurs in the absence of a clear cause for hypertrophy | |
| E. | there is increased thickness of the fibrous pericardium |
1 points
Question 40
What is the acid-base status of a patient with the following values for arterial blood gases: serum bicarbonate 36.5 mmol/L (normal range: 22-28) pCO2 75 mm Hg (normal range: 35-45) and serum pH 7.0?
| A. | metabolic acidosis | |
| B. | respiratory alkalosis | |
| C. | respiratory acidosis | |
| D. | metabolic alkalosis | |
| E. | hyperventilation |
1 points
Question 41
Which of the following is increased in progressive emphysema?
| A. | tidal volume | |
| B. | gas exchange membrane surface | |
| C. | forced expiratory volume | |
| D. | residual lung volume | |
| E. | vital capacity |
1 points
Question 42
Infective endocarditis
| A. | typically affects heart valves | |
| B. | leads to accumulation of fluid in the pericardial cavity | |
| C. | can lead to development of cardiac tamponade | |
| D. | usually develops as a complication of myocardial infarction | |
| E. | is generally caused by viruses |
1 points
Question 43
How does total obstruction of the airway lead to atelectasis?
| A. | air continues to be inspired but is trapped distal to the obstruction | |
| B. | lung tissue is compressed by air in the pleural cavity | |
| C. | decreased surfactant production impairs lung expansion | |
| D. | alveolar walls are destroyed distal to the obstruction | |
| E. | air is absorbed from the alveoli distal to the obstruction |
1 points
Question 44
Pathophysiologically constrictive pericarditis would increase
| A. | left ventricular stroke volume | |
| B. | size of the ventricular chambers | |
| C. | diastolic pressure in the right ventricle | |
| D. | systemic blood pressure | |
| E. | cardiac output |
1 points
Question 45
The main difference between unstable angina (UA) and myocardial infarction (MI) is that
| A. | unlike MI, UA shows no abnormal changes in ECG | |
| B. | atherosclerosis is involved in development of MI but not UA | |
| C. | unlike MI, UA does not present with chest pain | |
| D. | uppon resolving, UA does not leave myocardial necrosis behind | |
| E. | cardiac troponins are elevated in UA but not in MI |
1 points
Question 46
The main abnormality in mitral insufficiency is
| A. | flow of blood from LV to LA during ventricular systole | |
| B. | restricted ventricular wall stretching and filling with blood | |
| C. | regurgitation of blood from aorta into LV | |
| D. | abnormal flow of blood from left ventricle to right ventricle | |
| E. | significantly narrowed semilunar valves |
1 points
Question 47
One complication of emphysema is
| A. | cystic fibrosis | |
| B. | allergic alveolitis | |
| C. | pleural effusion | |
| D. | pulmonary fibrosis | |
| E. | spontaneous pneumothorax |
1 points
Question 48
Which of the following is a manifestation of closed pneumothorax?
| A. | increased breath sounds on the affected side | |
| B. | decreased respiratory rate | |
| C. | prominent wheezing on the affected side | |
| D. | asymmetrical chest movements | |
| E. | presence of fluid in alveoli on the affected side |
1 points
Question 49
Atrial fibrillation can cause all of the following except
| A. | increased risk of atrial thrombosis | |
| B. | development of ventricular aneurysm | |
| C. | absence of atrial systole | |
| D. | reduced filling of the left ventricle | |
| E. | increased risk of stroke |
1 points
Question 50
Cystic fibrosis would present in infancy with all of the following except
| A. | failure to thrive | |
| B. | liver cirrhosis | |
| C. | persistent inspiratory crackles | |
| D. | large bulky stools | |
| E. | frequent respiratory infections |
1 points
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