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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