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Contents
1- Physiology.…….… 3
2- Pathology…….…. 48
3- Pharmacology…... 74
4- Anatomy…………. 91
5- Embryology….… 105
6- Histology……….. 111
7- Microbiology….... 121
8- Biochemistry..….. 126

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1) Which of the following act as the normal pace-maker of the heart
a) atrio-ventricular node
b) Sino-atrial node
c) Purkinje fibers
d) Non of the above

2) The atrio-ventricular node can initiate cardiac impulses at a rate of

a) 45-60 per minute
b) 70-80 per minute
c) 60-90 per minute
d) Non of the above

3) The only muscular connection between the atria and the

ventricles in the human heart is the
a) Coronary sulcus
b) Purkinje fibers
c) atrio-ventricular groove
d) Bundle of his

4) The ability of the cardiac muscle to generate excitation waves

spontaneously and regularly is the
a) Contractility
b) Excitability
c) Rhythmicity
d) Conductivity

5) The phase of plateau is caused by slower but prolonged opening

of
a) Voltage –gated Na channel
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b) Voltage –gated K channel
c) Voltage –gated Ca channel
d) Non of the above

6) In the pacemaker potential which of the following phases are

absent
a) Phase 4, phase 0
b) Phase 1, phase 2
c) Phase 2, phase 3
d) Non of the above

7) In the pacemaker potential the Na influx play a minor role in

a) Phase 0
b) Phase 4
c) Phase 3
d) Phase 2

8) Any pace-maker other than the S-A node is called

a) Intrinsic heart rate
b) Vagal tone
c) Entopic pacemaker
d) Ectopic pacemaker

9) The rhythmicity of S-A node is.....While of purkinje system is

a) 105\m- 45-60\m.
b) 45-60\m- 25-40\m.
c) 105\m-25-40\m.
d) 25-40\m-105\m.

10) Which of the following about "intrinsic heart rate":

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a) Occurs when S-A node not influenced by any extrinsic or chemical
stimulation.
b) 105impulse\min.
c) all of the above.

11) Vagus nerve inhibits rhythmicity of the whole heart except.........

because they aren't supplied by it.
a) Atrium.
b) Ventricles.

12) By increasing the body temperature 1C, the heart rate raises
about:
a) 18 beats\min.
b) 20 beats\min.
c) 15 beats\min.

13) all of the following occur if excess Ca is added except:

a) Increase the systole.
B) Increase the diastole.
c) Calcium rigor.

14) Convert chemical energy into mechanical is

a) Excitability
b) Conductivity
c) Contractility

15) Contraction of fibers without shortening

a) Isotonic contraction
b) Conductivity
c) Isometric contraction
d) Excitability
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16) To open aortic and pulmonary valves, the heart do
a) Isotonic contraction
b) Isometric contraction
c) Must be relaxed
d) None of the above

17) Ions which are responsible for cardiac muscle contraction

a) ca
b) k
c) Na
d) ca and k

18) concerninng to Purkinje's fiber all are True Except

a) its fibers are larger in size.
b) have many gap junctions.
c) the slowest conduction

19) The slowest conduction is .....

a) Atrial pathway.
b) A-v node.
c) A-V bundle.
d) purikinj's system.

20) Hypokalemia decrease excitability due to

a) Depolarization
b) Repolarization
c) Hyperpolarization

21) Increased extracellular ca leads to

a) Increase heart rate
b) Increase myocardial contraction
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c) Increase conductivity
d) a-b

22) the instrument used to record the potential fluctuations during

the cardiac cycle is known as ………….
a) electrocardiogram
b) electrocardiograph
c) potential recorder
d) non of the above

23) the total number of waves in the normal electrocardiogram is

a) 2 WAVES
b) 3 WAVES
c) 4 WAVES
d) 5 WAVES

24) if the repolarization waves travelling away from the recording

electrodes , it will cause
a) positive wave
b) negative wave
c) no potential is recorded
d) non of the above

25) the positive terminal of the second bipolar lead is the ……….
a) right leg
b) left leg
c) right arm
d) left arm

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26) the right arm is usually connected to the ……….
a) positive terminal
b) negative terminal
c) the ground
d) non of the above

27) the indifferent electrode is connected to the

a) positive terminal
b) negative terminal
c) the ground
d) non of the above

28) the number of the unipolar chest leads is ………

a) 3 leads
b) 4 leads
c) 6 leads
d) 9 leads

29) the unipolar limb leads are arranged to view the heart in the
………….
a) frontal plane
b) transverse plane
c) obliqe plane
d) non of the above

30) the unipolar limb lead ""aVf"" is connected to the

a) right arm
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b) left arm
c) right foot
d) left foot

31) the position of the exploring electrode V5 is

a) right fourth intercostal space near the sternum
b) left fourth intercostal space near the sternum
c) left fifth intercostal space in the anterior axillary line
d) left fifth intercostal space in the mid-axillary line

32) which of the following electrode produce negative waves in the

normal ECG
a) v1
b) aVF
c) V2
d) B and C
e) A and C

33) depolarization of the last segment of the myocardium is directed

a) upward and to the left
b) downward and to the right
c) upward and to the right
d) downward and to the left

34) the duration of the initial ventricular deflection equals ……….

a) 1-3 small squares
b) 2-4 small squares
c) 2-3 small squares
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d) 3-4 small squares
35) the amplitude of the initial ventricular deflection equals
a) 15-20 small squares
b) 10-20 small squares
c) 15-25 small squares
d) 5-10 small squares

36) the duration of the Q-T interval is

a) 0.2-0.3 sec
b) 0.3-0.4 sec
c) 0.4-0.5 sec
d) 0.5-0.6 sec

37) the case that make the P wave large is the

a) atrial hypertrophy
b) atrial fibrillation
c) atrial ischemia
d) atrial stoppage

38) The cardiac cycle time is

a) 0.8 minute
b) 0.8 second
c) 1 second
d) 2 seconds

39- The duration of the atrial systole is

a) 0.1 sec

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b) 0.3 sec
c) 0.5 sec
d) 0.7 sec

40) The duration of the ventricular systole is

a) 0.1 sec
b) 0.3 sec
c) 0.5 sec
d) 0.7 sec

41) The duration of the atrial diastole is

a) 0.1 sec
b) 0.3 sec
c) 0.5 sec
d) 0.7 sec

42- The duration of the ventricular diastole is

a) 0.1 sec
b) 0.3 sec
c) 0.5 sec
d) 0.7 sec

43) regarding atrial systole

a) A-V valves are opened while semilunar valves are closed
b) semilunar valves are opened while A-V valves are closed
c) both of them are opened
d) both of them are closed

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44) the end diastolic pressure of the right ventricle is about
a) 8-12 mmHg
b) 7-9 mmHg
c) 6-9 mmHg
d) 3-6 mmHg

45) regarding the isovolumetric contraction

a) A-V valves are opened while semilunar valves are closed
b) semilunar valves are opened while A-V valves are closed
c) both of them are opened
d) both of them are closed

46) the first heart sound is caused by

a) closure of the semilunar valves
b) closure of the A-V valves
c) atrial systole
d) non of the above

47) the positive C wave of the isovolumetric contraction is due to

a) atrial contraction and increase the venous pressure
b) bulging of the atrioventricular leaflets back to the atrium
c) the flow of the blood into the atrium from the venous inflow tract
d) non of the above

48) in the rapid ejection phase , the blood flow across the valves is
very high and it is due to
a) the high pressure gradiant

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b) the strong force of contraction
c) the large valve opening "low resistance"
d) non of the above

49) in the reduced ejection , although the ventricular pressure falls

below the outflow tract but the blood still flow . it is due to
a) the large valve opening "reduced resistance"
b) the kinetic energy of the blood
c) the contraction of the papillary muscle
d) the rough part of the ventricles

50) the second hear sound is caused by

a) closure of A-V valve
b) closure of the semilunar valve
c) atrial systole
d) non of the above

51) the end systolic volume is about

a) 50 ml
b) 130 ml
c) 70 ml
d) 60 ml

52) the volume of the blood ejected by each ventricle per beat is the
a) end systolic volume
b) end diastolic volume
c) stroke volume

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d) A and C

53) in the rapid ventricular filling , opening of A-V valve causing

rapid fall of the atrial and jugular pulse which is represented by
a) X descent wave
b) y descent wave
c) positive C wave
d) positive V wave

54) the normal venous pulse is consisted of 3 positive waves which

are
a) A – V – Y
b) A – C – X
c) A – V – C
d) C – V – Y

55) intra-aortic pressure is known as

a) radial pulse curve
b) jugular pulse curve
c) cardiovascular curve
d) non of the above

56) the sudden closure of the aortic valve and the elastic recoil of
the aorta cause the
a) dicortic notch
b) dicortic wave
c) diastolic pressure
d) systolic pressure

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57) the cardioinhibitory neurons arise from the
a) dorsal motor neurons of the vagus
b) ventral motor neurons of the vagus
c) lower posterolateral part of the medulla
d) upper ventrolateral part of the medulla

58) regarding the vagi

a) the dilate the coronary vessels
b) they constrict the coronary vessels
c) the have no effect on the coronary vessels

59) the descending fibers of the vasoconstrictor neurons relay on

the lateral horn celss of the
a) cervical and thoracic segments
b) cervical and lumbar segments
c) thoracic and lumbar segments
d) thoracic segments only

60) the vasodilator neurons produce generalized vasodilatation by

a) stimulating the vasodilator nerves
b) inhibiting the vasoconstrictor centers
c) stimulation of the medullary sensory neurons
d) A and B

61) medullary sensory neuron is present in the

a) upper ventrolateral part of the medulla

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b) lower ventrolateral part of the medulla
c) upper posterolateral part of the medulla
d) lower posterolateral part of the medulla
62) the + ve chronotropic effect tend to increase the heart rate up to
a) 90 beats /min
b) 105 beats /min
c) 120 beats /min
d) 130 beats /min

63) the heart rate refers to the

a) atrial rate of contraction
b) ventricular rate of contraction
c) both atrial and ventricular contraction
d) neither atrial nor ventricular contraction

64) the heart rate is ……………………. The age

a) directly proportional to
b) inversely proportional to
c) not affected by

65) the vagus tone is ………………….. in the athletes than the non
athletes
a) greater
b) lower
c) the same

66) the heart rate during standing is …………………

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a) the same during recumbent position
b) higher than the recumbent position
c) lower than recumbent position

67) High pressure baroreceptors present in :

a) carotid sinus.
b) aortic arch.
c) Rt atrium.
d) Lt atrium.
e) a&b.

68) All of the following are about the nerve that transmits impulses from
carotid sinus except:
a) branch of glossopharyngeal nerve.
b) carotid sinus nerve.
c) nerve of hering.
d) vagus nerve.

69) High pressure baroreceptors are stimulated by pressure between

0&60 mmHg:
a) True.
b) False.

70) Concerning to Marey's reflex all are True Except:

a) Vasodilatation.
b) decrease A.B.P.
c) increase in heart rate.
d) decrease in heart rate.

71) The site of bainbridge reflex is:

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a) aortic arch.
b) carotid sinus.
c) wall of Rt atrium.

72) All of the following are about effects of bainbridge reflex except:
a) Vasodilatation.
b) decrease in A.B.P.
c) decrease in heart rate.
d) increase in heart rate.

73) So sever painful stimuli leads to:

a) increased in heart rate.
b) decrease in heart rate.

74) During inspiration all the following occur except:

a) increase in venous return.
b) congestion of Rt atrium.
c) bainbridge reflex.
d) Marey's reflex.

75) The heart rate in inspiration is.....& in expiration is.....

a) decreased-increased.
b) increased-increased.
c) increased-decreased.
d) decreased-decreased.

76) rapid infusion of the blood into the right atrium will increase the
atrial pressure and increase the heart rate by
a) stretching of SA node
b) marey's reflex
c) bainbrige reflex
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d) A and C

77) the bainbrige reflex isn't a controller of the arterial blood pressure
a) true
b) flase
78) a painful stimuli applied to the eyeball will lead to
a) increase in the heart rate
b) decrease in the heart rate
c) no effect

79) the primary center of the conditioned reflex is present in the

a) limbic system
b) thalamus
c) cerebral cortex
d) hypothalamus

80) severe emotions will lead to

a) increase in the heart rate
b) decrease in the heart rate
c) no effect on the heart rate

81) affrent impulses from the lung during inspiration lead to

a) inhibition of the vagal tone
b) stimulation of the vagal tone
c) no effect on the vagal tone

82) the receptors in the aortic body and carotid body are
a) sensitive to the blood pressure
b) senetive to the chemical composition of the blood
c) A and B
d) non of the above
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83) large amounts of CO2
a) increase the heart rate
b) decrease the heart rate
c) no effect on the heart rate
84) noradrenaline lead to decrease in the heart rate due to
a) it's direct effect on the heart
b) stimulation of the medullary cardiovascular centers
c) reflexly due to increase in the blood pressure
d) all of the above

85) the net effect of adrenaline on the blood pressure is

a) increase in the blood pressure
b) decrease in the blood pressure
c) unchanged blood pressure

86) thyroxin hormone increase the heart rate by

a) stimulation of the SA node within the heart
b) stimulation of the sympathetic system
c) increase in the metabolic rate of the body
d) all of the above

87) volume of the blood pumped by each ventricle per minute is the
a) stroke volume
b) cardiac output
c) cardiac index
d) ejection fraction

88) the cardiac index is the correlation between

a) cardiac output and the body surface
b) stroke volume and the end diastolic volume
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c) stroke volume and the heart rate
c) non of the above
89) the end systolic volume is about
a) 60 ml/beat
b) 70 ml/beat
c) 90 ml/beat
d) 130 ml/beat

90) the end systolic volume is affected by

a) cardiac contraction
b) venous return
c) arterial blood pressure
d) A and C
e) B and C

91) the ejection fraction is the ratio between

a) the end diastolic volume to the stroke volume
b) the end systolic volume to the stroke volume
c) the stroke volume to the end diastolic volume
d) the stroke volume to the end systolic volume

92) cardiac arrhythmia lead to

a) increase in the cardiac output
b) decrease in the cardiac output
c) no change

93) all of the following are mechanisms that allow the heart to pump the
extra amounts of the blood reaching from the veins except
a) frank starling mechanism
b) Bainbridge mechanism
c) increase in the arterial blood pressure
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d) stretching of the SA node

94) the venous return decreases to zero when the right atrial pressure is
a) +0 mmhg
b) +2 mmhg
c) +5 mmhg
d) +7 mmhg

95) increase in the right atrial pressure will lead to

a) decrease in the venous return
b) increase in the venous return
c) has no change on the venous retrun

96) increase in the sympathetic stimulation

a) increase the capacity of the circulation
b) decrease the capacity of the circulation c) has no effect

97) increase in the total peripheral resistance

a) increase the cardiac output
b) decrease the cardiac output
c) have no change on the cardiac output

98) hyperthyroidism……………….. the venous return and the cardiac

output
a) increase
b) decrese
c) don't change

99) in anemia , the peripheral resistance is decreased and this is due to

a) reduced viscosity of the blood
b) release of vasodilator products
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c) diminished delivery of the oxygen to the tissues
d) A and B
e) A and C

100) the ratio between the opened capillaries to the closed capillaries is
a) 10 : 90
b) 90 : 10
c) 30 : 70
d) 70 : 30

101) constriction of the veins lead to

a) increase in the venous return
b) decrease in the venous return
c) no effect on the venous return

102) which of the following is known as the peripheral heart

a) thoracic pumb
b) skeletal muscle pump
c) contraction of the spleen
d) sympathetic stimulation to the blood vessels

103) expiration increase the ……………..

a) intra thoracic negativity
b) intra thoracic positivity
c) non of the above

104) the resting pumping capacity of the heart is about …………

a) 4 L/MIN
b) 5 L/MIN
c) 13 L/MIN
d) 25 L/MIN
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105) in case of heart failure ……………… become the determinant of
cardiac output
a) venous return
b) SA node
c) pumping capacity of the heart
d) non of the above

106) the nervous stimulation to the heart increase the pumping capacity
of the heart by
a) chronotropic effect
b) inotropic effect
c) dromptropic effecy
d) A and B
e) A and C

107) the work of the heart during maximal activity may increase up to
……….. the cardiac work during rest
a) 2.5 fold
b) 4 fold
c) 7 fold
d) 13 fold

108) all of the following are mechanisms of the heart rate reserve
"which is about 125 beat/min" except
a) increased sympathetic stimulation
b) decreased vagal stimulation
c) increased body temperature
d) increased venous return

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109) the following are mechanisms that can increase the stroke volume
reserve except
a) increased sympathetic stimulation
b) cardiac dilatation
c) increased body temperature
110) the difference between the work of the heart in the maximal
activity and it's work during the basal condition is the
a) ejection fraction
b) pumbing capacity of the heart
c) stroke volume
d) cardiac reserve

111) increase in the ventricular cells occure only when the cardiac
weight exceed
a) 200 mg
b) 300 mg
c) 500 mg
d) 700 mg

112) the limiting factor in the cardia hypertrophy is the

a) coronary blood flow
b) over stretching of myocardial fibers
c) excessive increase in the heart rate
d) A and B

113) during muscular exercise , the non athlets increase their cardiac
output mainly by
a) increasing the heart rate
b) increasing stroke volume by sympathetic discharge
c) increasing stroke volume by starling law
d) A and B
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114) a trained athlete during rest has
a) low heart rate and low stroke volume
b) low heart rate and great stroke volume
c) great heart rate and great stroke volume
d) great heart rate and low stroke volume

115) raising the mean arterial blood pressure …………….. the pressure
volume work
a) increase
b) decrease
c) have no change

116) the total work done by the heart during rest is

a) 6 kg meter/min
b) 6.14 kg meter/min
c) 7 kg meter/min
d) 7.14 kg meter/min

117) the ratio between the pressure volume work of the right ventricle
to that of the left ventricle is
a) 6/1
b) 1/6
c) 7.14/1
d) 1/7.14

118) the potential energy oxidized by the heart comes mainly from
a) carbohydrates
b) proteins
c) fats
d) keton bodies and amino acids
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119-Amount of blood passing a given point in the circulation in agiven
period of time …….
a- Vascular resistance
b- Viscosity of blood
c-Blood flow
d-Blood velocity

120-During laminar flow of blood vessels ……….

a- Blood flows in all directions in the vessel
b-The central portion of the blood is the fastest flow
c- the blood flows in stream lines
d-b & c

121- The velocity of blood is directly proportional to ………..

a-blood flow
b-cross sectional area
c-P1-P2
d-A & C

122- To maintain the tension in a blood vessel ……

a-Blood velocity is decreased
b-Pressure difference of the blood is increased
c- The radius of the vessel is decreased
d-The radius of the vessel is increased

123- According to Laplace Law the vessel wall tension is inversely

proportional to the distending pressure …..
a-True
b- False

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124- Poiseuille 's Law expresses the relationship among blood pressure ,
vessel radius , vessel length & blood viscosity on turbulent flow …..
a-True
b- False

125- The effect of the radius on the blood flow is especially strong due to
a- Blood flow varies with the radius
b-Blood flow varies with the radius to the fourth power
c- Viscosity of the blood
d- Non of the above

126- Resistance is directly proportional to blood velocity and length of

the vessel ….
a-True
b- False

127- The total resistance in vessels connected in series is more than

those connected in parallel ……
a-True
b- False

128- In polycythemia ….
a- Blood velocity is increased
b- Blood flow is decreased
c- Haematocrit value increases up to 60 or 70
d- B & C

129- Total resistance is mostly controlled by ……..

a-Blood viscosity
b- Vessel length
c- Arterioles d- Blood velocity
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130- All of the following includig local regulation of blood flow Except
a-Metabolic autoregulation.
b- myogenic autoregulation .
c- Hormonal control.
d- Endothelial-mediated regulation.

131- All f the following occur during increase metabolic activity Except
a- decrease O2.
b- decrease PH.
c- vasoconstriction.
d- increase blood flow.

132- All cause vasodilatation Except

a- Rise in temperature.
b- K+ & lactate in SK..M.
c- decrease in Co2.
d- Adenosine in cardiac muscle.

133- Histamine is vasoconstrictors

a- True.
b- False.

134- Blocking blood supply to tissue for sometime & then released this
block
a- Active hyperemia.
b- Reactive hyperemia.

135- Which is True about Thromboxane A2

a- Vasoconstrictors.
b- platelet aggregation.
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c- Vasodialtors.
d- Inhibits platelet aggregation.
e- a&b.
f- c & d.

136- All of the following are Vasodilators Except

a- Prostacyclin.
b- No.
c- Endothelins.

137- Which is false about the stimuli of Angiotensin II formation

a- decrease BP.
b- Increase BP.
c- Hypovolemia.

138- Concerning the actions of Angiotensin II which is true

a-V.C of arteriolar.
b- Increase secretion of Aldesterone hormone through adrenal cortex.
c- increase salt and water retention .
d- All of the above.

139- The stimuli to release ADH are .....

a-increase Osmolality.
b- Hypovolomia.
c- Stimulation of Angiotensin II.
d- All of the above.

140- All are True about ADH Except

a- formed in hypothalamus & post pituitry gland.
b- Reduces Urine formation.
c- Increasing water reabsorbtion.
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d- the most vasodilators.

141- About Kinins which is True

a- V.D hormones
b- V.C hormones.
c- its action resemble to histamine.
d- a & c.

142- ANP released during .....

a- increase ECF.
b- Stretch of atrial wall.
c- Both.

143- Nervous system control of blood vessels mediated through .....

a- Medullary cardiovascular centers.
b- Cardiovascular reflexes.
c- Autonomic nervous system.
d- All of the above.

144- SNS ( sympathetic nervous system) innervates all blood vessles

Except
a- Arterioles.
b- Capillaries.
c- Venules.
d- b & c
.
145- Sympathetic nerves carry Vasoconstrictors fibers Only
a- True.
b- False.

146- Vasodilators fibers have tonic discharge

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a-True.
b- False.

147- the force exerted by the blood against any unit area of the vessel
wall is the
a- pulse pressure
b- mean pressure
c- arterial blood pressure
d- systolic blood pressure

148- the average pressure throughout the cardiac cycle is the

a- arterial blood pressure
b- mean pressure
c- pulse pressure
d- the stroke volume

149- regarding arterial blood pressure

a-women have lower blood pressure than men
b- men have lower blood pressure than women
c- both men and women have the same blood pressure

150- obese persons usually have

a-high systolic pressure
b- low systolic pressure
c- normal systolic pressure

151- during exercise

a-systolic Pressure is increased
b- diastolic pressure is increased
c- both systolic and diastolic pressure is increased
d- both of them remain constant
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152- when the blood reaches the right atrium , it's pressure is equal to
a-zero mm.hg
b- 93 mm.hg
c- 85 mm.hg
d- 15 mm.hg

153- which of the following have the greatest vascular resistance

a-arteries
b- arterioles
c- capillaries
d- veins

154- the arteriolar resistance is almost …………….. times as mush as that

of the capillaries
a-2 times
b- 3 times
c- 4 times
d- non of the above

155- which of the following can affect the arterial blood pressure
a-cardiac out put
b- changes in the blood volume
c- elasticity of the large arteries
d- all of the above

156- narrowing of the arteries with no change in the cardiac output lead
to
a-rise in the diastolic pressure
b- rise in the systolic pressure
c- decrease in the systolic pressure
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d- decrease in the diastolic pressure

157- in atherosclerosis
a- elastic and fibrous tissue are replaced by muscular tissue
b- elastic and muscular tissue are replaced by adipose tissue
c- elastic and muscular tissue are replaced by fibrous tissue

158- a decrease in the blood volume will lead to

a- increase in the arterial blood pressure
b- decrease in the arterial blood pressure
c- no change on the arterial blood pressure
159- All of the following is Short-term regulation of A.B.P Except:
a- Nervous mechanism.
b-Hormonal mechanism.
c- mechanism related to kidney function.
d- Capillary fluid shift.

160- All are True about Baroreceptors Except:

a- reduce variation in the arterial pressure.
b- have role in blood volum changes.
c- Rapidly acting mechanism.
d- Continue their disharge during presence of the stimulus.

161- Chemoreceptors reflex is a powerful arterial pressure controller.

a- True.
b- False.

162- Chemoreceptors reflex responds strongly when B.P falls .....

a- below 120 mmHg.
b- below 100 mmHg.
c- below 80 mmHg.
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163- All are True about stretch of atria ( atrial reflex) Except:
a- slight reflex V.D of peripheral arterioles.
b- strong reflex V.D of kidney arterioles.
c- stimulation of ADH.
d- increase the excretion of water by kidney.

164- Atrial reflexs are .....

a- pressure controllers.
b- volume controllers.
c- both.

165- Concerninng to CIR ( cerberal ischemic response) which is False

a- CIP is stimulated by cerebral ischemia.
b- B.P below 60 mmHg initiate response.
c- elevate B.P above 200 mmHg.
d- one of the mechanism for regulation normal arterial pressure.

166- CIR blocks blood flow to all tissues Except

a- heart.
b-lungs.
c-brain.
d- all of the above.

167- Metarterioles have sympathetic nerve supply

a- True.
b- False.

168- About Renin-Angiotensin system which is False.

a- V.C system.
b- slower action than nervous reflexes.
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c- requires 20 min. Becoming fully active.
d- shorter duration of action than nervous reflex.

169- The heart gets most of its coronary blood supply during .......
a- Systole.
b- diastole.

170) the capillary circulation contain about ….. of the circulating blood
a) 64%
b) 13%
c) 9%
d) 5%

171) the blood usually flow at a continuous rate through the capillaries
by a phenomenon called vasomotion
a) true
b) false

172) the most important factor that affect vasomotion is the

a) concentration of oxygen in the tissues
b) concentration of CO2 in the tissues
c) the rate of metabolism and oxygen consumbtion
d) non of the above

173) capillary tone refers to the

a) number of partially or totally opened capillaries
b) number of partially or totally closed capillaries
c) non of the above

174) diffusion rate is inversely related to the

a) solubility of the substances
36
b) temperature
c) molecular size
d) surface area available

175) O2 and CO2 may be transported by diffusion through ………….

a) slit pores
b) fenestrae
c) trancellular transport
d) pinocytosis

176) the process of bulk flow of water and solutes from the plasma to
the interstitial fluid by the hydrostatic pressure is known as
a) absorbtion
b) reabsorbtion
c) filtration
d) non of the above

177) large molecule "plasma proteins" are prevented to pass through

the pores of endothelial membrance so lead to
a) movement of water and solutes from the plasma to interstitial fluid
b) movement of water and solutes from interstitial fluid to the plasma
c) don't affect the movement of water and solutes

178) if the interstitial fluid pressure is negative , it will tend to move the
fluid
a) inward
b) outward
c) non of the above

179) the small quantities of proteins that diffuse into the interstitial fluid
are removed by the
37
a) thymus
b) venous capillaries
c) lymph capillaries
d) liver

180) the ratio of the proteins between the interstitial fluid to the plasma
is about
a) 1:1
b) 1:3
c) 3:1
d) 1:2

181) the ratio of the plasma crystalloids between the plasma and the
interstitial fluid is about
a) 1:1
b) 1:3
c) 3:1
d) 1:2

182) the plasma colloid osmotic pressure is about

a) 35 mmhg
b) 25 mmhg
c) 28 mmhg
d) 5 mmhg

183) the colloid osmotic pressure is mainly caused by

a) albumin
b) globulin
c) fibrinogen
d) non of the above

38
184) the summation of forces causing the filtration of fluid at the arterial
end is about
a) 9 mmhg
b) 10 mmhg
c) 11 mmhg
d) 12 mmhg

185) the fluid that has been filtered out will be reabsorbed by
a) the venous end of the capillaries only
b) lymph vessels only
c) mainly by the venous end and small amount by the lymph vessel
d) mainly by the lymph vessel and small amount by the venous end

186) if the rate of filtration exceed the rate of reabsorbtion , it may

result into
a) hypotension
b) hypertension
c) tissue oedema
d) A and C
e) B and C

187) the most important mechanism for the transport of nutrient

between the plasma and the interstitial fluid is the
a) diffusion
b) filtration
c) reabsorbtion
d) non of the above

188) oedema means abnormal increase in the

a) blood volume
b) interstitial fluid
39
c) lymph volume
d) all of the above

189) oedema may lead to ……………

a) water and electrolyte imbalance
b) interfere mechanically with the function of the tissues
c) hypotension
d) A and C
e) A and B

190) all of the following may lead to oedema except

a) extremes of temperature
b) hypoxia
c) hypotension
d) failure of the kidney

191) the normal lymph flow is about

a) 1 L/D
b) 2 L/D
c) 3 L/D
d) 5 L/D

192) most lymph comes from the

a) kidney
b) spleen
c) heart
d) liver

193) the lymphatic duct empties it's contents into

a) the left subclavian vein
b) left internal jugular vein
40
c) superior vena cava
d) inferior vena cava

194) lymph collected by the prephiral tissues is returned to the

cardiovascular system by
a) right lymphatic duct
b) thoracic duct
c) all of the above

d) non of the above

1- B
2- A
3- D
4- C
5- C
6- B
7- A
8- D
9- C
10- C
11- B
12- C
13- B
14- C
15- C
16- B
17- A
18- C
41
19- B
20- C

21- B

22- A
23- D
24- A
25- B
26- B
27- B
28- C
29- A
30- D
31- C
32- E
33- C
34- A
35- B
36- B
37- A
38- B
39- A
40- B
41- D
42- C
43- A
44- D
45- D
46- B
47- B
48- C
42
49- B
50- B
51- D
52- c
53- B
54- C
55- A
56- B
57- A
58- B
59- C
60- B
61- D
62- C
63- B
64- B
65- A
66-B
67-E.
68-D.
69-B.
70-C.
71-C.
72-C.
73-B.
74-D.
75-C.
76- D.
43
77- A.
78- B.
79- C.
80- B.
81- A.
82- B.
83- B.
84-C.
85-C.
86- D.
87- B.
88- A.
89- A.
90- D.
91- C.
92- B.
93- C.
94- D.
95- A.
96- B.
97- B.
98- A.
99- E.

44
100- A.
101- A.
102- B.
103- B.
104- C.
105- C
106- D.
107- D
108- B
109- C
110- D
111- C
112- A
113- A
114- B
115- A
116- D
117- B
118- C
119- C
120- D
121- D
122- C
123- B
124- B
45
125-B
126- B
127- A
128-D
129-c
130-C.
131-C.
132-C.
133-B.
134- B.
135-E.
136-C.
137-B.
138-D.
139-D.
140-D.
141-D.
142-C
143-D.
144-D.
145-B.
146-B.
147- C
148- B
149- A
150- A
151- A
152- A
153- B
154- B
155- D
46
156- A
157- C
158- B
159-C.
160-D.
161-B.
162-C.
163-C.
164-C.
165-D.
166-D.
167-B.
168-D.
169-D.
170- D
171- B
172- A
173- B
174- C
175- C
176- C
177- B
178- B
179- C
180- B
181- A
182- C
183- A
184- C
185- C
186- D
47
 187- A
188- B
189- E
190- C
191- B
192- D
193- A
194- B

1) Which of the following activate Extrinsic coagultion pathway:

a) Von wellibrnd factor.
b) activation of factor XII.
c) tissue thromboplastin.
d) non of the above.

2) which of the following responsible for platelate adhesion:

a) Von wellibrnd factor.
b) thromboplastin.
c) exposure of subendothelial collagen.
d) factor XII.
e) a& c.
3) Acquired hypercoagulability occur due to the following except:
a) increased blood viscosity.
b) oral contraceptives.
c) hypolipidimeia.
d) after slpenectomy.

4) Formation of a 1ry hemostatic plug due to ......

a) release of ATP.
48
b) thrombin + ADP+ Thromboxane A2.
c) release of ADP.

5) All of the following about mixed thrombus except.....

a) formed of platelets &blood clots .
b) On section shown lines of Zahn.
c) it's known as platelate thrombus.
d) it's known as coralline thrombu.

6) Arterial thrombi grow in

a) direction of blood flow.
b) retrograde direction from point of attachment.

7) Concerning to characteristic of lines of Zahn all are True except:

a) due to alternating layers of platelets& fibrin+RBCs.
b) noticed in large arteries.
c) noticed in vein or small areteries.

8) Red thrombus occurs in No stasis

a) True.
b) False.

9) Propagating thrombus is common in :

a) Arterial thrombi.
b) Venous thrombi.
c) capillary thrombi.

10) All of the following about blood clotting except:

a) occurs in Vivo & in Vitro.
b) formed when blood is stagnant.
c) there is lines of Zahn.
49
d) jelly like.

11) 90% of venous thrombi occur in upper extremities:

a) True.
b) False.
12) About Phlebothrombosis all is true except:
a) caused by stasis.
b) has propagated clot.
c) there is infalmmation.
d) known as red thrombi.

13) Disseminted intravascular coagulation (DIG) is about:

a) venous thrombi.
b) arterial thrombi. c) capillaries thrombi.

14) 99% of all emboli from......

a) air emboli.
b) amniotic emboli.
c) detached thrombi.
d) fat emboli.

15) In medium-sized emboli,if the lungs are healthy,it may be occur......

a) ischemia.
b) infarction.
c) pulmonary hemorrhage.

16) Which of the following isn't correct about repeated of small emboli:
a) Narrowing of vascular lumina.
b) increased vascular resistance.
c) development of pulmonary hypotension.
d) cor pulmonale.
50
17) According to systemic thromboebolism,the emboli orginate in:
a) Lt heart.
b) Aorta.
c) Large arteries.
d) All of the above.

18) Paradoxical emboli are venous emboli

a) True.
b) False.

19) ......... of air are required to produce problems.

a) 10-20 c.c.
b) 30-40 c.c.
c) 50-100 c.c
d) Non of the above.

20) According to Caisson's disease which is True:

a) Specilaized form of air embolism.
b) occurs due to exposure to sudden changes in atmospheric pressure.
c) occurs in deep diving&the gas breathed under high pressure.
d) all of the above.

21) All the following concerning Fat embolism is true EXCEPT:

a) appear following closed fractures of shafts of long bones.
b) access to circulation through ruptured arteries.
c) produce pulmonry or systemic embolism.

22) IN amniotic fluid emboli ,it ends in fetal pulmonary embolism to the
baby
a) True.
51
b) False.

23) Congestion is almost physiological

a) True.
b) False.
24) Which of the following isn't correct about active hyperemia:
a) Increase blood flow to organ.
b) physiological in muscular exercise.
c) pathological in acute inflammation.
d) The effected tissue is cynotic.

25) In Rt ventricular failure ,systemic venous congestion affects .......

a) All the organs.
b) The entire body sparing the lungs.
c) pulmonary circulating.
d) Non of the above.

26) What's the general effect of venous congestion

a) Hypoxia.
b) Edema.
c) Cynosis.
d) All of the above.

27) Which's False about causes of chronic venous congestion of lungs

a) Elevation in pulmonary veins pressure.
b) Occurs in mitral stenosis.
c) Occurs in Rt-sided heart failure.
d) Elevation in Lt atrial pressure.

28) Which is the Grossly picture of lungs in advanced stages

a) Voluminous.
52
b) Dark red.
c) Brown induration of the lungs.
d) Edematous.
29) Which is correct about hemosiderin
a) Produced by breakdown of RBCs.
b) Engulfed by macrophages.
c) It forms with macrophages "heart failure cells".
d) All of the above.

30) In Grossly cut section in chronic venous congestion of liver,all is true

Except
a) mottled appearance.
b) Dark red area alternating with yellow fatty areas.
c) Like"Beet-root".
d) Like"netmeg".

31) Microscopically, in chronic venous congestion of liver,the

hepatocytes in the mid zones are.....
a) Atrophic.
b) Chronic hypoxia.
c) develope fatty change.

32) Inadequate blood supply to an organ is

a) thrombosis.
b) infarction .
c) ischemia .
d) hemorrhage.

33) sudden complete ischemia caused by all of the following except

a) atherosclerosis.
b) embolism.
53
c) thrombosis.
d) ligatures of an artery.

34) the arterial infarction is caused by :

a) embolism.
b) endothelial injury.
c) twisting of a pedicle of an organ .
d) hypoxia.

35) pale infarction of the heart is caused by the following except :

a) external obstruction.
b) atherosclerosis .
c) embolism.
d) compression on a vein.

36) the septic infarction may occurs due to :

a) infarction in the brain.
b)emboli of infective endocarditis.
c) atherosclerosis.
d) alternation in normal blood flow.

37) fibroblast is the least sensitive tissue to hypoxia ( )

38) large infarction is healed by scar formation ( )

39) infarction leads to leukopenia ( )

40-Concerning Acute Rheumatic Fever ………

a) It is an immune mediated disease caused by direct invasion of st.
pharyngitis
b) Immunologically mediated reaction ; Type 2 hypersensitivity reaction
54
 c) Common in adults more than children
d) All of the above

41- Acute rheumatic fever classically develops in children 2 to 3weeks

after a group A β-hemolytic streptococcal (Streptococcus pyogenes )
infection of the ………….
a) Aorta
b) Heart
c) Lungs
d) Pharynx
e) Skin

42- Focal inflammatory reactions widely scattered in the connective

tissue in various body sites ……
a) Aschoff's cells
b) Aschoff's nodules
c) T cells
d) Plasma cells

43- A 31-year-old female presents with fever, intermittent severe pain in

the left upper quadrant of her abdomen, and painful lesions involving
her fingers and nail beds. History reveals that she had acute rheumatic
fever as a child and that when she was around 20 years of age she
developed a new cardiac murmur. At the present time one of three
blood cultures submitted to the hospital lab grows out a particular
organism. Which one of the following is most likely to be that organism?

a) Staphylococcus aureus
b) α-hemolytic viridans streptococci
c) Candida species
d) Group A streptococci
55
 e) Pseudomonas species

44- The most characteristic and frequent feature of chronic rheumatic

heart disease is the development of…….
a) Vegetations on the endocardium
b) Aschoff bodies within the myocardium
c) Fibrin deposits within the pericardium
d) Stenosis of the mitral valve
e) Incompetence of the pulmonic valve

45- a patient suffering from pain in his knee joint , clinical examination
showed signs of inflammation on the knee , history reveals that he had
an infection of his pharynx the patient is suffering from ………
a) Polyarthritis d.t acute rheumatic fever
b) Beta haemolytic streptococcal infection
c) Erthyma marginatum
d) Non of the above

46- in rheumatic chorea the affected part of the brain is ……….

a) Cerebral cortex
b) The thalamus
c) Basal ganglia
d) Cerebellum

47- A child with a previous history of rheumatic fever suffering from

arthralgia and carditis he is mostly affected of …….
a) Chronic rheumatic heart disease
b) Acute rheumatic heart disease
c) Angina pectoris
d) Non of the above

56
 48- The most characteristic and frequent feature of chronic rheumatic
heart disease is the development of
a) Vegetations on the endocardium
b) Aschoff bodies within the myocardium
c) Fibrin deposits within the pericardium
d) Stenosis of the mitral valve

49- .......... increase resistance of blood flow through open mitral valve
during diastole
a-Endocarditis.
b- Mitral incompetence.
c- Mitral stenosis.
d- Aortic incompetence.

50- All the following occur in Mitral stenosis Except

a- Stasis of blood in Lt atrium.
b- Thrombus formation.
c- Normal sized or slightly atrophid Lt ventricle.
d- Increase COP.

51- ........ regurgitation of blood from Lt ventricle to Lt atrium during

systole
a- Mitral stenosis.
b- Aortic incompetence.
c- Mitral incompetence.
d- Endocarditis.

52- .......is infection & colonization of valvular and mural endocardium by

micro-organism
a- Rheumatic fever.
b- Heart failuar.
57
c- Infective endocarditis.

53- All of the following about Acute bacterial endocarditis (ABE) Except
a- caused by highly virulent oraganism.
b- its duration is < 6 weeks.
c- the valves are previously diseased.
d- lesions are invasive,suppurative.

54- Which of the following is False about SABE.

a- the valves are previously diseased.
b- caused by low virulent oraganism.
c- its duration is > 6 weeks.
d- High grade fever.

55- ABE caused by .....

a- staphylococcal epidermis.
b- streptococcal viridans.
c- staphylococcal aureus.
d- streptococcal pneumonia.

56- Which of the following is predisposing factors of Infective

endocarditis
a- bacteraemia & septicemia.
b- Underlying heart disease.
c- Impaired host defense.
d- All of the above.

57- All of the following is True about vegetations of Infective

endocarditis Except
a- large.
b- friable.
58
c- tightly adherent.
d- more than one row in cusps.
58- Destruction of valves is common in SABE than ABE
a- True.
b- False.

59- Which of the following isn't Cardiac complications of Infective

endocarditis
a-destruction of valves.
b- Myocardial abcesses.
c- systemic pyemia.
d- cardiac failure.

60- weakening of the blood vessel wall may lead to

a) thrombosis
b) ischemia
c) aneurysmal formation
d) non of the above

61- damage of the endothelium may lead to

a) thrombosis
b) ischemia
c) aneurysmal formation
d) non of the above

62- atherosclerosis affect

a) large elastic arteries
b) large and medium sized muscular arteries
c) small arteries and arterioles
d) A and B
e) A and C
59
63-all of the following increase the risk of atherosclerosis except
a) an increase in the level of LDL
b) an increase in the level of HDL
c) increase in the level of cholesterol
d) increase in the level of triglycerides

64- cigarate smoking increase the risk of atherosclerosis which is due to

a) increase the level of cholesterol and LDL
b) vasoconstrictor material present in it
c) A and B
d) non of the above

65-all of the following are minor risk factor for atherosclerosis except
a) high carbohydrate diet
b) obesity and high caloric intake
c) diabetes mellitus
d) contraceptive pills

66-which of the following can induce the development of focal

endothelial injury of the arteries
a) hypertension
b) hyperlipidemia
c) endotoxins
d) all of the above

67- monocytes are transformed into foam cells within the

a) tunica intima
b) tunica media
c) tunica adventitia
d) non of the above

60
68- microscopically , atheromatous plaques is composed of
a) 1 layer
b) 2 layers
c) 3 layers
d) 4 layers

69- in the complicated plaque , dystrophic calcification is very common

in
a) superficial fibrous cap
b) lipid core of the plaque
c) the proliferating smooth muscle base
d) non of the above

70- atherosclerosis remain asymptomatic until it forms the …………..

a) fatty spots and steaks
b) atheromatous plaque
c) complicated plaque
d) non of the above

71-atherosclerosis may lead to embolic complications such as

a) cholesterol embolism
b) thromboembolic complication
c) A and B
d) non of the above

72- in monckeberg's sclerosis there is calcific deposits in the

a) tunica intima
b) tunica media
c) tunica adventitia
d) non of the above
61
73- monckeberg's sclerosis lead to obstruction of the lumen of the blood
vessel wall
a) true
b) false

74- arteriolosclerosis affects

a) large elastic arteries
b) large and medium sized muscular arteries
c) vessels of 1mm in diameter or less
d) all of the above

75- Which of the following causes of IHD .....

a-Reduced coronary blood flow.
b- Increased myocardiall demand.
c- Factors aggravate effects of ischemia.
d- All of the above.

76-All of the following causes reduced coronary blood flow Except

a- Coronary atherosclerosis with thrombosis.
b- sever brady cardia.
c- sever hypotension.
d- Aortic valve diseases.

77- which is considered constitutional risk factors of IHD

a-age & sex.
b- Type A personality.
c- Familial predisposition.
d- a & c.

78- All of the following are Major risk factors of IHD Except
62
a- Hyperlipidaemia.
b- Diabeted mellitus.
c- Hypertension.
d- physical Inactivity.

79- All of the following increase risk of IHD & atherosclerosis Except
a-Hypercholesterolemia.
b- LDL.
c- VLDL.
d- HDL.

80- Regular exercises reduce the rate of fatal heart attack through ....
a-increase serum level of LDL.
b- development of collaterals.
c- increase serum level of HDL.
d- b & c.

81- Which is False about stable angina

a- the most common form of ab=ngina pectoris.
b- Occurs in physical activity & stress.
c- there is fixed of atheroscelrosis narrowing.
d- There's elevation of ST segment.

82- In unstable angina, the mural thrombus is completely occlusive

a-True.
b- False.

83- In which form of Angina occurs myocardial cell necrosis ...

a-Stable .
b- unstable.
c- prinzmetal.
63
84- In transmural infarct , the necrosis invloves full thickness of
ventricular wall
a- True.
b- False.

85- In transmural infarct , the necrosis starts in the entire thickness of

ventricular wall
a- True.
b- False.

86- After 4 hours of MI ( mycocardial infarction )the Grossly appearance

chracterized by ...
a- Pallor.
b- softeness.
c- granulation tissue.
d- No finding.

87- All the following are the most common affected site of MI except
a-Apex.
b- Lt ventricle.
c- Atria.
d- interventricular septa.

88- Occlusion of Ant. Descending branch of Lt coronry artery involves

infarction of all sites Except
a- Apex.
b- Ant.wall of Lt ventricle.
c- Lateral wall of Lt ventricle.
d- Ant. 2\3 of IV septa.

64
89- Softeness infarction occur at ......
a-12-24 hours.
b- 1-3 days.
c- 4-7 days.
d- weeks- months.

90- In,MI ,the anginal may be silent in ....

a-Hypertensives.
b- Hypotensives.
c- Diabetes.
d- a & c.

91- All of the following is used in Early diagnosis of MI Except

a-Troponin.
b- Myoglobin.
c- CK-MB.
d- LDH-1.
92- Which is False about the complications of MI from mintutes to
hours.
a-Arrhythmias.
b- cardiogenic shock.
c- Rupture of infarcted area.
d- Acute Lt heart failure.

93-In complications of MI, acute pericarditis impair the cardiac function

a-True.
b- False.

94- Which is False about Dressler syndrome

a-it's complication of transmural infarct.
b- Autimmune disorder.
65
c- occurs in a few days of MI.
d- Corticosteroid treatment is beneficial.

95- Three weeks following a myocardial infarction, a 54-year-old male

presents with fever, productive cough, and chest pain. The pain is worse
with inspiration, better when he is sitting up, and not relieved by
nitroglycerin.
Physical examination finds a friction rub along with increased
jugular venous pressure and pulsus paradoxus (excess blood pressure
drop
with inspiration). What is the most likely explanation for these findings?
a. Caplan’s syndrome
b. Dressler’s syndrome
c. Ruptured papillary muscle
d. Ruptured ventricular wall
e. Ventricular aneurysm

96- All are True about Acute Cor pulmonale Ecept

a-caused by pulmonary emboli.
b- emboli obstructing more than 50% of pulmonary vascular bed.
c- Rt venrticular hyperatrophy.
d- Rt ventricular dilation.

97- Haemopericardium is accumulaion of ....... in pericardial sac

a-fluid.
b- mixed blood.
c- pure blood.

98- ................... causes cardiac tamponade

a- accumulating blood fills the pericardial sac at low pressure.
b- accumulating blood fills the pericardial sac at high pressure.
66
99- Shaggy or mantile like shown in ......
a-purulent pericarditis.
b- Haemorrhagic pericarditis.
c- fibrinous pericarditis.
d- fibrous pericarditis.

100- Haemorrhagic pericarditis caused by .....

a-Tuberculosis.
b- Malignancy.
c- cardiac surgery.
d- All of the above.

101- ............ Caused by Constrictive pericarditis associated with ascitis

& venous congestion
a-Cor pulmonale.
b- Dressler syndrom.
c- Pick's disease.

102- A 64-year-old male presents with recurrent chest pain that

develops
whenever he attempts to mow his yard. He relates that the pain goes
away
after a couple of minutes if he stops and rests. He also states that the
pain
has not increased in frequency or duration in the last several months.
What
is the correct diagnosis for this patient?
a. Stable angina
b. Unstable angina
67
c. Atypical angina
d. Prinzmetal’s angina
e. Myocardial infarction

103- All are False about Berry aneurysm Except ....

a-diffuse dilatation.
b-circumferential dilatation.
c- 5-20 cm in diameter.
d- seen in circle of Wills.

104- All the following is True about Atherosclerotic aneurysm Except ...
a- The most common cause of aortic aneurysm.
b- Occurs with male to female ratio 5:1 .
c- mainly in ascending aorta.

105- which is True about complication of Atherosclerosis aneurysum

a-Occlusion of iliac,renal ,mesenteric arteries.
b- thromboembolic complications.
c- Compression on the adjacent structure.
d- Rupture.
e- All of the above.

106- Which is False about syphilitic aneurysm

a- occurs in ascending aorta and its arch.
b- Occur endarteritis obliterans of vasa vasora.
c- occurs in 2nd stage of syphilis.
d- medial necrosis.

107-In, Dissecting aneurysm, the blood dissects the laminar planes of

intima
a-True.
68
b- False.
108- Aortic dissection occurs in ..........
a-hypertensive men ( 40-60 years).
b- Marfen syndrom.
c- Vit.C deficiency.
d- All of the above.

109- The diastolic pressure is less important than systolic

a-True.
b- False.

110- Which is True about Malignant hypertension

a-occurs in 95% of hypertensive pateints.
b- easily controlled by antihypertensive agents.
c- B.P is more than 200\120 mmHg.
d- female more than males.

111- In 2ry hypertension, increased PVR occurs due to all of the

following Except
a-Activation of renin-angiotensin system.
b- excess catecholamine secretion.
c- genetic defect in vascular smooth muscle growth.
d-stimulation of vasomotor centers.

112-Which is True about Hyaline arteriolosclerosis

a- occurs in malignant hypertension.
b- in benign hypertension.
c- appears as homogeneous pink thickening of the wall.
d- b & c.

113- In Benign hypertension, the diastolic B.P > 120 mmHg

69
a-True.
b- False.

114- Malignant hypertension occurs from 4th -6th decades

a-True.
b-False.

1-C.
2-E.
3-C.
4-C.
5-C.
6-B.
7-C.
8-B.
9-B.
10-c.
11-b.
12-c.
13-c.
14-C.
15-C.
16-C.
17-D.
18-A.
19-C.

70
20-D.
21-B.
22-B.
23- B.
24- D.
25- B.
26- D.
27- C.
28- C.
29- D.
30- C.
31- C.
32-C.
33-A.
34-A.
35-C.
36-B.
37-F.
38- F.
39- F.
40-B
41-D
42-B
43-B
44-D
45-B
46-C
47-B
71
48-D
49-C.
50-D.
51-C.
52-C.
53-C.
54-D.
55-C.
56-D.
57-C.
58-B.
59- C.
60- C
61- A
62- D
63- B
64- B
65- C
66- D
67- A
68- C
69- B
70- C
71- C
72-B
73- B
74- C
75-D.
76-B.
77-D.

72
78-D.
79-D.
80-D.
81-D.
82-B.
83-B.
84-A.
85-B.
86-D.
87-C.
88-C.
89-C.
90-D.
91-D.
92-C.
93-B.
94-C.
95-B.
96-C.
97-C.
98-B.
99-C.
100-D.
101-C.
102-A.
103-D.
104- C.
105-E.
106-C.
107-B.
108-D.
73
 109-B.
110-C.
111-C.
112-D.
113-B.

114-B.

1) which of the following about phase 0:

a) rapid depolarization.
b) parteial repolarization.
c) inflow of Na+.
d) a&c.

2) All of the following about phase 3 except:

a) repolarization.
b) K+ out flow.
c) inflow of Na+.
d) Ca++ current inactivates.

3)Dysrrhythmia is an abnormality of the heart rhythm involving

change in:
a) heart rate.
b) regularity.
c) a or b

4) Refrectory period including phases:

a) phases 0-1.
b) phases 1-2.
c) phases 1-3 .

5) which of the following causes slow conduction in whole heart:

a) K+ channel blockers.

74
b) Ca++ channel blockers.
c) Na+ channel blockers.

6) Ca++ channel blockers slow conduction in :

a) Whole of the heart.
b) A-V node.
7) Na+ channel blockers prolongate .......
a) P-R interval.
b) Q-T interval.
c) QRS complex.

8) K+ channel blockers prolongate .........

a) QRS complex.
b) Q-T interval.
c) P-R interval.

9) class I a has …………………………. Of interaction with Na channels

a) slow kinetic
b) intermediate kinetic
c) rapid kinetic

10) quinidine result into prolongation of the duration of action

potential and it is due to
a)blocking of Na channel
b) blocking Ca channel
c) blocking k channel

11) quinidine result into

a) prolongation of QRS complex
b) prolongation of QT interval
c) non of the above
d) A and B

12) quinidine is used for the suppression of

a) supraventricular arrhythmia

75
b) ventricular arrhythmia
c) non of the above
d) A and B

13) torsade de pointes is a side effect of quinidine that is due to

a) prolongation of QRS complex
b) prolongation of QT interval
c) non of the above
d) A and B

14) the drug of choice in myocardial infarction and ventricular

tachycardia is
a) quinidine
b) lidocaine
c) flecainide
d) digoxin

15) the drug of choice in the heart failure and supraventricular

arrhythmia is
a) quinidine
b) lidocaine
c) flecainide
d) digoxin

16) one of the most potent Na channel blockers is

a) quinidine
b) lidocaine
c) flecainide
d) amiodarone

17) which of the following is used prophilacticaly against arrhythmia

in myocardial infarction
a) lidocain
b) digoxin
c) beta blockers ""class II""

76
d) aminodarone
18) amiodarone slow the heart rate and AV conducation via
a) blocking Na channel
b) blocking Ca channel
c) blocking K channel
d) blocking beta receptor
e) B and D

19) class III "amiodarone" prolong QT interval so os causes torsade

de pointes
a) true
b) false

20) verapamil is contra indicated in

a) supraventricular tachycardia
b) ventricular tachycardia
c) all of the above
d) non of the above

21) all subtypes of class I drugs are used in the treatment of

supraventricular and ventricular arrhythmia except ……………….
Which is used for the treatment of ventricular arrhythmia only
a) class I a
b) class I b
c) class I c

22-The following vastatins should be taken at bedtime except …..

a) simvastatin
b) atorvastatin
c) lovastatin
d) pravastatin

23-the rate controlling enzyme in Cho biosynthesis is …..

a) Cytochrome P450
b) HMG-Co A synthase

77
c) HMG-Co A reductase
d) Non of the above

24-Vastatins are effective in lowering plasma LDL-C by ……

a) Inhibiting Cho synthesis in the liver
b) Up-regulation of LDL-R
c) Decrease production of VLDL
d) All of the above

25-The major effect of HMG-Co A reductase inhibitors is …….

a) Decrease LDL-C
b) Increase HDL-C
c) Decrease VLDL-C
d) All of the above

26-During therapy with vastatins we must measure…..

a) Liver transaminases
b) craetine kinase
c) A & B

27-The followings are adverse effects of vastatins except …..

a) Headache
b) Myopathy
c) Hepatotoxicity
d) GIT upset

28-The following agents target endogenous cholesterol except …..

a) Nicotinic acid
b) Fibrates
c) Cho uptake inhibitors
d) HMG-Co A reductase inhibitors

29- Vastatins potentiate the action of anticoagulants and

antidiabetic drugs by …..
a) Decreasing their excretion

78
b) Displacement from plasma protein binding site
c) Increasing their conc of free active form
d) b&c

30-common adverse effect between vastatins and fibrates is …..

a) hepatotoxicity
b) myopathy
c) GIT disturbance
d) Non of the above

31) Fibrates is contraindicated in all of the following except

a) pregnancy and lactation
b) diabetes mellitus
c) preexisting gall bladder stones

32) fibrates perform their action through

a) stimulation of peroxisome proliferator activated receptor α
b) inhibition of 3 hydroxy 3 methyl glutaryl co-enzyme A reductase
c) A and B
d) non of the above

33) fibrates leads to increased free fatty acid metabolism by

a) alfa oxidation
b) beta oxidation
c) gamma oxidation

34) niacin decrease the vLDL synthesis by ……………

a) decreasing FFA metabolism from adipocytes so decreasing TG
b) inhibiton of a key enzyme from TG synthesis
c) A and B
d) non of the above

35) niacin flushing cauld be avoided by

a) low level of aspirin 1/2 H before niacin
b) intermediate level of aspirin 1/2 H before niacin

79
c) high level of aspirin 1/2 H before niacin
d) non of the above

36) all of the following are adverse effects of niacin except

a) hyperglycemia
b) hepatotoxicity
c) gall stones
d) reactivation of peptic ulcer

37) ezetimibe act by

a) inhibit the absorbtion of dietary CHO
b) inhibit the reabsorbtion of dietary CHO
c) A and B
d) non of the above

38) ezetimibe impairs the dietary and biliary CHO absorbtion so it

affects the fat soluble vitamins
a) true
b) false

39) colestipol and cholestyramine aren't absorbed but they bind to

…………………. In the intestinal luman
a) chylomicron
b) bile acid
c) vLDL
d) non of the above

40) bile acid binding resins may lead to ……………….. in border line
patients
a) decrease the level of vLDL
b) increase the level of HDL
c) A and B
d) non of the above

80
41) regarding the absorbtion of fats and fat soluble vitamins
a) ezetimibe can impair it while bile acid binding resins don't impair
it
b) bile acid binding resins can impair it while ezetimibe don't impair
it
c) both of them can impair it
d) both of them don't impair it

42- All of the following have no direct effect on cardiac muscle in

treating angina except
a- Nitrates
b- nifedipine
c- Verapamil
d- Amlopidine

43- Organic nitrates drugs cause

a- Increase in myocardial oxygen supply
b- Increase myocardial oxygen demand
c- increase platelet aggregation
d- All of the above

44- I.V Nitroglycrine and isosorbide dinitrate infusion can be used in

a- Stable and instable angina
b- Unstable angina and heart failure
c- All types of angina
d- Vasospastic and stable angina

45- All of the following are the side effects of organic nitrates
except
a- Visual disturbance
b- Headache
c- Nitrate tolerance
d- Hypertension

81
46- The most appropriate anti angina therapy for patients with
hypotension is
a- Nifedipine
b- Nitrates
c- Amlodipine
d- Verapamil

47- B- blockers are the treatment of choice in the cases of

a- Hypertension
b- Ischemic heart disease
c- Stable and unstable angina
d- All of the above

48- Non selective B blockers are contraindicated in

a- Asthmatics
b- Stable angina
c- Unstable angina
d- All of the above

49- B- blockers inhibit the sympathetic reflexes caused by

a- Nitrates only
b- Nifedipine
c- A & B
d- Non of the above

50-Concerning primary hypertension …….

a) Cannot be cured but controlled

b) Accompanied by underlying medical illness
c) Represents 5-10% of patients

51- Hypertension may cause end organ damage in the following

organs except ………..

82
a) Liver
b) Heart
c) Brain
d) Kidney

52- The following are major risk factors for hypertension except

a) Hyperlipidemia
b) Hypokalemia
c) Smoking
d) Obesity and stress

53- A patient with simple hypertension 145\95 and no major risk

factors ,, the initial treatment for lowering BP …..

a) Life style modification with drug therapy

b) Life style modification for 12 months
c) Drug therapy only
d) Non of the above

54- A diabetic patient with high pressure (140\90) after

investigation there was no EOD

The doctor have to lower BP to 130\80 by ……..

a) Vasodilator
b) Life style modification
c) Life style modification with drug therapy
d) Drug therapy only

55- drug of choice in simple mild-moderate hypertension in eldery

patients is …………

a) Loop diuretics
b) Beta blockers
83
c) Thiazide diuretics
d) All of the above

56- loop diuretics are best used with …………..

a) Hypertensive patient with normal kidney

b) Hypertensive patient with renal insufficiency
c) Heart failure to decrease preload
d) B & C

57- Beta adrenoceptor blockers are used in ………….

a) Simple hypertension in low renin patients

b) HTN with EOD in contraindication to ACEIs and ARBs
c) Hyper tension with renal insufficiency
d) All of the above

58-The following are therapeutic uses of ACEIs EXEPT …………

a) Low renin hypertension

b) Hypertension with diabetes
c) Hypertension with EOD
d) High renin hypertension

59- one advantage of ACEIs and ARBs is that ………….

a) Used In pregnancy
b) Effective in diabetic nephropathy
c) Cause reflex tachycardia and fluid retention
d) Non of the above

60- ARBs are used instead of ACEIs in cases of …………….

a) Pregnancy
b) Angioedema and cough

84
c) Hyperkalemia
d) Bilateral renal artery stenosis

61- in hypertensive patient who is taking insulin to treat diabetes

which of the following drugs is to be used with extracautions and
advice to the patient ?

a) Hydralazine
b) Prozasin
c) Guanithidine
d) Propranolol
e) Methyldopa

62- significant relaxation of both venules and arterioles is produced

by which of the following druds ?

a) Hydralazine
b) Minoxidil
c) Diazoxide
d) Sodium nitroprusside
e) Nifepidine

63-The following neurohormones level is increased during CHF

except …….

a) Aldosterone
b) Epinephrine
c) Norepinephrine
d) Angiotensin

64-During treatment of CHF signs and symptoms we aim to ……

a) Increase heart rate

b) Decrease oxygen demand

85
c) Increase the cardiac load
d) Increase plasma volume

65-Cardiac contractility is dependent on ………..

a) Free ca+2 ions intracellularly

b) Decreased Na ions extracellularly
c) Decreased K ions extracellularly
d) All of the sbove

66- Digoxin has indirect effect on the heart through ………….

a) Deceasing heart rate

b) Increasing cardiac contractility
c) Decrease oxygen consumption
d) A & C

67-The direct action of Digoxin on the heart is increased by ……..

a) Hypocalcaemia
b) Hypokalemia
c) Hyperkalemia

68- The main cardiac effect of digoxin is ……..

a) Increased cardiac contractility

b) Increased end systolic volume
c) Increased stroke volume
d) Increased heart rate
e) A & C

69- A 75-year old female in CHF unable to climb a flight of stairs

without experiencing shortness of breath. Digoxin is administered
to improve cardiac muscle contractility, within 2 weeks she has a

86
marked improvement in her symptoms .what cellular action of
Digoxin account for this?

a) Inhibition of cAMP synthesis

b) Inhibition of mitochondrial Ca release
c) Inhibition of Na \ K pump
d) Inhibition of beta adrenergic stimulation
e) Inhibition of ATP degradation

70- If Quinidine and Digoxin are administered concurrently , which

of the following effects does Quinidine have on Digoxin ?

a) Decreased absorption of digoxin from the GIT

b) The metabolism of digoxin is prevented
c) The plasma digoxin concentration is increased
d) The effect of digoxin on the AV node is antagonized
e) The ability of digoxin to inhibit Na K-stimulated ATPase is
reduced

71- The preferred agent to combat extreme Digoxin overdose is

a) K
b) Ca
c) Phenytoin
d) Digibind
e) Mg

For each drug of the following match with the most compatible
statement on the right :

72- Dobutamine a- preferred beta blocker in CHF

73- diuretics b- decrease plasma volume

74- amrinone c- antagonize aldosterone

87
75- ACEIs d- shows hepatotoxicity and
BMS

76- hydralazine e- venous dilator

77- nitrates f- can decrease cardiac load

78- metoprolol g- used in acute exacerbation of

CHF

79- spironolactone h- arteriodilator decrease after

load

1-D.
2-C.
3-C.
4-C.
5-C.
6-B.
7-C.
8-B.
9- B.
10- C.
11- D.
12- D.
13- B.
14- B.
15- D.
16- C.
17- C.
18- E.

88
19- B.
20- B.
21- B.
22-B
23-C
24-D
25-A
26-C
27-A
28-C
29-D
30-B
31- B
32- A
33- B
34- C
35- A
36- C
37- C
38- B
39- B
40- A
41- B
42- C
43- A
B -44
45- D
46- D
47- D
48- A
49- C
89
50- A
51- A
52- B
53- B
54- C
55- C
56- D
57- B
58- A
59- B
60- B
61- D
62- D
63- B
64- B
65- D
66- D
67- B
68- E
69- C
70- C
71- D
72- G
73- B
74- D
75- F
76- H
77- E
78- A
79- C

90
1) The sterno-costal surface is formed mainly by
a) The right atrium
b) The left atrium
c) The right ventricle
d) The left ventricle

2) The upper border of the sterno-costal surface is formed of

a) The right atrium only
b) The left atrium only
c) The left ventricle only
d) The right and left atria

3) The coronary sinus lies between

a) The back of the left atrium and left ventricle
b) The back of the right atrium and right ventricle
c) The back of the right atrium and left atrium
d) The back of the right ventricle and left ventricle

4) The upper border is concealed by

a) Pulmonary artery and descending aorta
b) Pulmonary trunk and ascending aorta
c) Pulmonary trunk and superior vena cava
d) Pulmonary trunk and pulmonary vein

5) Diaphragmatic surface contain

a) Anterior inter-ventricular groove
b) Posterior inter ventricular groove
c) Atrio-ventricular groove
d) None of the above
91
6) The base of the heart is formed by
a) Left atrium
b) Right ventricle
c) Left ventricle
d) Right ventricle

7) All of the following are points of the quadrilateral surface

anatomy of the borders of the heart except
a) Right third costal cartilage
b) Left second costal cartilage
c) Right six costal cartilage
d) Left fifth costal cartilage
e) Left fifth intercostal space

8) The surface anatomy of the apex of the heart is

a) The left fifth intercostal space 3.5 cm from the middle line
b) The right fifth intercostal space 3.5 inches from the middle line
c) The left fifth intercostal space 3.5 inches from the middle line
d) The right fifth intercostal space 3.5 cm from the middle line

9) The valves of the heart lie behind the left border of the sternum
except
a) Pulmonary valve
b) Aortic valve
c) Mitral valve
d) Tricuspid valve

10) The heart and pericardium make up the content of

a) Superior mediastinum
b) Middle mediastinum
c) Anterior mediastinum
92
 d) Posterior mediastinum

11) The fibrous pericardium attaches anteriorly to the sternum by

a) The central tendon of diaphragm
b) The two sterno-intercostal ligament
c) The inner serous pericardium
d) Oblique sinus

12) The posterior boundaries of the transvers sinus of serous

pericardium are
a) Right atrium
b) Left atrium
c) Superior vena cava
d) All of the above

13) Oblique sinus separates the base of the heart from

a) Descending aorta
b) Oesophagus
c) A & B
d) None of the above

14) The right atrium receives venous blood from the entire body except
that of
A) SVC
b) Descending aorta
c) Pulmonary arteries
d) Pulmonary veins

15) All of the followings are openings in the right atrium except
a) SVC
b) IVC
93
c) Pulmonary veins
d) Tricuspid valve

16) The bicuspid valve is an atrio--ventricular valve between the left

atrium and left ventricle
A) True
B) False

17) The main vein draining blood from muscles of the heart
A) SVC
B) Pulmonary trunk
C) Coronary sinus
D) Non of the above

18) All of the following are present in the right ventricle except
A) Pectinate muscles
B) Chorda tendinae
C) Pulmonary valve
D) Septal papillary muscles

19) Trabeculae carneae are finer and numerous in

A) Left ventricle
B) Right ventricle
C) Right atrium
D) Non of the above

20) SA node is anatomically located in

A) Superior end of crista terminalis
B) Inter atrial septum
C) Entry of SVC
D) A and c
94
21) Concerning bundles of his all of the following are true except
A) Originate from AV node
B) The septo-marginal trabeculae contain right bundles branches
C) It is located at the entry of SVC
D) Can be seen as bands of myocardium

22) Concerning the tricuspid valve the following is not true except
A) Formed of 2 cusps anterior and posterior
B) Lies between the right atrium and right ventricle
C) Attached to ant and post papillary muscles only
D) Open during ventricular systole

23) During the cardiac systole

A) The tricuspid and mitral valves are closed
B) The aortic and pulmonary are open
C) The blood passes from heart to different body parts
D) All of the above

24) The elevation at the middle of aortic and pulmonary valves is called
A) Lunule
B) Nodule
C) Uvula
D) Non of the above

25) The aortic valve is formed of 3 semilunar cusps one posterior and 2
anterior
A) True
B) False

26) Innominate veins are contents of

a) Inferior mediastinum
95
b) Superior mediastinum
c) Anterior mediastinum
d) Posterior mediastinum

27) Superior mediastinum contains

a) Left recurrent laryngeal nerve
b) sterno-pericardial ligaments
c) Thoracic artery
d) Ascending aorta

28) S.V.C and I.V.C are contents of

a) Superior mediastinum
b) Middle mediastinum
c) Anterior mediastinum
d) Posterior mediastinum

29) Widest part of inferior mediastinum is

a) Anterior mediastinum
b) Middle mediastinum
c) Posterior mediastinum
d) Superior mediastinum

30) Azygos venous system is a content of

a) Posterior mediastinum
b) Anterior mediastinum
c) Superior mediastinum
d) Inferior mediastinum

31) All of the following are contents of superior mediastinum except

a) esophagus
b) Trachea

96
c) S.V.C
d) Ascending aorta

32) The arch of the aorta begins at the level of

a) 5th costal cartilage
b) 2nd costal cartilage
c) 4th costal cartilage
d) Non of the above

33) All of the following are located inferior to the aortic arch except
a) Ligamentum arteriosum
b) Superficial cardiac plexus
c) Right recurrent laryngeal nerve
d) Bifurcation of pulmonary trunk

34) All of the following are branches of the aortic arch except
a) Left phrenic nerve
b) Left common carotid artery
c) Left subclavian artery
d) Left brachiocephalic trunk

35) The pulmonary trunk is connected to the concavity of the aortic

arch by the
a) Aortic ligament
b) Pulmonary infundibulum
c) Ligamentum arteriosum
d) Truncus arteriosus

36) The azygous vein receives all of the following except

a) hemi-azygous and accessory hemi-azygous
b) Esophageal, mediastinal & pericardial veins
97
c) Right posterior intercostal veins
d) First posterior intercostal vein

37) The thoracic duct curves obliquely upwards, posterior to the

esophagus at the level of the
a) 12th thoracic vertebra
b) 5th thoracic vertebra
c) 6th thoracic vertebra
d) 7th thoracic vertebra

38) The ligamentum arteriosum is ……………………. To the aortic arch

a) Anterior
b) Posterior
c) superior
d) inferior

39) the right coronary artery gives the following branches:

a) the marginal branch and the anterior interventricular artery
b) the marginal branch and the posterior interventricular artery
c) the circumflex branch and tha anterior interventricular artery
d) the circumflex branch and the posterior interventricular artery

40) the right coronary artery ends by anastomosing with …………….

a) the marginal branch
b) the anterior interventrricular branch
c) the circumflex branch
d) the posterior interventricular branch

41) which the following veins open into the middle of the coronary sinus
a) middle cardiac vein
b) venae cordis minimae
98
c) oblique vein of the left atrium
d) A and B
E) A and C

42) the great cardiac vein opens into

a) the right side of the coronary sinus
b) the left side of the coronary sinus
c) the middle of the coronary sinus
d) the right atrium

43) the small cardiac vein runs along the …………….

a) anterior interventricular groove
b) posterior interventricular groove
c) lower border of the heart
d) upper border of the heart

44) the anterior cardiac vein arise from the

a) right ventricle
b) left ventricle
c) right atrium
d) left atrium

45) which of the following aortic sinuses don't give coronary artery
a) anterior aortic sinus
b) right posterior aortic sinus
c) left posterior aortic sinus
d) non of the above

46) the posterior interventricular artery supplies

a) the posterior 2/3 of the interventricular septum
b) the posterior 1/3 of the interventricular septum
99
c) the anterior 2/3 of the interventricular septum

d) the anterior 1/3 of the interventricular septum

47- The origin of RT common carotid artery is

a- Arch of aorta.
b- Brachiocephalic.
c- Descending aorta.
d- ascending aorta.

48- The end of common carotid artery is

a- between T3 & T4.
b- between C2 &C3.
c- between C3 & C4.
d- between C1 & C2.

49- Which of the following is False about the beginning of External

carotid artey
a- at level of superior border of thyroid cartilage.
b- disc bet. C3 & C4.
c- at level of lower border of thyroid cartilage.

50- Which of the following is terminal branch of External carotid artey

a- Maxillary artery.
b- Mandibular artery.
c- Superfacial temporal artery.
d- a&c.
e- b&c.

51- Which artery pierces the trapezius muscle.

100
a- lingual artery.
b- facial artery.
c- Occipital artery.
d- post.auricle artery.

52- All of the following are branches of External carotid artery Except
a- Lingual artery.
b- Ascending pharyngeal artery.
c- Anterior auricle artery
d- superior thyroid artery

53-Internal carotid artery enter foramen.....

a- spinosum.
b- lacerum.
c- available.

54- Which of the following is False about terminal branches of Internal

carotid artery
a- Anterior cerberal artery.
b- Posterior cerebral artery.
c- Middle cerebral artery.

55- External jugular vein is formed by .......

a- posteroir auricle &anterior devision of retromandibular veins.
b-post.auricle& Post.devision of retromandibular veins.
C- sigmoid venous sinus.

56- All of the following are tributaries of External juglar vein Except
a- Transverse cervical vein.
b- suprascapular vein.
c- common facial vein.
101
d- Anterior jugular vein.

57- Internal juglar vein is acontinuation of ......

a- Transvers sinus.
b- Sigmoid sinus.
c- Cavernous sinus.

58- I.J.V descends medial to internal & common carotid arteries in

carotid sheath
a- True.
b- False.

59- I.J.V joining subclavian vein to form ........

a- Anterior juglar vein.
b- brachiocephalic vein.

60- All of the followingare branches of I.J.V Except

a- common facial vein.
b- Lingual vein.
c- inferior thyroid vein.
d- inferior petrosal sinus.

1- C
2- D
3- A
4- B
5- B
6- A
102
7- D
8- C
9- D
10- B
11- B
12- D
13- C
14- D
15- c
16- A
17- C
18- A
19 - A
20- D
21- C
22- B
23- D
24- A
25- B
26- B
27- A
28- B
29- B
30- A
31- D
32- B
33- C
34- A
35- C
36- D
37- B
103
38- D
39- B
40- C
41- E
42- B
43- C
44- A
45- B
46- B
47- B.
48-C.
49-C.
50-D
51-C.
52-C
53-B.
54-B.
55-B.
56-C.
57-B.
58-B.
59-B.
60-C.

104
1) The cranial end of the heart tube is connected to the
a) Ventral aorta
b) Dorsal aorta
c) Dorsal pulmonary
d) Ventral pulmonary

2) When the cardiac loop invaginate the pericardial cavity, the

pericardial cavity hangs by
a) Dorsal mesocardium
b) Ventral mesocardium
c) Dorsal endocardium
d) Ventral endocardium

3) Degeneration of the dorsal mesocardium leads to the formation

of the
a) Oblique sinus
b) Coronary sinus
c) Transverse sinus
d) Non of the above

4) The proximal part of the aorta and pulmonary arteries are

formed by the
a) Truncus arteriosus with the proximal part of the bulbus cordis
b) Truncus arteriosus with the distal part of the bulbus cordis
c) Sinus venosus with the proximal part of the bulbus cordis
d) Sinus venosus with the distal part of the bulbus cordis

5) The smooth part of the right and left ventricles are formed by
a) The proximal part of the ventricle chamber
105
b) The distal part of the ventricle chamber
c) The proximal part of the bulbus cordis
d) The distal part of the bulbus cordis

6) The sinus venosus receives venous blood from

a) 3 veins
b) 4 veins
c) 5 veins
d) 6 veins

7) The right and left valves of the sino-atrial orifice fuse cranially to
form
a) Atrial septum
b) Ventricular septum
c) Septum spurium
d) Non of the above

8) The smooth part of the left atrium is formed by the absorption of

a) Left horn of sinus venosus
b) Right horn of sinus venosus
c) Pulmonary artery
d) Pulmonary vein

9) Membranous part of inter-ventricular septum is formed by

a) Atrioventricular cushions.
b) Bulbar cushions.
C) Muscular part of interventricular septum.
d) all of the above.

10) Mitral & tricuspid valves are formed by

a) Atrioventricular cushions.
106
b) Bulboventricular cushions.
c) All of the above.

11) Pulmonary & aortic valves are formed by

a) Bulboventricular cushions.
b) Atrioventricular cushions.
c) All of the above.

12) Bulboventricular cushions are

a) 2 major cushions (ventral &dorsal) &2 minor (RT & Lt).
b) Ventral & dorsal cushions.
c) Rt & Lt Cushions.
d) 2 majors cushions (RT &Lt) & 2 minor (ventral& dorsal).

13) After rotation, pulmonary orifice has

a) 2 anterior cusps & 1 posterior cusp.
b) 2 posterior cusps & 1 ant, cusp.

14) Atrial septal defects (ASD) include the following except

a) Foramen secondum defect.
b) Foramen primum defect.
c) Core trilocular biatriam.
d) Core trilocular biventricular.

15) Fallot's tetralogy including the following except

a) Hypertrophy oh RT ventricle.
b) Pulmonary stenosis.
c) ASD.
d) Over riding of aorta.

16) Ectopic cordis meaning

107
a) Apex of heart lies on right side.
b) Absence of anterior thoracic wall so the heart exposed to exterior.

17) .......... bypass liver & joins the IVC

A) Foramen ovale.
b) Ductus arteriosus.
C) Ductus venosus.
d) Non of the above.

18) Which of the following connects the pulmonary trunk to the

aortic arch
a) Foramen secondum.
b) Ductus arteriosus.
c) Ductus venosus.
d) Non of the above.

19) Umbilical arteries becomes

a) Ligamentum venosum.
b) Ligamentum arteriosum.
c) Medial umbilical ligament.
d) Round ligament of the liver

20) The dorsal aorta will become

a) Ascending aorta.
b) arch of aorta.
c) descending aorta.

21) the 1st aortic arch disappears completely:

a) True.
b) false.

108
22) the 2nd aortic arch disappears except part forming.....
a) Maxillary artery.
b) stapedial artery.
c) Mandibular artery.

23) Internal carotid artery is formed by:

a)distal segment of the 3rd arch.
b) Dorsal aorta cranial to the 3rd arch.
c) Dorsal aorta caudal to 3rd arch.
d) a&c.
e) a&b.

24) The arch of the aorta is formed by all the following Except:
a) left 4th arch
b) left horn of aortic sac.
c) right horn of aortic sac.
d) distal aorta distal to the 4th arch.

25) which of the following formed pulmonart artery on each side:

a) proximal segment of the 6th arch .
b) the bud of 6th arch.
c) distal segment of 6th arch.
d) a&b.
e) b&c.

26) The distal segment of 6th arch gives:

a) ductus arteriosus on the Rt side.
b) pulmonary artery.
c) ductus arteriosus on the LT side.

27) The left recurrent laryngeal nerve hooks around :

109
a) left Subclavian artery.
b) right subclavian aretery.
c) ligamentum arteriosus.

28) According to preductal coarctation :

a) coarctation lies after the origin of subclavian artery.
b) coarctaction lies before the ligamentum arteriosus.
c) accompanied by oblitration of ductus arteriosus.
d) accompanied by patent ductus arteriosus.
e) b&c.
f) b& d.

29) In Retropharyngeal subclavian artery, the RT subclavian artery is

formed by:
a) Rt 4th aortic arch.
b) 7th RT cervical intersegmental artery.
c) proximal part of RT dorsal oarta.
d) small distal portion of RT dorsal artery.
e) b&c.

1- B
2- A
3- C
4- B
5- C
6- D
7- C
8- D
110
 9- D
10- A
11- A
12- D
13- A
14- C
15- C
16- B
17- C
18- B
19- C
20-C.
21-B.
22-B.
23-E.
24-C.
25-D.
26-C.
27-C.
28-F.
29-E.

1) The layer uniting the myocardium with the subendothelial layer is

a) Endothelial layer
b) Subendocardial layer
c) Subepicardial layer
d) Non of the above
111
2) The epicardium forms the visceral layer of pericardium
a) True
b) False

3) Concerning the cardiac valves which of the following is true

a) They are folds of the endocardium
b) Their core is of dense vascular C.T
c) They are a modified cardiac muscle
d) Non of the above

4) The base for the cardiac valves is called

a) Myocardium
b) Cardiac muscle fibers
c) Fibrous skeleton of the heart
d) Non of the above

5) The cardiac muscle structure corresponding to the endomysium

of the skeletal muscle is
a) collagen and elastic fibers between bundles of cardiac muscle
fibers
b) A net of reticular fibers and fine elastic fibers between bundles of
cardiac muscle fibers
c) A net of reticular fibers and fine collagen fibers surrounding each
muscle fiber

6) Concerning the cardiac muscle fibers

a) Long cylindrical fibers with branches and anastomoses
b) Fainter striations
c) Cardiomyocytes are joined end to end by intercalated discs
d) All of the above

112
7) Fainter striations of the cardiac muscle fibers is due to
a) Lesser myofibrils in the cardiac fibers
b) The branching and anastomoses of the myofibrils
c) The myofibrils are not perfectly in register with one another
d) b&c

8) The following is not true concerning T tubules of the cardiac

muscle fibers EXCEPT
a) Smaller than those of skeletal muscle fibers
b) There are 2 T tubules per sarcomere
c) Facilitate access of ca from the extra cellular space
d) Associated from both sides with saccules of the sarcoplasmic
reticulum

9) Concerning the intercalated discs

a) They have a transverse portion and oblique portion
b) Contain only one type of intercellular junction
c) Allow separation of cardiomyocytes during contraction
d) Non of the above

10) The desmosomes resemble the macula adherence of epithelial

cells in
a) The attached intermediate filaments are desmin
b) They both give attachment to intermediate filaments
c) a&B

11) The intercellular junction in the longitudinal portion of the

intercalated discs are
a) Macula adherence
b) Fascia adherence

113
c) Gap junction
d) A &B

12) In comparison with the skeletal muscle fibers, the cardiac fibers
have
a) More and larger mitochondria
b) More glycogen granules
c) Lipid droplets
c) All of the above

13) The layer of the blood vessel that is related to the function of
the vessel is the
a) Tunica intima
b) Tunica media
c) Tunica advebtitia
d) Non of the above

14) In the tunica intima, the condensation of the elastic element

externally forming
a) The endothelium
b) Sub endothelium
c) Internal elastic lamina
d) External elastic lamina

15) The vasa vasora is present in the

a) Tunica intima
b) Tunica media
c) Tunica advebtitia
d) Non of the above

16) The tunica adventitia is more thick in the

114
a) Large artery
b) Medium sized artery
c) Arterioles

17) The pulmonary arteries contain …………… than other arteries of

the same size
a) Less muscular and elastic tissue
b) More muscular and elastic tissue
c) More muscular but less elastic
d) Less muscular but more elastic

18) In the large arteries , which of the following is responsible for

the production of the elastic lamellae and extracellular component
??
a) The endothelium of the tunica intima
b) The smooth muscles in the tunica media
c) The amorphous ground substance of the tunica media
d) Non of the above

19) The number and thickness of the elastic laminae is related to

the
a) Size of the artery
b) Type of the vessel
c) Age and blood pressure
d) Non of the above

20) The subendothelium contain smooth muscle in which of the

following
a) Large elastic artery
b) Medium sized artery
c) Arterioles
115
 d) All of the above

21) The internal and external elastic lamina is well defined and
evident in the
a) Large elastic artery
b) Medium sized artery
c) Arterioles
d) Non of the above

22) All of the following chracteristic of the arterioles Except:

a) thick wall & narrow lumen.
b) its diameter 100 µ or less .
c) has external elastic lamina.
d) the media is formed of 2 layers of smooth muscles.

23) Weibel-palade granules contain:

a) Factor II.
b) Factor III.
c) Factor VIII.
d) non of the above.

24) Tunica media in large veins forms :

a) 50%.
b) 70%.
c) 10%.
d) 30%.

25) All of the following about tunica adventitia in large veins Except:
a) forms 70%.
b) consists of fibro-elastic C.T
c) longitudinal-arranged smooth muscle.
116
d) longitudinal collagens fibers.

26) Which of the following vessles contain cardiac muscle :

a) Tunica adventia of large veins.
b) pulmonary arteries.
c) all of the above.

27) Medium-sized vein contain elastic fibers:

a) True.
b) False.

28) Tunica intima well developed in:

a) large veins.
b) medium-sized vein.
c) medium –sized artery.
d) a&c.

29) Tunica media forms 50% in :

a) medium-sized vein.
b) medium-sized artery.
d) large artery.
e) large vein.

30) All of the following are True about valves of veins Except:
a) permit the flow of blood in one direction,toward the heart.
b) abundent in veins of extremities.
c) present in veins of thorax &abdomen.

31) 1-2 layers of smooth muscles in tunica media present in:

a) Arterioles.
b) Muscular venules.
117
c) all of the above.

32) the diameter of the capillary is about

a) 5-10 μm
b) 7-9 μm
c) 9-12 μm
d) 12-15 μm

33) according to capillary , the single layer of flat endothelial cells is held
together by …………
a) anchoring junction
b) adhering junction
c) communicating junction
d) tight junction

34) according to the met arterioles

a) the ressemble wide arterioles
b) the have double layers of endothelial lining
c) the supply many capillaries
d) they contain continuous layer of smooth muscle fiber

35) all of the following are true according to the pericytes except
a) they are mesenchymal cells
b) they completely surround the endothelial cells
c) the have long cytoplasmic processes
d) the help in the repair process

36) type 1 capilaries is found in the ………

a) lung
b) endocrine glands
c) intestine
118
d) glomerioli

37) the type 2 capillaries is found in the following sites except

a) intestine
b) endocrine glands
c) skin
d) glomerioli

38) which type of capillaries enter the structure of the blood brain
barrier
a) muscle type
b) visceral type
c) sinusoids
d) metareterioles

39) the diameter of the lumen of the blood sinusoids is about ……………..
a) 30 μ or more
b) 20 μ or more
c) 10 μ or more
d) 5 μ

40) …………………… are contractile

a) muscle capillaries
b) visceral capillaries
c) blood sinusoids
d) A-V shants

41) …………………. Are found in large lymphatic vessels but not found in
the A-V shants
a) collagen fibers
b) elastic fibers
119
c) reticular fibers
d) type 1 collagen fibers.

1- B
2- A
3- A
4- C
5- C
6- D
7- D
8- C
9- D
10- B
11- C
12- C
13- B
14- C
15- C
16- B
17- A
18- B
19- C
20- A
21- B
22-C.
23-C.
24-D.
25-D.
26-C.

120
 27-B.
28-D.
29-B.
30-C.
31-C.
32- C
33- D
34- C
35- B
36- A
37- C
38- A
39- A
40- D
41- B

1) Inflammatory change in the heart caused by rheumatic fever is:

a) Endocarditis.
b) Pericarditis.
c) pancarditis.
d) Myocarditis.

2) Alpha heamolytic streptococci:

a) cause complete lysis of RBCs.
b) cause partial destruction of RBCs.
c) are unable to heamolyse RBCs.

3) The complete heamolysis of beta heamolytic streptococci resulting in :

a) Clear zone around the colonies.

121
b) Greenish ring around the colonies.
c) no effect on the blood agar.

4) The lancefield grouping depending on the ………….. of the bacterial

cell-wall :
a) proteins.
b) peptedoglycans.
c) C-carbohdrate.
d) Lipoteicoic acid.

5) All of the following are the morphology of str. Pyogenes except :

a) non motile.
b) non sporing.
c) impede phagocytosis.
d) gram negative cocci.

6) Srt. Pyogenes is :
a) catalase negative and not sensitive to bacitracin.
b) catalase positive and not sensitive to bacitracin.
c) catalase negative and sensitive to bacitracin.
d) catalase negative and not sensitive to bacitracin.

7) The virulence of group A streptococci is determined by the presence

of :
a) hyaluronic acid.
b) M protein.
c) lipoteichoic acid.
d) all of the above.

8) The …………….. enzyme works to break up and dissolve blood clots:

a) Hyaluronidase.
122
b) streptokinase.
c) Heamolysins.
c) Streptococcal pyrogenic exotoxin.
9) All of the following are true about streptolysin S (SLS) except:
a) is not activated by oxygen.
b) Oxygen labile.
C) is not antigenic.

10) All of the following are true about Viridans streptococci except:
a) produce partial heamolusis and green colouration around around
colonies.
b) is not bile soluble.
c) Gram positive cocci.
d) their growth is inhibited by optochin disc.

11) The most common cause of bacterial endocarditis is :

a) enterococci.
b) staphylococci.
c) viridans streptococci.
d) candida albicans.

12-Enterococci are a normal flora of:

a) Lower respiratory tract
b) Urinary tract
c) Upper intestinal tract
d) lower intestinal tract

13- NaCl and bile salt inhibit the growth of enterococci ( )

14- ………………… can produce catalase enzyme

a) enterococci
123
b) streptococci pyogens
c) Staph Epidermidis
d) candida albican

15- Enterococcus faecalis can cause all of the following except

A) surgical wound infection
b) intestinal tract infection
c) bacteremia
d) endocarditis

16- effect of enterococci on blood agar is .

A) Beta haemolysis
b) alpha haemolysis
c) no haemolysis
d) all of the above

17- which of the following is not an antigen of staph aureus

a) teichoic acid
b) capsular polysaccharide
c) receptor for streptococcal bacteriophage
d) protein A

18- which of the following is considered a superantigen of

Staphylococci
a) Haemolysin
b) enterotoxin
c) exofoliative toxin
d) leucocidine

19- the enzyme responsible for formation of septic metastasis in Staph

is
124
a) coagulase
b) staphylokinase
c) beta lactamase
d) catalase
20- staph epidermidis is novobiocin positive ( )

1- C
2-B
3- A
4- C
5- D
6- C
7- D
8- B
9- B
10- D
11-C
12- D
13- False
14- C
15- B
16- D
17- C
18- B
19- B
20- True

125
1) the concentration of ATP in the heart is variable:
a) True.
b) False.
2) the ATP resynthesied mainly by:
a) Oxidative phosphorylation.
b) glycolytic payhway.

3) Which of the following produce Acetyl-CoA:

a) Fatty acid oxidation.
b) protein oxidation.
c) carbohydrate oxidation.
d) a&c.

4) which of the following accounts for 60-80% of the ATP synthesis

in the heart:
a) Glucose.
b) lactate.
c) fatty acid.

5) Lipolysis ( triglyceride breakdown) is inhibited by:

a) Dopamine.
b) insulin.
c) Adrenaline.

6) All of the following about Fatty-acyl-CoA except:

a) convert to fatty acid carnitine.
126
b) Shuttle into mitochondria by carnitine shuttle system.
c) it's permeable to mitochondria membrane.

7) Which is the 1ry source of CHO fuel for the myocardium:

a) extracelluar glucose.
b) glycogen stores.
c) extracellular lactate.
d) all of the above.

8) GLUT1 is predominant in myocardium:

a) True.
b) False.

9) Pyruvate produces by:

a) glycolysis.
b) oxidation of lactate
c)oxidation of fatty .
d) a&b.
e) b& c.

10) PDH is activated by

a) phosphorylation.
b) dephoshorylation.
c) PDH kinase.
d) PDH phosphatase.
e) a&c.
f) b&d.

127
11) All of the following are about Myoglobin except:
a) low molecular –weight.
b) haem-containing protein.
c) it's cardiac specific.
d) found in skeletal & cardiac muscle.

12) CK-MM presents mainly in :

a) cardiac muscle.
b) striated muscle.
c) brain.
d) colon.

13) which is specific for myocardial damage:

a) CK-BB.
b) CK-MM.
c) CK-MB.

14) AST&LDH are commenly of practical value in management of pts

with suspected myocardial infarction.
a) True.
b) False.

15) There are structural differences between cardiac & SK.muscle

TnC.
a) True.
b) False.

128
16) Troponins are not early markers of acute myocardial infarction:
a) True.
b) False.

17) Which type of Troponins is elevated in chronic renal failuar:

a) TnC.
b) TnT.
c) TnI.

1-B.
2-A.
3-D.
4-C.
5-B.
6-C.
7-D.
8-B.
9-D.
10-F.
11-C.
12-B.
13-C.
14-B.
15-B.
16-A.
17-B.

129