SF4 Questions b.

gives rise to the coronary sinus

c. gives rise to the superior vena cava
1. Which of the following would be a cause of cor pulmonale? d. opens into the truncus arteriosus
a. right ventricular hypertrophy
b. left ventricular hypertrophy 11. The great cardiac vein drains into:
c. pulmonary oedema a. right atrium
b. left atrium
2. Which of the following would not be associated with increased pulmonary vascularization? c. coronary sinus
a. Patent ductus arteriosus d. middle cardiac vein
b. Atrial septal defect
c. Ventricular septal defect 12. Which of the following is the intrinsic conducting system present in the interventricular
d. Aortic dissection septum?
a. Sinoatrial node
3. Which of the following travels in the Posterior Interventricular groove with the Posterior b. Purkinje fibres
Interventricular artery? c.the bundle of His and its branches
a. Middle Cardiac Veins d. the atrioventricular node
b. Great Cardiac Vein
c. Small Cardiac Vein 13. Increasing the preload in cardiac muscle will
d. Anterior Cardiac Vein a. reduce ventricular end diastolic pressure
b. increase ventricular wall tension
4. Which of the following travels with the Anterior Interventricular Artery? c. decrease peak tension in the ventricular muscle
a. Middle Cardiac Veins d. decrease the time for the ventricular muscle to reach peak tension
b. Great Cardiac Vein
c. Small Cardiac Vein 14. Stimulation of the high pressure baroreceptors is associated with
d. Anterior Cardiac Vein a. increased cardiac contractility
b. increased heart rate
5. What is the origin of the visceral pericardium? c. increased discharge rate of vagal efferent neurons
a. Myoepicardial mantle d. decreased systolic blood pressure
b. Septum traversum
c. Somatopleural mesoderm 15. An ECG shows an RR interval of 0.8s. What is the heart rate?
d. Epicardial mesoderm a. 72 beats per minute
b. 75 beats per minute
6. Where is the anterior border of the oblique sinus found? (not sure of question) c. 100 beats per minute
a. Oesophagus d. 120 beats per minute
b. Left atrium
c. Left ventricle
d. Fibrous pericardium
16. Starling’s Law of the heart
7. Which of the following does NOT drain directly into the right atrium? a. does not operate in the failing heart
a. Superior Vena Cava b. explains the increase in heart rate during exercise
b. Inferior Vena Cava c. explains the increase in cardiac output when venous return increases
c. Right Superior Pulmonary Vein d. explains the increase in cardiac output when sympathetic input to the heart is
d. Coronary Sinus stimulated

8. Where does lymph drainage occur? 17. A decrease in cardiac output is associated with
a. bone a. high environmental pressure
b. skeletal muscles b. pregnancy
c. cartilage c. sitting or standing from a lying position
d. cns d. anxiety and excitement

9. The superior Vena Cava is:
a. formed by the joining of the left brachiocephalic vein and left subclavian vein
b. formed at the lower border of the thyroid cartilage.
c. formed at the lower border of the left 1st costal cartilage.
d. formed at the lower border of the right first costal cartilage
10. The sinus venosus:
a. is on the arterial end of the endothelial heart tube
18. Which of the following is not associated with an increase in heart rate ?
a. decreased activity in baroreceptors in the arteries, left ventricle and pulmonary
circulation
b. increased activity of atrial stretch receptors (inc in sv, dec in hr)
c. Bainbridge reflex
d. Increased intracranial pressure
19. Which organ receives the greatest blood flow per 100ml of tissue?
 a. kidney a. Used to treat Type IIA & TypeIIB hypertensive
b. liver b. Used when genetic defect in LDL receptor
c. brain c. Causes cataract formation
d. heart muscle d. Prevents mevolonic acid converted to cholesterol

20. Which of the following slows conduction through the atrioventricular node and has its primary 29. Diastolic heart failure is characterized by:
action on L-type Calcium channels? a. Decrease cardiac output
a. Adenosine b. Absence of pulmonary edema
b. Esmolol
c. Lidocaine 30. Which drug has the largest half-life:
d. Verapamil a. Quinidine
b. Amiodarone
21. Which of the following would be used to treat digoxin overdose? c. Atenolol
a. Lidocaine d. Digoxin
b. Magnesium
c. Digoxin antibodies 31. Which of the following drugs has the longest half life?
d. Potassium (Slow K) a. amiodarone
b. lignocaine
22. All of the following are associated with right heart failure except c. digoxin
a. ascites d. dysopyramide
b. swelling of the lower extremities
c. pulmonary oedema 32. Which of the following has the longest half life?
d. jugular venous distension a. Amiodarone
b. Quinidine
c. Dysopyramide
d. Procainamide
23. Which of the following is associated with angiotensin?
a. peripheral vasodilation 33. When there is a total lack of transmission of excitation from atria to ventricles it is
b. aldosterone secretion a. 1st degree heart block
c. Sodium and water loss b. Sinus Sickness
d. Regression in size of cardiac myocytes c. 2nd degree heart block
d. 3rd degree heart block
24. Which antilipaemic agent is paired correctly with its effects?
a. Cholestyramine – antioxidant effect (prevents the oxidation of LDL) 34. P wave of ECG represents:
b. Niacin – inhibits cholesterol synthesis a. Atrial depolarization
c. Ezetimibe – prevents absorption of dietary cholesterol b.Ventricular depolarization
d. Privastatin – prevents absorption of bile salts c.Sinoatrial automaticity
d. Ventricular repolarization
25. Hyperglycemia is likely to occur in treatment of hypertension with
a. Frusemide 35. What is the normal range of ECG?
b. Atenolol a. 3-6
c. Prazosin b. 1.5 – 4
d. Bendrofluazide c. 6–8

26. Pulmonary vascularity is increased in all of the following except? 36. Which does not reduce mortality in CCF?
a. PDA a. Propanolol
b. VSD b. Digoxin causes arrhythmias
c. ASD c. Diuretic
d. PS
37. Woman treated with thiazide, digoxin and beta1-blocker. What effect would adding
27. The definition of hypertension has improved significantly over the last 40 years. The reason procainamide to the regimen have? Reduce arrhythmias
for this is:
a. The increased prevalence of hypertension worldwide 38. Which of the following is clinically relevant or physiological important for positive inotropic
b. The improved efficacy of anti-hypertensive drugs effect?
c. The recognition of adverse prognosis with lower blood pressures a. Digoxin
d. The better side effect profile of anti-hypertensive drugs b. Enalopril
c. Adrenaline – chronotropic i.e. inc hr
28. Which statement about HMGCoA reductase is incorrect? d. Captopril – ace inhibitor
 47. A 70 year old male has a systolic blood pressure and a diastolic blood pressure of 90mmHg.
Which pair represents his mean arterial pressure and his pulse pressure?
a. 140mmHg : 90mmHg
39. An infant, cyanotic at birth, eventually dies at 5 weeks what is the most likely explanation for b. 100 mmHg: 30mmHg
the Congenital Heart Failure? c. 120mmHg : 40mmHg
a. TOF d. 120mmHg : 30mmHg
b. TGA
c. CoA 48. A 70 kg man has a systolic pressure of 120 mm Hg and a diastolic pressure of 80 mm Hg.
d. PDA Which would be his arterial pressure and his pulse pressure?
a. 100, 10 mm Hg
40. The five week old infant, cyanotic from birth died of congestive cardiac failure. Which b. 70, 90
condition did he have? c. 100, 30
a. Tetralogy of fallot d. 90, 30
b. Transposition of the great arteries
c. Patent ductus arteriosius 49. Which of the following classes of drugs is NOT used in the treatment of systolic heart failure?
d. Ventro septal defect a. Diuretics
b. Inotropics
41. Which is least likely explanation for congestive cardiac failure in young children? c. Arterial vasodilators - nitrates
a. Severe Coarctation of Aorta d. Venous vasoconstrictors
b. Large Ventricular Septal Defect
c.TOF 50. Which of the following is the most common anatomical site of an atherosclerotic (aortic?)
d. PDA aneurysm?
a. thoracic aorta
42. 1st degree heart block is characterized by: b. supra-renal abdominal aorta
a. QT > 0.20s c. infra-renal abdominal aorta
b. QT >0.40s d. renal arteries
c. PR >0.12s
d. PR >0.20s 51. The pumping action of the heart is done by the:
a. endocardium
43. Which of the following is an irregular cardiac rhythm? b. pericardial sac
a. sinus tachycardia c. myocardium
b. atrial fibrillation d. epicardium
c. ectopic atrial tachycardia
d. ventricular tachycardia 52. Inserting a chest tube
a. Is a non-surgical procedure
44. Vasodilation of arterioles in most tissues is produced by b. Requires presence of a thoracic surgeon
a. Decrease local temperature c. Cannot be performed safely outside of an operating theatre
b. Increase discharge for nor-adrenergic vasomotor nerves d. May be a life saving maneuver in the emergency room
c. Circulating Na+/K+ Inhibitors
d. Decrease local pH

45. Which Beta1 antagonist is used in the treatment of congestive heart failure? 53. Which of the following can be used to treat digitoxin toxicity?
a. Atenolol a. Lignocaine
b. Dobutamine b. Magnesium
c. Captopril c. Slow potassium
d. Digoxin d. ? antibodies

54. Which are features of left ventricular failure?

a. Pleural effusion
b. Pulmonary oedema
46. All of the following have been shown to reduce the mortality of congestive heart failure c. Hepatomegaly
except:
a. Captopril 55. Which is a beta-1 selective antagonist used to treat hypertension?
b. Atenolol a. atenolol
c. Digoxin b. propranolol
d. Quinidine c. cimetidine
56. A 62-year-old man has a complete thrombotic occlusion of his left circumflex artery. Which of a. Dehydration
the following is likely to occur within an hour? b. Renal failure
a. syncope c. Hypotension
b. thromboembolism d. Pancreatitis
c. arrhythmia
66. All of the following may be used to assess blood flow except:
57. Regarding rheumatic fever, which is incorrect? a. CT
a. it is a sequel of beta haemolytic streptococcal infection b. Conversional angiography
b. blood samples show active infection with beta-haemolytic streptococcus group A c. Magnetic resonance imaging
c. it occurs mostly in children d. Plain x-ray
d. the preferred prophylaxis is intramuscular penicillin once per month
67. What gives the embryologic origin of crista terminalis?
58. Cardiac tamponade may be associated with a. Left venous valve of sinus venosus
a. tension haemothorax b. Right venous valve of sinus venosus
b. cardiogenic shock c. Body of sinus venosus
c. sepsis d. Septum Primum

59. Conduction of the rhythmic electrical activity of the heart begins by activity in the:
a. Sinoatrial node
b. Atrio ventricular node
c. Atria 68. Which group of lymph nodes does the cephalic vein drain into?
d. Ventricles a. Posterior axillary lymph nodes
b. Central axillary lymph nodes
60. The normal rhythm of contraction of heart is controlled by c. Infraclavicular lymph nodes
a. SA Node d. Epitrochlear lymph nodes
b. AV Node
c. Bundle of His 69. Which of the following structures forms a part of the anterior boundary of the transverse
d. Ventricular muscle sinus of the pericardium?
a. pulmonary trunk

70. A 45 y-o grand multipara presents to have a hysterectomy done because of particular
61. Which of the following would be a good serum indicator of heart failure? troublesome leiomyomata uterii. Her preoperative evaluation reveals her to be hypertensive,
a. insulin 160/100.
b. brain natriuretic peptide
c. adrenalin In what category of HTN does she fall?
a. Malignant
62. Which of the following is incorrect about the ECG? b. Severe
a. Right axis deviation is between -90 and +120 degrees and is caused by right c. Mild
ventricular hypertrophy d. Moderate
b. The normal electrical axis of the heart is -30 to +120 degrees
c. Left axis deviation is between + 120 and – 180 degrees and is caused by left 71. Which does not affect the flow of blood to the muscle?
ventricular hypertrophy a. [K+]
d. Right axis deviation is between – 30 and – 90 degrees and is caused by right b. [Na+]
ventricular hypertrophy c. [Ca2+]
d. temperature
63. The primary regulator of electrolytes in blood is:
a. The renin-angiotensin-aldosterone system 72. All of the following increase the flow of blood to the muscle during exercise except:
b. Antidiuretic hormone a. low K+
c. Baroreceptors b. increased temperature to the muscle
d. The adrenergic system c. increased pCO2
d. increased H+
64. Which cardiomyopathy would have caused obstructed left ventricular outflow?
a. Dilated 73. Which of the following does not cause vasodilation?
b. Hypertrophic a. decreased CO2
c. Endocardial fibrosis b. decreased H+
d. Restrictive c. K+
d. muscle temperature
65. Which of the following non-infectious response can trigger response identical to sepsis?
74. Which of the following causes of major chest injury is correct? b. nitroglycerine
a. securing airway is never a problem c. hydralazine
b. Patients are usually able to breathe properly d. propanolol
c. The amount of energy transferred is trivial
d. Life threatening injuries are common 83. Which of the following is a most likely early complication?
a. ventricular aneurysm
b. arrythymias

84. Three hours post presentation he just ups and dies. On Post Mortem, which of the following
75. Congenital heart failure in infancy changes is most likely to be seen on the affected myocardium?
a. Results from untreated Tetralogy of fallot a. pale
b. Results in poor weight gain and linear growth b. haemorrhagic
c. Is associated with respiratory symptoms c. yellow
d. Is not treated with diuretics d. normal

76. Drug used for hypertension in patients with severe failure 85. Which is least important independent factor resulting in risk for Cardiovascular disease?
a. Indapamide a. smoking
b. Frusamide b. hyperlipidaemia
c. Bendroflumazide c. diabetes mellitus
d. Acetozolamide d. obesity

77. During exercise a man consumes 1.8L/min of oxygen. His arterial blood containing 190ml/L 86. A 30 y-o female presents with lower limb oedema and dyspnoea. On exam she is found to
and his mixed venous blood contains 134ml/L. From these figures, what is his estimated cardiac have a pansystolic murmur in the left fifth intercostal space. She then reports having been
output? admitted to hospital 20 years aback for fever and sore throat.
a. 3.2L/min
b. 16L/min Most likely aetiologic agent is?
c. 32L/min a. group D beta haemolytic streptococcus
d. 54L/min b. group A beta haemolytic streptococcus
c. staph aureus
78. Increasing viscosity of blood would d. staph epidermidis
a. increase cardiac output
b. increase mean blood pressure 87. The valve/s most likely to be affected from such an involvement is/are?
a. mitral only
79. Which of the following directly stimulates the vasomotor centre? b. aortic only
a. K + concentration c. mitral and aortic
b. Ca 2+ concentration d. mitral aortic and tricuspid
c. O 2 and CO 2 Concentration
88. The latest complication to occur from such an involvement is?
80. Which of the following is the true about ductus arteriosus? a. fusion of the chordae tendinea
a. blood flows through it from the pulmonary artery to the aorta. b. fusion of the commisural edges
b. blood flows through it from the aorta to pulmonary artery c. thickening of the valve leaflets
c. Joins the umbilical artery and internal iliac artery d. vegetations
d. It becomes the ligamentum arteriosus

81. A 45 y-o man has a 6 hour history of crushing, retrosternal chest pain that radiates to left
shoulder tip, dyspnoea, and diaphoresis. He is tachycardic at 140/min his BP is 160/120. 89. Anxiety before a major sporting event gives rise to all of the following except:
a. tremor
Which of the following is the most appropriate immediate investigation? b. increased venous return
c. increased respiratory rate
a. troponin I d. increased heart rate
b. LDH
c. CXR 90. Which of the following is not increased in exercise?
d. EKG (some say ECG) a. arterial BP
b. resting respiratory rate
c. [lactic acid]

82. Which of the following agents would be most effective in reducing his BP? 91. For the treatment of angina pectoris all of the following are used except
a. verapamil a. Nitroglyceride
 b. Nitrate d. decrease peripheral systemic blood pressure

92. Which of the following drugs can be given orally (sublingually) for the treatment of 101. To which stage does the third heart sound correspond?
angina
a. Amyl Nitrate a. a wave
b. Nitroglycerin b. c wave
c. Isosorbite Nitrate c. x descent
d. Erythrtyl tetranitrate d. y descent

93. An increase in which is most likely associated with pulmonary congestion 102. Which of the following statements concerning the action of loperimide is correct?
a. minimum left ventricular pressure a. It activates muscarinic receptors
b. left ventricular end diastolic pressure b. It activates peripheral opiate receptors only
c. mean left atrial pressure c. It has a moderate laxative action
d. mean atrial a wave pressure gradient d. It stimulates acetylcholine release

94. In imaging of the heart 103. In which condition is infective endo valve involvement least likely?
a. M-mode U/S gives good anatomical information on each chamber a. Prosthetic valves
b. Nuclear medicine (Scintigraphy) can be used to evaluate ischemian b. Valves in chronic rheumatic heart disease
c. Papilliary muscle can be identified on plain chest X-Ray c. ASD
d. Anatomical structures are superimposed on Computed Topography Scan d. VSD
Images

95. Which of the following increase immediately after haemorrhage?

a. HR
b. CO
c. VR 104. Which valve is most likely to see involvement in chronic rheumatic heart disease?
d. firing of baroreceptors a. Mitral
b. Tricuspid
96. Arterial occlusion c. Pulmonary
a. may be treated with systemic thrombolytics d. Aortic
b. is usually treated by emergency bypass grafting
c. may be associated with atrial fibrillation 105. Stimulation of the vagus results in:
d. only occurs in elderly patients a. Hyperpolarization of the SA node
b. Depolarization of the SA node
c. Quicker conduction through AV node

97. In regards to a patient with pneumothorax: 37. Which of the following travels in the Posterior Interventricular groove with the Posterior
a. These patients have had a penetrating injury in every case Interventricular artery?
b. clamping of the chest tube is done as a safety measure a. Middle Cardiac Veins
c. an open pneumothorax is better than a tension pneumothorax b. Great Cardiac Vein
d. cardiac output is not affected c. Small Cardiac Vein
d. Anterior Cardiac Vein
98. What drug can be used to block the anti-muscarinic affects of quinidine?
a. Digoxin 38. Which of the following travels with the Anterior Interventricular Artery?
b. Propranolol a. Middle Cardiac Veins
c. Pirenzipine b. Great Cardiac Vein
d. pyridostigmine inc muscular effect c. Small Cardiac Vein
d. Anterior Cardiac Vein
99. Which of the following does not occur during systole?
a. isovolumetric contraction 39. What is the origin of the visceral pericardium?
b. isovolumetric relaxation a. Myoepicardial mantle
c. aortic valve opening b. Septum traversum
d. atrial filling c. Somatopleural mesoderm
d. Epicardial mesoderm
100. In exercise physiology, CO is augmented by:
a. increase sympathetic stimulate on 48. Where is the anterior border of the oblique sinus found? (not sure of question)
b. vasoconstriction in skeletal muscle a. Oesophagus
c. increase peripheral resistance to VR b. Left atrium
 c. Left ventricle f. increase ventricular wall tension
d. Fibrous pericardium g. decrease peak tension in the ventricular muscle
h. decrease the time for the ventricular muscle to reach peak tension
49. What is the surface marking of the parietal pleura?nnjj
151. Stimulation of the high pressure baroreceptors is associated with
a. Midclavicular line 6th rib a. increased cardiac contractility
b. Midaxillary line 8th rib b. increased heart rate
c. increased discharge rate of vagal efferent neurons
50. Which of the following does NOT drain directly into the right atrium d. decreased systolic blood pressure
a. Superior Vena Cava
b. Inferior Vena Cava 152. An ECG shows an RR interval of 0.8s. What is the heart rate?
c. Right Superior Pulmonary Vein e. 72 beats per minute
d. Coronary Sinus f. 75 beats per minute
61. Where does lymph drainage occur? g. 100 beats per minute
a. bone h. 120 beats per minute
b. skeletal muscles
c. cartilage 153. Starling’s Law of the heart
d. cns e. does not operate in the failing heart
63. Which of the following is the true about ductus arteriosus. f. explains the increase in heart rate during exercise
a. blood flows thru it from the pulmonary artery to the aorta. g. explains the increase in cardiac output when venous return increases
b. blood flows thru it from the aorta to pulmonary artery h. explains the increase in cardiac output when sympathetic input to the heart is
c.Joins the umbilical artery and internal iliac artery stimulated
d It becomes the ligamentum arteriosus
154. A decrease in cardiac output is associated with
79. The superior Vena Cava is: a. high environmental pressure
e. formed by the joining of the left brachiocephalic vein and left subclavian vein b. pregnancy
f. formed at the lower border of the thyroid cartilage. c. sitting or standing from a lying position
g. formed at the lower border of the left 1st costal cartilage. d. anxiety and excitement
h. formed at the lower border of the right first costal cartilage
155. Which of the following is not associated with an increase in heart rate ?
112. The ductus arteriosus: a. decreased activity in baroreceptors in the arteries, left ventricle and pulmonary
a. transports blood from the pulmonary artery to the aorta circulation
b. transports blodd from the aorta to the pulmonary artery b. increased activity of atrial stretch receptors
c. becomes the ligamentum arteriosus just before birth c. Bainbridge reflex
d. is between the iliac and umbilical vein d. Increased intracranial pressure

128. The sinus venosus: 156. Which of the following has the greatest blood flow per 100ml of tissue?
a. is on the arterial end of the endothelial heart tube a. brain
b. gives rise to the coronary sinus b. heart muscle
c. gives rise to the superior vena cava c. liver
d. opens into the truncus arteriosus d. kidney

133. The great cardiac vein drains into: 157. Which of the following slows conduction through the atrioventricular node and has its
a. right atrium primary action on L-type Calcium channels?
b. left atrium a. Adenosine
c. coronary sinus b. Esmolol
d. middle cardiac vein c. Lidocaine
d. Verapamil
149. Which of the following is the intrinsic conducting system present in the interventricular
septum? 158. Which of the following would be used to treat digoxin overdose?
a. Sinoatrial node a. Lidocaine
b. Purkinje fibres b. Magnesium
c. The bundle of His9+816 and its branches c. Digoxin antibodies
d. The atrioventricular node d. Potassium (Slow K)

150. Increasing the preload in cardiac muscle will 159. Which of the following would you use to increase urine output in a hypertensive patient
e. reduce ventricular end diastolic pressure with benign prostate hyperplasia?
 a. Prazosin c. ASD
b. Propranolol d. PS
c. Bendofluazide
d. Metoprolol 196. The normal rhythm of contraction of heart is controlled by
a. SA Node
160. All of the following are associated with right heart failure except b. AV Node
e. ascites c. Bundle of His
f. swelling of the lower extremities d. Ventricular muscle
g. pulmonary oedema
h. jugular venous distension 197. A male of 70kg has a systolic blood pressure of 120 and diastolic pressure of 90mmHg.
Calculate the Mean Arterial pressure and Pulse pressure
161. Which of the following is associated with angiotensin?
e. peripheral vasodilation
f. aldosterone secretion 201. The definition of hypertension has improved significantly over the last 40 years. The
g. Sodium and water loss reason for this is:
h. Regression in size of cardiac myocytes a. The increased prevalence of hypertension worldwide
182. Which antilipaemic agent is paired correctly with its effects? b. The improved efficacy of anti-hypertensive drugs
e. Cholestyramine – antioxidant effect (prevents the oxidation of LDL) c. The recognition of adverse prognosis with lower blood pressures
f. Niacin – inhibits cholesterol synthesis d. The better side effect profile of anti-hypertensive drugs
g. Ezetimibe – prevents absorption of dietary cholesterol
h. Privastatin – prevents absorption of bile salts 202. Which statement about HMGCoA reductase is incorrect
a. Used to treat Type IIA & TypeIIB hypertensive
b. Used when genetic defect in LDL receptor
184. The maximal absorption of fats takes place in the c. Causes cateract formation
a. ileum d. Prevents mevolonic acid converted to cholesterol
b. jejunum
c. duodenum 208. Diastolic heart failure is characterized by:
d. colon a. Decrease ….
185. An 8 year old boy presents with dome shaped lesions with umbilication on his limbs. He b. Decrease cardiac output
is otherwise healthy. He likely has an infection of c. Decrease…
a. Tinea manum d. Absence of pulmonary edema
b. Mulloscum contagiosum
c. Pityriasis rosea 209. The role of epidemiology in the identification of risk factors associated with
d. Malassezia furfur disease is most influenced by:
a. Measurement of disease
186. Pancreatitis is associated with b. Statistical methods for analysis
a. Autodigestion of the duodenal mucosa c. Comparison of groups with characteristics of interest
b. Phospholipase A, elastin and proteases d. Measurement of precise exposure/risk factors
c. Increased activation of pepsinogens
210. Which drug has the largest half-life:
e. Quinidine
193. Hyperglycemia is likely to occur in treatment of hypertension with f. Amiodarone
a. Frusemide g. Atenolol
b. Atenolol h. Digoxin
c. Prazosin 212. Complete heart block of impulses from atria to ventricle is called:
d. Bendrofluazide a. 1st degree heart block
b. Sick sinus syndrome
194. A cardiologist is carrying out a study to determine the survival time of people with a c. 2nd degree heart block
specific condition. He looked up the case report for the past 3 years whether dead or d. 3rd degree heart block
alive. The most suitable study design:
a. Randomized controlled clinical trial 213. P wave of ECG represents:
b. Retrospective cohort study a. Atrial depolarization
c. Case-control study b. Ventricular depolarization
d. Ecological study c. Sinoatrial automaticity
d. Ventricular repolarization
195. Pulmonary vascularity is increased in all of the following except?
a. PDA
b. VSD 216. What is normal range of ECG?
 d. 3-6 h. Decrease local pH
e. 1.5 – 4
f. 6–8 243. Active absorption of bile salts takes place in the:
a. Duodenum
223. Which does not reduce mortality in CCF? b. Jejunum
d. Propanolol c. Ileum
e. Digoxin d. Colon
f. Diuretic
254. All of the following have been shown to reduce the mortality of congestive heart failure
224. Woman treated with thiazide, digoxin and beta1-blocker. What effect would adding except:
procainamide to the regimen have? a. Captopril
227. Which drug can assist in voiding of urine in a hypertensive patient with prostactic b. Atenolol
hyperplasia? c. Digoxin
a. Prazosin d. Quinidine
b. Propanolol 257. Which Beta1 antagonist is used in the treatment of congestive heart failure?
c. Bendrofluazide e. Atenolol
d. Metaprolol f. Dobutamine
g. Captopril
229. Which of the following is clinically relevant or physiological important for positive h. Digoxin
inotropic effect
a. Digoxin
b. Enalopril 262. A 70 year old male has a systolic blood pressure and a diastolic blood pressure of
c. Adrenaline 90mmHg. Which pair represents his mean arterial pressure and his pulse pressure:
d. Captopril e. 140mmHg : 90mmHg
236. An infant, cyanotic at birth, eventually dies at 5 weeks what is the most likely f. 100 mmHg: 30mmHg
explanation for the Congenital Heart Failure a. 120mmHg : 40mmHg
a. TOF b. 120mmHg : 30mmHg
b. TGF
c. CoA 265. Which of the following classes of drugs is NOT used in the treatment of systolic
d. PDA heart failure?
a. Diuretics
238. Which is least explanation for congestive cardiac failure in young children? b. Inotropics
a. Severe Coarctation of Aorta c. Arterial vasodilators
b. Large Ventricular Septal Defect d. Venous vasoconstrictors
c. TOF
d. PDA 266. Which of the following is the most common anatomical site of an atherosclerotic
(aortic?) aneurysm?
239. 1st degree heart block is characterized by: a. thoracic aorta
e. QT > 0.20s b. supra-renal abdominal aorta
f. QT >0.40s c. infra-renal abdominal aorta
g. PR >0.12s d. renal arteries
h. PR >0.20s 265. Which of the following classes of drugs is NOT used in the treatment of systolic
240. Which is most appropriate for a 3 year old child who is moderately dehydrated? heart failure?
a. Any soda that is uncolored a. Diuretics
b. Commercially prepared rehydration solution b. Inotropics
c. Apple juice c. Arterial vasodilators
d. IV fluid d. Venous vasoconstrictors

241. Which of the following shows irregular cardiac rhythm: 266. Which of the following is the most common anatomical site of an atherosclerotic
a. Sinus tachycardia (aortic?) aneurysm?
b. Atrial fibrillation a. thoracic aorta
c. Ventricular fibrillation b. supra-renal abdominal aorta
d. Ectopic atrial tachycardia c. infra-renal abdominal aorta
d. renal arteries
242. Vasodilation of arterioles in most tissues is produced by 276. Active absorption of bile salts takes place in the:
e. Decrease local temperature a. duodenum
f. Increase discharge for nor-adrenergic vasomotor nerves b. jejunum
g. Circulating Na+/K+ Inhibitors c. ileum
 d. colon 303. Which is a beta-1 selective antagonist used to treat hypertension?
d. atenolol
277. Digestion and the emulsification of bile salts....? e. propranolol
a. AIP f. cimetidine
b. Lipase
c. Lecithin 304. A 62-year-old man has a complete thrombotic occlusion of his left circumflex artery.
d. Bile acids Which of the following is likely to occur within an hour?
283. The pumping action of the heart is done by the: a. syncope
a. endocardium b. thromboembolism
b. pericardial sac c. arrhythmia
c. myocardium
d. epicardium 305. Regarding rheumatic fever, which is incorrect?
e. it is a sequela of beta haemolytic streptococcal infection
284. Which of the following is an irregular cardiac rhythm? f. blood samples show active infection with beta-haemolytic streptococcus group A
a. sinus tachycardia g. it occurs mostly in children
b. atrial fibrillation h. the preferred prophylaxis is intramuscular penicillin once per month
c. ectopic atrial tachcardia
d. ventricular tachycardia 306. Cardiac tamponade may be associated with
d. tension haemothorax
285. Which organ receives the greatest blood flow per 100ml of tissue? e. cardiogenic shock
a. kidney f. sepsis
b. liver
c. brain 307. Lead time bias is
d. heart muscle a. increased time in calculating survival because of pushing back time when diagnosis is
made earlier
286. What is the heart rate of someone with an RR interval of is 0.80s on an ECG? b. decreased time in calculating survival because of diagnosis made upon screening

287. Which of the following drugs has the longest half life? 308. A study was done of hypertensives in the corporate area. Households were randomly
a. amiodarone – class 3 Antiarrythmic – 40-55 days selected, and interviews were done of persons present at the chosen household between the
b. lidnocaine – class 1B Antiarrythmic – 2.5 – 8hrs hours of 8:30 a.m. and 4:30 p.m. on weekdays. This study may have incurred
c. digoxin -36-40 hrs a. random error
d. dysopyramide – class 1A antiarrythmic – 4 -10hrs b. systematic error
290. Inserting a chest tube c. confounding
a. Is a non-surgical procedure 319. When there is a total lack of transmission of excitation from atria to ventricles it is
b. Requires presence of a thoracic surgeon a. 1st degree heart block
c. Cannot be performed safely outside of an operating theatre b. Sinus Sickness
d. May be a life saving maneuver in the emergency room c. 2nd degree heart block
d. 3rd degree heart block
293. Which of the following can be used to treat digitoxin toxicity?
a. Lidocaine 320. Conduction of the rhythmic electrical activity of the heart begins by activity in the:
b. Magnesium e. Sinoatrial node
c. Slow potassium f. Atrio ventricular node
d. ? antibodies g. Atria
h. Ventricles
300. Which of the following would be a cause of cor pulmonale
d. right ventricular hypertrophy 324. A 70 kg man has a systolic pressure of 120 mm Hg and a diastolic pressure of 80 mm Hg.
e. left ventricular hypertrophy Which would be his arterial pressure and his pulse pressure?
f. pulmonary oedema a. 100, 10 mm Hg
b. 70, 90
301. Which are features of left ventricular failure? c. 100, 30
d. Pleural effusion d. 90, 30
e. Pulmonary oedema
f. Hepatomegaly 325. Which of the following would be a good serum indicator of heart failure?
d. insulin
302. HMG Co A reductase inhibitors e. brain natriuretic peptide
a. are useful in types IIa and IIb hyperlipidaemia f. adrenalin
b. prevent the release of mevalonic acid in the synthesis of cholesterol
326. Which of the following corticosteroid drugs would have the LEAST effect on the blood d. Ventro septal defect
glucose level?
a. Dexamethasone 344. A 23 year old medical student had hypertension which was constant or 3 consecutive
b. Prednisolone examinations but had normal physical findings. What did she have?
c. Flucortisone a. Congenital adrenal hyperplasia
d. Betamethasone b. Primary aldosteronism
c. ….
327. Which of the following would not be associated with increased pulmonary d. Cushing’s syndrome
vascularisation?
e. Patent ductus arteriosus 345. Which non-bacterial infestation causes symptoms similar to sepsis:
f. Atrial septal defect a. Hypotension
g. Ventricular septal defect b. Pancreatitis
h. Aortic dissection c. Renal failure
d. …
333. Which of the following is incorrect about the ECG? 350. Complete heart block from atria to ventricle…..
a. Right axis deviation is between -90 and +120 degrees and is caused by right a. First degree heart block
ventricular hypertrophy b. Sinus sickness
b. The normal electrical axis of the heart is -30 to +120 degrees c. Second degree heart block
c. Left axis deviation is between + 120 and – 180 degrees and is caused by left d. Third degree heart block
ventricular hypertrophy
d. Right axis deviation is between – 30 and – 90 degrees and is caused by right 351. Which of the following has the longest half life?
ventricular hypertrophy a. Amiodarone
b. Quinidine
336. Which of the following reduces cardiac output? c. Dysopyramide
a) High environmental pressure d. Procainamide
b) Pregnancy
c) Sitting or standing from a lying position 352. Increasing preload of cardiac muscle:
d) Anxiety and excitement a. Decreases ventricular end-diastolic volume
b. Increases ventricular wall tension
337. The agent to most appropriately rehydrate a 3year old who is moderately dehydrated is: c. Decreases peak tension in muscle
a. Any soda without colour d. Decreases time taken for peak muscle to reach peak tension
b. Commercially prepared rehydration salts
c. Apple juice 354. All of the following may be used to assess blood flow except:
d. Intravenous fluid a. CT
b. Conversional angiography
338. All of the following are clinically or physiologically proven to have positive inotropic effect c. Magnetic resonance imaging
except: d. Plain x-ray
a. Digoxin
b. Enapril 355. The portion of the intrinsic conduction system located in the interventricular septum is:
c. Adrenaline a. Sinoatrial node
d. Captopril b. Purkinje fibers
c. Bundle of His and its branches
339. The primary regulator of electrolytes in blood is: d. Atrioventricular node
a. The renin-angiotensin-aldosterone system
b. Antidiuretic hormone
c. Baroreceptors
d. The adrenergic system
342. Which cardiomyopathy would have caused obstructed left ventricular outflow?
a. Dilated
b. Hypertrophic
c. Endocardial fibrosis
d. Restrictive

343. The five week old infant, cyanotic from birth died of congestive cardiac failure. Which
condition did he have?
a. Tetralogy of fallot
b. Transposition of the great arteries
c. Patent ductus arteriosius