1-Which is true about sinusoids?

A. Narrow lumens
B. Rapid flow of blood
C. Irregular fenestrated lumen
D. Absence of basement membrane

2-Purkinje fibers are rich in which of the following?

A. Glycogen
B. Heparin
C. Lipids
D. Sodium carbonate

3-Internal and external elastic laminae are clearly seen in which of the
following?
A. Aorta
B. Basilar artery
C. Medium sized veins
D. Coronary arteries

4-Vasa vasorum are usually seen in which of the following?

A. Intima of large veins
B. Media of coronary veins
C. Adventitia of large veins
D. Media of muscular arteries

5- Which of the following sinuses gives rise to the right coronary artery?
A. The right posterior aortic sinus
B. The left posterior aortic sinus
C. The anterior aortic sinus
D. The posterior pulmonary sinus

6- Which of the following veins drain directly into the right atrium?
A. Middle cardiac
B. Great cardiac
C. Anterior cardiac vein
D. Left oblique
7- Angiography done to a 55 year old man following chest pain revealed
obstruction of the posterior interventricular artery. Which of the following
myocardial areas is likely to be ischemic?
A. Right atrium
B. Right ventricle
C. Anterior 2/3 of the interventricular septum
D. Posterior 1/3 of the interventricular septum

8- A cardiologist wanted to auscult the pulmonary valve which of the following

sites is suitable to place the stethoscope?
A. Second left intercostal space
B. Second right intercostal space
C. Fiftth left intercostal space at midclavicular line
D. At xiphisternal junction

9- Which of the following is the anatomical site of the pericardial oblique sinus?
A. Posterior to the left atrium
B. Anterior to the right ventricle
C. Between ascending aorta and superior vena cava
D. Between ascending aorta and pulmonary trunk

10- Which of the following veins is the embryological remnant of the left horn
of the sinous venosus?
A. Anterior cardiac
B. Middle cardiac
C. Great cardiac
D. Left oblique

11- Which of the following is a derivative of the truncus arteriosus during

development of the heart?
A. Pulmonary trunk
B. Right atrium
C. Pappillary muscles
D. Tricuspid valve

12- A medical student is examining cardiac tissue under the microscope. He

identified purkinji fibers. The tissue sample is most likely taken from which of
the following parts?
A. Atrial wall
B. Ventricular wall
 C. Atrioventricular valve
D. Atrial septum

13- Which of the following is the anatomical site of the coronary venous sinus?
A. Anterior interventricular sulcus
B. Posterior interventricular sulcus
C. Atrioventricular sulcus
D. Right border of the heart

14- Which of the following is a feature of the right atrium?

A. Fossa ovalis
B. Papillary muscle
C. Purkinjy fibers
D. Chorda tendinae

15- Which of the following structures lies in the superior mediastinum?

A. Descending aorta
B. Left common carotid artery
C. The heart
D. The thymus gland

16- A second year medical student is holding a nerve that lies between the
trachea and the esophagus. Which of the following is likely to be this structure?
A. Phrenic nerve
B. Azygos vein
C. Recurrent laryngeal nerve
D. Internal thoracic artery

17- A cardiac catheter is performed for diagnostic purpose. An obstruction

was noted in one one of the right coronary artery branches. Which of the
following is likely to be the obstructed branches?

A. Anterior interventricular
B. Posterior interventricular
C. Diagonal
D. Circumflex

18- Which of the following provides sensory supply to the parietal

part of serous pericardium?
 A. Phrenic nerve
B. Vagus nerve
C. Sympathetic Plexus
D. Parasympathetic plexus
19- A first year medical student was asked about the fetal remnants in
the right atrium. In the light of your anatomical knowledge, which of
the following would be the correct answer?

A. Tricuspid valve.
B. Opening for the anterior cardiac vein.
C. Fossa ovalis.
D. Opening of coronary sinus.

20- Which of the following is the anatomical site of the pericardial

transverse sinus?
A. Posterior to the left atrium
B. Anterior to the right ventricle
C. Between ascending aorta and superior vena cava
D. Between ascending aorta and pulmonary trunk

21- Which description is true of continuous capillaries?

A. Wide lumens
B. Most common in both brain and muscle
C. Abundant fenestrations
D. Lack a complete basement membrane
22- Which of the following is true about ventricles?
A. Located at the base of the heart
 B. Their Myocardial cells contain abundant granules
C. Receive blood directly from the venae cavae and pulmonary veins
D. Their walls contain Purkinje fibers

23- Which of the following represents a vessel with fenestrated endothelium

and irregular lumen?
A. Large vein
B. Arteriole
C. Sinusoid
D. Fenestrated capillary
24- Which of the following vessels has a visible external elastic lamina?
A. Aorta
B. Pulmonary artery
C. Medium sized vein
D. Coronary artery
25- Which of the following is the most internal cardiac structure?
A. Fibrous skeleton
B. Purkinje fibers
C. Endothelial lining
D. Epicardium
26- Which of the following is a characteristic of the aorta?
A. Thin media
B. Presence cardiac myocytes
C. Very thick media
D. Internal elastic lamina
27- Which is true about the subendothelial layer of blood vessels?
A. It is adjacent to the adventitia
 B. It releases histamine and heparin
C. Consists of loose connective tissue and smooth muscle fibers
D. It is the most internal structure of blood vessels

28- Which of the following is the structure with low resistance pathways
between myocardial cells that allow for easy spread of action potentials
A. T tubules.
B. Sarcoplasmic reticulum.
C. Gap junctions.
D. Intercalated discs.
29- Which of the following vascular beds provide the greatest resistance to
blood flow?
A. Aorta.
B. Arterioles.
C. Capillaries.
D. Veins.
30- Which of the following best describes the contractile response of cardiac
muscle?
A. Obeys the all or none law.
B. Starts at the same time of electric excitation.
C. Is triggered by the release of Ca2+ from sarcoplasmic reticulum as in
skeletal muscle.
D. Last for the same time as its action potential.

31- Which of the following statements explains why the, lymph flow
increases when the rate of blood capillary filtration increases?
A. Interstitial pressure increases.
 B. Interstitial fluid colloid osmotic pressure decreases.
C. Lymph valves remain open for longer period of time.
D. Interstitial volume increases.
32- Which of the following represents the slowest conduction velocity in the
cardiac muscle?
A. Purkinje fibers.
B. A-N region of A-V node.
C. N-zone of AV node.
D. N-H region of AV node.
33- Which of the following describes the change in ventricular volume
during the isometric contraction phase of cardiac cycle?
A. Decreases.
B. Increases.
C. Remains unchanged.
D. Decreases as the intraventricular pressure increases.
34- Which of the following events occur during atrial systole of the cardiac
cycle?
A. The first heart sound occurs.
B. over 70% of ventricular filling occurs.
C. The A-V valves are closed.
D. The aortic valve is closed.
35- Which of the following is true about normal ventricular depolarization?
A. Begins on the epicardial surface.
B. Begins on the right side of intraventricular septum.
C. Begins on the left side of intraventricular septum.
D. Occurs during atrial contraction.
36- Which part of ECG coincides with the plateau of ventricular action
potential?
A. P wave.
B. P-Q interval.
C. T wave.
D. S-T segment.
37- Which of the following is associated with Stimulation of high pressure
barorecptors?
A. Increase in cardiac contractility.
B. increase in heart rate.
C. Increase in discharge of vagal efferent.
D. Stimulation of vasopressor centers.

38- Which is true about the atrial natriuretic factor?

A. It is a phospholipid
B. It is a polypeptide secreted by Purkinje fibers
C. It promotes sodium and water loss
D. It is secreted by endothelial cells

39- What of the following describes the absolute refractory period in the
heart?

A. Is shorter than that in the skeletal muscle

B. During which heart can respond to subthreshold stimuli
C. Extends till ends of repolarization
D. Lasts almost as long as systole period

40- Which of the following is correct about the Frank starling relation-ship?

A. It is the main operating mechanism in the denervated and transplanted hearts

B. It is responsible for maintainance of the cardiac output in the afterload
conditions
C. It implies that the force of myocardial contraction is inversely proportional to
the intial length of cardiac muscle fiber
D. Least contractility occurs at sarcomere length of 2.2 micrometer

41- Which of the following represents supernormal phase?

A. It occurs in slow response action potential

B. It is apparent in purkinje cells
C. It is more prominent in atria, ventricles and AV node
D. It is called so because it requires a suprathreshold to produce a propagated
action potentia

42- Regarding QRS complex in the ECG, which event correctly matches this
complex?

A. Coincides with atrial and ventricular repolarization

B. Represents electric systole in the heart
C. Q wave represents depolarization of apex while S wave represents
repolarization of base
D. Q wave and S wave are sometimes normally absent in ECG leads

43- What is the explanation for absence of waves representing repolarization

for the atria in the ECG record?

A. The leads can’t record it because it is too small

B. No repolarization of the atria occurs normally
C. It occurs simultaneously with ventricular depolarization and is masked by
QRS complex
D. It is represented in some leads and absent in others

44- Which of the following states Einthoven’s law for leads of ECG record?

A. Voltage in lead II = Voltage in lead I + Voltage in lead III

B. Voltage in lead III = Voltage in lead II + Voltage in lead I
C. Voltage in lead II = Voltage in lead I – Voltage in lead III
D. Voltage in lead II = Voltage in lead I divided by Voltage in lead III
 45- What events occur during isovolumetric contraction phase of the cardiac
cycle?

A. The ventricular pressure is decreased

B. The ventricular volume is increased
C. The coronary blood flow is decreased
D. No heart sounds are heard

46- Which of the following takes place during the maximum ejection phase?

A. Third heart sound is heard

B. T wave of ECG is at its peak
C. The aortic pressure is decreased
D. Ventricular pressure reaches its maximum

47- What is the correct statement about the second heart sound?

A. It occurs during reduced ejection phase

B. It marks end of systole
C. It is due to closure of Atrio-Ventricular valves
D. It occurs during rapid filling phase

48- What is the correct about homeometric regulation of cardiac output?

A. It is initiated by increase in the venous return

B. It is a preload phenomena
C. It occurs with a change in the end diastolic volume (initial length)
D. It is prolonged and follows heterometric regulation

49- Which of the following increases the cardiac output?

A. Increased vagal activity
B. Beta-adrenergic receptor blocker
C. Increased end diastolic volume
D. Standing up from the recumbent position

50- Which of the following condition has a decreased EDV?

A. Hypervolemia
B. Athletes
 C. Cardiac tamponade
D. Increased atrial contraction

51-Which of the following predominantly control coronary blood flow?

A. Sympathetic impulses
B. Parasympathetic impulses
C. Autoregulation
D. Hormones

52- Which is correct about the blood flow through the left coronary artery?

A. Increases in the presence of hypoxia

B. Is greatest during early systole
C. Is not regulated by sympathetic nerve fibers
D. Is increased in parasympathetic overactivity

53- Which of the following affects the filteration of fluid from the capillaries?

A. Increases when the preceding arteriole constricts

B. Increases when the plasma oncotic pressure is elevated
C. Decreases by lowering the limb below the heart level
D. Increases when the draining vein constricts

54- Which term best describes alternative opening and closure of capillaries
accorfing to metabolic demand?
A. Capillary reserve
B. Capillary hydrostatic pressure
C. Vasomotion
D. Interstitial tissue hydrostatic pressure

55- Which of the following is an action of Angiotensin II?

A. stimulate Na+ and water retention
B. inhibit thirst sensation
C. decrease noradrenaline release
D. decrease the peripheral resistance

56- About arterial baroreceptors, which of the following is true?

A. start to fire when ABP less than 50 mmHg
 B. are present in the carotid bodies only
C. act as rapid mechanism for regulation of ABP
D. its resetting doesn’t affect ABP

57- Which of the following increases the total peripheral resistance?

A. decrease turbulence of blood flow
B. increase the diameter of arterioles
C. increase the viscosity of blood
D. muscular exercise
58- What is the reason for the action of the venous system as blood reservoir?
A. low oxygen saturation of venous blood
B. large volume capacity of venous system
C. low compliance of venous wall
D. superficial location of veins

59- HMG-CoA reductase is rate limiting enzyme of which of the following

metabolic pathway?
A. Ketone body synthesis
B. Fatty acid synthesis
C. Cholesterol synthesis
D. B- oxidation of fatty acids

60- Which of the following is activated by the Apolipoprotein CII ?

A. LCAT
B. Phospholipase C
C. Extrahepatic lipoprotein lipase
D. Hepatic lipoprotein lipase
61- Which of the following is a scavenger antioxidant?
A. Ceruloplasmin
B. Albumin
C. Carotenes
D. Transferrin
62- Where Chylomicrons are synthesized?
A. Intestine
 B. Pancreas
C. Liver
D. Spleen

63- Which of the following enzyme inhibited by statin drug to lowering level of
serum cholesterol?
A. HMG-CoA lyase
B. HMG-CoA reductase
C. Phospholipase A2
D. Hormone sensitive lipase

64- Activated LCAT is essential for the conversion of which of the following?
A. Discoid HDL into spherical HDL
B. VLDL to HDL
C. IDL into LDL
D. Chylomicron into its remnant

65- Which of the following is the etiology of Rheumatic fever ?

A. Suupurative disease
B. Chronic sclerosisng disaese
C. Immune mediated collagen disease
D. Degeneartive disease.
66- Which of the following diseases is characterized by (bread and butter)
appearance?
A. Rheumatic pericarditis
B. Rheumatic myocarditis
C. Rheumatic valvitis
D. Rheumatic endocarditis.
67- An 8 years old child had sore throat, two weeks later, he presented with
fever and polyarthritis. Laboratory investigations showed elevated ESR
 and C reactive protein in blood. Which of the following is the most
possible diagnosis?
A. Diphtheria.
B. Rheumatic fever
C. Typhoid.
D. Tuberculosis.
68- Which of the following is the most common cause of death in
myocardial infarction?
A. Rupture of the heart ( cardiac tamponade )
B. Rupture of papillary muscles
C. Acute heart failure
D. Arrhythmia

69- A 66 y old male, suffered from attacks of severe chest pain. Laboratory
investigations revealed increased serum LDH.ECG findings revealed
inadequate coronary blood flow. Which of the following is the most
possible diagnosis?
A. Hypertension.
B. Coronary atherosclerosis.
C. Aortic stenosis
D. Aortic anomaly.
70- Which of the following is the most common important cause of
secondary hypertension?
A. Cerebral diseases
B. Renal diseases
C. Liver diseases
D. Blood diseases
 71- A 52 years old man suffers from severe headache and blurring of vision,
his blood pressure is 250/160mmHg. Urine showed proteinuria. Which
of the following is expected to be seen is renal biopsy?
A. Renal tissue necrosis
B. Fibrinoid necrosis of walls of arterioles
C. Diffuse hyaline change.
D. Fibrosis.
72- What is the most common site of Atherosclerotic aneurysms?
A. Retina
B. Abdominal aorta
C. Thoracic aorta
D. Cerebral arteries

73- Which of the following is the most common risk factor for
atherosclerosis in a patient under 45 years?
A. Smoking
B. Hyperlipidaemia*
C. lack of physical exercise
D. Male sex.

74- 11 y old female suffering from fleeting arthritis and endocardial biopsy
revealed Aschoff nodule. What is the most common complication occurs in this
case?
 A. Suppurative lung disease
B. infective endocarditis
C. Cerebral hemorrhage
D. Aneamia

75-Mac Callum" patches is a feature of which of the following?

A. Rhaumatic pericarditis
B. Rhaumatic myocarditis
C. Rhaumatic vulvitis
D. Rhaumatic endocarditis

76- A 40-year-old diabetic man presented to the Emergency Department with a

3 days history of chest pain, nausea and dyspnea that was not relieved by
nitroglycerin. Medical history was significant for long-standing hypertension
and angina for many years. An ECG is disturbed. The troponin T level was
elevated. The patient died of coronary rupture. Which of the following
microscopic features is most indicative of reperfusion of irreversibly damaged
ischemic myocardium?
A. Endothelial swelling
B. Hypereosinophilic cytoplasm
C. Necrosis with contraction bands
D. Neutrophilic infiltrate

77- Left ventricle is more affected by infarction than right ventricle due to
which of the following?
A. Right ventricle have double blood supply
B. C-Left ventricle blood supply narrow than the right
C. left ventricle is more overloaded than right ventricle
D. D-Coronaries of the left ventricles more affected with atherosclerosis than
right

77- What is the most important cause of transmural myocardial infarction?

A. coronary thrombosis
B. coronary embolism
C. congitital anamoly
D. smoking

78- What are the vessels affected by Hypertension?

A. Veins
B. lymphatics
 C. capillaries
D. different sized arteries

79- What is the most common cause of secondary hypertention?

A. blood disease
B. liver diseases
C. cerebral diseases
D. Renal diseases

80- A 30 years old male suffers of sever headach, blurring of vision. His pressure
is 250/160mmHg.Urine examination showed proteinuria. If we examine renal
biopsy what is the characteristic pathology?
A. Necrosis of tubules
B. fibrinoid necrosis of walls of arterioles
C. Inflamamtory infiltration
D. Interstitial hemorrhage

81- What is the etiology of atherosclerosis?

A. Degenerative
B. Inflamamtory
C. lack of physical exercise
D. Autoimmune

82- Which of the following drugs promotes formation of collateral coronary

vessels?
A. B blockers
B. Nitrates
C. Cardio selective calcium channel blockers
D. Vascular selective calcium channel blockers

83- Which of the following drugs is the first line drugs in treatment of
vasospastic angina?
A. B blockers
B. Nitrates
C. Cardio selective calcium channel blockers
D. Vascular selective calcium channel blockers

84- Dipyridamole is more effective dilator of which of the following?

A. Epicardial median sized arteries
 B. Small intracardiac arteries
C. Collateral arteries
D. Aorta

85-Vsodilator effect of niacin is due to increase synthesis of which of the

following?
A. Histamine
B. Nitric oxide
C. Serotonin
D. Prostaglandin

86-Which of the following drugs decreases vitamin K absorption?

A. Statins
B. Fibrates
C. Ezetimide
D. Bile acid binding resin

87-Which of the following drugs is least likely to produce myopathy?

A. Atorvastatin
B. simvastatin
C. Fluvastatin
D. Pravastatin

88- Which of the following is the antihypertensive drug of choice in

hypertensive diabetic patient?
A. Angiotesine converting enzyme inhibitors
B. B blockers
C. Vasculspecific calcium channel blockers
D. Diuretics

89- Which of the following drugs has the shortest duration of action?
A. Diazoxide
B. sodium nitroprusside
C. Minoxidil
D. Hydralazine

90- Which of the following has the most potent antihypertensive effect?
A. Chlorthalidone
B. Furosimide
C. amilioride
D. Spironolactone

91- Which of the following drugs is the first line drugs in treatment of
exertional (atheroscletotic & classical ) angina?
A. B blockers
B. Nitrates
C. Cardioselective calcium channel blockers
D. Vasculoselective calcium channel blockers

92- Which of the following drugs causes coronary vasodilation and

bradycardia?
A. B blockers
B. Nitrates
C. Cardioselective calcium channel blockers
D. Vasculoselective calcium channel blockers
93- Which of the following has the most potent diuretic effect?
A. Chlorthalidone
B. Furosimide
C. Amilioride
D. Spironolactone
94- Which of the following drugs is the most elevator of plasma HDL?
A. Statins
B. Fibrates
C. Niacin
D. Bile acid binding resin
Read the following clinical case and answer the following MCQs (95, 96 & 97)
a 59-years old man presents to the emergency department with chest pain,
fever, fatigue, and arthralgias. His past medical history is significant for
rheumatic heart disease and oral surgery procedure a few weeks before
admission. Endocarditis is suspected.

95- What is your probable diagnosis?

A. Staphylococcus aureus
B. Viridans streptococci
C. Klebsiella
D. Pseudomonas

96- Which of the following is a appropriate to prevent this condition?

A. Vaccination against the causative organism
B. Giving immunoglobulins against the causative organism
C. A single large dose of amoxicillin should be given 1 hour before the
procedure
D. A single large dose of amoxicillin should be given 1 hour after the procedure

97- Which of the following organisms has a role in development of rheumatic

fever in this patient?
A. Klebsilla pneumonia
B. Staphylococcus epidermidis
C. Pseudomonas aeruginosa
D. Streptococcus pyogenes

After extraction of a wisdom tooth, an 18-year male student was

diagnosed as having subacute bacterial endocarditis. He has a
congenital heart disease that has been under control.

98- Which of the following is the most likely organism causing his infection?
A. Staph aureus
B. Staph epidermidis
C. Strept. pneumoniae
D. Strept. viridans

99- This organism if stained by gram stain , will appears as:

 a. Positive cocci
b. Positive bacilli
c. Negative cocci
d. Negative bacilli

100- What kind of hemolysis can be done by this organism?

A.Alpha hemolysis
B. Beta hemolysis
C. Complete hemolysis
D. Gamma Hemolysis

101- What is the most likely test that can be used to identify this organism?
A.Bactercine
B. Coagulase
C. Optochin
D. Oxidase

102. The patient’s condition could be avoided by:

a- Prophylactic antibiotic therapy.

b- Good oral hygiene.

c- Reducing physical effort.

d- Be on a diet system.