Question 1


Which of the following descriptions is consistent with pleuritic pain?

A. deep, dull and poorly localised chest pain
B. constant, severe, crushing, substernal pain
C. unilateral, sharp, stabbing pain worse on inspiration/coughing
D. tightness, heaviness or constriction in the chest
E. burning, scalding pain that radiates into the throat

1 points

Question 2


The most common cause of death immediately following a myocardial infarction is

A. parasympathetic stimulation depresses the SA node
B. ventricular fibrillation develops
C. left ventricle ruptures
D. blocked coronary artery bursts
E. aortic valve fails permanently

1 points

Question 3

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The process responsible for development of oedema in acute inflammation is

A. chemotaxis
B. exudation
C. vasoconstriction
D. ischaemia
E. congestion

1 points

Question 4


When stroke volume decreases (as in heart failure), which of the following processes could help maintain the cardiac output?

A. decreased peripheral resistance
B. decreased venous return
C. generalised vasodilation
D. increased perfusion of the kidneys
E. increased heart rate

1 points

Question 5


What happens with intrapleural pressure in pneumothorax?

A. it becomes negative
B. it becomes lower than atmospheric pressure
C. it does not change from physiologic
D. it becomes lower than alveolar pressure
E. it becomes equal to/greater than alveolar pressure

1 points

Question 6


Pericarditis could cause a reduction in cardiac output as a result of which of the following?

A. excess fluid in the pericardial cavity, which decreases ventricular filling
B. weak myocardial contractions due to friction
C. myocardial ischaemia due to widespread atherosclerosis
D. delays in the conduction system, interfering with normal cardiac rhythm
E. incompetent valves, which allow regurgitation of blood

1 points

Question 7


Growth and development of a child with cystic fibrosis may be delayed because of

A. deficit of gastric enzymes for protein digestion
B. mucus plugs obstructing the flow of pancreatic enzymes
C. loss of too much electrolytes in sweat
D. increased production of protein-rich sputum
E. abnormal salivary secretions

1 points

Question 8


Compensation mechanism for decreased cardiac output in cases of congestive heart failure includes

A. decreased coagulability of blood
B. reduced erythropoietin release
C. increased urinary output
D. increased production of renin and aldosterone
E. slow cardiac contractions

1 points

Question 9


All of the following can produce restrictive lung condition except

A. idiopathic pulmonary fibrosis
B. muscular dystrophies
C. pneumoconiosis
D. restrictive cardiomyopathy
E. chronic extrinsic allergic alveolitis

1 points

Question 10


Which of the following would be particularly characteristic of chronic bronchitis?

A. marked dilations of bronchi
B. decreased activity of the mucous glands
C. fibrosis of the bronchial wall
D. accumulation of IgE in airway walls
E. formation of bullae on the lung surface

1 points

Question 11


Which of the following is unlikely to cause hypoxaemia and central cyanosis?

A. status asthmaticus
B. serious pulmonary embolism
C. pulmonary oedema
D. non-infective pericarditis
E. serious pneumonia

1 points

Question 12


Varicose ulcers are generally slow to heal because of

A. stenotic venous valves block flow of venous blood
B. reduced oxygenation of blood in the lungs
C. arterial vasodilation in the area
D. arterial blood supply to the area is decreased
E. venous atherosclerosis reduces venous blood flow

1 points

Question 13


What effect will chronic hypertension have on left ventricular muscle?

A. replacement of muscle cells with connective tissue cells
B. coagulative necrosis of cardiac muscle cells
C. development of hypertrophy
D. hyperplasia of cardiac muscle cells
E. development of reactive myocarditis

1 points

Question 14


Which of the following statements about chronic bronchitis is not correct?

A. it is mediated by type I hypersensitivity reaction
B. it can coexist with emphysema
C. it is characterised by reduced FVC
D. it can lead to right ventricular failure
E. unlike asthma it does not respond well to bronchodilators

1 points

Question 15


The presence of squamous epithelium in the respiratory airways of a person with a history of heavy smoking is consistent with

A. healing through regeneration
B. metaplastic change
C. type I hypersensitivity
D. chronic inflammation
E. coagulative necrosis

1 points

Question 16


In which of the following locations atherosclerosis would not be expected?

A. arteries in lower extremities
B. cerebral arteries
C. femoral vein
D. renal arteries
E. descending aorta

1 points

Question 17


Pulmonary oedema can cause hypoxaemia because of

A. leakage of oxygen into the pulmonary cavity
B. reduced concentration of haemoglobin in blood
C. reduced diffusion of oxygen into the blood
D. accumulation of carbon dioxide in the blood
E. widespread airway obstruction

1 points

Question 18


What causes the expanded anteroposterior thoracic diameter (barrel chest) in patients with emphysema?

A. accumulation of air in the pleural cavity
B. compression on the lungs by the diaphragm
C. excessive air trapping in alveolar spaces
D. increased peak expiratory flow rate
E. loss of elasticity of the chest wall

1 points

Question 19


_______________________ suggests that a neoplasm is malignant.

A. Cellular anaplasia
B. Hydropic change
C. Presence of connective tissue capsule
D. Cellular hyperplasia
E. Excessive cell proliferation

1 points

Question 20


The normal delay in electrical conduction through the AV node in the heart is essential for

A. completing ventricular filling
B. limiting the time for a myocardial contraction
C. allowing AV valves to close
D. allowing the ventricles to contract before the atria
E. preventing an excessively rapid heart rate

1 points

Question 21


Airway obstruction in asthma can be caused by all of the following except

A. increased airway wall thickness
B. increased mucus production in airways
C. presence of fluid in alveoli
D. contraction of bronchial smooth muscle
E. oedema of bronchial mucosa

1 points

Question 22


_______________ develops as a consequence of pneumothorax.

A. extrinsic allergic alveolitis
B. bronchiectasis
C. pneumoconiosis
D. lung atelectasis
E. filling of alveolar spaces with fluid

1 points

Question 23


Reduced ____________________ would not be expected in restrictive lung disorders.

A. SpO2
C. lung compliance
D. Tiffeneau-Pinelli Index

1 points

Question 24


Rheumatic heart disease usually manifests in later years as

A. cardiac arrhythmias and heart murmurs
B. ventricular aneurysm
C. essential hypertension
D. mural thrombosis and systemic embolism
E. pericarditis and pericardial rub

1 points

Question 25


Cyanosis of the affected leg can occur in DVT because of

A. increased filtration of fluid into interstitial space
B. decreased capillary pressure
C. accumulation of deoxygenated haemoglobin
D. increased inflow of arterial blood
E. decreased level of haemoglobin in blood

1 points

Question 26


The biggest problem in ventricular fibrillation is

A. increase in systemic blood pressure
B. backflow of blood from LV to LA
C. absence of cardiac output
D. pulmonary congestion
E. increased risk for DVT/PE

1 points

Question 27


Important finding supporting diagnosis of heart failure is

A. positive D-dimer blood test
B. reduced cardiac creatine kinase level in blood
C. increased pO2 in blood
D. presence of ventricular ectopic beats on ECG
E. reduced ejection fraction on ultrasonography

1 points

Question 28


Which statement about cystic fibrosis is incorrect?

A. it is a multisystem disease
B. it is mediated by IgE antibodies
C. mucous produced in the airways is excessively thick
D. it is an inherited condition
E. it is often associated with bronchiectasis

1 points

Question 29


Which factor usually causes metabolic acidosis to develop in association with hypoxia?

A. liver dysfunction
B. compensation by the kidneys
C. anaerobic metabolism
D. failure to excrete carbon dioxide
E. increased blood volume

1 points

Question 30


Which of the following statements is correct?

A. tissue affected by congestion is warm and red
B. congestion leads to increased blood hydrostatic pressure
C. right sided heart failure typically causes pulmonary congestion
D. tissue affected by hyperaemia is cyanotic
E. hyperaemia results from vasoconstriction

1 points

Question 31


Long-term hypertension is not a risk factor for


A. ischaemic heart disease
B. left ventricular failure
C. deep leg vein thrombosis
D. cerebral haemorrhage
E. chronic renal failure

1 points

Question 32


The main contributing factor in airway obstruction in emphysema is

A. fibrosis and thickening of the airways
B. persistent contraction of airway smooth muscle
C. collapse of small airways due to loss of alveoli
D. presence of fluid in alveolar spaces
E. presence of air in the pleural cavity

1 points

Question 33


Why does cor pulmonale develop with chronic pulmonary disease?

A. thrombosis occurs in pulmonary circulation
B. pulmonary fibrosis and vasoconstriction increase vascular resistance
C. the right ventricle pumps more blood than the left ventricle
D. too much blood comes back from the lungs
E. demands on the left ventricle are excessive

1 points

Question 34


Underfilling of the systemic circulation is not a main mechanism in ____________ shock.

A. hypovolaemic
B. haemorrhagic
C. anaphylactic
D. neurogenic
E. cardiogenic

1 points

Question 35


Which if the following would indicate that pulmonary infarction has occurred during pulmonary embolism?

A. positive D-dimer in blood
B. pulmonary hypertension
C. hypoxaemia
D. sharp pleuritic pain
E. distended neck veins

1 points

Question 36


Chronic heart failure that develops as a result of long standing systemic hypertension is generally results from

A. large coagulative necrosis
B. ventricular outflow obstruction
C. atrial inflow obstruction
D. ventricular volume overload
E. decreased systemic vascular resistance

1 points

Question 37


Which of the following would not be expected in right heart failure?

A. liver congestion
B. paroxysmal nocturnal dyspnoea
C. peripheral dependant oedema
D. ascites
E. distended neck veins

1 points

Question 38


Pulmonary embolism can produce all of the following except

A. pulmonary hypertension
B. right ventricular strain
C. acute airway obstruction
D. lung infarction
E. hypoxaemia

1 points

Question 39


Hypertrophic cardyomyopathy would be suggested when

A. ventricular chambers enlarge for no clear reason
B. there is increased thickness of atrial and not ventricular muscle
C. there is concentric hypertrophy  of the LV
D. LV hypertrophy occurs in the absence of a clear cause for hypertrophy
E. there is increased thickness of the fibrous pericardium

1 points

Question 40


What is the acid-base status of a patient with the following values for arterial blood gases: serum bicarbonate 36.5 mmol/L (normal range: 22-28) pCO2 75 mm Hg (normal range: 35-45) and serum pH 7.0?

A. metabolic acidosis
B. respiratory alkalosis
C. respiratory acidosis
D. metabolic alkalosis
E. hyperventilation

1 points

Question 41


Which of the following is increased in progressive emphysema?

A. tidal volume
B. gas exchange membrane surface
C. forced expiratory volume
D. residual lung volume
E. vital capacity

1 points

Question 42


Infective endocarditis

A. typically affects heart valves
B. leads to accumulation of fluid in the pericardial cavity
C. can lead to development of cardiac tamponade
D. usually develops as a complication of myocardial infarction
E. is generally caused by viruses

1 points

Question 43


How does total obstruction of the airway lead to atelectasis?

A. air continues to be inspired but is trapped distal to the obstruction
B. lung tissue is compressed by air in the pleural cavity
C. decreased surfactant production impairs lung expansion
D. alveolar walls are destroyed distal to the obstruction
E. air is absorbed from the alveoli distal to the obstruction

1 points

Question 44


Pathophysiologically constrictive pericarditis would increase

A. left ventricular stroke volume
B. size of the ventricular chambers
C. diastolic pressure in the right ventricle
D. systemic blood pressure
E. cardiac output

1 points

Question 45


The main difference between unstable angina (UA) and myocardial infarction (MI) is that

A. unlike MI, UA shows no abnormal changes in ECG
B. atherosclerosis is involved in development of MI but not UA
C. unlike MI, UA does not present with chest pain
D. uppon resolving, UA does not leave myocardial necrosis behind
E. cardiac troponins are elevated in UA but not in MI

1 points

Question 46


The main abnormality in mitral insufficiency is

A. flow of blood from LV to LA during ventricular systole
B. restricted ventricular wall stretching and filling with blood
C. regurgitation of blood from aorta into LV
D. abnormal flow of blood from left ventricle to right ventricle
E. significantly narrowed semilunar valves

1 points

Question 47


One complication of emphysema is

A. cystic fibrosis
B. allergic alveolitis
C. pleural effusion
D. pulmonary fibrosis
E. spontaneous pneumothorax

1 points

Question 48


Which of the following is a manifestation of closed pneumothorax?

A. increased breath sounds on the affected side
B. decreased respiratory rate
C. prominent wheezing on the affected side
D. asymmetrical chest movements
E. presence of fluid in alveoli on the affected side

1 points

Question 49


Atrial fibrillation can cause all of the following except

A. increased risk of atrial thrombosis
B. development of ventricular aneurysm
C. absence of atrial systole
D. reduced filling of the left ventricle
E. increased risk of stroke

1 points

Question 50


Cystic fibrosis would present in infancy with all of the following except

A. failure to thrive
B. liver cirrhosis
C. persistent inspiratory crackles
D. large bulky stools
E. frequent respiratory infections

1 points

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