1. Which of the conditions may lead to acute hypoxemic (type 1) respiratory failure?
a) pulmonary oedema
b) pneumonia
c) respiratory muscle weakness
d) A,B
e) A,B,C
2. What are the normal values of PaCO2 in arterial blood?
a) 21-28 mmHg
b) 25-35 mmHg
c) 35-45 mmHg
d) 45-55 mmHg
e) 55-65 mmHg
3. Which of the statements concerning acute respiratory distress syndrome
(ARDS) correct? (couldn't see the last word but looks like it starts with f)
a) ARDS is characterized by presence of diffuse alveolar infiltrates on chest…
b) Hypoxaemia in ARDS responds easily to oxygen therapy
c) ARDS is usually a part of multiorgan failure (MOF) and need to be treated … care unit
d) overall mortality of ARDS is >50%
e) all statements are correct
4. Chronic bronchitis is characterized by:
A: Productive cough
B: Hypoxemia and hypercapnia
C: Cyanosis
D: A+B
E: A+B+C
5. Which of the following conditions are cause of pleural transudate
A: Heart failure, nephrotic syndrome, actue pancreatitis
B: Liver cirrhosis, heart failure, hypothyroidism
C: Liver cirrhosis, nephrotic syndrome, bacterial pneumonia
D: Lung cancer, connective tissue disease, bacterial pneumonia
E: Dressler's syndrome, tuberculosis, heart failure
6. Which of the statements concerning pleural fluid examinations is correct?
A: Bacterial infection of pleural fluid leads to elevated pH and glucose content
B: Predominance of lymphocytes in pleural fluid excludes tuberculosis
C: Fluid protein above 30 g/dL and LDH above 200IU/L is characteristic of exudate
D: Lack of malignant cells in pleural fluid excludes the presence of lung cancer
E: High content of amylase in pleural fluid is characteristic of connective tissue
7. Choose false statement concerning mitral stenosis?
A) A presystolic accentuation of the diastolic murmur is only ........
murmur
B) The diastolic murmer is low pitched, rumbling and best heard with..........
with the patient lying in left lateral position
C) The interval between S2 and the opning snap has no significance..........
stenosis
D) symptoms of mitral stenosis may include dyspnea, orthopnea, .... dyspnea
haemoptysis, ascites, oedema, fatigue
E) Among ascultary hallmarks of mitral stenosis are loud S1.......................
hypertension is present
correct answer (false) either c or d. Check valve slides p. 2 and 3.
8. The most commen cause of mitral stenosis is
A) Bacterial endocarditis
B) Connective tissue disease
C) Cardiomyopathy
D) Mitral valve prolaps (MPV)
E) Rheumatic Fever
9. The ejection murmur of aortic stenosis
A) Diamond shaped
B) May be preceded by an opning snap
C) Low-pitched and of rumbling quality
D) Radiates to the apex
E) Associated with increased A2
10.choose the false about aortic regurgitation?
a.acute regurgition may associated with the precence of austin flint.......diastolic murmuer heared at the apex ofmimicking mitral stenosis.
b.aotric regurgition may med cause laterally displacment apex beat.
c.water -hammer or collapsing plus(plus celer et altus)is charactristic...... regurgitation.
d.diastolic murmuer ofaortic regurgitation is decerescendo murmur.
e.the diastolic murmur of the aortic regurgitation radiates to the axialla.
11.what of the follwoing symbotms is not characteristic of aortic stenosis?
a.exertional angina.
b.exertional haemoptysis
c.extertional syncope.
d a+ b
e. a+b+c
12.plateau plus(plus parvus et tardus )is charactristic for ?
a.aortic regurgitation
b.tricuspid stenosis
c.aortic stenosis.
d.tricuspid regurgitation
e.mitral regurgitation
13- Choose the false statement about heart auscultation
a) most of murmers originating in the right heart are aceentuate
b) High-pitched diastolic murmurs of aortic regurgitaion is best heard with stethoscope at the right and left second and third intercostal space..upright, leaning forward position
c) The carotid pulse is proceded by S1 and followed byS2
d) The intensity of a murmur is closely related to the severity of.....
e) The perdarcial friction rub typically has three components:....
14- Acute mitral regurgitation may be a complication of:
a) infective endocarditis
b) cardiomyopathy
c)myocardial infarction
d) A, C
e) A, B, C
15- Which of the following feature is not a feature of mitral regurgitation
a) loud S1
b) enlarged left ventricle
c) pansystolic murmur
d) displaced apex beat
16. A 21 woman has presented a history of …, fatigue, discomfort on the precordial area. On auscultation a midsystolic click and a …systolic murmur was heard. …asthenic body habitus there was no other abnormalities in physical examination. A likely d..would be:
A) Pulmonary hypertension
B) mitral valve prolapse
C) aortic stenosis
D) pericarditis
E) infective endocarditis
17. Metabolic disturbances in chronic renal failure include:
A) decreased erythropoietin production.
B) impaired vitamin D3 hydroxylation
C) increased rennin production
D) A, B
E) A, B, C
18. Which of the following are characteristic for renal failure?
a) plasma volume disturbance, metabolic alkalosis, hypokalemia
b) metabolic acidosis, hypophosphatemia, hyperkalemia
c) metabolic acidosis, hyperphosphatemia, hyperkalemia
d) metabolic alkalosis, hypocalcemia, hypokalemia
e) hyperphosphatemia, hyperkalemia, hypercalcemia
19. what is urinary sodium excretion in pre-renal failure?
a) always undetectable
b) < 20mmol/L
c) >20mmol/L
d)>40mmol/L
e)>60mmol/L
20. which of the following emergencies is not related tochronic renal failure?
a) hyperkalemia
b) pericarditis
c) hypertensive encephalopathy
d)gastrointestinal bleeding
e) infarction
23. Choose the best statement about heart auscultation:
a) most of murmurs originating in the right heart are accentuated ….
b) hight pitched diastolic murmurs of aortic regurgitation is best … sthetoscope at the right and left 2nd and 3rd intercostal … upright, leaning forward position
c) the carotid pulse is proceeded? by S1 and followed by S2
d) the intensity of a murmur is closely related to the severity …
e) a pericardial friction rub typically has 3 components: …
24. The typical change of previous full thickness (transmural) myocardial infarction on ECG:
a) ST segment depression
b) ST segment elevation
c) T wave inversion
d) deep Q wave
e) bundle branch block
25. The ECG changes in inferior wall myocardial infarction are seen in the leads:
a) V1 to V4
b) V4 to V6, aVL and I
c) II, III and aVL
d) I, aVL, V5 to V6
e) II, III, aVF
26. The most useful in the diagnoses of acute myocardial infarction are enzymes:
a) CK-MB and troponin T (not sure)
b) CK-MB and aspartate aminotransferase
c) Troponin T and aspartate aminotransferase
d) LDH and Troponin T
e) CK-MB and LDH
27. The causes of high cardiac output failure - which is false?
a) large atriovenous shunt
b) multiple pulmonary emboli
c) Beriberi disease
d) severe anemia
e) thyrotoxicosis
28. The causes of ventricular inflow obstruction are?
1. Mitral stenosis
2. Hypertension
3. Endomyocardial fibrosis
4. Aortic stenosis
5. Constructive pericarditis
A) 1,2,3 B) 2,3,4, C) 1,3,5 D)1,4,5 E) 2,4,5
29. Which symptoms or signs is not characteristic of pulmonary oedema?
1. ...................
2. ...................
3. ...................
4. ...................
5. ...................
30. ...........................................................................................? hmmm
1. High jugular venous pressure
2. Peripheral oedema
3. Orthopnea ?
4. Ascites
5. pleural effusion
31.Physcial sign of astma,which one is wrong ?
a.hyperresonant sound on percussion note.
b.reduce chest wall movment.
c.expiratory polyphonic wheeze
d.expiratory and inspiratory brhonchi
e.prolonged inspiration
32.Tthe short defination of cor plumonale is
a.left heart failure in the patient with COPD.
B.right side heart failure in the patinet with COPD.
C.unstable angina
d.constructive pericarditis
e.bactarial endocarditis
33-What is false concerning with patients of COPD
a)loss of wieght
b)pursed- lip breathing
c)central cyanosis
d)flapping tremor
e)peripheral cyanosis
34-Diagnosis and classification of COPD is based on sprirometry, .....is below
a) 10% perdicted
b) 20% perdicted
c) 30 % perdicted
d) 40% perdicted
e) 50% predicted (Check this answer,not sure)
35- The most common organism that causes acute endocarditis is
a) Streptococcus viridans
b) Staphylococcus aurcus
c) Candida albicans
d) Aspergillus fumigatus
e) Coxiella burnetii
36 The most sensitive method which is used to confirm the presence of…patient with subacute endocarditis is:
A) transthoracic echocardiography
B) thransoesophageal echocardiography
C) ECG
D) cornonary angiography
E) chest X-ray
37 In subacute endocarditis antibiotics are chosen on the basis of resulting…the treatment should be continued for at least:
A) 1 weeks
B) 2 weeks
C) 3 weeks
D) 4 weeks
E) 3 months
38. The characteristic physical sign in a patient with atrial septal defect (ASD) is:
a) wide fixed splitting of the second heart sound
b) wide fixed splitting of the first heart sound
c) diastolic flow murmur over the pulmonary valve
d) systolic murmur over the aortic valve
e) diastolic murmur over the aortic valve
39. Pan?systolic murmur usually heard best at the left sterna edge is usually found in a patient with:
a)atrial septal defect
b) ventricular septal defect
c) tetralogy??? Of Fallot
d) pectalogy???? Of Fallot
e) coarctation of the aorta
40. ECG in atrial fibrillation (AF) shows:
a) normal but irregular QRS complexes, no P waves, irregular fibrillation waves
b) irregular QRS complexes, no P waves, regular fibrillation waves
c) normal, regular QRS complexes, no P waves
d) irregular QRS complexes, presence of P waves before each QRS complex
e) irregular QRS complexes, abnormal (sometimes barely visible) P waves
41.In atrial flutter rapid atrial rate is about 300min and ECG shows:
A) characteristic saw-toothhod flutter waves usually associated with A-V block,
B) irregular P waves, usually observed in V5 and V6
C) abnormal P waves in II,III and V1 after QRS complexes
D) normal and regular QRS complexes
E) irregular fibrillation waves associated with A-V block
42. Left ventricular hypertrophy is caused by:
A) aortic stenosis, coarctation of the aorta, hypertension, tetralogy of Fallot,
B) aortic stenosis, coarctation of the aorta, hypertension, hypertrophis cardiomyopathy
C) hypertension, primary pulmonary hypertension, aortic stenosis, coarctation of the aorta
D) hypertension, primary pulmonary hypertension, hypertropic cardiomyopathy,
E) aortic stenosis, coarctation of the aorta, tetralogy of Fallot
43) QRS complex in limb lead with increased amplitude with a very large R wave in V5 or V...., S wave in V1 or V2, ST depression and T wave inversion in lead II, III, aVF, V5 and V............. is characteristic for
A) unsable angina
B) left bundle branch hemiblock?
C) Right venricular hypertrophy
D) recent lateral myocardial infarction
E) left ventricular hypertrophy
44)Hypertension grade 3 means systolic/diastolic blood pressure
A) 140-159/90-99 mmHg
B) 160-179/100-109 mHg
C) 180/ more than 110 mmHG
D) more than 140/ less than 90 mmHg
E) less than 140/ more than 90 mmHg
45) Hypertensive encephalopathy in..................
A) high blood pressure
B) high............................
46 The assessment of global risk in a patients with hypertension includes:
A: Target organ damage, other diseases, decreased LDL and total cholesterol
B: Diabetes mellitus, renal failure, heart failure, cerebral hemorrhage, increased LDL, decreased total cholesterol
C: Diabetes mellitus, renal failure, heart failure, cerebral hemorrhage, increased LDL, increased total cholesterol, smoking, obesity, positive family history
E:Lack of regular exersize, obesity, high caloric diet
47 The most common cause of liver cirrhosis is:
A: Autoimmune hepatitis
B: Alcohol induced liver damage
C: Wilson's disease
D: Primary biliary cirrhosis
E: chronic hepatitis type B and C
48) Portal hypertention leads to:
a) jaundice
b) recurrent bleeding
c) decreased albumin level
d) an accumulation of iron in the liver
e) increased serum aldosterone level
49) Uremia, drugs, gastrointestinal bleeding, hypokalaemia, infection, constipation in…..liver cirrhosis can predispose to the development of:
a) refractory ascites
b) renal failure
c) hepatic encephalopathy
e) congestive gastropathy
50) Grade 4 hepatic encephalopathy means:
a) poor concentration ability
b) occasional aggressive behavior
c) a patient is sleepy but responds to pain
d) slurred speech, slow mentation
e) hepatic coma
51 The first step in the treatment of cirrhotic ascites is:
A) bed rest and low sodium diet ( yes, if it is 1st stage of cirrhosis)
B) diuretics ( yes, if it is 2nd stage of cirrhosis)
C) paracentesis
D) albumin infusion
E) liver transplantaion
63. Zollinger-Ellison syndrome is related to overproduction of:
A) somatostatin
B) gastrin
C) glucagon
D) pancreatic juice
E) bile
64. Which drug is not used for Helicobacter pylori eradication:
A) omeprazole
B) diclophenac
C) amoxicillin
D) clarithromycin
E) metronidazole
65)Sulfasalzine is a drug commonly used in
A) oesophagitis
B) peptic ulcer disease
C) hiatal hernia
D) chronic pancreatitis
E) Crohn´s disease
66) A total duration for a standard regimen for tuberculosis treatment is
A) 3 days
B) 1 week
C) 6 weeks
D) 6 months
E) for the rest of patients life
N3 typing-internal test of n1/n3 2008
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