Cardiology MCQ

102. The following is present in ECG in case of Wolff-Parkinson-White syndrome: A) delta-wave B) short PQ C) wide QRS D) PQ of normal prolongation E) QRS of normal width The right answer is: 1) A, B, C 2) A, C, D 3) D, E 4) A, D, E

1) A, B, C

411. Which statements about AV block complicating acute myocardial infarction are true? A. AV block complicating acute myocardial infarction most often resolves itself spontaneously within 2-7 days B. Permanent cardiac pacing is not recommended since it does not influence the prognosis of these patients C. Permanent pacing affect short- and long-term mortality in patients with anterior infarction D. Patients with AV block complicating acute myocardial infarction will benefit from cardiac pacing Correct is: 1. A,B 2. CD 3. A,D 4. A,C

1. A,B

430. CCB are indicated in post-MI for CVS secondary prophylaxis when A. BB are contraindicated B. No LV failure C. LV hypertrophy D. Severe edema 1. A,B 2. A,C 3. A,D

1. A,B

88. The novel oral anticoagulants for stroke prevention in atrial fibrillation include the following classes: A. The oral direct thrombin inhibitors B. Oral factor Xa inhibitors C. Vitamin K antagonists D. Antithrombin III inhibitors Correct: 1. A,B 2. A,C 3. A,B,C,D

1. A,B

65. The following criteria meet the diagnosis for prior MI: A. Pathological Q waves with or without symptoms in the absence of non-ischaemic causes. B. Imaging evidence of a region of loss of viable myocardium that is thinned and fails to contract, in the absence of a non-ischaemic cause. C. Pathological findings of a prior MI Correct: 1. A,B,C 2. A,B 3. A,C

1. A,B,C

424. A HACEK organism definition is formed from the initials of the following ones (several correct answers): A. Haemophilus B. Actinobacillus C. Cardiobacterium hominis D. Eikenella corrodens E. E. coli F. Kingella (Kingella kingae) G. Klebsiella Correct: 1. A,B,C,D, F 2. A,B,C,D 3. A,B,C,G 4. A,B,C,D,G

1. A,B,C,D, F

92. Excessive anticoagulant effect in bleeding due to warfarin can be reversed by: A) omission the drug B) administration of vitamin K C) cholestyramine D) prothrombin complex concentrates E) diuretics Correct: 1. A,B,D 2. A,E 3. B,E

1. A,B,D

102. Mitral valve prolapse is described by the following: A) mesosystolic click at the apex B) late systolic murmur at the apex C) systolic murmur at Erb's point D) diastolic murmur at Erb's point The right answer is: 1) A 2) A, B 3) A, C 4) A, D 5) B, D

2) A, B

102. Sinus bradycardia is characterized by: A) actual P waves having a configuration similar to P waves of sinus genesis B) P waves rate is less than 65 min-1 C) P waves rate is less than 55 min-1 D) P wave's rate is less than 50 min-1 The right answer is: 1) A, C 2) A, B 3) A, D 4)C,D

2) A, B

102. Sinus rhythm exists if: A) the source of the pace is sinoatrial node B) impulse rate is 55-80 x min-1 C) p-wave is positive in ii and avr leads D) atrial excitement is directed from the left upper part to the right lower part The right answer is: 1) A 2) A, B 3) A, B, C 4) A, B, C, D 5)B

2) A, B

102. Sinus arrhythmia is characterized by: A) actual P waves having a configuration similar to P waves of sinus genesis B) P-P interval difference is more than 5% C) P-P interval difference is more than 15% D) P-P interval difference is more than 25% The right answer is: 1) A, B 2) A, C 3) A, D

2) A, C

363. Paroxysmal supraventricular tachycardia is characterized by: A) narrow (< 0.1″) QRS complexes B) wide (> 0.12″) QRS complexes C) regular R-R intervāls D) irregular R-R intervāls E) heart rate is 100-130 min-1 F) heart rate is 120-200 min-1 The right answer is: 1) A, D, E 2) A, C, F 3) B, C, E

2) A, C, F

102. The following signs are typical for the complete blockage of the left branch of the bundle (LBBBC): A) QRS < 0.12″ B) QRS > 0.12″ C) absent QI, QV5, QV6 D) QRS complex of M shape in V1 and V2 leads E) in I, avl, V5 or V6 leads QRS complex is wide with a plateau The right answer is: 1) A, C, D 2) B, C, E 3) C, D, E 4) A, C, D, E 5) B, C, D, E

2) B, C, E

102. ECG changes due to myocardial infarction of the left ventricle of latero-inferior localization are registered in: A) V1-V2 B) V3-V4 C) V5-V6 D) I, aVL E) III, aVF The right answer is: 1) A, B 2) C, E 3) D, E 4) A, E

2) C, E

66. Criteria for acute MI include: A. Symptoms of ischaemia. B. New or presumed new significant ST-segment-T wave (ST-T) changes or new left bundle branch block (LBBB). C. Development of pathological Q waves in the ECG. D. Imaging evidence of new loss of viable myocardium or new regional wall E. Identification of an intracoronary thrombus by angiography or autopsy Correct are: 1. A,C 2. A,B,C,D,E 3. C,D,E

2. A,B,C,D,E

426. Death in patients with untreated atrioventricular (AV) block is usually due to A. Sudden cardiac death caused by bradycardia-triggered ventricular tachyarrhythmia B. Sudden cardiac death caused by prolonged asystole C. Pulmonary embolism D. Heart failure (HF) secondary to low cardiac output 1. A 2. A,B,D 3. CD 4. D

2. A,B,D

102. AV block of II degree, type I (Mobitz I) is characterized by: A) progressively prolonged PQ interval B) some P waves are not followed by QRS C) PQ interval remains stabule The right answer is: 1) A 2) B 3) A, B 4) B, C 5) C

3) A, B

102. Describe the fixed splitting of S2: A) it is audible at tr. Pulmonalis B) respiration does not influence the degree of splitting C) it indicates atrial septal defect D) it indicates ventriclular septal defect The right answer is: 1) A, B 2) A, C 3) A, B, C 4) A, B, D

3) A, B, C

102. AV block of I degree is characterized by: A) stable prolonged PQ interval B) stable normal PQ interval C) each P wave is followed by QRS complex D) P-Q progressively increases E) Certain QRS are absent The right answer is: 1) A 2) A, B 3) A, C 4) C, D, E

3) A, C

102. Sinus tachycardia is characterized by: A) actual P waves having a configuration similar to P waves of sinus genesis B) P wave rate exceeds 80 min-1 C) P wave rate exceeds 90 min-1 D) P wave rate exceeds 120 min-1 The right answer is: 1) A 2) A, B 3) A, C 4) A, D

3) A, C

Describe the physiological splitting of S2 (double): A) it sometimes exists in healthy people B) it is best audible at tr. Pulmonalis C) it disappears on exhalation D) it can indicate pathology of the right ventricle The right answer is: 1) A, B 2) B, C 3) B, C, D 4) A, B, C

4) A) it sometimes exists in healthy people B) it is best audible at tr. Pulmonalis C) it disappears on exhalation

102. The following criteria are strongly necessary to diagnose atrial fibrillation: A) all R-R intervals are different B) P waves are not registered C) fibrillation (f) waves are present The right answer is: 1) A, B 2) B, C 3) A, C 4) A, B, C

4) A, B, C

102. Describe the paradoxical split of S2: A) it is audible at tr. Pulmonalis B) it appears on exhalation C) it indicates pathology of the right ventricle or its conduction ways D) it indicates pathology of the left ventricle or its conduction ways The right answer is: 1) A, C 2) A, B 3) A, D 4) A, B, D 5) A, B, C 6) A, B, E

4) A, B, D

102. Complete AV block is characterized by: A) no electrical communication between QRS complex and P waves B) PQ interval remaining stabule C) QRS complexes could be narrow D) QRS complexes could be wide The right answer is: 1) A 2) B, C 3) B, D 4) A, C, D

4) A, C, D

102. Aortic accentuation of the II sound is when: A) the IInd sound at the aorta is louder than the IInd sound at tr. Pulmonalis B) The IInd sound at the aorta is louder than the Ist sound at the aorta C) The IInd sound at the aorta is louder than the Ist sound at the apex D) indicates hypertension in the large circuit E) indicates hypertension in the small circuit The right answer is: 1) A 2) B 3) C 4) A, D 5) B, E 6) C, E

4) A, D

102. AV block of II degree, type II (Mobitz II) is characterized by: A) progressively prolonged PQ interval B) some P waves not followed by QRS C) PQ interval remains stable The right answer is: 1) A 2) B 3) A, B 4) B, C 5) C

4) B, C

102. The following signs are characteristic for the complete blockage of the right branch of the bundle: A) QRS < 0.12″ B) QRS > 0.12″ C) Double R wave in leads V1 or (and) V2 D) Wide S1, SV5, SV6 The right answer is: 1) A, C 2) B, C 3) A, C, D 4) B, C, D

4) B, C, D

102. Elevated blood pressure is: A) 130/85 B) 190/70 C) 140/90 D) 135/100 E) 120/90 F) 140/80 G) 120/85 The right answer is: 1) A, B, C, D, F 2) B, C, D, E, F, G 3) B, C 4) B, C, D, E, F 5) B, C, F

4) B, C, D, E, F

364. Paroxysmal ventricular tachycardia is characterized by: A) narrow (< 0.1″) QRS complexes B) wide (> 0.12″) QRS complexes C) regular R-R intervāls D) irregular R-R intervāls E) heart rate is 100-130 min-1 F) heart rate is 120-200 min-1 The right answer is: 1) A, D, E 2) A, C, F 3) B, C, E 4) B, C, F

4) B, C, F

102. In diagnostics of atrial flutter the following is considered: A) regular saw-like waves of rate 180-280 min-1 in leads II, III, avf B) regular saw-like waves of rate 250-350 min-1 in leads II, III, avf C) regular saw-like waves of rate 200-300 min-1 in leads V1-V6 D) R-R intervals (regular or irregular) The right answer is: 1) A, D, 2) A, B 3)A, C 4) B, D 5) C, D

4) B, D

102. Describe the pathological splitting of S2:\ A) it is audible at tr. Pulmonalis B) it reduces but does not disappear on exhalation C) can be found in healthy people D) can indicate the pathology of the right ventricle or its conduction ways The right answer is: 1) A, B 2) B, C 3) C, D 4) B, D 5) A, B, D

5) A, B, D

102. The usual site of aortic valve auscultation is: A) the 2nd intercostal space to the right of the sternum B) the 2nd intercostal space to the left of the sternum C) Erb's point D) the lowest third of the sternum The right answer is: 1) A 2) B 3) C 4) A, B 5) A, C 6) A, D

5) A, C

102. Heart tamponade features are: A) arterial collapse B) dicrotic pulse C) overfilled neck viens D) pulsus paradoxus The right answer is: 1) A, B 2) B, C 3) A, C 4) A, B, C 5) A, C, D

5) A, C, D

102. Constrictive pericarditis features are: A) normal heart size B) enlarged heart size / dimensions C) elevated central venous pressure (300 mmH2O and higher) D) heart failure E) hepatomegalia The right answer is: 1) A, C 2) B, C 3) A, C, D 4) B, C, D 5) A, C, D, E 6) B, C, D, E

5) A, C, D, E

102. The following is found in case of cardiac asthma: A) inspiratory dyspnoea with prolonged inhalation B) expiratory dyspnoea C) coarse crackles in the basal part of the lung D) some dry rales in the lungs The right answer is: 1) A, C 2) B, D 3) B, C 4) A, D 5) C, D

5) C, D

102. The following is typical for the blockage of the posterior division of the left branch of His bundle: A) sinistrogram > -30° B) dextrogram > + 120° C) narrow (< 0.1″) QRS complex D) other causes of dextrogram are excluded The right answer is: 1) A 2) B 3) A, C 4) B, C 5) A, C, D 6) B, C, D

6) B, C, D

102. The following is typical for mitral stenosis: A) "quail" rhythm B) diamond-shaped murmur at the aorta C) gallop rhythm D) pulsus celer et altus E) high systolic arterial blood pressure

A) "quail" rhythm

102. Chronic heart failure patient suffers from fatigue, shortness of breath and heart palpitations on unusually extreme exercise. Which chronic heart failure functional class by NYHA is it? A) 1 B) 2 C) 3 D) 4

A) 1

102. Anticoagulants in patients with atrial fibrillation and undulation with relation to sinus rhythm restoration procedures must be applied when: 1) If the duration of atrial fibrillation is longer than 48 hours; 2) If a patient has ≥ 2 CHA2DS2iVASc risk score points; 3) Only if electrical cardioversion is used; 4) At least 3 weeks prior and at least 4 weeks after sinus rhythm restoration; 5) If the patient has a high risk of atherosclerosis; 6) If the patient has a holosystolic murmur at the apex; Correct are: A) 1 + 4 B) 2 + 5 C) 1 + 2 + 5 D) 1 + 2 + 6 E) 3 + 4 F) 1 + 5 + 6

A) 1 + 4

102. Apex beat in a healthy person is palpable during: A) 1st 1/3 of systole; B) 2nd 1/3 of systole; C) 3rd 1/3 of systole; D) regularly throughout the whole systole time

A) 1st 1/3 of systole;

1. Stable angina attacks most often last: A) 2-3 min B) 15-20 min C) 20-30 min D) 3-5 seconds E) 10-20 seconds

A) 2-3 min

102. What conclusions may be correct, if the ST segment in lead V1 is directed towards the top 1 - 2 mm? 1 Acute myocardial infarction 2 Pericarditis 3 Left ventricular overload 4 Norm A) All conclusions are possible. B) Only 1 C) Only 3 D) Only 1 and 2 E) Only 1 and 3

A) All conclusions are possible.

399. A 64-year-old man presents to the emergency dep artment with chest pain, fever, fatigue, and arthralgias. His past medical history is significant for a dental procedure a few weeks before admission. He currently shows no "stigmata" of endocarditis on physical examination, although endocarditis is suspected. The most likely organism is A) Alpha haemolytic streptococci B) Staphylococcus aureus C) Enterococcus fecalis D) Pseudomonas

A) Alpha haemolytic streptococci

1. Which anti-arrhythmic preparation has the most durable effect? A) Amiodarone B) Procainamide C) Lidocaine D) Propafenone E) Verapami

A) Amiodarone

1. What statement is incorrect? Myocardial scintigraphy with 201Tl chloride: A) At present is a replacement for coronarography. B) An evidence of myocardial microcirculation C) Evidence of viability in myocardial area, which is adjacent to focal necrosis. D) Discovers myocardial ischemia during exercise. E) Is more sensitive than ECG to detect myocardial ischemia during exercise.

A) At present is a replacement for coronarography.

102. Which of pharmacological agents should not be used for ventricular fibrillation treatment between defibrillation attempts? A) Atropine 0,5 - 1,0 mg B) Epinephrine 0,5 - 1,0 mg C) Lidocaine 1,0 mg/kg IV bolus D) Oxygen.

A) Atropine 0,5 - 1,0 mg

1. What statement is incorrect? Beta-adrenoblockers: A) Causes orthostatic hypotension when treating arterial hypertension. B) Reduce cardiac output. C) May cause atrioventricular block. D) Can worsen bronchial permeability. E) Reduce the increase of heart rate during exercise.

A) Causes orthostatic hypotension when treating arterial hypertension.

102. Murmur of a gradually increasing pitch is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform

A) Crescendo

1. Right ventricle failure in a patient with chronic pulmonary heart is characterized by the following symptoms, except: A) High blood pressure in pulmonary veins B) High blood pressure in right atrium C) Fluid retention D) Liver congestion, oedema, ascites E) Cyanosis

A) High blood pressure in pulmonary veins

102. Trapezoid configuration of the heart is typical for: A) Hydropericardium B) Cardiomyopathy C) Myocarditis D) Endocarditis

A) Hydropericardium

102. Which leads belong to the so-called "left" lead group? A) I, aVL,V5-V6 B) II, III, aVF C) V1- V2 D) V3- V4

A) I, aVL,V5-V6

102. Crescendo cardiac murmur: A) Increases B) Decreases C) is of a constant amplitude D) increases, then decreases

A) Increases

1. The first loud tone at the heart apex is more typical for: A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis D) Aortic regurgitation E) Arterial hypertension

A) Mitral stenosis

1. Can cardiomegaly be observed in case of severe somatic vegetative dysfunction? A) No B) Yes, in most cases C) Yes, in addition to heart insufficiency

A) No

1. Which drug is indicated in case of acute second-degree atrioventricular conduction disturbances? 1 Atropine 2 Dobutamine 3 Verapamil 4 Norepinephrine 5 Dopamine A) Only 1 is correct B) Only 1, 2 and 4 are correct C) Only 1, 2, 3 and 5 are correct D) Only 1, 2, 3 and 4 are correct E) Only 1, 3 and 5 are correct

A) Only 1 is correct

102. For a patient with acute coronary syndrome and STEMI a first-line treatment tactic is: A) Percutaneous coronary intervention (PCI); B) Thrombolysis; C) Nitroglycerin and Morphine; D) Rest for 5 days and heparin group medications

A) Percutaneous coronary intervention (PCI);

102. The most significant in acute coronary syndrome pathogenesis is: A) Plaque instability and rupture. B) Endothelial dysfunction. C) Plaque size.

A) Plaque instability and rupture.

102. A patient, who has ST segment elevation during chest pain, most likely has: A) Prinzmetal's angina B) Mitral valve prolapse C) Myocarditis D) Pulmonary arterial thromboembolism. E) Subendocardial infarction

A) Prinzmetal's angina

102. Murmur audible in the beginning of diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic

A) Protodiastolic

102. Murmur audible in the beginning of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) Pansystolic

A) Protosystolic

1. During heart auscultation and pulse palpation the following symptoms can indicate atrial fibrillation: A) Pulse and heart absolute irregularity B) Regular but very slow heartbeat C) Two consecutive contractions, followed by a pause D) Pulse wave drop in each third contraction E) Explicit tachycardia with individual pulse wave drop

A) Pulse and heart absolute irregularity

102. Which of the following are first-choice medicines at first prophylaxis of coronary heart disease? A) Ramipril, Perindopril; B) Enalapril, Captopril; C) Cilazapril, Benazepril;

A) Ramipril, Perindopril;

102. The most common pain localization in angina pectoris attack is: A) Retrosternal B) in the heart region C) in the heart region and radiating to the left arm D) in epigastrium

A) Retrosternal

102. The most important objective finding in heart failure patient of age older than 40 is: A) S3 B) S4 C) lung ronchi D) soft apical S1 E) soft heart sounds

A) S3

102. Pulsus filiformis is typical for: A) Shock B) right ventricle failure C) aortic regurgitation

A) Shock

1. The most typical and earliest ventricular failure symptoms: A) Shortness of breath B) Enlarged liver C) Oedemas D) Cyanosis E) Swollen neck veins

A) Shortness of breath

102. What statement is correct? A) Small doses of dopamine have a selective vasodilation effect. B) Norepinephrine reduces myocardial oxygen consumption; C) Dobutamine explicitly increases peripheral resistance.

A) Small doses of dopamine have a selective vasodilation effect.

102. A high nephroprotective and metabolic effect is demonstrated by: A) Telmisartan; B) Eprosartan; C) Azilsartan; D) Valsartan;

A) Telmisartan;

102. Leads where P wave can be biphasic: A) V1 B) V2, V3 C) V4, V5 D) V6

A) V1

102. Which is the drug of choice for narrow AV node reflex tachycardia relief? A) Verapamil B) Digoxin C) Propranolol D) Amiodarone E) Lidocaine.

A) Verapamil

102. P wave should be always negative in: A) aVR B) aVL C) aVF D) V1

A) aVR

102. Austin Flint murmur is audible in case of: A) aortic regurgitation B) aortic stenosis C) hypertrophic cardiopathy D) mitral stenosis E) tricuspid regurgitation

A) aortic regurgitation

102. Mitral valve opening snap is audible: A) at the apex B) at the 2nd intercostal space to the right of the sternum C) at the 2nd intercostal space to the left of the sternum D) at processus xyphoideus E) at Erb's point

A) at the apex

102. A-waves disappear in the phlebogram in case of: A) atrial fibrillation B) complete AV block C) tricuspid stenosis D) tricuspid regurgitation

A) atrial fibrillation

102. A wave in a phlebogram originates from: A) atrial systole B) atrial diastole C) ventricular systole D) ventricular diastole

A) atrial systole

102. In case of acute pericarditis the pain can be relieved: A) by the patient leaning forward B) by lying supine C) by lying in the left lateral decubitus position D) by lying in the right lateral decubitus position

A) by the patient leaning forward

Prolonged S1 is audible in case of: A) complete AV block B) mitral stenosis C) tricuspid stenosis D) extra systoles E) atrial fibrillation

A) complete AV block

102. All the following are typical for chronic right ventricle failure, except: A) decreased appetite, nausea B) heaviness in the right undercostal area C) severe leg oedema D) ascites E) cough with blood spitting on exercise

A) cough with blood spitting on exercise

102. Pulsus differens is: A) different pulse in symmetric arteries B) pulse waves of different volumes C) pulse waves of irregular amplitude

A) different pulse in symmetric arteries

102. Apex beat displaced downwards and to the left is typical for: A) dilatation of the left ventricle; B) hypertrophy of the right ventricle; C) hypertrophy of the left atrimu; D) hypertrophy of the right atrium

A) dilatation of the left ventricle;

102. Q wave is: A) first negative QRS complex wave B) any negative wave C) the first wave of QRS complex D) negative wave before any positive wave

A) first negative QRS complex wave

102. Manifestation of the Wolff-Parkinson-White syndrome depends on: A) functioning of Kent's bundle B) functioning of James' bundle C) functioning of Bachman's bundle D) functioning of Wenkebach's bundle

A) functioning of Kent's bundle

102. "Nun's" murmur is audible in: A) healthy people B) tricuspid regurgitation C) stenosis of ostium aortae D) mitral stenosis

A) healthy people

102. Pulsus alternans is typical for: A) heart failure B) heart tamponade C) hypertrophic obstructive cardiomyopathy

A) heart failure

102. Apex beat displaced to the left is typical for: A) hypertrophy of the left ventricle; B) severe dilatation of the left ventricle; C) severe hypertrophy of the left atrimu; D) severe hypertrophy of the right atrium

A) hypertrophy of the left ventricle;

102. Diamond-shaped cardiac murmur: A) increases, then decreases B) increases C) decreases D) is of a constant amplitude

A) increases, then decreases

102. The following clinical feature is characteristic of mitral regurgitation: A) late manifestation B) early manifestation with shortness of breath C) early manifestation with blood spitting D) early manifestation with lightheadness

A) late manifestation

102. The left border of the heart is displaced to the left only in case of: A) left ventricle hypertrophy B) left atrium hypertrophy C) right atrium hypertrophy D) right atrium dilatation

A) left ventricle hypertrophy

102. Ictus cordis is intensified due to: A) left ventricle hypertrophy; B) right ventricle dilatation C) right ventricle dilatation and hypertrophy D) right atrium dilatation and hypertrophy

A) left ventricle hypertrophy;

102. Hyperkinetic (hyperdynamic) apex beat is found in patients with: A) left ventricle volumetric overload due to aortic regurgitation B) left ventricle pressure overload due to aortic stenosis C) left ventricle dyskinesia after myocardial infarction D) tricuspid regurgitation

A) left ventricle volumetric overload due to aortic regurgitation

102. The following is typical for mitral stenosis: A) loud flapping (accentuated) S1 B) S2 accent at the aorta C) systolic murmur at the apex D) diastolic murmur at the lowest part of the sternum E) pulsus celer et altus

A) loud flapping (accentuated) S1

102. Chronic right ventricle failure can cause one of the following pathologies: A) lung emphysema B) primary hypertension C) aortic ostium stenosis D) aortic regurgitation

A) lung emphysema

102. Apex beat is not displaced to the left and downwards in case of: A) mitral stenosis B) aortic regurgitation C) arterial hypertension D) myocarditis

A) mitral stenosis

102. Diastolic thrill at the heart region is typical for: A) mitral stenosis B) mitral regurgitation C) aortic stenosis D) aortic regurgitation

A) mitral stenosis

102. Left ventricle hypertrophy is not present in patient with lung oedema in case of: A) mitral stenosis B) mitral regurgitation C) aortic ostium stenosis D) primary hypertension

A) mitral stenosis

102. Systolic murmur at the aorta is not audible in: A) mitral stenosis B) aortic stenosis C) hypertrophic obstructive cardiopathy D) hyperthyroidism

A) mitral stenosis

Extremely soft S1 at the apex is found in all the following cases, except: A) mitral stenosis B) mitral regurgitation C) aortic regurgitation D) aortic ostium stenosis E) severe left ventricle hypertrophy

A) mitral stenosis

102. Pathological (wide and / or deep) Q wave is evidence of: A) myocardial necrosis B) hypertrophy of ventricle C) nonspecific changes in myocardium D) hyperkaliemia

A) myocardial necrosis

102. Sinoatrial block of II degree is characterized by: A) periods of PQRS absence B) periods of P wave absence, followed by timely QRS presence C) periods of QRS absence, P wave is present timely

A) periods of PQRS absence

S1 is soft in case of: A) prolonged PQ interval B) atrial contraction decceleration C) ventricular contraction acceleration D) atrial contraction acceleration

A) prolonged PQ interval

102. Which of the following indicates heart tamponade? A) pulsus paradoxus B) high pulse pressure C) deep y-wave on phlebogram D) strong apex beat E) inspiratory dyspnoea

A) pulsus paradoxus

102. Cor bovinum is typical for: A) severe dilatation of the heart B) hydropericardium C) hypertrophic obstructive cardiomyopathy D) pericarditis with effusion

A) severe dilatation of the heart

102. The following could be found in case of aortic stenosis: A) skin paleness B) carotid dance C) ventricularization of the venous pulse D) "quail" rhythm

A) skin paleness

102. The usual site of mitral valve auscultation is: A) the 5th intercostal space, 1 cm medially from l. medioclavicularis sin. B) the 5th intercostal space to the left of the sternum C) the lowest part of the sternum D) the connection site of processus xyphoideus and sternum E) the 4th intercostal space to the right of the sternum

A) the 5th intercostal space, 1 cm medially from l. medioclavicularis sin.

102. Pulsus paradoxus is when: A) the pulse disappears on inhalation B) the pulse disappears on exhalation C) there is no standardization of the fullness degree D) no standardization for the alteration of rate

A) the pulse disappears on inhalation

102. S4 can be heard, if: A) ventricular myocardial diastolic function - relaxation - is disturbed B) atrial contraction is intensified C) ventricular contraction is intensified

A) ventricular myocardial diastolic function - relaxation - is disturbed

102. Audible S3 in a patient of age 40 or older year indicates: A) ventricular systolic dysfunction B) nothing, it can be physiological C) bentricular diastolic dysfunction D) increased contractility of myocardium

A) ventricular systolic dysfunction

Pulmonary accentuation of the II sound is: A) when the IInd sound at tr. pulmonalis is louder than the IInd sound at the aorta B) when the IInd sound at tr. pulmonalis is louder than the Ist sound at tr. pulmonalis C) when the IInd sound at tr. pulmonalis is louder than the Ist sound at the tricuspid valve D) indicative of hypertension of the small circuit E) indicative hypertension of the large circuit The right answer is: 1) A 2) B 3) C 4) A, D 5) B, D 6) A, E

A) when the IInd sound at tr. pulmonalis is louder than the IInd sound at the aorta D) indicative of hypertension of the small circuit

76. A carotid IMT value, reflecting primary vascular hypertrophy and/or atherosclerosis is A. 0.9 mm B. 1.0 mm C. 1.1 mm

A. 0.9 mm

432. BB treatment efficiency (in CVS secondary prophylaxis) is revealed during A. 1-st year of treatment B. 2-nd year of treatment C. At once

A. 1-st year of treatment

58. Typical ventricular (and pulse) rate in AU of 2:1 is: A. 150 bpm B. 250 bpm C. 300 bpm D. 90 bpm

A. 150 bpm

450. The recommended INR range for warfarin therapy in atrial fibrillation is: A. 2-3 B. 1.5-3 C. 2-4 D. 1.5-4

A. 2-3

64. The entire process leading to a healed infarction usually takes at least A. 5-6 weeks B. 5-6 days C. 8-12 weeks

A. 5-6 weeks

449. Antiarrhythmic drug that can be used in patients of atrial fibrillation with heart failure is: A. Amiodarone B. Flecainide C. Propafenone D. Sotalol

A. Amiodarone

429. The most often (significant) post-MI complication, the main reason of post-MI mortality is: A. Arrhythmia B. Aneurism rupture C. Left ventricle failure D. Pericarditis

A. Arrhythmia

55. The following SVT occurs more often in younger women A. Atrioventricular nodal reentrant tachycardia (AVNRT) B. Atrioventricular reciprocating tachycardia (AVRT) C. Atrial tachycardia (AT) D. Atrial fibrillation E. Atrial undultation

A. Atrioventricular nodal reentrant tachycardia (AVNRT)

84. Specific drug therapy in pulmonary arterial hypertension (PAH) includes everything, except: A. B-blockers B. CCB C. Endothelin receptor antagonists D. Phosphodiestherases type 5-inhibitors

A. B-blockers

406. A 65-year-old female patient who has developed endocarditis with viridans streptococci (MIC ≤ 0.1 ug/mL) on a native heart valve. The patient has no known drug allergies and normal renal function. Which of the following intravenous regimens is most appropriate? A. Ceftriaxone 2 g once daily for 2 weeks B. Penicillin G 12-18 million units every 24 hours for 4 weeks C. Cefazolin 2 g every 8 hours for 2 weeks plus gentamicin 1 mg/kg every 8 hours for 2 weeks D. Penicillin G 12-18 million units every 24 hours for 4 weeks plus gentamicin 1 mg/kg every 8 hours for 2 weeks

A. Ceftriaxone 2 g once daily for 2 weeks

71. White-coat hypertension associates with (several answers possible): A. Female sex B. Male sex C. Smoking D. Non-smoking E. Age

A. Female sex D. Non-smoking E. Age

72. Hypertension induced organe damage (OD) is more closely related to A. Home BP B. Office BP

A. Home BP

435.Hibernating myocardium can be recognized by the following ECHO findings: A. LV wall abnormal motion B. LV abnormal thickness C. Valve morphology D. Fibrin vegetation

A. LV wall abnormal motion

63. Coronary spasm evaluated by arteriography is defined as: A. Lumen reduction between 75-99% when compared with the diameter following NTG injection B. Lumen reduction between 55-75% when compared with the diameter following NTG injection C. Lumen reductions less than 30% e. Pericarditis

A. Lumen reduction between 75-99% when compared with the diameter following NTG injection

77. Presence of a plaque can be identified by an IMT A. More than 1.5 mm B. More than 1,1 mm C. Focal increase of thickness of 0,5 mm or 50% of the surrounding carotid IMT value

A. More than 1.5 mm

81. Pulmonary hypertension has been defined as an increase in mean pulmonary arterial pressure (PAP) as assessed by right heart catheterization : A. More than 25 mmHg at rest B. More than 18 mmHg at rest C. More than 30 mmHg at rest D. More than 14 mmHg at rest

A. More than 25 mmHg at rest

423. Surgery in infective endocarditis patient should be performed immediately, irrespective of antibiotic therapy in case of A. Persistent pulmonary oedema or cardiogenic shock B. Persistent sepsis C. Relapsing IE D. Large vegetations (>10 mm)

A. Persistent pulmonary oedema or cardiogenic shock

59. Bradycardia-tachycardia syndrome is typical for: A. Sick sinus syndrome B. WPW C. AF D. VT

A. Sick sinus syndrome

409. The administration of aminoglycosides by the extended-interval dosing method is not currently recommended by the American Heart Association Guidelines; however, some positive data suggest that this approach is reasonable for endocarditis caused by A. Streptococci B. Staphylococci C. Enterococci D. HACEK microorganisms

A. Streptococci

90. Which of the following tachycardias is associated with QT prolongation A. Torsades de pointes B. Belhassen's tachycardia C. Atrioventricular nodal reentrant tachycardia D. Atrioventricular reentrant tachycardia

A. Torsades de pointes

91. Which of the following tachycardias are not amenable to radiofrequency catheter ablation: A. Torsades de pointes B. Belhassen's tachycardia C. Atrioventricular nodal reentrant tachycardia D. Atrioventricular reentrant tachycardia

A. Torsades de pointes

425. Total survival and the risk of sudden cardiac death of patients with sick sinus syndrome (SSS) (irrespective of symptoms) are similar to that of the general population A. True B. False C. Depends on age

A. True

61. In SVT the following non-pharmacological manipulation is used to slow the attack of fast rate: A. Vagal maneuvers B. Stop of exercise C. Increasing the exercise D. Horizontal body position

A. Vagal maneuvers

68.The relative CV risk associated with overweight is greater in A. Younger patients B. Older patients

A. Younger patients

67. The preferred biomarker due to its specificity and sensitivity —overall and for each specific category of MI—is A. cTn (I or T) B. CK-MB C. Leu D. CRP

A. cTn (I or T)

80. A DBP recommended target: A. less than 90 mmHg B. less than 80 mmHg C. less than 85 mmHg

A. less than 90 mmHg

70. In SCORE, total cardiovascular disease (CVD) risk is expressed as A. the absolute risk of dying from CVD (not just coronary) within 10 years B. the absolute risk of dying from CVD within 10 years C. the absolute risk of dying from CVD within 2 years

A. the absolute risk of dying from CVD (not just coronary) within 10 years

75. US examination of the carotid arteries with measurement of intima media thickness (IMT) and/or presence of plaque has been shown to predict (independently to traditional risk factors): A. the occurrence of stroke B. the occurrence of MI C. the development of LVH D. All of above

A. the occurrence of stroke

427. The aim of pacing in extrinsic (functional) bradycardia A. to prevent (traumatic) recurrent syncope B. To prevent pulmonary embolism C. To prevent CAD (coronary artery disease) D. Pacing is not recommended

A. to prevent (traumatic) recurrent syncope

444. If a patient has been in atrial fibrillation for more than 7 days, the chance of spontaneous conversion is rare. A. true B. false

A. true

102. In case of hypertrophic cardiomyopathy the following have substantial high-risk features, except: A) Genetic inheritance by vertical transfer; B) Joining of a systolic sound on apex and Erb point; C) Holter monitoring of unstable ventricular tachycardia; D) Delayed accumulation of gadolinium on MRI; E) Anamnesis of syncope or presyncope;

B) Joining of a systolic sound on apex and Erb point;

102. Murmur audible in the middle of diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic

B) Mesodiastolic

102. Murmur audible in the middle of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) Pansystolic

B) Mesosystolic

1. Which of the preparation is preferable, if the patient has stable angina and hypertension? A) Hydrochlorothiazide B) Metoprolol C) Prazosin D) Enalapril E) Telmisartan

B) Metoprolol

1. For what heart disorder systolic murmur at the apex beat is typical? A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis

B) Mitral regurgitation

1. What heart disease causes early congestion in the lungs? A) Aortic stenosis B) Mitral stenosis C) Aortic regurgitation D) Mitral regurgitation E) Tricuspid regurgitation

B) Mitral stenosis

102. The basic concept that distinguishes the mitral and aortic valve disease mechanisms, origin and pathogenesis: A) Mitral valve has two leaflets, aortic valve - three leaflets; B) Mitral valve is an endocardial structure, aortic valve - arterial structure; C) Mitral valve is exposed to a lower hydrodynamic pressure;

B) Mitral valve is an endocardial structure, aortic valve - arterial structure;

102. The levels of the following are elevated in a blood test in case of acute myocardial infarction: A) ALT B) Myoglobin C) alkaline phosphatase D) acid phosphatase

B) Myoglobin

102. Patient's posture or maneuver in which the mitral stenosis is heard better: A) Patient bending forward; B) On the left side; C) Squatting position; D) Valsalva maneuver; E) Lying on the back.

B) On the left side;

102. The following are used for chronic heart failure treatment: 1. Beta blockers 2. Diuretics 3. Cardiac glycosides 4. Enalapril 5. Diltiazem A) Only 1, 2 and 3 are correct B) Only 1, 2, 3 and 4 are correct C) Only 1, 2, 4 and 5 are correct D) Only 2, 3, 4 and 5 are correct E) All 1 - 5 are correct

B) Only 1, 2, 3 and 4 are correct

102. The following are used for chronic heart failure treatment: 1. Treatment of the underlying disease. 2. Digoxin 3. Spironolactone 4. Prazosin 5. Perindopril. A) Only 1, 2 and 5 B) Only 1, 2, 3 and 5 C) Only 2, 3 and 5 D) 1, 2, 3, 4 and 4 E) All 1 - 5.

B) Only 1, 2, 3 and 5

102. The most effective agents for AV node re-entry tachycardia paroxysm relief are: 1. Digoxin IV 2. Verapamil IV 3. Propafenone PO 4. Adenosine 5. Procainamide A) Only 1 and 3 B) Only 2 and 4 C) Only 3 and 5 D) Only 1 and 5 E) Only 2 and 3

B) Only 2 and 4

102. The two main theories of origin of cardiac tachyarrhythmias are: 1. Increased automatism in the sinus node. 2. Re-entry phenomenon. 3. Decreased automatism. 4. After depolarization. A) Only 1 and 3 are correct B) Only 2 and 4 are correct C) Only 2 and 3 are correct D) Only 3 and 4 are correct

B) Only 2 and 4 are correct

102. The most effective medicine for atrial fibrillation relief is: 1. Digoxin IV 2. Verapamil IV 3. Propafenone PO 4. Sotalol 5. Amiodarone A) Only 1 + 2 B) Only 3 + 5 C) Only 2 + 4 D) Only 4 + 5

B) Only 3 + 5

1. WPW syndrome is characterized by the following signs, except: A) Additional conduction paths in the myocardium B) PQ interval is longer than 0,20 seconds C) QRS complex expansion D) Delta wave at the beginning of ventricular complex E) Prone to attacks of paroxysmal tachycardia

B) PQ interval is longer than 0,20 seconds

102. Chest pain that lessens when sitting and bending forward is typical for: A) Esophageal spasms B) Pericarditis C) Mitral valve prolapse D) Aortic detachment E) Costochondritis.

B) Pericarditis

102. In which of the given cases, coronary artery spasms have a major role? A) Classic angina. B) Prinzmetal's angina. C) Acute myocardial infarction D) Sudden coronary death. E) In all cases.

B) Prinzmetal's angina.

1. Most common myocardial infarction complication? A) Sudden death B) Rhythm disorder C) Acute cardiac failure D) Acute cardiovascular insufficiency E) Thromboembolism

B) Rhythm disorder

1. In case of what degree of atrioventricular conduction disorder we can observe arrhythmic ventricle activity? A) First degree B) Second degree C) Third degree.

B) Second degree.

102. Systolic click of mitral valve prolapse is best audible when patient is: A) Sitting B) Standing C) lying supine D) lying in the left lateral decubitus position

B) Standing

102. Among antihypertensive agents hyperuricemia and hypokalemia can be induced by: A) Beta-adrenoblockers. B) Thiazide diuretics. C) Calcium antagonists. D) Angiotensin-converting-enzyme inhibitors. E) Angiotensin II receptor blockers.

B) Thiazide diuretics.

102. ECG changes due to myocardial infarction of the left ventricle of anterior-septal localization are registered in: A) I, aVL B) V1-V2 C) V3-V4 D) V5-V6 E) III, aVF

B) V1-V2

1. At what arrhythmia the hemodynamic disorders are most pronounced? A) Complete atrioventricular block B) Ventricles undulations C) Atrial fibrillations D) Atrial undulations

B) Ventricles undulations

1. Most common cause of acute myocarditis: A) Allergies B) Viral infection C) Bacterial infection D) Unknown cause (idiopathic myocarditis)

B) Viral infection

1. In case of aortic stenosis second tone above the aortic valves usually: A) Increased B) Weakened C) Normal D) Split

B) Weakened

1. The first tone at aortic valves in patients with aortic stenosis usually: A) Increased B) Weakened C) Normal D) Split

B) Weakened

102. Neck veins of a healthy person are filled when the angle between the superior body and a horizontal surface is: A) about 15-20° B) about 30-45° C) about 55° D) about 75°

B) about 30-45°

102. R wave of the QRS complex is: A) the main (the greatest) wave B) any positive wave C) the first negative wave D) the second negative wave

B) any positive wave

102. Pulsation at the 2nd intercostal space to the right of the sternum originates from: A) right ventricle; B) aorta; C) a. subclavia dx.; D) right atrimu

B) aorta;

102. Carotid dance is observed in case of: A) left ventricle regurgitation B) aortic regurgitation C) tricuspid regurgitation D) right ventricle failure E) mitral regurgitation

B) aortic regurgitation

102. Pulse pressure is increased in case of: A) aortic opening stenosis B) aortic regurgitation C) mitral regurgitation D) tricuspid regurgitation E) pulmonary regurgitation

B) aortic regurgitation

102. Pulsus celer et altus is typical for: A) mitral regurgitation B) aortic regurgitation C) aortic ostium stenosis D) tricuspid stenosis E) pulmonary stenosis

B) aortic regurgitation

102. Aortic ejection click is typical for: A) aortic valve idiopathic stenosis (fibrocalcinosis) B) aortic valve congenital stenosis (bicuspid valve) C) aortic valve atherosclerotic damage D) aortic valve stenosis of syphilitic origin

B) aortic valve congenital stenosis (bicuspid valve

102. The following is not found in case of aortic regurgitation: A) carotid dance B) decreased pulse blood pressure C) Musset symptom D) dilatation of the left ventricle E) Diroje's double sound

B) decreased pulse blood pressure

102. Pulsus bisferiens is classified as such when: A) anacrota consists of two parts B) double pulse wave is palpable C) pulse waves follow one another as a pair (bigeminy) D) dicrotic amplitude decreases until its complete disappearance

B) double pulse wave is palpable

102. The best method to diagnose pericardial effusion is: A) x-ray examination B) echocardiography C) pericardial cavity puncture

B) echocardiography

102. "Nun's" murmur indicates: A) stenosis of v. jugularis externa B) enforced blood flow in jugular vesels C) tricuspid regurgitation D) stenosis of ostium aortae

B) enforced blood flow in jugular vesels

Soft S1 at the tricuspid valve can be induced by: A) tricuspid stenosis B) failure of the right side of the heart C) anaemia D) hyperthyroidism

B) failure of the right side of the heart

102. Pulsus bisferiens is typical for: A) arterial hypertension B) hypertrophic obstructive cardiomyopathy C) mitral regurgitation D) tricuspid regurgitation

B) hypertrophic obstructive cardiomyopathy

102. Pulsus irregularis is: A) pulse waves of different volume B) irregular pulse waves C) different pulse in symmetric arteries D) pulse waves of different peaks

B) irregular pulse waves

102. Peripheral oedema in a patient with chronic left ventricle failure: A) is absent B) is possible C) is present in case of right ventricle failure

B) is possible

102. The following is not characteristic of Frederic Still murmur: A) it is often audible in children B) it is well audible at the pulmonary valve auscultation point, but never at the apex C) its loudness is 1/6-3/6 by Levine grading scale D) it is not palpable E) it is audible during systole

B) it is well audible at the pulmonary valve auscultation point, but never at the apex

102. Mitral valve opening snap is audible in: A) AV block of the first degree B) left atrioventricular stenosis C) hypertrophy of the left ventricle D) mitral regurgitation E) conduction disturbances in His bundle branches

B) left atrioventricular stenosis

Soft S1 at the apex is audible in case of: A) mitral stenosis B) left ventricle failure C) anaemia D) hyperthyroidism

B) left ventricle failure

102. Prolonged pex beat is found in patients with: A) left ventricle volumetric overload due to aortic regurgitation B) left ventricle pressure overload due to aortic stenosis C) left ventricle dyskinesia after myocardial infarction D) tricuspid regurgitation

B) left ventricle pressure overload due to aortic stenosis

102. Which of the following heart pathologies can not cause chronic left ventricle failure? A) primary hypertension B) lung emphysema C) coronary artery disease D) alcoholic cardiomyopathy

B) lung emphysema

Soft S1 at the apex is audible in case of: A) mitral stenosis B) mitral regurgitation C) anaemia D) hyperthyroidism

B) mitral regurgitation

102. Mitral valve opening snap is audible in patients with: A) mitral regurgitation B) mitral stenosis C) hypertrophy of the left ventricle D) dilatation of the left ventricle E) intraventricular block

B) mitral stenosis

102. S wave is: A) any negative wave of QRS complex B) negative wave after any positive wave C) negative wave after the last positive wave D) the third wave of QRS complex

B) negative wave after any positive wave

404. Based on IE diagnostic criteria, the two most important parameters for the diagnosis are A) laboratory abnormalities and positive blood cultures B) positive blood cultures and echocardiographic changes C) ECG changes and positive physical findings D) positive physical findings and positive blood cultures

B) positive blood cultures and echocardiographic changes

102. Pulsation at the 2nd intercostal space to the left of the sternum originates from: A) pulsation of v. cava superior B) pulsation of conus pulmonalis C) pulsation of the left ventricle D) pulsation of a. Ascendens

B) pulsation of conus pulmonalis

102. Pulsus inaequalis is: A) different pulse in symmetric arteries B) pulse of different amplitude in the artery C) irregular pulse

B) pulse of different amplitude in the artery

102. Pulsus alternans is classified as such when: A) every second pulse wave disappears B) pulse waves of normal amplitude interchange with waves of a lower amplitude C) pauses of normal duration interchange with prolonged pauses D) amplitude increases on a. radialis sinistra during exhalation, whereas during inhalation amplitude increases on a. radialis dextra

B) pulse waves of normal amplitude interchange with waves of a lower amplitude

94. Thrombus type most likely to be formed in low pressure veins A) white thrombus B) red thrombus

B) red thrombus

102. Graham-Steell murmur is related to: A) relative mitral stenosis due to aortic regurgitation B) relative a. pulmonalis regurgitation C) relative tricuspid regurgitation D) blood turbulences due to mitral stenosis

B) relative a. pulmonalis regurgitation

Soft S1 at the apex is audible in case of: A) mitral stenosis B) severe calcification of mitral valve leaflets C) anaemia D) hyperthyroidism

B) severe calcification of mitral valve leaflets

102. Auscultative pattern in case of mitral regurgitation is: A) loud S1 at the apex B) soft S1 at the apex C) mitral valve opening snap D) S2 accent at the aorta

B) soft S1 at the apex

102. Auscultative pattern in case of mitral regurgitation is: A) loud systolic murmur which radiates to blood vesels B) soft S1, systolic murmur C) loud S1, diastolic murmur D) soft S1 at the apex and fixed double S2 at the aorta E) diastolic murmur over the whole heart region

B) soft S1, systolic murmur

102. An abnormal phlebogram consisting of one positive wave (s wave) is typical of: A) tricuspid stenosis B) tricuspid regurgitation C) pulmonary hypertension D) pulmonary hypotension

B) tricuspid regurgitation

403. The condition associated with the highest risk of developing infective endocarditis (IE) is A) mitral valve prolapse with regurgitation B) Artificial heart valves C) Recent myocardial infarction D) rheumatic fever without valvular defects

B)Artificial heart valves

98. What is the recommended daily dose of dabigatran for the prevention of stroke and systemic embolism in a patient aged over 80 years? A. 110mg once daily B. 110mg twice daily C. 150mg twice daily D. None- dabigatran is contraindicated for patients over 80 years of age

B. 110mg twice daily

78. Antihypertensive treatment: ´the lower the better" concept assumes: A. 120/80 mmHg B. 115/75 mmHg C. 110/80 mmHg

B. 115/75 mmHg

73. The prevalence of masked hypertension averages about A. 5% B. 13% C. 25%

B. 13%

97. What is the recommended daily dose of rivaroxaban for the prevention of stroke and systemic embolism in a patient with moderate or severe renal impairment (CrCl 15-49ml/min)? A. 10mg B. 15mg C. 20mg D. 30mg

B. 15mg

431. ACE treatment efficiency (in CVS secondary prophylaxis) is revealed during A. 1-st year of treatment B. 2-nd year of treatment C. At once

B. 2-nd year of treatment

56. The following SVT occurs more often in younger women and may be comorbid with WPW: A. Atrioventricular nodal reentrant tachycardia (AVNRT) B. Atrioventricular reciprocating tachycardia (AVRT) C. Atrial tachycardia (AT) D. Atrial fibrillation

B. Atrioventricular reciprocating tachycardia (AVRT)

410. Which of the following comments is true concerning standard monitoring parameters in patients receiving endocarditis treatment? A. Serum bactericidal titers should be obtained during the first week of therapy to determine the likely response to treatment B. Blood culture should be negative within a few days C. The goal peak gentamicin concentration should be 6 µg/mL D. The MBC should be determined for all streptococci

B. Blood culture should be negative within a few days

436. Gold standard for the diagnosis of the no-reflow phenomenon in the setting of percutaneous coronary intervention (PCI) is: A. Echo B. Myocardial contrast ECHO C. Coronary angiography D. Exercise testing

B. Myocardial contrast ECHO

102. Typical skin colour for patients with acute endocarditis is: A) Acrocyanosis; B) Diffuse cyanosis ; C) "Cafe au lait »; D) Paleness;

C) "Cafe au lait »;

102. Certain murmur over jugular veins is intensified due to arrhythmia, it is: A) Austin-Flint murmur B) Rivero-Karvallo murmur C) "Nun's" murmur D) Graham Steell murmur E) Diroje murmur

C) "Nun's" murmur

102. Pulsus frequens is considered a pulse more rapid than: A) 80 min-1 B) 95 min-1 C) 100 min-1 D) 110 min-1

C) 100 min-1

1. In case of typical atrial fibrillation, atrial contraction frequency in 1 minute is: A) 150 - 200 B) 127 - 240 C) 250 - 350 D) 360 - 400 E) Above 400

C) 250 - 350

102. Chronic heart failure patient suffers from fatigue, shortness of breath and heart palpitations even on minimal exercise. Which chronic heart failure functional class by NYHA is it? A) 1 B) 2 C) 3 D) 4

C) 3

102. The predicted venous pressure when measured by a non-invasive method is: A) 0-40 mmH2O B) 40-60 mmH2O C) 70-80 mmH2O D) 100-200 mmH2O

C) 70-80 mmH2O

102. The blockage of the anterior division of the left branch of His bundle is characterized by QRS axis: A) > +45° B) 0° C) > -45°

C) > -45°

1. Mitral valve opening snap auscultation moment in case of mitral stenosis is: A) Right after first tone B) Right before second tone C) After second tone

C) After second tone

1. In case of which cardiomyopathy atrial fibrillation is common? A) Hypertrophic B) Restrictive C) Alcoholic D) Hypertensive

C) Alcoholic

1. Which is the most effective drug for atrial fibrillation attack prevention? A) Digoxin B) Verapamil C) Amiodarone D) Procainamide

C) Amiodarone

1. Which of the listed drugs are indicated for paroxysmal ventricular tachycardia in patients with acute myocardial infarction? A) Digoxin B) Adenosine C) Amiodarone D) Propafenone E) Verapamil

C) Amiodarone

1. For what heart disease increased pulse pressure amplitude is typical? A) Mitral regurgitation B) Mitral stenosis C) Aortic regurgitation

C) Aortic regurgitation

1. What changes in ECG indicate a myocardial necrosis (infarction)? A) T wave changes B) ST - depression C) Appearance of a pathological Q wave D) ST interval uplift E) Atrioventricular block

C) Appearance of a pathological Q wave

102. The risk of stroke in patients with atrial fibrillation is determined by: A) Symptomatic; B) Left atrium size; C) CHA2DS2iVASc risk score; D) HAS-BLED risk score;

C) CHA2DS2iVASc risk score

102. Diagnostic marker of myocardial damage (acute coronary syndrome) is: A) AST B) ALT C) CK-MB D) total CK E) alkaline phosphatase

C) CK-MB

102. The most important diagnostic marker of focal myocardial necrosis is elevation of: A) ALT B) LDH C) CK-MB D) AST E) total CK

C) CK-MB

1. In what case arterial hypertension is based on changes in electrolyte content? A) Thyrotoxicosis B) Glomerulonephritis C) Conn's syndrome D) Primary arterial hypertension E) Pheochromocytoma

C) Conn's syndrome

1. if one month after myocardial infarction ST elevation persists in patients ECG, then must think about: A) Dressler's syndrome B) Ventricular septal rupture C) Development of heart aneurysm D) Cardiac failure progression E) Threatening heart rhythm disorders

C) Development of heart aneurysm

1. Which medication is less important for emergency treatment of myocardial infarction-induced pulmonary edema? A) Furosemide B) Morphine C) Digoxin D) Nitroglycerin (or isosorbide dinitrate) sublingually.

C) Digoxin

1. In a patient with myocardial infarction on the 3rd week of sickness following symptoms have appeared: chest pain, pericardial friction rub, increased temperature ( 39 C ), ESR - 50 mm/h. Probable diagnosis? A) Infarct zone expansion B) Idiopathic pericarditis C) Dressler's syndrome D) Myocardial infarction E) Ventricular septal perforation

C) Dressler's syndrome

1. What is the most informative investigation to detect even a small pericardial effusion? A) Heart percussion B) Heart X-ray investigation C) Echocardiography D) ECG E) Cardiac catheterization

C) Echocardiography

102. The most effective method of sinus rhythm restoration in a patient with atrial fibrillation is: A) Amiodarone intravenous up to 1800mg / 24h; B) Amiodarone with a perfusor up to 2400mg / 24h; C) Electrical cardioversion; D) Propafenone intravenous;

C) Electrical cardioversion;

102. Forced position of a patient sitting leaning forward is due to: A) Myocarditis; B) Aortic ostium stenosis; C) Fibrinous pericarditis; D) Cardiac asthma attack;

C) Fibrinous pericarditis;

102. The following medicines are used for hypertensive crisis relief, except: A) Clonidine B) Nifedipine C) Hydrochlorothiazide D) Captopril E) Sodium nitroprusside

C) Hydrochlorothiazide

1. The most typical ECG sign complex in case of of left ventricular hypertrophy? A) Increase of R wave in lead I and S wave in V5-V6 leads B) Increase of R wave in leads V1-V2and S wave in lead I C) Increase of R wave in leads V5-V6and S wave in V1-V2 leads

C) Increase of R wave in leads V5-V6and S wave in V1-V2 leads

102. Dukes major and minor criteria relate to: A) Damage level determination of arterial hypertension target organs; B) Determination of atherosclerotic plaque size; C) Infectious endocarditis diagnostics; D) Heart insufficiency classification after Braunwald;

C) Infectious endocarditis diagnostics;

102. The following drugs belong to the angiotensin-converting-enzyme inhibitors, except: A) Lisinopril B) Perindopril C) Lacidipine D) Enalapril E) Ramipril

C) Lacidipine

1. When recording the ECG, the third standard lead corresponds with: A) Right hand, left hand B) Left hand, right hand C) Left hand, left foot D) Right hand, right foot E) Right foot, left foot

C) Left hand, left foot

102. All of the following is typical for tricuspid regurgitation, except: A) ventricularization of venous pressure B) systolic murmur at the 4th intercostal space to the left of the sternum C) Musset symptom D) soft S1 at the lower part of the sternum E) heart borders displaced to the right

C) Musset symptom

102. Pulmonary thromboembolism often has to be differentiated from: A) Myocarditis B) Pericarditis C) Myocardial infarction D) Dilated cardiomyopathy E) Mitral stenosis

C) Myocardial infarction

1. In what case, in a patient with myocardial infarction, thrombolytic therapy is the most effective? A) In case of posterior wall infarction B) Myocardial infarction during the first 4 - 6 hours C) Myocardial infarction during the first and second hour D) If the infarction is complicated by arrhythmia E) Thrombolytic therapy for 7-12 hours after myocardial infarction

C) Myocardial infarction during the first and second hour

1. What antianginal agent can be used for cardiac asthma relief? A) Metoprolol B) Verapamil C) Nitroglycerin SL D) Nifedipine PO

C) Nitroglycerin SL

1. Which measure is not indicated in case of cardiogenic pulmonary edema? A) Half sitting position with the legs lowered down. B) Furosemide intravenous. C) Norepinephrine intravenous. D) Morphine intravenous.

C) Norepinephrine intravenous

102. The most effective medicine to reduce tachysystolic atrial fibrillation is: 1. Digoxin 2. Verapamil 3. Metoprolol 4. Propafenone PO 5. Procainamide A) Only 3 + 4 + 5 B) Only 1 + 3 + 5 C) Only 1 + 2 + 3 D) Only 4 + 5

C) Only 1 + 2 + 3

1. Embolus getting into the leg arteries due to a thombus detaching from: 1. In case of mitral stenosis of left atrium. 2. In case of left heart valve bacterial endocarditis. 3. In case of heart failure in the right heart chamber trabecular spaces. 4. Abnormal atherosclerotic aorta. 5. Mesenteric veins. A) Only 1 is correct B) Only 1, 2 and 3 are correct C) Only 1, 2 and 4 are correct D) Only 1, 3, 4 and 5 are correct E) All 1 - 5 are correct

C) Only 1, 2 and 4 are correct

102. Acute right ventricle overload ECG signs are: 1. S1 2. QIII 3. QI 4. Negative TIII 5. Negative T V1-V2 A) Only 1, 3 and 5 are correct B) Only 3, 4 and 5 are correct C) Only 1, 2 and 5 are correct D) All 1 - 5 are correct E) Only 1, 2, 4 and 5 are correct

C) Only 1, 2 and 5 are correct

102. In primary arterial hypertension (between crisis) treatment first-line drugs are: 1. Amlodipine 2. Doxazosin 3. Fosinopril 4. Enalapril 5. Valsartan A) Only 1, 3, 4 and 5 B) Only 1 and 2 C) Only 1, 3 and 4 are correct D) Only 1, 2, 3 and 5 E) All 1 - 5

C) Only 1, 3 and 4 are correct

102. What contributes to the limitation of necrosis area in case of myocardial infarction? 1. Rest 2. Nifedipine 3. Nitroglycerin 4. Streptokinase 5. Propranolol A) Only 1, 2 and 4 B) Only 2, 3 and 4 C) Only 1, 3, 4 and 5 D) 2, 3, 4 and 5 E) All 1 - 5

C) Only 1, 3, 4 and 5

1. Nowadays, which antihypertensive agents belong to the first-line drugs? 1. Angiotensin II Receptor Blockers; 2. Clonidine 3. Calcium antagonists 4. Diuretics 5. Angiotensin-converting-enzyme inhibitors A) Only 1 and 2 are correct B) Only 1, 2 and 3 are correct C) Only 1, 3, 4 and 5 are correct D) Only 2, 3, 4 and 5 are correct E) All 1 - 5 are correct

C) Only 1, 3, 4 and 5 are correct

102. Which ECG leads represent myocardial infarction in the left ventricular lateral wall? 1. II, III 2. I, aVL 3. V1 - V2 4. V3 - V4 5. V5 - V6 A) Only 1 B) Only 3 and 4 C) Only 2 and 5 D) Only 1 and 4

C) Only 2 and 5

1. If a patient has a chronic sinus bradycardia (36-38 beats per minute), which is accompanied by dizziness and fainting several times, the most effective help is: A) Atropine B) Theophylline C) Pacemaker implantation D) Epinephrine E) None of the above

C) Pacemaker implantation

1. In a patient with angina the main medical effect of nitroglycerin is connected with: A) Hypotension B) Peripheral arterial dilatation C) Peripheral venous system dilatation D) Increase in coronary blood flow due to heart rate acceleration E) Heart rate increase and decrease of oxygen demand

C) Peripheral venous system dilatation

102. Murmur audible at the end of diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic

C) Presystolic

1. Main ECG signs in case of intraventricular conduction disturbances: A) QRS complex arrhythmia B) QT interval extension C) QRS complex expansion D) PQ interval extension E) TP interval extension

C) QRS complex expansion

1. For what arterial hypertension urine changes are uncommon? A) Chronic pyelonephritis B) Renal amyloidosis C) Renal artery stenosis D) Chronic pyelonephritis

C) Renal artery stenosis

2. In the X-ray in anterior-posterior position left heart contour consists of all the required parts of the heart, except: A) Aortic arch B) Pulmonary artery C) Right atrium D) Left ventricle E) Left artium

C) Right atrium

102. The following is inaudible in case of mitral stenosis: A) S1 at the heart apex B) S2 accentuation at tr. Pulmonalis C) S2 accentuation at the mitral valve D) diastolic murmur at the apex

C) S2 accentuation at the mitral valve

102. The following is not typical for a patient with compensated aortic stenosis: A) systolic murmur of diamond shape B) soft S2 at the aortic valve C) S3 D) murmur irradiating to neck vesels E) prolonged apex beat

C) S3

102. Oedema due to heart failure is characterised by: A) Morning facial oedema; B) Unilateral shin oedema with local cyanosis; C) Shin and feet oedema in the evening; D) Unilateral infraorbital oedema; E) Eyelid oedema with skin itching;

C) Shin and feet oedema in the evening;

1. Myocardial ischemia can be caused by various types of pain. Which are less typical for coronary ischemia? A) Burning type B) Radiating on both hands C) Short, stabbing D) Increase when walking E) Pain from emotions

C) Short, stabbing

1. Chronic pulmonary heart usually manifests with all the mentioned symptoms, except: A) High and sharp P wave in lead aVF B) Electric heart axis deviation to the right C) Shortness of breath attacks at night D) Hepatomegaly E) Ascites

C) Shortness of breath attacks at night

1. What diuretic does not cause hypokalemia? A) Torasemid B) Furosemide C) Spironolactone D) Hydrochlorothiazide

C) Spironolactone

1. What angina can be treated ambulatory (in out-patient)? A) First-time angina (in III FK level) B) Progressing rest angina and stable angina C) Stable angina

C) Stable angina

102. Murmur audible at the end of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) Pansystolic

C) Telesystolic

102. The usual site of pulmonary valve auscultation is: A) Erb's point B) The 3rd intercostal space to the right of the sternum C) The 2nd intercostal space to the left of the sternum D) The 2nd intercostal space to the right of the sternum E) The 3rd intercostal space to the right of the sternum

C) The 2nd intercostal space to the left of the sternum

102. What "door-to-balloon" time means? A) The time from the first medical contact to catheter guidewire injection in the coronary blood vessel; B) The time from symptom onset to admission to a department; C) Time from the patients admission to the hospital until catheter guidewire injection in the coronary blood vessel; D) Time from the patient entering the catheterization laboratory until the end of the procedure;

C) Time from the patients admission to the hospital until catheter guidewire injection in the coronary blood vessel;

102. Diagnostic marker of myocardial damage (acute coronary syndrome) is: A) AST B) ALT C) Troponin I D) Total CK E) alkaline phosphatase

C) Troponin I

102. The most important diagnostic marker of focal myocardial necrosis is elevation of: A) ALT B) LDH C) Troponin T D) AST E) Total CK

C) Troponin T

1. Most typical criteria of myocardial infarction: A) Leukocytosis B) Erythrocyte sedimentation rate increase C) Troponin level increase in the blood D) Hypercholesterolemia E) Appearance of C - reactive protein

C) Troponin level increase in the blood

102. In which leads on a normal ECG there are no Q waves? A) I and II B) II and III C) V1- V2 D) V5-V6 E) aVL and aVF

C) V1- V2

102. In which leads the S wave is the biggest at norm? A) I, aVL B) II, III, aVF C) V1- V2 D) V3- V4 E) V5- V6

C) V1- V2

102. The transitional zone (R = S) is usually registered in: A) V1 B) V2 C) V3 D) V4 E) V5 F) V6

C) V3

102. Systolic thrill at the heart region is typical for: A) mitral stenosis B) mitral regurgitation C) aortic stenosis D) aortic regurgitation

C) aortic stenosis

102. The following is not found in case of isolated right ventricle failure: A) intensified heart beat B) epigastric pulsation C) apex beat displaced to the left and downwards D) pulsation in the 2nd intercostal space to the left of sternum

C) apex beat displaced to the left and downwards

102. The following is not typical for a patient with compensated mitral stenosis: A) diastolic murmur B) Graham-Steell murmur C) apex beat displacement to the left and downwards D) pathological splitting of sounds E) pulsus differens

C) apex beat displacement to the left and downwards

102. Pulsus filiformis is typical for: A) aortic ostium stenosis B) arterial hypertension C) blood loss D) mitral stenosis E) mitral regurgitation

C) blood loss

102. Hydrothorax develops in case of: A) right ventricle failure B) left ventricle failure C) both left and right ventricle failure

C) both left and right ventricle failure

102. Systolic murmur between scapulae is evidence of: A) mitral regurgitation B) aortic stenosis C) coarctation of aorta D) pulmonary stenosis

C) coarctation of aorta

102. Which of the following is typical for a patient with chronic left ventricle failure? A) Hepatomegaly B) overfilled neck viens C) coarse crackles in the lungs D) ascites

C) coarse crackles in the lungs

102. The following can not auscultated in lungs in case of cardiac asthma: A) sharp vesicular breathing B) coarse crackles in the basal part of the lung C) coarse cracles in the lung apex D) some dry crackles in the lung

C) coarse cracles in the lung apex

102. Murmur of a pitch which increases in the beginning of the heart cycle but then reduces is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform

C) crescendo-decrescendo (diamond-shaped)

102. Heart beat corresponds to: A) pulsation at the apex region B) pulsation at the 2nd intercostal space to the right of the sternum C) diffuse pulsation in the heart region by the left margin of the sternum D) pulsation at the 2nd intercostal space to the left of the sternum E) pulsation at fossa jugularis

C) diffuse pulsation in the heart region by the left margin of the sternum

102. Phlebogram pattern in case of heart tamponade is: A) diminished a-wave B) diminshed v-wave C) enlarged x-wave D) enlarged y-wave

C) enlarged x-wave

102. The following is not typical for mitral stenosis: A) loud S1 B) presystolic murmur C) gallop rhythm D) S2 accent at tr. Pulmonalis E) S2 split at tr. pulmonalis

C) gallop rhythm

102. Pericardial sound is audible: A) in the beginning of the systole B) in the end of the systole C) in the beginning of the diastole D) in the end of the diastole

C) in the beginning of the diastole

102. Lentiform cardiac murmur: A) Increases B) Decreases C) is of a constant amplitude D) decreases, then increases

C) is of a constant amplitude

102. Frederic Still murmur is not characterised by the following: A) it is often audible in children B) it is audible at pericardial region C) it is usually audible during systole but could also be audible during presystole D) its loudness is 1/6-3/6 E) it is not palpable

C) it is usually audible during systole but could also be audible during presystole

102. Late apex beat is found in case of: A) left ventricle volumetric overload due to aortic regurgitation; B) left ventricle pressure overload due to aortic stenosis; C) left ventricle dyskinesia after myocardial infarction; D) tricuspid regurgitation

C) left ventricle dyskinesia after myocardial infarction;

102. The following is not found in case of aortic regurgitation: A) Musset symptom B) the left border of the heart is displaced laterally (to the left) C) low systolic pressure D) carotid dance E) increased blood pulse pressure

C) low systolic pressure

102. Pericardial friction rub includes the following, except: A) protodiastolic component B) presystolic component C) mesodiastolic component D) systolic component

C) mesodiastolic component

102. Heart configuration with a missing waistline and hypertrophy of the right ventricle is characteristic of: A) stenosis of the aortic ostium B) aortic regurgitation C) mitral stenosis D) mitral regurgitation

C) mitral stenosis

102. Mesosystolic click is audible in case of: A) mitral stenosis B) organic mitral regurgitation C) mitral valve prolapse

C) mitral valve prolapse

102. Dysphagia in mitral stenosis is usually caused by: A) oesophageal blood vessel spasm B) oesophagus suppression due to enlarged right atrium C) oesophagus suppression due to enlarged left atrium D) oesophagus suppression due to left ventricle dilatation

C) oesophagus suppression due to enlarged left atrium

102. The following is typical for a patient with aortic regurgitation: A) Acrocyanosis; B) pale pinkish skin; C) paleness; D) wax-like paleness; E) grey-coloured skin

C) paleness;

102. P wave in presence of sinus rhythm should be: A) positive in I, II and III and negative in aVR B) positive in I, II and III C) positive in II lead and negative in aVR D) positive in II and all chest leads

C) positive in II lead and negative in aVR

102. Diastolic murmurs of aortic regurgitation are best audible when the patient is: A) Standing B) lying supine C) sitting leaning forward D) sitting E) lying in the left lateral decubitus position

C) sitting leaning forward

102. The following is not typical for mitral stenosis with elastic valve: A) Fibrillation B) mitral valve opening snap C) soft S1 at the apex cordis D) diastolic murmur at the apex cordis

C) soft S1 at the apex cordis

102. The following is typical for tricuspid regurgitation: A) S2 accent at the aorta B) S2 accent at a. Pulmonalis C) systolic murmur intensification at the lowest third of the sternum during inhalation D) "quail" rhythm E) Flint's murmur

C) systolic murmur intensification at the lowest third of the sternum during inhalation

102. The following is not found in case of mitral stenosis: A) pulsus differens on aa. Radialis B) epigastric pulsation C) systolic thrill D) sometimes apex beat can not be palpated

C) systolic thrill

102. Diastolic murmur due to mitral stenosis is best audible when: A) the patient lies supine B) the patient is leaning forward C) the patient exhales lying in the left lateral decubitus position D) the patient inhales lying in the left lateral decubitus position

C) the patient exhales lying in the left lateral decubitus position

102. Graham-Steell murmur is best heard at: A) apex cordis B) aorta C) tr. pulmonalis D) Erb's point

C) tr. pulmonalis

102. Which pathology does not usually lead to left ventricle failure? A) coronary artery disease B) arterial hypertension C) tricuspid regurgitation D) mitral regurgitation

C) tricuspid regurgitation

102. Hepatic pulsation and ventricularization of the venous pulse are caused by: A) mitral regurgitation; B) aortic regurgitation; C) tricuspid regurgitation; D) mitral stenosis; E) myocardial infarction;

C) tricuspid regurgitation;

102. The most important diagnostic marker of focal myocardial necrosis is elevation of: A) ALT B) LDH C) troponin I D) AST E) total CK

C) troponin I

93. Cutaneous necrosis due to reduced protein C activity occurs during the first weeks of therapy with: A) streptokinase B) abciximab C) warfarin D) ticlopidine E) aspirin

C) warfarin

438. Which of the following is a characteristic reperfusion arrhythmia: A. Atrial fibrillation B. Junctional tachycardia C. Accelerated idioventricular rhythm D. Torsades de pointes

C. Accelerated idioventricular rhythm

57. The following SVT occurs more often in middle age or in persons with heart failure or chronic obstructive pulmonary disease: A. Atrioventricular nodal reentrant tachycardia (AVNRT) B. Atrioventricular reciprocating tachycardia (AVRT) C. Atrial tachycardia (AT)

C. Atrial tachycardia (AT)

402. In a patient with subacute endocarditis, which of the following laboratory findings do not support the diagnosis? A. Normocytic, normochromic anemia B. Proteinuria C. Decreased erythrocyte sedimentation rate D. Thrombocytopenia

C. Decreased erythrocyte sedimentation rate

452. Electrical cardioversion is contraindicated in patients of atrial fibrillation with: A. Heart failure B. Myocardial ischemia C. Digitalis toxicity D. All the above

C. Digitalis toxicity

54. How to diagnose AF by palpation? A. Irregulary regular pulse B. Regulary irregular pulse C. Irregulary irregular pulse D. Pulsus bisferiens

C. Irregulary irregular pulse

89. Which of the following rhythms is taken as a marker of successful ablation of atrioventricular nodal re-entrant tachycardia (AVNRT)? A. Ventricular tachycardia B. Sinus rhythm C. Junctional rhythm D. Atrial fibrillation

C. Junctional rhythm

446. Strongest risk factor for stroke in patients with atrial fibrillation is: A. Irregular atrial rhythm B. Increased ventricular rate C. Lack of anticoagulation D. None of the above

C. Lack of anticoagulation

433. Post-MI sudden death risk can be reduced by 25% when treatment includes: A. Nifedipin B. Enalapril C. Metoprolol D. Acebutolol

C. Metoprolol

400. A patient that recently had mitral valve replacement (38 days ago) was admitted to the clinic with persistent fever and malaise. Endocarditis is suspected, and the most likely etiology is A. group A streptococci B. viridans streptococci C. Staphylococcus epidermidis D. Enterococcus fecalis

C. Staphylococcus epidermidis

79. A SPB goal less than 140 mmHg is recommended in A. patients with low cardiovascular (CV) risk B. patients with diabetes C. elderly hypertensives D. patients with previous stroke

C. elderly hypertensives

1. What statement is incorrect? In a patient with coarctation of aorta the following symptoms can be observed: A) Arterial hypertension, when measuring arterial blood pressure on arms. B) Systolic murmur in the paravertebral area at the back. C) Palpable arterial pulsation in the intercostal slots. D) Blood pressure on the feet higher than on the arms. E) Signs of electrocardiographic left ventricular hypertrophy.

D) Blood pressure on the feet higher than on the arms.

422. Which of the following organisms is not commonly implicated in infective endocarditis? A) Streptococcus species B) Staphylococcus species C) Enterococcus species D) Candida species

D) Candida species

1. In case of what kind of conduction disorder a permanent pacemaker implantation is indicated: A) His bundle left branch block B) In case of type I second degree atrioventricular block in patients with posterior wall myocardial infarction C) Supraventricular tachycardia with atrioventricular block D) Complete atrioventricular block in anterior myocardial infarction

D) Complete atrioventricular block in anterior myocardial infarction

1. Right heart failure signs along with "small" heart and absence of cardiac apex impulse most often indicates: A) Idiopathic dilated cardiomyopathy B) Mitral regurgitation C) Arterial hypertension D) Constrictive pericarditis E) Heart aneurysm

D) Constrictive pericarditis

1. What instrumental examination method directly points to mitral stenosis? A) ECG B) X-ray investigation C) Myocardial scintigraphy D) Echocardiography

D) Echocardiography

1. Of what kind of conduction disorders indicates an expansion of the QRS complex by more than 0,12 seconds? A) Atrioventricular conduction disturbances B) His bundle front left branch block C) Sino-atrial block D) Full block of the left branch

D) Full block of the left branch

103. The main use of cardiac resynchronization therapy (CRT) is: A) Same as the standard pacemaker only in younger patients; B) Same as the standard pacemaker only in elderly patients; C) Is only applied at atrial fibrillation in the presence of bradysystole; D) Heart insufficiency treatment method;

D) Heart insufficiency treatment method;

102. Murmur throughout diastole is called: A) Protodiastolic B) Mesodiastolic C) Presystolic D) Holodiastolic

D) Holodiastolic

102. Murmur audible throughout the whole systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic

D) Holosystolic

102. What statement is correct? To diagnose of painless myocardial ischemia, the main significance is the : A) Echocardiogramm B) Anamnesis C) ECG at rest D) Holter monitoring and veloergometry E) All above are correct

D) Holter monitoring and veloergometry

102. Which of the following electrolyte changes contribute to cardiac glycosides toxicity? A) Hypomagnesaemia B) Hypocalcaemia C) Hypernatremia D) Hypokalemia

D) Hypokalemia

102. The following symptom is usually not observed in case of lung oedema: A) foamy sputum B) cyanosis C) coarse crackles in the lung D) Kussmaul breathing

D) Kussmaul breathing

1. Which does not correspond to the direct signs of mitral stenosis? A) Presystolic murmur B) Mitral valve opening snap C) Diastolic murmur D) Left atrium enlargement E) ECHO mitral stenosis sign

D) Left atrium enlargement

102. Pulmonary thromboembolism is promoted by the following factors, except: A) Obesity. B) Trauma of lower extremities and pelvis. C) Oral contraceptive use. D) Liver cirrhosis. E) Malignant tumors.

D) Liver cirrhosis.

102. Nitroglycerin can relieve chest pain in all cases except: A) Prinzmetal's angina. B) Esophageal spasm. C) Mitral valve prolapse D) No exceptions (relieves in all cases).

D) No exceptions (relieves in all cases).

1. Asymmetric ventricular septal hypertrophy is particularly characteristic of: A) Myocarditis B) Valvular cardiomyopathy C) Dilated cardiomyopathy D) Obstructive cardiomyopathy

D) Obstructive cardiomyopathy

1. Which CAD form causes chronic cardiac insufficiency? A) Unstable angina B) Progressive angina pectoris C) Silent ischemia D) Old myocardial infarction

D) Old myocardial infarction

1. Which antihypertensive agents have sedative effects? 1. Clonidine 2. Prazosin 3. Methyldopa 4. Enalapril 5. Amlodipine A) Only 1 is correct B) Only 1, 2 and 3 are correct C) Only 2, 3 and 4 are correct D) Only 1 and 3 are correct E) Only 1, 3, 4 and 5 are correct

D) Only 1 and 3 are correct

1. Which of the following medicines are not basic medications for chronic arterial hypertension treatment? 1 Nitrates 2 Telmisartan 3 Clonidine 4 Enalapril 5 Lacidipine A) Only 1 is correct B) Only 1, 2 and 3 are correct C) Only 2, 4 and 5 are correct D) Only 1 and 3 are correct E) Only 1, 3 and 4 are correct

D) Only 1 and 3 are correct

1. Signs of congestion in the lungs frequently observed in patients with: 1. Acute myocardial infarction 2. Mitral stenosis 3. Acute pulmonary arterial thromboembolism 4. Atrial septal defect 5. Uncontrolled arterial hypertension A) Only 3 is correct B) Only 1 and 4 are correct C) Only 2 and 3 are correct D) Only 1, 2 and 5 are correct E) All 1 - 5 are correct

D) Only 1, 2 and 5 are correct

1. The following are important in chronic heart failure pathogenesis: 1 Ejection fraction reduction 2 Peripheral vasoconstriction 3 Deterioration of renal perfusion 4 SNS suppression 5 RAAS activation A) Only 1 is correct B) Only 1 and 2 are correct C) Only 1, 2, 3 and 4 are correct D) Only 1, 2, 3 and 5 are correct E) All 1 - 5 are correct

D) Only 1, 2, 3 and 5 are correct

102. In primary arterial hypertension pharmacotherapy (between crisis) first-line drugs are: 1. Ramipril 2. Telmisartan 3. Hydrochlorothiazide 4. Clonidine 5. Felodipine A) Only 1 and 2 are correct B) Only 1, 2 and 3 are correct C) Only 2, 3, 4 and 5 are correct D) Only 1, 2, 3 and 5 are correct E) All 1 - 5 are correct.

D) Only 1, 2, 3 and 5 are correct

102. Which of the following medicines can retain fluid in the body? 1. Reserpine 2. Methyldopa 3. Diclofenac 4. Clonidine 5. Isosorbide dinitrate 6. Indomethacin A) Only 1 B) Only 1, 2 and 3 C) Only 4 and 5 D) Only 1, 2, 3, 4 and 6

D) Only 1, 2, 3, 4 and 6

1. For frequency control in case of atrial fibrillation or undulation, without any symptoms of heart failure the next is indicated: 1 Digoxin 2 Propafenone 3 Bisoprolol 4 Procainamide 5 Verapamil A) Only 5 is correct B) Only 1 is correct C) Only 1, 2 and 4 are correct D) Only 1, 3 and 5 are correct E) All 1 - 5 are correct

D) Only 1, 3 and 5 are correct

1. Which of the listed symptoms are most important to diagnose cardiogenic shock in case of myocardial infarction? 1. Urinary excretion 2. Shortness of breath 3. Pericardial friction rub 4. Arterial blood pressure 5. Clammy skin (cold, sweaty) A) Only 1 and 2 are correct B) Only 1, 3 and 4 are correct C) Only 2, 4 and 5 are correct D) Only 1, 4 and 5 are correct E) All 1 - 5 are correct

D) Only 1, 4 and 5 are correct

102. What is typical for right atrial overload on ECG? 1. Wide P wave in lead I; 2. High P wave in lead II 3. A high positive wave in lead V1 4. Explicit P wave negative phase in lead V1 A) Only 1 and 2 are correct B) Only 1 and 3 are correct C) Only 1 and 4 are correct D) Only 2 and 3 are correct E) Only 2 and 4 are correct

D) Only 2 and 3 are correct

1. Following arrhythmias create a possibility of ventricular fibrillation. 1. Atrial fibrillation 2. Group-like ventricular extrasystoles 3. Atrial undulation 4. Supraventricular (node) paroxysmal tachycardia 5. Ventricular paroxysmal tachycardia A) Only 1 is correct B) Only 1, 2 and 3 are correct C) 1, 3 and 4 are correct D) Only 2 and 5 are correct E) Only 2, 4 and 5 are correct

D) Only 2 and 5 are correct

1. Which of the listed drugs are effective, if used in case of acute heart failure induced pulmonary edema, due to their ability to reduce heart strain (preload) caused by venous inflow? 1 Nifedipine 2 Digoxin 3 Nitroglycerin 4 Isosorbide dinitrate 5 Dopamine A) Only 1 is correct B) Only 1 and 2 are correct C) Only 2, 3 and 4 are correct D) Only 3 and 4 are correct E) All 1 - 5 are correct

D) Only 3 and 4 are correct

102. The basis of infectious endocarditis diagnosis is: A) Heart sounds. B) Leukocytosis with deviation to the left. C) Petechiae. D) Positive hemocultures.

D) Positive hemocultures.

1. Supraventricular and ventricular extrasystole basic differences: A) Complaints B) Heart auscultation data C) RR interval measurements D) QRS complex analyses

D) QRS complex analyses

102. In the pathogenesis of primary arterial hypertension the following internal factors are important, except: A) Sodium transport and excretion inhibition; B) Renin-angiotensin-aldosterone and increased SNS activity; C) Vascular wall increased sensitivity to angiotensin and noradrenaline; D) Reduced output of angiotensin converting enzyme; E) Reduces output of kallikrein and prostacyclin (vasodilator).

D) Reduced output of angiotensin converting enzyme;

1. What statement concerning a short-acting form of Nifedipine is incorrect? A) Relaxes vascular smooth muscle. B) Is used in the treatment of Raynaud's syndrome. C) It is a drug with a antihypertensive effect. D) Reduces oxygen consumption in the myocardium. E) Reduces strain on the heart (afterload) caused by peripheral resistance.

D) Reduces oxygen consumption in the myocardium.

102. LQTS type 2 in children and adolescents is often disguised by: A) Continuous headache in the evening; B) Elevated low-density cholesterol; C) Proteinuria; D) Small type (Petit mal) epileptic seizures;

D) Small type (Petit mal) epileptic seizures;

1. In case of which angina four functional classes can be distinguished? A) Unstable angina B) Spontaneous (special) angina C) Progressive angina pectoris D) Stable angina E) Angina - occurring for the first time

D) Stable angina

1. What arrhythmias are in particular characterized by strong pulse deficit? A) Sinus bradycardia B) Complete atrioventricular block C) Atrioventricular block 2:1 D) Tachisystolic form of atrial fibrillation

D) Tachisystolic form of atrial fibrillation

102. What is intra-aortic counterpulsation in cardiology intensive care practice? A) The standard method for patients with severe acute left ventricular systolic dysfunction; B) The method to be used in some cases at large front wall myocardial infarction; C) A standby method at acute renal failure; D) The standard method in case of cardiogenic shock;

D) The standard method in case of cardiogenic shock;

102. The highest R wave is usually registered in: A) V1 B) V2 C) V3 D) V4 E) V5 F) V6

D) V4

102. Normal Q wave appears in the following chest leads: A) V1-V6 B) V2-V6 C) V3-V6 D) V4-V6

D) V4-V6

102. Protodiastolic gallop rhythm is audible in: A) primary arterial hypertension B) aortic stenosis C) mitral stenosis D) aortic regurgitation

D) aortic regurgitation

102. The following is not found in case of isolated right ventricle failure: A) Ascitis B) Hepatomegalia C) overfilled neck viens D) coarse crackles in the basal part of the lung

D) coarse crackles in the basal part of the lung

102. Which of the following is not typical for cardiac asthma? A) Dyspnoea B) Orthopnoea C) Tachypnoea D) coarse crackles over the whole lung area

D) coarse crackles over the whole lung area

102. constrictive pericarditis, the phlebogram features: A) diminished a-wave B) diminished v-wave C) enlarged x-wave D) enlarged y-wave E) enlarged x and y wave F) diminished x and y waves

D) enlarged y-wave

102. Facies Corvisart is typical for: A) hepatic failure; B) Myxoedema; C) Peritonitis; D) heart failure; E) vitamin B12 deficiency anaemia

D) heart failure;

102. In case of aortic regurgitation the following is usually found: A) pulsus parvus et tardus B) "quail" rhythm C) Graham-Steell murmur D) high pulse pressure

D) high pulse pressure

102. The following is inaudible in case of mitral stenosis: A) Graham-Steell murmur B) protodiastolic murmur at the apex C) presystolic murmur at the apex D) holosystolic murmur at the apex

D) holosystolic murmur at the apex

102. The following is usually found in case of aortic regurgitation: A) S1 intensification at the apex B) vertical heart axis on ECG C) skin and mucosa cyanosis D) increased pulse pressure

D) increased pulse pressure

102. Murmur of a constant pitch is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform

D) lentiform

102. Diastolic murmurs of mitral stenosis are best audible when patient is: A) standing, breathing regularly B) lying supine, inhaling deeply C) lying in the left lateral decubitus position, inhaling deeply D) lying in the left lateral decubitus position, exhaling deeply E) sitting, holding breath

D) lying in the left lateral decubitus position, exhaling deeply

102. Heart configuration with a missing waistline and hypertrophy of the left ventricle is characteristic of: A) stenosis of the aortic ostium B) aortic regurgitation C) mitral stenosis D) mitral regurgitation

D) mitral regurgitation

102. The following is not typical for a patient with compensated aortic regurgitation: A) diastolic decrescendo murmur B) soft S2 at the aortic valve C) S3 D) murmur irradiating to neck vesels E) Austin Flint murmur

D) murmur irradiating to neck vesels

102. Heart failure is not caused by: A) coronary artery disease B) arterial hypertension C) valvular heart disease D) neurovegetative disorders

D) neurovegetative disorders

102. The following is not typical for oedema of cardiac origin: A) skin paleness and / or cyanosis; B) localization on the legs; C) appearance in the evening; D) oedema is hard on palpation, no pits remain after pressing; E) cold skin

D) oedema is hard on palpation, no pits remain after pressing;

102. Left ventricle failure usually manifestates with: A) overfilled neck viens B) ascitis C) anorexia D) orthopnoea E) hepatomegaly

D) orthopnoea

S1 does not include: A) valvular component B) muscular component C) blood vessel component D) rheological component

D) rheological component

102. In case of mitral stenosis the following is not observed: A) pulsus differens B) loud apical S1 C) diastolic murmur at the apex D) soft S2 at a. Pulmonalis

D) soft S2 at a. Pulmonalis

102. All of the following is typical for aortic stenosis except: A) soft S1 at the apex B) harsh systolic murmur at the aorta C) murmur is also auscultated at a. Carotis D) traube's double sound E) reduced S2 at the aorta

D) traube's double sound

102. Pericardial friction sound is found in patients with: A) nephrotic syndrome B) nephritic syndrome C) urinary tract infection D) uremia E) nephrolithiasis

D) uremia

95. Immediate hemostatic responds to the damage vessel: A) platelet adhesion B) platelet aggregation C) platelet viscous metamorphosis D) vasospasm E) white thrombus formation

D) vasospasm

102. Cardiac asthma attack usually manifests with a certain symptom also typical for bronchial asthma attack, it is: A) bronchial breathing B) intensified bronchophony C) coarse crackles D) wheezing E) tympanic sound

D) wheezing

434. Clinical situations resulting in myocardial stunning include: A. Acute myocardial infarction B. After percutaneous trans luminal coronary angioplasty (PTCA) C. After cardiac surgery D. All of above

D. All of above

69. CV risk may be higher than indicated in assessment charts in A. Patients who are older than 75 B. Patients with elevated fasting glucose and/or abnormal glucose tolerance test, who do not meet the diagnostic criteria for diabetes C. Individuals with a family history of premature CVD (before the age of 55 in men and 65 in women) D. All of above

D. All of above

74. Masked hypertension is associated with A. Two-times higher incidence of CV events B. Increased risk of diabetes C. Sustained hypertension D. All of above

D. All of above

82. Drugs and toxins known to definitely induce pulmonary arterial hypertension (PAH) are: A. Aminorex B. Fenfluramine C. Toixic rapseed oil D. All of above

D. All of above

85. Risk markers in Pulmonary embolism (PE)-related early mortality rate include: A. Clinical findings (shock or hypotension) B. RV dysfunction C. Myocardial injury D. All of above

D. All of above

86. Predisposing factors for Pulmonary embolism (PE) include: A. Previous DVT or PE B. Recent surgery or immobilization C. Active malignancy D. All of above

D. All of above

447. The management of atrial fibrillation involves which of the following objectives? A. Rate control B. Correction of rhythm disturbance C. Prevention of thromboembolism D. All of the above

D. All of the above

451. Which of the following are the non-pharmacological treatments for atrial fibrillation? A. Maze surgery B. Radiofrequency catheter ablation C. Implantable cardioverter defibrillators D. All of the above

D. All of the above

448. In patients who have self-limited episodes of atrial fibrillation (AF), antiarrhythmic drugs are unnecessary to prevent recurrence unless AF is associated with severe symptoms related to: A. Hypotension B. Myocardial Ischemia C. Heart failure D. Any of the above

D. Any of the above

453. Which of the following patients can undergo cardioversion without prior anticoagulation? A. Atrial fibrillation less than 48 hours B. Atrial fibrillation less than 72 hours C. Atrial fibrillation less than 96 hours D. Atrial fibrillation less than 7 hours

D. Atrial fibrillation less than 7 hours

401. A 74-year-old man with a history of endocarditis underwent prostate surgery 3 weeks ago. For the past week he has had persistent fever and weakness. Blood cultures are pending, but an echocardiogram suggests a potential change consistent with new endocarditis. If the patient is subsequently diagnosed with this infection, the most likely organism is A. group A streptococci B. viridans streptococci C. Staphylococcus epidermidis D. Enterococcus fecalis

D. Enterococcus fecalis

87. Effective screening for atrial fibrillation is recommended in patients 65 years and older by considering: A. Past history of complications B. Past history of syncope C. ECG prolonged record D. Irregular pulse palpation (followed by ECG)

D. Irregular pulse palpation (followed by ECG)

99. A patient is being switched from warfarin to rivaroxaban for the prevention of stroke in AF. How should this be done? A. Half the current warfarin daily dose and start rivaroxaban. Take both drugs for 5 days and then stop warfarin B. Stop warfarin. Start rivaroxaban as soon as the patients INR falls below 2 C. Continue taking warfarin at full therapeutic dose and start rivaroxaban. Continue both drugs for 2 days and then stop warfarin D. Stop warfarin. Start rivaroxaban as soon as the patients INR falls to 3 or below

D. Stop warfarin. Start rivaroxaban as soon as the patients INR falls to 3 or below

443. Which of the following is a potentially reversible cause for atrial fibrillation? A. mitral stenosis B. hypertension C. young age D. hyperthyroidism

D. hyperthyroidism

102. Epigastric pulsation can be caused by: 1) hepatic pulsation 2) pulsation of a hypertrophic right ventricle 3) pulsation of a hypertrophic left ventricle 4) pulsation of a. abdominalis 5) pulsation of a hypertrophic right atrium The right answer is: A) A, B; B) B, C; C) D; D) E' E) A, B, D; F) B, E; G) A, B, E

E) A, B, D;

1. When using hydrochlorothiazide 25 mg daily for primary arterial hypertension treatment, the following side effect can occur: 1 Uric acid level increase in the blood 2 Hypokalemia 3 Increased sensitivity to cardiac glycosides 4 Impaired glucose tolerance A) Only 1 is correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 1, 2 and 3 are correct E) All 1 - 4 are correct

E) All 1 - 4 are correct

102. In primary arterial hypertension (between crisis) treatment first-line drugs are: 1. Candesartan 2. Amlodipine 3. Hydrochlorothiazide 4. Enalapril A) Only 1 is correct B) Only 1 and 3 are correct C) Only 2, 3 and 4 are correct D) Only 1, 3 and 4 are correct E) All 1 - 4 are correct

E) All 1 - 4 are correct

1. Patient, who previously suffered from a myocardial infarction, complains about the angina type of pain. What questions to ask the patient to diagnose unstable angina? 1. Does the pain occur at rest? 2. Since when the pain got more intense? 3. Did the distance that the patient can walk without pain, decrease? 4. Did the pain intensity increase? 5. Did the frequency of pain occurrence increase? A) Only 3 and 4 are correct B) 1, 3 and 5 are correct C) Only 2, 3 and 5 are correct D) Only 1, 2, 4 and 5 are correct E) All 1 - 5 are correct

E) All 1 - 5 are correct

1. Pulmonary oedema can be caused by: 1. Mitral stenosis 2. Too much fluid administration 3. Inhalation of irritating gases 4. Terminal renal failure 5. Rapid ascent at high altitude A) Only 1 is correct B) Only 1 and 4 are correct C) Only 1, 2, 4 and 5 are correct D) Only 2, 3, 4, 5 are correct E) All 1 - 5 are correct

E) All 1 - 5 are correct

102. The following are used for chronic heart failure treatment: 1. Treatment of the underlying disease. 2. Beta-blockers. 3. Cardiac glycosides. 4. Diuretics. 5. ACE inhibitors. A) Only 1, 2 and 3 are correct B) Only 1, 2 and 4 are correct C) Only 2, 3, 4 and 5 are correct D) Only 1, 2, 4 and 5 are correct E) All 1 - 5 are correct

E) All 1 - 5 are correct

102. Which of the following belong to the non-medication treatment of primary arterial hypertension? A) Weight normalization B) Dietary salt restriction C) Dynamic exercise D) Limited alcohol intake E) All of the above

E) All of the above

102. Pupil pulsation is typical for: A) Mitral stenosis; B) Tricuspid regurgitation; C) Aortic ostium stenosis; D) Thyrotoxicosis; E) Aortic regurgitation;

E) Aortic regurgitation;

1. Witch heart disorder is characterized by a triad of symptoms: 1. Stenocardia 2. Fainting 3. Shortness of breath A) Mitral stenosis B) Mitral regurgitation C) Aortic regurgitation D) Dilated cardiomyopathy E) Aortic stenosis

E) Aortic stenosis

102. High risk stroke symptoms in patients with atrial fibrillation after CHA2DS2-VASc are all listed, except: A) Diabetes mellitus; B) Arterial hypertension; C) Age is over 65 years; D) Illness of peripheral arteries (including coronary arteries); E) Aortic valve stenosis;

E) Aortic valve stenosis;

102. Which of the given clinical manifestations does not characterize severe aortic stenosis? A) Angina B) Fainting C) Heart failure D) Sudden death E) Arterial hypertension.

E) Arterial hypertension.

1. When a presystolic murmur is better heard? A) While standing B) In case of atrial fibrillation C) At inhale while lying D) Lying on your left side E) At exhale while lying on your left side

E) At exhale while lying on your left side

1. In case of what arrhythmia we always observe arrhythmic ventricular contraction? A) Atrial undulation B) Second degree atrioventricular block C) First degree atrioventricular block D) Sino-atrial block E) Atrial fibrillation

E) Atrial fibrillation

1. What statement is incorrect? Mitral valve prolapse is often manifested by: A) Late systolic murmur. B) Atypical chest pain and palpitations. C) Rhythm and repolarization phase ECG changes. D) Easily identifiable echocardiogramm signs. E) Bad prognosis.

E) Bad prognosis

102. Which of the following combinations of antihypertensives in the least justified? A) Beta-adrenoblockers + Captopril B) Nitrendipine + Beta-adrenoblockers C) Diuretics + Enalapril D) Prazosin + Diuretics E) Captopril + Doxazosin

E) Captopril + Doxazosin

1. Electrocardiogram shows prolonged PQ interval, scaphoid ST-segment depression, ventricular extrasystoles, bradycardia. What is the most likely reason for this change? A) Coronary blood circulation insufficiency B) Hypokalemia C) Myocarditis D) Hypercalcemia E) Cardiac glycoside overdose

E) Cardiac glycoside overdose

102. Despite the revascularization and optimal pharmacotherapy, a systolic dysfunction (EF <35%) and QRS width >120 minutes remain in a patient 90 days after myocardial infarction. Further treatment tactics: A) Increase ACE inhibitor doses; B) Maximum level of lenient treatment; C) Aldosterone antagonists and beta-adrenoblockers; D) Implantable cardioverter-defibrillators; E) Cardiac resynchronization device with defibrillator function;

E) Cardiac resynchronization device with defibrillator function;

102. The first choice drug for supraventricular paroxysmal tachycardia treatment is: A) Amiodarone; B) Verapamil; C) Adenosine; D) Propranolol; E) Catheter ablation;

E) Catheter ablation;

102. For patients without structural heart changes and atrial fibrillation a first-line treatment medication is: A) Amiodarone; B) Propafenone; C) Atenolol; D) Catheter ablation; E) Class IC antiarrhythmics or catheter ablation by patient's choice;

E) Class IC antiarrhythmics or catheter ablation by patient's choice;

1. In case of what arrhythmia ECG shows a full P wave and QRS complex dissociation? A) Atrial fibrillation B) Sino-atrial blocks C) Atrial conduction disturbances D) Atrial undulations E) Complete atrioventricular blocks

E) Complete atrioventricular blocks

1. Depending on auscultation and clinical data for the 35year old asthenic woman explicit suspicion of the mitral valve prolapse. Which of the following methods may be the best to confirm the diagnosis? A) Lung X-ray in two projections B) ECG at rest C) ECG during exercise D) Myocardial scintigraphy E) Echocardiography

E) Echocardiography

102. The main diagnostic method of long QT syndrome (LQTS) is: A) Nuclear magnetic resonance; B) Echocardiography; C) 3D Echocardiography; D) Positron emission tomography; E) Electrocardiography;

E) Electrocardiography;

102. ECG changes due to myocardial infarction of the left ventricle of inferior localization are registered in: A) aVL B) V1-V2 C) V3-V4 D) V5-V6 E) III, aVF

E) III, aVF

1. Which of the following symptoms does not comply with the clinic of acute left ventricular failure? A) Shortness of breath B) Cough C) Tachycardia D) Orthopnea E) Increased filling of neck veins

E) Increased filling of neck veins

1. What statement is incorrect? For isolated expressed aortic regurgitation the following symptoms are typical: A) Left chamber enlargement. B) High arterial pulse pressure. C) Diastolic murmurs over the aortic valve. D) Visible aortic pulsation in supraclavicular areas. E) Increased systolic gradient between the left ventricle and the aorta.

E) Increased systolic gradient between the left ventricle and the aorta.

1. What is not a typical symptom of aortic regurgitation A) Visible capillary pulse. B) Early diastolic murmur. C) Tones above the arterial blood vessels. D) Pulsus celer et altus. E) Increased systolic gradient between the left ventricle and the aorta.

E) Increased systolic gradient between the left ventricle and the aorta.

1. What statement is incorrect? Compensated aortic valve stenosis symptoms include: A) Meso-and late systolic murmur at the IInd intercostal to the right of the sternum. B) Murmur propagation of the carotid arteries. C) Small pulse amplitude. D) Slow pulse rate curve increase. E) Left ventricle dilation.

E) Left ventricle dilation.

1. What is the most unfavorable prognostic risk factor in case of primary arterial hypertension? A) Frequent headaches B) Smoking C) Excessive use of alcohol D) Overweight E) Left ventricle hypertrophy

E) Left ventricle hypertrophy

1. His bundle left branch block in the clinical picture is manifested by: A) Palpitations B) Chest pain C) Heart rhythm disorders D) Rapid heartbeat E) Neither of the mentioned signs

E) Neither of the mentioned signs

1. What statement concerning the myocardial infarction is correct? A) The greatest danger of myocardial rupture is 6-7 weeks after the onset of illness. B) In case of epistenocarditic pericarditis clotted blood enters the pericardial cavity. C) Left ventricular wall thrombus may cause paradoxical embolism. D) Granulation tissue at infarction area (after myomalation) start to develop during the fourth week of illness. E) None of the above is correct.

E) None of the above is correct.

102. Which of the ECG leads has an active electrode on the left leg? 1. I and II 2. II and III 3. aVR 4. aVL 5. aVF A) Only 1 and 3 are correct B) Only 2 and 4 are correct C) Only 1 and 4 are correct D) Only 3 and 5 are correct E) Only 2 and 5 are correct

E) Only 2 and 5 are correct

102. What statement is correct? In a patient with chronic left ventricular failure, edema on the shins: 1. Do not occur. 2. Occur, if in addition there is right ventricular failure. 3. Occure even without right ventricular failure. 4. Associated with Na retention in the kidneys caused by kidney blood supply deficiency. 5. Is based on the consequences of cardiac output reduction. A) Only 1 is correct B) Only 2 is correct C) Only 3 and 4 are correct D) Only 3 and 5 are correct E) Only 2, 3, 4 and 5 are correct

E) Only 2, 3, 4 and 5 are correct

417 .Emboli of IE commonly affect in the following order: a) Kidney>spleen>liver>mesenteric arteries b) Mesenteric arteries>liver>spleen>kidney c) Spleen>kidney>liver>mesenteric arteries d) Liver>spleen>kidney>mesenteric arteries

c) Spleen>kidney>liver>mesenteric arteries

102. Pendulum rhythm (embriocardia) is audible in case of: A) atrioventricular block B) the patient being a child C) attack of paroxysmal tachycardia D) tricuspid regurgitation in Erb's point E) severe left ventricle hypertrophy

c) attack of paroxysmal tachycardia

415.The best predictive sign of myocardial abscess in IE of aortic valve is: a) Tachycardia b) Ejection systolic murmur c) S3 of LV d) ECG showing new onset AV block

d) ECG showing new onset AV block

416 . Duke criteria is based on a/an: a) Physician b) Patient c) Hospital d) University

d) University

412.The composition of vegetation due to infective endocarditis includes: a) Fibrin b) Platelet c) Microorganism d) Inflammatory cells e) All of the above

e) All of the above

421.Roth spots are seen in : a) IE b) Leukaemias c) Scurvy d) Aplastic anaemia e) All of the above

e) All of the above

414 .Fever of IE is typically absent in patients with: a) Heart failure b) Diabetes mellitus c) Chronic kidney disease d) Liver failure e) Previous treatment with antibiotics f) Less virulent organisms g) All of the above

g) All of the above

102. ECG findings in case of mitral stenosis are: A) left ventricle hypertrophy B) right ventricle hypertrophy C) right atrium hypertrophy D) left ventricle and right atrium hypertrophy E) right ventricle and left atrium hypertrophy

right ventricle and left atrium hypertrophy

102. All of the following is typical for tricuspid regurgitation, except: A) epigastric pulsation B) systolic murmur at the lower part of the sternum C) positive venous pulse D) Austin Flint's murmur

D) Austin Flint's murmur

1. Sudden death of a patient in the third, fourth day of myocardial infarction most often is stated by: A) Pulmonary arterial thromboembolism. B) Heart rupture and tamponade. C) Epistenocarditic pericarditis. D) Thromboembolism in the brain. E) Acute aortic valve regurgitation.

B) Heart rupture and tamponade.

102. Which leads belong to the so-called "lower" lead group? A) I, aVL B) II, III, aVF C) V1- V2 D) V3- V4 E) V5- V6

B) II, III, aVF

102. In which leads it is better to assess P wave in case of arrhythmia? A) I, aVL B) II, aVF, V1 C) V3- V4 D) V5- V6

B) II, aVF, V1

102. Clubbing fingers are typical for: A) Acute pneumonia; B) Infective endocarditis; C) Cholelithiasis; D) Acute myocardial infarction;

B) Infective endocarditis;

1. What pericarditis has more pronounced pain syndrome? A) Exudative B) Fibrinous C) Adhesive D) Constrictive

B) Fibrinous

102. The following can not be auscultated in case of aortic regurgitation: A) Flints' murmur B) Graham Steell's murmur C) soft S2 at the aorta D) diastolic murmur at the aorta

B) Graham Steell's murmur

102. Lukin-Libman's (Rot) spots can be found in cases of: A) Aortic ostium stenosis; B) Infective endocarditis; C) Acute pericarditis; D) Acute myocarditis;

B) Infective endocarditis;

1. Which statement is incorrect? If there is a suspicion of coronary artery disease, veloergometry must be stopped: A) In case of cardiac pain or shortness of breath B) Heart rate 115 per minute C) ECG, decreasing or increasing ST interval longer than 2 mm D) Systolic arterial pressure increases till 190 mmHg E) Frequent extrasystoles, and appearance of polytop extrasystoles

B) Heart rate 115 per minute

102. Osler's nodes can be found in cases of: A) Aortic ostium stenosis; B) Infective endocarditis; C) Acute pericarditis; D) Acute myocarditis;

B) Infective endocarditis;

102. In case of tricuspid regurgitation the following is not found: A) hepatic pulsation B) "nun's" murmur at vv. Jugulares C) ventricularization of venous pulse D) holosystolic murmur at the 5th intercostal space to the right of the sternum

B) "nun's" murmur at vv. Jugulares

102. Predicted width of QRS complex is not more than: A) 0.08″ B) 0.10″ C) 0.12″ D) None of the answers is correct

B) 0.10″

102. Predicted width of P wave is less than: A) 0.08″ B) 0.1″ C) 0.12″ D) 0.14″

B) 0.1″

102. The symptoms of massive pulmonary thromboembolism are: 1. Severe pain in the chest without irradiation; 2. Arterial hypertension. 3. Acute respiratory failure. 4. Shock. 5. Acute right heart ventricular failure. 6. Cyanosis. A) 1, 2, 3 and 5 B) 1, 3, 4, 5 and 6 C) 1, 2, 5 and 6 D) 2, 3 and 5 E) 1, 2 and 3

B) 1, 3, 4, 5 and 6

1. A healthy persons systolic pressure (mm Hg) a. pulmonalis at rest is: A) 3 - 12 B) 15 - 30 C) 32 - 42 D) 45 - 53 E) 54 - 61

B) 15 - 30

102. Chronic heart failure patient suffers from fatigue, shortness of breath and heart palpitations on usual exercise. Which chronic heart failure functional class by NYHA is itt? A) 1 B) 2 C) 3 D) 4

B) 2

102. Angina on exertion attack usually lasts: A) 1-2 min B) 2-10 min C) 10-20 min D) 20-30 min E) 30-40 min

B) 2-10 min

102. The typical breath rate in case of cardiac asthma is: A) 12-20 min-1 B) 20-40 min-1 C) 50-60 min-1

B) 20-40 min-1

102. Pulsus rarus is considered a pulse slower than: A) 65 min-1 B) 60 min-1 C) 55 min-1 D) 50 min-1

B) 60 min-1

102. Marked pulsation of a. carotis is typical for patients with: A) Aortic stenosis; B) Aortic regurgitation; C) Mitral regurgitation; D) Tricuspid regurgitation; E) Pulmonary regurgitation;

B) Aortic regurgitation;

102. "Nun's (top's) murmur" is audible: A) At the basis cordis B) At fossa jugularis C) At epigastrium D) In a zone of the heart absolute dullness

B) At fossa jugularis

101. Man (50 years old) with no complaints, ECG shows irregular 0:07 sec. wide QRS complexes at a frequency of 140 -150 bpm, no P wave. Initial therapy to reduce the frequency of arrhythmia includes all of the following, except: A) Digoxin B) Cardioversion C) Verapamil

B) Cardioversion

102. Clubbing fingers are typical for: A) Acute pneumonia; B) Congenital valvular heart diseases; C) Cholelithiasis; D) Urolithiasis;

B) Congenital valvular heart diseases;

102. What needs to be performed for a patient with possible hypertrophic cardiomyopathy? A) Cardiac catheterization; B) Coronary angiography; C) Phlebography; D) Spirography; E) Phonocardiography; F) Echocardiography; G) Nuclear magnetic resonance; H) 24 hour ECG recording (Holter monitoring);

B) Coronary angiography; F) Echocardiography; G) Nuclear magnetic resonance; H) 24 hour ECG recording (Holter monitoring);

102. Decrescendo cardiac murmur: A) Increases B) Decreases C) is of a constant amplitude D) decreases, then increases

B) Decreases

102. Murmur of a gradually reducing pitch is called: A) Crescendo B) Decrescendo C) crescendo-decrescendo (diamond-shaped) D) lentiform

B) Decrescendo

1. In ECG how left ventricular hypertrophy differentiates from LV overload? A) Higher QRS complex voltage B) Discordant ST interval deviation accession to QRS changes C) ST interval uplift in the left chest leads D) QRS complex changes accession in the right chest leads

B) Discordant ST interval deviation accession to QRS changes

100. A patient is being switched from anticoagulant other than warfarin to rivaroxaban for the prevention of stroke in AF. How should this be done? A. Continue taking the previous drug at full therapeutic dose and start rivaroxaban. Continue both drugs for 2 days and then stop the previous drug B. Start rivaroxaban 0 to 2 hours prior to next scheduled evening administration of the drug and omit administration of the other anticoagulant C. Half the current drug daily dose and start rivaroxaban. Take both drugs for 5 days and then stop the previous drug D. Stop the previous drug. Start rivaroxaban as soon as the patients INR falls below 2

B. Start rivaroxaban 0 to 2 hours prior to next scheduled evening administration of the drug and omit administration of the other anticoagulant

408. A 41-year-old woman has prosthetic valve endocarditis due to coagulase-negative staphylococci that is methicillin-resistant. She has no known drug allergies, and her renal function is within normal limits. Which of the following regimens is most appropriate? A. Nafcillin 2 g every 4 hours for 6 weeks and gentamicin 1 mg/kg every 8 hours for 6 weeks B. Vancomycin 1 g IV every 12 hours for 6 weeks plus Gentamicin 120 mg IV every 24 hours C. Nafcillin 2 g every 4 hours and rifampin 300 mg orally every 8 hours for 6 weeks plus gentamicin 1 mg/kg every 8 hours for the initial 2 weeks D. Vancomycin 15 mg/kg intravenously every 12 hours and rifampin 300 mg orally every 8 hours for 6 weeks plus gentamicin 1 mg/kg every 8 hours for the initial 2 weeks

B. Vancomycin 1 g IV every 12 hours for 6 weeks plus Gentamicin 120 mg IV every 24 hours

407. A 35-year-old intravenous drug abuser has been diagnosed with tricuspid valve endocarditis due to methicillin-sensitive Staphylococcus aureus. Other than intravenous drug abuse, his past medical history is noncontributory. He has no known drug allergies, normal renal function, and appears in no apparent distress. Which of the following intravenous regimens would be most appropriate? A. Nafcillin 2 g every 4 hours for 2 weeks plus gentamicin 1 mg/kg every 8 hours for 2 weeks B. Vancomycin 1g IV every 12 hours for 4 weeks plus gentamicin 120 mg IV every 24 hours for 4 weeks C. Nafcillin 2 g every 4 hours for 4 weeks D. Nafcillin 2 g every 4 hours for 4 weeks plus gentamicin 1 mg/kg every 8 hours for 4 weeks

B. Vancomycin 1g IV every 12 hours for 4 weeks plus gentamicin 120 mg IV

445. Which of the following intravenous drugs can be used to chemically convert recent onset atrial fibrillation in the Emergency Department? A. lidocaine B. ibutilide C. sotalol D. esmolol

B. ibutilide

405. The following situations may lead to "culture negative" infective endocarditis except A. the use of antibiotics prior to blood culture sampling B. subacute, left-sided IE C. nonbacterial etiologies (e.g., fungi) D. gram-negative bacteria from the HACEK group (e.g., Kingella kingae).

B. subacute, left-sided IE

102. What is the most common cardiac pathology that contributes to pulmonary thromboembolism? A) Supraventricular tachycardia B) Ventricular fibrillation C) Ventricular extrasystole D) Atrial fibrillation E) Complete atrioventricular block

D) Atrial fibrillation

102. Chronic heart failure patient suffers from fatigue, shortness of breath and heart palpitations on rest. Which chronic heart failure functional class by NYHA is it? A) 1 B) 2 C) 3 D) 4

D) 4

102. Orthopnoea relieves: A) Cardiac pain; B) Palpitations; C) Oedema of the upper extremities; D) Acute dyspnoea; E) Headache;

D) Acute dyspnoea;

1. In case of which of the following diseases, there is no risk of arterial embolism? A) Acute myocardial infarction B) Atrial fibrillation C) Bacterial endocarditis D) Acute pericarditis E) Mitral stenosis

D) Acute pericarditis

1. A heart glycoside overdose is characterized by the following symptoms, except: A) Nausea B) Extrasystole C) Atrioventricular conduction disturbances D) Acute renal failure E) Bradycardia

D) Acute renal failure

102. Oral anticoagulants reduce stroke risk in patients with: A) Only with permanent atrial fibrillation; B) Only with symptomatic atrial fibrillation; C) Does not affect the risk of stroke in patients with atrial undulation; D) All patients with any atrial undulation or atrial fibrillation type;

D) All patients with any atrial undulation or atrial fibrillation type;

1. Rheumatism can damage: A) Only endocardium B) Only myocardium C) Myocardium and pericardium D) All three heart layers

D) All three heart layers

102. The most effective agent for ventricular tachycardia paroxysm relief is: A) Digoxin IV B) Verapamil IV C) Lidocaine D) Amiodarone E) Propafenone PO F) Procainamide

D) Amiodarone

1. Male (55 years old) suffering from a long-term arterial hypertension; sudden appearance of chest pain. The pain has further spread to the upper abdomen and back. Investigating the patient: blood pressure - 190/105 mmHg, oliguria, electrocardiogram - left ventricular hypertrophy. Normal troponin levels. What is the most plausible diagnosis? A) Pulmonary thromboembolism B) Hypertensive crisis C) Myocardial infarction D) Aortic aneurysms detachment (dissection) E) Acute pericarditis

D) Aortic aneurysms detachment (dissection)

1. What heart disorder comes to mind when hearing a diastolic sound to the left of the sternum, at costal cartilage of III and IV ribs? A) Mitral stenosis B) Mitral regurgitation C) Aortic stenosis D) Aortic regurgitation

D) Aortic regurgitation

1. Excluding coronary heart disease, stenocardia (angina) is more likely to be found in patients with: A) Mitral stenosis B) Mitral regurgitation C) Pulmonary artery stenosis D) Aortic stenosis E) Aortic regurgitation

D) Aortic stenosis

1. For what heart disorder dizziness and fainting is typical? A) Mitral stenosis B) Mitral regurgitation C) Aortic regurgitation D) Aortic stenosis

D) Aortic stenosis

102. Atrial fibrillation appeared in a patient with WPW syndrome on ECG, but without previous paroxysmal tachycardia. Your tactic: A) Add Amiodarone; B) Increase Statin doses; C) Increase ACE inhibitor doses; D) At first perform catheter ablation of additional conduction path;

D) At first perform catheter ablation of additional conduction path;

1. What statement concerning the myocardial infarction is incorrect? A) During days and weeks before the infarction angina attacks can occur. B) Typical angina pain lasting more than ½ hours. C) Its onset is often expressed as a shock or epigastric pain and vomiting. D) During auscultation an occurrence of tachycardia, ventricular extrasystole, gallop rhythm, pericardial friction rub is possible. E) Painless form is more commonly observed in people younger than 40 years than in elderly people.

E) Painless form is more commonly observed in people younger than 40 years than in elderly people.

1. If a patient has a chronic sinus bradycardia (49 beats per minute), which is not accompanied by other clinical symptoms (fatigue, dizziness, fainting, shortness of breath, etc.), it is expedient to use: A) Atropine B) Nitrates C) Permanent electrocardiostimulation D) Any of the mentioned treatment methods E) The mentioned treatment methods are unnecessary

E) The mentioned treatment methods are unnecessary

102. Mitral valve prolapse is common, often benign finding. All mentioned is a serious complication of the disease, except: A) Infectious endocarditis. B) Paroxysmal supraventricular tachycardia. C) Fainting. D) Ischemic ECG changes. E) Third degree AV block.

E) Third degree AV block.

102. Aortic ejection murmur is audible due to: A) aortic regurgitation B) supravalvular aortic stenosis C) valvular aortic stenosis and severe valve leaflet calcification D) subaortic stenosis (hypertrophic cardiopathy) E) aortic valvular stenosis with valid leaflet elasticity

E) aortic valvular stenosis with valid leaflet elasticity

102. Pulsus dicroticus is classified as such when: A) anacrota consists of two parts B) dicrotic duration is extremely increased C) pulse waves follow one another as a pair (bigeminy) D) dicrotic amplitude decreases until its complete disappearance E) dicrotic wave amplitude is markedly increased

E) dicrotic wave amplitude is markedly increased

S2 accentuation at the pulmonary artery is not typical for: A) mitral stenosis B) mitral regurgitation C) lung emphysema D) cor pulmonale E) essential hypertension

E) essential hypertension

S2 accentuation at the aorta is not typical for: A) primary arterial hypertension B) nephritic syndrome C) aortic atherosclerosis D) aortic coarctation E) mitral stenosis

E) mitral stenosis

102. In which leads negative R waves can be registered? A) aVR B) aVL C) V1 D) V2 E) none of the above mentioned

E) none of the above mentioned

102. All the following is typical for angina pectoris except: A) pain occurs during physical exercise B) retrosternal pain C) pain is relieved by nitroglycerine D) attack occurs mostly during cold and windy weather E) pain often occurs on empty stomach

E) pain often occurs on empty stomach

102. Murmur audible in the beginning and in the middle of systole is called: A) Protosystolic B) Mesosystolic C) Telesystolic D) Holosystolic E) protomesosystolic

E) protomesosystolic

102. Arterial hypertension patients usually have all the following symptoms except: A) elevated blood pressure B) S2 accent at the aorta C) the left of the heart border is displaced to the left D) R >V5, V6 > RV4 E) soft S1 at the tricuspid valve

E) soft S1 at the tricuspid valve

428. Typical reasons for bradycardia include: A. adverse drug effects B. acute myocardial infarction C. intoxication D. electrolyte disorders E. All of above

E. All of above

83. Parameters with established importance for assessing pulmonary arterial hypertension (PAH) severety include: A. Clinical evidence of RV failure B. Past history of syncope C. 6-minute walk test D. Cardio-pulmonary exercise test E. All of above

E. All of above

102. Which drugs belong to the calcium antagonist group? 1. Felodipine 2. Diltiazem 3. Amlodipine 4. Nifendipine A) Only 2 is correct B) Only 4 is correct C) Only 2 and 4 are correct D) Only 1, 3 and 4 are correc E) Only 1, 2 and 3 are correct F) All 1 - 4 are correct G) None of the above

F) All 1 - 4 are correct

96. Increases prothrombin time: A) cimetadine B) metronidazole C) trimethoprim-sulfamethoxazole D) fluconazole E) disulfram F) All of above

F) All of above

102. The usual site of pulmonary valve auscultation is: A) the 3rd intercostal space by the left border of the sternum B) the connection point of the 4th right rib and the sternum C) the middle third of the sternum D) the lower third of the sternum E) processus xyphoideus F) The 2nd intercostal space by the left border of the sternum G) The 5th intercostal space by the left border of the sternum

F) The 2nd intercostal space by the left border of the sternum

437. Atrial rate always equal to ventricular rate in: a) AVRT (atrioventricular re-entrant tachycardia) b) Atrial tachycardia c) Bundle branch re-entry d) Atrial flutter with bypass tract

a) AVRT (atrioventricular re-entrant tachycardia)

398. Which of the following statements about infective endocarditis is wrong? a) Splenomegaly is more common in acute than sub acute infective endocarditis b) Disease manifestation occurs within two weeks of the cause of bacteremia c) Cerebral embolism is more common in the middle cerebral artery territory d) 5% chance of intracranial hemorrhage

a) Splenomegaly is more common in acute than sub acute infective endocarditis

62. Coronary angiography shows no obstruction in epicardial coronary arteries in a patient with sufficiently typical chest pain together with ischemia-like ECG abnormalities and/or positive stress test, the following should be suspected: a. Primary coronary microvascular disease b. Wellen syndrome c. Brugada syndrome d. AV block

a. Primary coronary microvascular disease

102. The following is not found in case of mitral stenosis: A) Acrocyanosis B) redness of the cheeks C) apex beat displaced downwards and to the left D) epigastric pulsation

apex beat displaced downwards and to the left

418. Drug of choice for HACEK organisms in IE: a) Vancomycin b) Ceftriaxone c) Ampicillin d) Metronidazole

b) Ceftriaxone

Soft S1 at the tricuspid valve is audible in case of: A) tricuspid stenosis B) tricuspid regurgitation C) anaemia D) hyperthyroidism

b) tricuspid regurgitation

Loud S1 at the heart apex is audible in case of: A) mitral stenosis B) mitral regurgitation C) essential hypertension D) anaemia

b)mitral stenosis

413 Dukes criteria for diagnosis of IE was published in: a) 1900 b) 1985 c) 1994 d) 2000

c) 1994

420. All are true regarding Libman sach's endocarditis except: a) Seen in ventricular surface of valves b) Multiple c) Commonly affects aortic valve than mitral valve d) Recur after valve replacement

c) Commonly affects aortic valve than mitral valve

419.The strongest indication for emergency surgery in IE is: a) Persistence of fever b) Septic embolism c) Congestive cardiac failure d) Perivalvular invasive disease

c) Congestive cardiac failure