Cardiovascular System MCQs Past papers

PART 1:

1.   Which is LEAST LIKELY to cause high-output heart failure?

A.   anemia

B.   high fever

C.   hypertrophic cardiomyopathy (*)

D.   hyperthyroidism

E.   Paget's osteitis deformans

2.   "Fibrolipomatosis", a newly-discovered cause of sudden death

in athletic young people, is usually found by the pathologist in

the

A.   aortic valve cusps

B.   right atrium

C.   right ventricle (*)

D.   left atrium

E.   left ventricle

3.   At autopsy of a "victim" of cocaine abuse, which of these

would be most helpful to the pathologist in confirming that

cocaine actually caused the death?

A.   amyloid deposition

B.   contraction band necrosis (*)

C.   endocardial fibrosis

D.   mycotic aneurysm(s)

E.   septal hypertrophy

4.   What did the brewers in Quebec add to their beer, causing

the epidemic cardiomyopathy?

A.   adriamycin

B.   cobalt (*)

C.   dioxin

D.   homocysteine

E.   selenium

5.   Which of these bacteria is most likely to set up acute

bacterial endocarditis on a previously-normal valve?

A.   clostridia

B.   staphylococcus (*)

C.   streptococcus pyogenes

D.   streptococcus viridans

E.   pseudomonas

6.   Cardiomyopathy of pregnancy is most closely related

epidemiologically to

A.   alcohol abuse

B.   folic acid deficiency

C.   high salt intake

D.   poverty (*)

E.   tobacco smoking

7.   Which systemic disease often features sterile vegetations

located on the surfaces of valve leaflets, and not just their

lines of closure?

A.   amyloidosis B

B.   hemophilia

C.   lupus (*)

D.   rheumatoid arthritis

E.   scleroderma

8.   What accumulates in the heart in Pompe's disease?

A.   cholesterol

B.   glycogen (*)

C.   lipofuscin

D.   mitochondria

E.   non-pigmented lipid breakdown products

9.   Which is most likely to produce tricuspid valve stenosis?

A.   carcinoid heart disease (*)

B.   Ebstein's anomaly

C.   endocarditis from IV drug use

D.   severe atherosclerosis

E.   tetralogy of Fallot

10.  In Kawasaki's disease, you will probably NOT see

A.   enlarged lymph nodes containing granulomas (*)

B.   erythema of the palms

C.   fever

D.   reddening of the oral mucosa

E.   reddening of the surfaces of the eyes

11.  What's the major risk factor for Buerger's thromboangiitis

obliterans?

A.   alcohol abuse

B.   cocaine use

C.   old age

D.   sexual promiscuity / multiple partners

E.   smoking (*)

12.  In Osler-Weber-Rendu, you'll first notice the little

vascular malformations on the

A.   conjunctiva

B.   digits

C.   lips (*)

D.   retina

E.   skin of the face

13.  Unable to make HDL...

A.   common familial hypercholesterolemia

B.   Milroy's disease

C.   Noonan's syndrome

D.   Refsum's disease

E.   Tangier's disease (*)

PART 2

1.   Which is most typical in Down's syndrome?

A.   atrial septal defect just above crux of heart (*)

B.   coarctation of the aorta

C.   sinus venosus defect

D.   very low-placed tricuspid valve

E.   widely patent foramen ovale

2.   Sudden death during sleep in a 30 year old Laotian man with

no known coronary risk factors

suggests

A.   Brugada's (*)

B.   cardiac syndrome X

C.   lipoprotein LpS2

D.   Lp(a)

E.   Tangier's

3.   Which fact about a group of vegetations would be most

helpful in letting you know that it's

Libman-Sacks (as in lupus anticoagulant syndrome) rather than

marantic endocarditis (as in

cancer of the pancreas)?

A.   contain numerous plasma cells

B.   cause damage to the underlying valve

C.   contain hematoxylin bodies

D.   contain many neutrophils

E.   not confined to lines of closure (*)

4.   What's the eponym for angina caused by coronary spasm?

A.   Buerger's

B.   Ebstein's

C.   Heberden's

D.   Osler's

E.   Prinzmetal's (*)

5.   A healthy, sedentary adult's heart usually weighs no more

than

A.   150 gm

B.   250 gm

C.   350 gm (*)

D.   450 gm

E.   550 gm

6.   Wavy fibers in the absence of other myocardial pathology

suggest what to the autopsy

pathologist?

A.   amyloidosis

B.   cobalt cardiomyopathy

C.   hypertrophic cardiomyopathy

D.   long QT (abnormal waves)

E.   sudden coronary death (*)

7.   Most "unstable angina" is probably due to

A.   a thrombus forming and lysing (*)

B.   extreme hypercholesterolemia and rapid atherogenesis

C.   multiple emboli to the coronaries

D.   serial hemorrhages within a plaque

E.   various rhythm disturbances developing and disappearing

8.   Which is most likely to produce dextrocardia, i.e., a heart

on the right side instead of the left?

A.   Down's syndrome

B.   fetal alcohol syndrome

C.   immotile cilia syndrome (*)

D.   rubella in the unborn child

E.   Turner's XO syndrome

9.   Which structure is most likely to rupture as a result of

Barlow's syndrome?

A.   mitral chorda (*)

B.   papillary muscle body

C.   posterior leaflet, longitudinally

D.   posterior leaflet, transversely

E.   ventricular free wall

10.  Which is LEAST LIKELY to give you a dilated cardiomyopathy?

A.   amyloid cardiomyopathy (*)

B.   autoimmune cardiomyopathy

C.   Chagas's cardiomyopathy

D.   Duchenne's cardiomyopathy

E.   sarcoid cardiomyopathy

11.  Listen carefully to your ankylosing spondylitis patients

because they are much more likely than

other folks to develop

A.   aortic insufficiency (*)

B.   aortic stenosis

C.   carotid bruits

D.   mitral insufficiency

E.   pulmonic stenosis

12.  Finding a Weibel-Palade body on electron microscopy

establishes that the cell is

A.   endothelium (*)

B.   myocardium

C.   myointima

D.   neoplastic

E.   smooth muscle

13.  A folic-acid deficient diet probably places a person at risk

for coronary disease by raising

plasma

A.   homocysteine (*)

B.   homogentisic acid

C.   oxidized LDL

D.   lipoprotein A

E.   total LDL cholesterol

14.  You are LEAST LIKELY to see hyperplastic arteriolar

sclerosis as a result of

A.   hemolytic-uremic syndrome from E. coli

B.   malignant hypertension

C.   scleroderma

D.   severe diabetes (*)

E.   ventricular septal defect leading to Eisenmenger's

PART 3: 

1.      The myocardial hypertrophy seen in patients with aortic stenosis, which is often extreme but which usually allows the heart to empty adequately, is considered an example of:

*        A.        concentric hypertrophy

B.        eccentric hypertrophy

          C.        egocentric hypertrophy

D.        hypertrophic cardiomyopathy

E.        physiologic hypertrophy

2.      Infamous as a cause of sudden death:

          A.        aortic regurgitation

*        B.        aortic stenosis

          C.        mitral stenosis

          D.        pulmonic stenosis

          E.        tricuspid insufficiency

3.      In "sudden cardiac death" without an acute coronary artery lesion, the pathologist usually finds at least what percent stenosis of all three coronary arteries?

A.        50-55%

B.        60-65%

*        C.        70-75%

D.        80-85%

E.        90-95%

4.      In long QT syndrome caused by a potassium channel mutation, sudden death commonly occurs during participation in what sport?

          A.        basketball

          B.        being struck in the chest by a baseball

          C.        skiing (cold exposure)

*        D.        swimming

          E.        weight-lifting

5.      In classic tertiary syphilis, the valve lesion was

*        A.        aortic insufficiency

          B.        aortic stenosis

          C.        mitral stenosis

          D.        papillary fibroelastoma

          E.        tricuspid insufficiency

6.      Which portion of the mitral valve is most likely to calcify as a result of old age?

*        A.        annulus

          B.        anterior leaflet

          C.        chordae

          D.        papillary muscle

          E.        posterior leaflet

7.      What's the common cardiac malformation in fetal alcohol syndrome?

          A.        Chiari meshwork

          B.        Ebstein's anomaly

          C.        patent ductus arteriosus

          D.        sinus venosus ASD

*        E.        ventricular septal defect

8.      A very widely patent foramen ovale, causing an atrial septal defect, is described as (a)

A.        Lutembacher's syndrome

B.        ostium primum defect

*        C.        ostium secundum defect

D.        Roger's disease

E.        sinus venosus defect

9.      Uncomplicated hypertension and diabetes are most likely to produce what change at the level of the arterioles?

A.        amyloidosis

B.        atherosclerosis

*        C.        hyaline sclerosis

D.        intimal onionskinning

E.        transmural inflammation