1.
What are the principle mechanisms that causes vascular disease?
A. Narrowing or complete occlusion of the vessel lumen
B. Weakness of the blood vessel wall
C. Damage to the adventitia
D. Damage to the small arteries that prevents proper vasoconstriction and vasodilation
Correct Answer
A. A and B
Explanation
The principle mechanisms that cause vascular disease are narrowing or complete occlusion of the vessel lumen and weakness of the blood vessel wall. These factors can lead to restricted blood flow and increased risk of blood clots, which can result in various vascular diseases such as atherosclerosis and aneurysms. Damage to the adventitia and small arteries may also contribute to vascular disease, but they are not the primary mechanisms. Therefore, the correct answer is A and B.
2.
What vessel leads to easy penetration of tumors and inflammatory processes?
A. Capillaries
B. Venules
C. Lymphatics
Correct Answer
B. B
Explanation
Venules are the correct answer because they are small blood vessels that connect capillaries to veins. They play a crucial role in the inflammatory response by allowing white blood cells to easily penetrate into tissues. Tumors also rely on venules for their growth and spread, as they provide a pathway for cancer cells to enter the bloodstream and metastasize to other parts of the body.
3.
Which of the following pairs are complications of atherosclerosis?
A. Occlusion and Calcification
B. Occlusion and Spasm
C. Aneurysm formation and Ulceration
D. Dilation and Ulceration
E. Dilation and Calcification
Correct Answer
A. A,B,C
Explanation
The correct answer is A,B,C. Atherosclerosis is a condition characterized by the buildup of plaque in the arteries. Occlusion refers to the narrowing or blockage of an artery due to the buildup of plaque, which can lead to reduced blood flow. Calcification refers to the hardening of the plaque, which can make the arteries less flexible and more prone to complications. Aneurysm formation refers to the weakening and bulging of the arterial wall, which can lead to the formation of a balloon-like structure that is at risk of rupture. Ulceration refers to the development of open sores in the arterial wall, which can further contribute to complications.
4.
What is the first step in teh pathogenesis of atherosclerosis?
A. Platelet adhesion
B. SMC proliferation
C. Lipoprotein accumulation
D. Endothelial injury
E. Lipid accumulation
Correct Answer
D. D
Explanation
The first step in the pathogenesis of atherosclerosis is endothelial injury. This injury can occur due to various factors such as high blood pressure, smoking, or high levels of cholesterol. Once the endothelium is injured, it becomes permeable to lipoproteins, which leads to their accumulation in the arterial wall. This accumulation then triggers an inflammatory response, attracting immune cells and promoting the formation of fatty streaks. Over time, these fatty streaks can progress into atherosclerotic plaques, leading to narrowing and hardening of the arteries.
5.
Select the false statements:
A. Blood pressure = cardiac output x blood volume
B. Cardiac output is affected by blood volume and Na concentration
C. Peripheral resistance is not affected by neural and hormonal inputs, only blood volume and Na concentration.
D. Steroids and Decongestants can cause or contribute to hypertension
E. Among the lab exams you would order regarding diagnosis of hypertension are serum potassium and creatinine
Correct Answer
A. A,C
Explanation
The false statements are A and C. Blood pressure is not equal to cardiac output multiplied by blood volume. Cardiac output is affected by blood volume and Na concentration. Peripheral resistance is affected by neural and hormonal inputs, as well as blood volume and Na concentration.
6.
During a hypertensive emergency, what symptoms may be reported?
A. HA (headache)
B. Malaise
C. Increased urination
D. Blurred vision
Correct Answer
E. A,B,D
Explanation
During a hypertensive emergency, patients may report symptoms such as headache (A), malaise (B), and blurred vision (D). These symptoms can be indicative of the elevated blood pressure levels and the potential damage it can cause to various organs and systems in the body. Increased urination (C) is not typically reported as a symptom of a hypertensive emergency.
7.
What are examples of clinical signs during a hypertensive emergency?
A. Funduscopic changes
B. Increased intracranial pressure
C. Confusion
D. Heart Failure
Correct Answer
A. All of the above
Explanation
Clinical signs during a hypertensive emergency can include funduscopic changes, increased intracranial pressure, confusion, and heart failure.
8.
Which of the following would be considered reasonable medications to prescibe for hypertension?
A. ARB's
B. ACE inhibitors
C. Calcium Channel blockers
D. Albuterol
E. Macrolide
Correct Answer
B. A,B,C
Explanation
ARBs (angiotensin receptor blockers), ACE inhibitors (angiotensin-converting enzyme inhibitors), and calcium channel blockers are all commonly prescribed medications for hypertension. ARBs and ACE inhibitors work by blocking the effects of a hormone called angiotensin II, which causes blood vessels to narrow. This helps to relax and widen the blood vessels, reducing blood pressure. Calcium channel blockers work by relaxing the muscles of the blood vessels, allowing them to widen and lower blood pressure. Therefore, A, B, and C are considered reasonable medications to prescribe for hypertension.
9.
Which of the following is the correct definition for a false aneurysms?
A. It involves all Three layers of the arterial wall.
B. Breach in the vascular wall leading to an extravascular hematoma
C. Blood enters the wall of the artery
Correct Answer
B. B
Explanation
A false aneurysm, also known as a pseudoaneurysm, is a breach in the vascular wall that leads to an extravascular hematoma. This means that there is a rupture or tear in the wall of an artery, allowing blood to escape and form a hematoma outside of the blood vessel. This is the correct definition for a false aneurysm.
10.
Which of the following statements if FALSE regarding varicose veins?
A. More common to occur on the lower extermities of a patient.
B. Due to an inflammatory condition of the blood vessel wall
C. Complications resulting from it include: edema, ulcers and stasis dermatitis
Correct Answer
B. B
Explanation
Varicose veins are more common to occur on the lower extremities of a patient, which makes statement A true. Complications resulting from varicose veins include edema, ulcers, and stasis dermatitis, making statement C true. However, varicose veins are not caused by an inflammatory condition of the blood vessel wall, so statement B is false.
11.
Which of the following statements pretain to thrombophlebitis?
A. Inflammation of the lymph system from infection
B. Accumulation of interstitial fluid due to obstruction
C. Venous thrombosis and inflammation
E. Signs include: heat, tenderness and Homan's sign
D. Patient may show no signs
Correct Answer
C. C,E,D
Explanation
Option A : Refers to lymphangitis
Option B: Refers to Lymphedema
12.
What statements are true regarding congenital hemangiomas?
A. Most commonly found on skin and mucus membranes
B. They can be described as a "wad" of capillaries
C. They are an abnormal dilation of pre-existing small vessels in the skin
Correct Answer
C. C
Explanation
Option C: Refers to Telangiectasia
13.
Heart disease is the number one cause of death in the US population
Correct Answer
A. True
Explanation
Heart disease is indeed the number one cause of death in the US population. This is supported by numerous studies and data from reputable sources such as the Centers for Disease Control and Prevention (CDC) and the American Heart Association (AHA). Heart disease includes various conditions such as coronary artery disease, heart attacks, and heart failure, which collectively account for a significant number of deaths each year. Risk factors for heart disease include high blood pressure, high cholesterol levels, smoking, obesity, and a sedentary lifestyle. Therefore, it is accurate to say that heart disease is the leading cause of death in the US population.
14.
The number one etiology for heart disease is atherosclerosis.
Correct Answer
A. True
Explanation
Atherosclerosis is the leading cause of heart disease. It is a condition where plaque builds up inside the arteries, causing them to narrow and restrict blood flow to the heart. This can lead to various heart problems, such as heart attacks and strokes. Therefore, it can be concluded that atherosclerosis is the number one cause of heart disease.
15.
Which of the following statements regarding left-sided heart failure is FALSE?
A. Causes include systemic hypertension and diseases of the myocardium
B. Signs include rales at the lung bases
C. Results in decrease blood flow to the kidney
D. The most common cause is right-sided heart failure
Correct Answer
D. D
Explanation
Left-sided heart failure is characterized by the inability of the left ventricle to effectively pump blood to the rest of the body. The correct answer, D, states that the most common cause of left-sided heart failure is right-sided heart failure. This statement is false because left-sided heart failure can occur independently and is not primarily caused by right-sided heart failure. The most common causes of left-sided heart failure include systemic hypertension and diseases of the myocardium.
16.
Congestive heart failure is a clinical syndrome with ________ cardiac output to the level that it cannot keep pace with the venous return leading to __________.
Correct Answer
Decreased
congestion
Explanation
Congestive heart failure is a clinical syndrome where the cardiac output decreases to a level that it cannot keep up with the venous return. This leads to congestion, which refers to the accumulation of fluid in various parts of the body. Therefore, the correct answer is "Decreased, congestion."
17.
Which of the following is a cause of ischemic heart disease?
A. Diminished oxygen carrying capacity
B. CO poisoning
C. Hypertension
D. A reduction in Coronary artery blood flow
E. Stroke
Correct Answer
C. A,B,C,D
Explanation
Option B = is an example of diminished oxygen-carrying capacity of the blood
Option C = An example of Increased demand
18.
Which of the following statements regarding right sided heart failure is FALSE?
A. Signs include ascites and pleural effusion
B. The most common cause is left sided heart failure
C. The examiner will appreciate a mid-systolic click upon auscultation
D. Symptoms include very few respiratory symptoms
Correct Answer
C. C
Explanation
Option C = refers to mitral valve prolapse
19.
Identify the true statements
A. Ischemic heart disease is an imbalance of oxygen supply to meet the muscle demand in the heart
B. The most rare type of congenital heart disease is a left to right shunt
C. Cor Pulmonale is an example of right-sided heart failure
D. Patients with a mitral valve prolapse are at increased risk for ventricular arrhythmias
Correct Answer
F. A,C,D only
Explanation
Option B = Left to right shunt is the most common type of congenital heart disease
20.
Which of the following statements regarding Right to left shunt congenital heart disease is FALSE?
A. It is a cyanotic heart disease
B. Poorly oxygentated blood from right side mixes with left side oxygenated blood.
C. Examples are ASD, VSD, PDA
Correct Answer
C. C
Explanation
Option C = ASD (atrial septal defect), VSD (ventral septal defect),and PDA; these are examples of left to right shunt defects
21.
Which of the following is a clinical syndrome of ischemic heart disease?
A. Angina pectoris
B. Sudden cardiac death
C. Chronic ischemic heart disease
D. Acute myocardial infarction
Correct Answer
A. All of the above
Explanation
All of the options listed (Angina pectoris, Sudden cardiac death, Chronic ischemic heart disease, and Acute myocardial infarction) are clinical syndromes of ischemic heart disease. Angina pectoris refers to chest pain or discomfort caused by reduced blood flow to the heart. Sudden cardiac death is an unexpected death due to a sudden loss of heart function, often caused by a heart attack. Chronic ischemic heart disease is a long-term condition caused by reduced blood flow to the heart. Acute myocardial infarction, commonly known as a heart attack, occurs when there is a sudden blockage of blood flow to the heart, leading to damage or death of heart muscle tissue.
22.
Which of the following is NOT associated with a symptom of angina pectoris?
A. Dyspnea
B. Substernal chest pain
C. Vomiting
D. Relief by oxygen and nitroglycerin
E. Radiation to the epigastrium
Correct Answer
B. A and C only
Explanation
Angina pectoris is a symptom of coronary artery disease and is typically characterized by substernal chest pain that may radiate to the left arm or jaw. Dyspnea, or shortness of breath, is commonly associated with angina as the heart is unable to pump enough blood to meet the body's demands. Vomiting, however, is not typically associated with angina. Relief of angina symptoms by oxygen and nitroglycerin is a characteristic feature of this condition. Therefore, the correct answer is A and C only, as vomiting is not associated with angina pectoris.
23.
Chronic ischemic heart diase will result in pump failure
Correct Answer
A. True
Explanation
Chronic ischemic heart disease refers to a condition where the blood flow to the heart muscle is reduced or restricted over a long period of time. This can lead to damage to the heart muscle and impair its ability to pump blood effectively, ultimately resulting in pump failure. Therefore, it is true that chronic ischemic heart disease can lead to pump failure.
24.
Which of the following statements is true?
A. The usual cause of sudden cardiac death is an arrhythmia
B. Sudden cardiac death hHas been see in world class atheletes
C. Telangiectasias are common in obsese individuals with a history of diabetes
D. Rheumatic Valvular disease is most often seen in children 5-15 years
Correct Answer
E. A,B,D only
Explanation
The correct answer is A,B,D only. This means that statements A, B, and D are true, while statement C is not true. Statement A states that the usual cause of sudden cardiac death is an arrhythmia, which is true. Statement B states that sudden cardiac death has been seen in world-class athletes, which is also true. Statement C states that telangiectasias are common in obese individuals with a history of diabetes, which is not true. Statement D states that rheumatic valvular disease is most often seen in children 5-15 years old, which is true.
25.
Hypertensive heart disease is _______ enlargement due to _________ and no other cause
Correct Answer
ventricular
hypertension
Explanation
Hypertensive heart disease refers to the enlargement of the ventricles of the heart due to hypertension, which is high blood pressure. This means that the correct answer is "ventricular, hypertension" because the enlargement specifically affects the ventricles and the cause is hypertension.
26.
Which of the following may be a cause of heart murmurs?
A. Metabolic rate
B. Congenital abnormalities
C. Vessel stenosis
Correct Answer
E. All of the above
Explanation
Heart murmurs can be caused by a variety of factors, including metabolic rate, congenital abnormalities, and vessel stenosis. Metabolic rate refers to the rate at which the body converts food into energy, and an imbalance in this process can lead to heart murmurs. Congenital abnormalities are structural defects present at birth, such as abnormal heart valves or chambers, which can disrupt blood flow and cause murmurs. Vessel stenosis refers to the narrowing or blockage of blood vessels, which can also disrupt blood flow and result in murmurs. Therefore, all of the given options can potentially be causes of heart murmurs.
27.
Which of the following will NOT be credible evidence in the diagnosis of Rheumatic fever?
A. Elevated erythrocyte sedimentation rate
B. Serological evidence of previous streptococcal infection
C. 2 or more major criteria from the Jones criteria
D. An X-ray exhibiting a patchy distribution in the right upper lobe.
Correct Answer
E. A and D only
Explanation
Only B and C are true
Jones criteria includes: Carditis, migratory polyarthritis of large joints, subcutaneous nodules, Erythema marginatum of the skin, Sydenham chorea.