Question no.366

     A 22 year old woman presents with " skipped heartbeats" & on cardiac examination is found to have a midsystolic click followed by a late systolic murmur. Echocardiogram shows prolapse of the mitral valve.

Which of the following is true about this condition?

a) Mitral valve prolapse is present in up to 10% of the population.

b) Mitral valve prolapse is more commom in men.

c) Prophylaxis against bacterial endocarditis is never recomended.

d) Risk of pulmonary embolism is high.

e) Ventricular arrhythmias don't occur.

Question no.362

        You make the diagnosis of Marfan syndrome in a very tall 22 year old man with long, thin extremities.

1) What other finding is associated with this disease?

        A) Family history in 100%of the patients.

        B) Upward sublaxation of the lenses.

        C) Mental retardation.

        D) Malar rash.

        E) Increased length of trunk compared with the limbs.

ECG 5

What is your finding?

USMLE 30

     

    A 54 year old man presents to ER complaining of epigastric discomfort, which began while he was walking after dinner about one hour earlier.He hasn't received medical care for several years.On examination he is moderately obese and  his Bp 160/98. His ECG reveals inferior wall myocardial infarction.

Which of the following is the most appropriate next step in management?

A) Trial of antacid immediately.

B) Reassurance and arrange outpatient follow up.

C) Arrange for cardiac ICU bed.

D) Begin thrombolytic therapy in the ER.

E) Arrange for urgent echocardiogram.

Spot diagnosis 86

What is your clinical diagnosis?

USMLE 23

   A 23 year old woman presents with skipped heartbeats and on cardiac examination is found to have a mid-systolic click followed by a late systolic murmur.

Echo shows prolapse of the mitral valve.

Which of the following is true about this condition?

a) Mitral valve prolapse is present in up to 10 % of the population.

b) Prophylaxis against bacterial endocarditis is never recommended.

c) Mitral valve prolapse is more common in men.

d) Risk of pulmonary embolism is high.

e) Ventricular arrhythmias don't occur.

Medical MCQ 41

Hypercyanoptic spell of T.O.F. is best treated with all of the following except:

a- Knee chest position.

b- Morphine.

c- Digoxin.

d- Propranolol.

e- Sodium bicarbonate.

USMLE 18

You make the diagnosis of Marfan syndrome in a very tall 22 year old man with long, thin extremities.

1- What other finding is associated with this disease?

a) Family history in 100 % of the patient.

b) Mental retardation.

c) Malar rash.

d) Upward sublaxation of the lenses.

e) Increased length of trunk compared with the limbs.

2- The major cause of morbidity & mortality in Marfan patients is cardiac.

Which of the following is  common complications?

a) Aortic root dilatation.

b) V.S.D.

c) Coronary artery disease.

d) Pulmonary stenosis.

e)  Pulmonary hypertension.

USMLE 17

A dentist asks you to evaluate a 42-year-old woman before tooth extraction.

1-Which of the following would prompt you to prescribe prophylactic antibiotics?

a) Midsystolic click at the left sternal border.

b) Insulin dependent diabetes.

c) a prior history of infective endocarditis.

d) a history of conestive heart failure.

e) S4 gallop.

2- Which of the following is the prophylactic antibiotic of choice for dental procedures?

a) Amoxicillin.

b) Cephalexin.

c) Penicillin.

d) Vancomycin.

e) Clindamycin.

3-  In patients who aren't (IV) drug users and who don't have prosthetic valves.

Which of the following organisms is the most common cause of bacterial endocarditis?

a) Enterococcus.

b) Sterptococcus.

c) Candida.

d) Gram negative bacilli.

e) Pseudomonas.

Medical MCQ 40

Haemoptysis occurs most frequently in:

a) Mitral  regurgitation.

b) Mitral stenosis.

c) Tricuspid regurgitation.

d) Aortic regurgitation.

e) Aortic stenosis.

Medical MCQ 39

The carey coomb murmur is due to:

a) Inflammation of the mitral valve.

b) Increased diastolic flow across the mitral valve.

c) Cardiac decompression.

d) Defibrillation.

Medical Case 30

 A female patient 55 years old was admitted to the hospital with severe chronic heart failure. Her pulse rate was 120\ min & regular, Investigations were done and treatment was started in the form of:

rest, salt restriction, digitalis, thiazides and vasodialtors.

Would you or would you not prescribe beta-blockers in this case? Why?

True or False Question 11

Wide fixed splitting of S2 sound is a characteristic feature of  PDA.

True or False Question 10

Left ventricular failure never occur in pure Mitral stenosis.

( T / F ) .

ECG 4

A 57 year old woman is seen urgently for chest pain of two hours duration. the pain is mild, continuous, aching and localized to the upper chest and shoulder. No previous cardiovascular problems.

Does the ECG suggest Myocardial ischemia or subendocardial injury?

What appropriate investigation is indicated?

USMLE 12

A 72-year-old male comes to the office with intermittent symptoms

of dyspnea on exertion, palpitations, and cough occasionally productive of

blood. On cardiac auscultation, a low-pitched diastolic rumbling murmur

is faintly heard toward the apex. The origin of the patient’s problem proba-

bly relates to

a. Rheumatic fever as a youth

b. Long-standing hypertension

c. Silent MI within the past year

d. Congenital origin

True or False Question 9

Systemic but not pulmonary embolism occurs in AMI.                 ( T / F ).

ECG 3

69 years old man with substernal chest discomfort. BP 70 mm Hg, History of HTN.

In what part of the heart is there a problem?

What is the differential for ST segment abnormality seen in V1 and V2

Medical MCQ 2

Enlarged left atrium seen in:

a) Mitral valve disease.

b) Aortic valve disease.

c) Pericardial effusion.

d) Bilharzial cor-pulmonale.

True or False Question 8

Austin flint murmur is a late systolic murmur heard in cases of AR.   ( T / F ).