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    Prof. of Hepatology & Gastroenterology, Cairo University.

    Consultant of Hepatology,Gastroenterology and Endoscopy

    Management Positions: •

    Chief of Hepatology unit El Manial University Hospital (1994-1998).

    • Chief of Gastroentero ICU in Cairo university hospital (1997-2000)

    • President of the board of AlfaScope GI Specialized center (2004-2014).

    • Head of Endoscopy Unit in Cairo University Hospitals (2005-2010).       


     .Read more


    استاذ الكبد و الجهاز الهضمى بكلية الطب جامعة القاهرة

    استشارى الكبد و الجهاز الهضمى و المناظير

    دكتوراه امراض الكبد و الجهاز الهضمى من كلية الطب جامعة القاهرة

    الرئيس السابق لقسم الامراض الباطنية بكلية الطب جامعة ٦ اكتوبر

    الرئيس السابق لوحدة مناظير الجهاز الهضمى و مركز الكبد و الرعاية المركزة بقصر العينى


    إقرأ المزيد


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Wednesday, Aug 23rd

Last update10:09:06 AM


MCQs part II

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MCQs Part II

These MCQs are parts of the MCQs bank of Internal Medicine Department, Kasr El Aini Faculty of medicine. 

1) Pericardial rub is best audible in all except:

A.   By pressing the chest piece of stethoscope.

B.   After holding the breath.

C.   On the left side of lower sternum.

D.   In lying down position

E.    None of above


2) Slow rising pulse is a feature of:

A.   Endotoxic shock.

B.   AS.

C.   MS.

D.   Constrictive pericarditis

E.    Coarctation of aorta


3) Pulsus alternans is produced by:

A.   Pericardial effusion.

B.   Left-sided heart failure.

C.   Chronic obstructive airway disease.

D.   Pulmonary thromboembolism

E.    Extrasystoles every other beat.


4) Central cyanosis is not found in:

A.   Acute pulmonary oedema.

B.   Fallot's tetralogy

C.   Left-to-right shunt.

D.   Transposition of great vessels.

E.    Patent ducts arteriosus


5) Which is not a cause of sinus bradycardia:

A.   Myxoedema.

B.   Complete heart block.

C.   Hypothermia.

D.   Obstructive jaundice.

E.    Increased intracranial tension


6) Regarding neck venous pulsation which is false:

A.   Undulating.

B.   Better felt than seen.

C.   Becomes prominent on lying down.

D.   There are two negative waves.

E.    Emptying during systole


7) Water-hammer pulse is present when pulse pressure is at least above:

A.   30 mm Hg.

B.   80 mm Hg.

C.   40 mm Hg.

D.   60 mm Hg

E.    10 mmHg


8) Left parasternal heave is diagnostic of:

A.   Left ventricular hypertrophy.

B.   Right atrial hypertrophy.

C.   Right ventricular hypertrophy.

D.   Hypertrophic cardiomyopathy.

E.    Tricuspid stenosis


9) Pulsus bisferiens is found in:

A.   Combined AS and AI.

B.   Combined MS and AS.

C.   Combined AI and MI.

D.   Combined MS and MI

E.    Combined MS and AI.


10) v-wave in JVP becomes prominent in:

A.   Tricuspid incompetence.

B.   Cardiac tamponade.

C.   Ventricular tachycardia.

D.   Right atrial myxoma

E.    Complete heart block


11) Which is false regarding oedema in congestive cardiac failure:

A.   Initially noticed in the morning.

B.   Starts in the dependent part.

C.   Pitting oedema.

D.   Sacral oedema in non-ambulatory patients.

E.    Is characterized by reduced sodium excretion.


12) Which does not produce regularly irregular pulse:

A.   2nd degree heart block.

B.   Atrial fibrillation.

C.   Extrasystoles.

D.   Sinus arrhythmia.

E.    Atrial tachycardia with block.


13) Sudden death may occur in:

A.   AS.

B.   ASD.

C.   Constrictive pericarditis.

D.   PDA

E.    Floppy mitral valve.


14) RBBB with left axis deviation in ECG is characteristically seen in:

A.   VSD.

B.   Ostium primum ASD.

C.   PDA.

D.   Fallot's tetralogy.

E.    Ostium secundum ASD


15) All of the following produce systemic hypertension except:

A.   Polycystic kidney disease.

B.   Phaeochromocytoma.

C.   Addison's disease.

D.   Conn's syndrome.

E.    Unilateral renal artery stenosis


16) Classical JVP finding in cardiac tamponade is:

A.   Prominent a-wave.

B.   Prominent x-descent.

C.   Prominent y-descent.

D.   Small v-wave.

E.    Kussmaul’s sign


17) All are bedside differential diagnosis of MS except:

A.   Carey Coombs murmur.

B.   Left atrial myxoma.

C.   Austin Flint murmur.

D.   Mitral valve prolapse syndrome.

E.    Chronic MR


18) The least common complication of MS is:

A.   Cerebral thrombosis.

B.   Subacute bacterial endocarditis.

C.   Pulmonary hypertension.

D.   Atrial fibrillation.

E.    Haemoptysis


19) Haemoptysis may be found in

A.   Left ventricular failure.

B.   Right ventricular failure.

C.   Pulmonary stenosis.

D.   Left-to-right shunt

E.    Marfan’s syndrome.


20) Which chamber of heart fails first in MS:

A.   Right atrium.

B.   Right ventricle.

C.   Left atrium.

D.   Left ventricle.

E.    Biventricular


21) In critical MS, the mitral valve orifice is:

A.   < 6 cm2.

B.   < 4 cm3.

C.   < 2cm2

D.   < 1 cm2.

E.    < 3 cm2.

22) Hill's sign is diagnostic of:

A.   AI.

B.   MS.

C.   AS.

D.   MI.

E.    PI


23) Which of the following gives rise to heaving apex beat:

A.   MS.

B.   MI.

C.   AS.

D.   AI.

E.    HOCM


24) Which of the following does not lead to Eisenmenger's syndrome:

A.   Coarctation of aorta.

B.   PDA.

C.   ASD.

D.   VSD.

E.    Transposition of great vessels


25) Seagull murmur is not a feature of:

A.   Acute myocardial infarction.

B.   Acute rheumatic fever.

C.   Subacute bacterial endocarditis.

D.   Floppy mitral valve.

E.    Prosthetic valve endocarditis


26) Which is not an aetiology of MI:

A.   Pseudoxanthoma elasticum.

B.   Osteo arthritis

C.   Osteogenesis imperfecta.

D.   Ehlers-Danlos syndrome

E.    Endocardial cushion defect.


27) Commonest organism producing acute bacterial endocarditis is:

A.   Streptococcus viridans.

B.   Staphylococcus aureus.

C.   Streptococcus faecalis.

D.   Pneumococcus

E.    H influenza.


28) Which is not included in 'minor manifestation' of Jones criteria in rheumatic fever:

A.   Prolonged PR interval.

A.   Arthralgia.

B.   Increased ESR.

C.   Elevated ASO titre.

D.   Previous  attack of rehumatic fever


29) Which is not a major manifestation' of Jones criteria in rheumatic fever:

A.   Chorea.

B.   Erythema nodosum.

C.   Subcutaneous nodule.

D.   Polyarthritis.

E.    Erythema marginatum


30) Diastolic shock' in not found in:

A.   Chronic cor pulmonale.

B.   PS.

C.   MS.

D.   VSD.

E.    Systemic sclerosis


31) Incidence of infective endocarditis is least in:

A.   MI.

B.   PDA.

C.   ASD.

D.   VSD.

E.    AS


32) Sudden death may occur in all of the following except:

A.   Atrial fibrillation.

B.   Massive myocardial infarction.

C.   Ventricular fibrillation.

D.   Massive pulmonary thromboembolism.

E.    Long Q-T interval syndrome


33) Carey Coombs murmur is found in:

A.   Pulmonary hypertension.

B.   AI.

C.   Acute rheumatic fever.

D.   MS

E.    Atrial myxoma.


34) Which is not advocated in the treatment of acute pulmonary oedema:

A.   Diuretics.

B.   Trendelenburg position.

C.   Morphine.

D.   Rotating tourniquets

E.    Vasodilators


35) Digitalis toxicity is precipitated by all except:

A.   Old age.

B.   Hypokalaemia.

C.   Renal failure.

D.   Hepatic encephalopathy.

E.    Quinidine


36) Cannon wave in the neck vein is seen in:

A.   Complete heart block.

B.   Constrictive pericarditis.

C.   Tricuspid incompetence.

D.   Right atrial myxoma.

E.    Pulmonary hypertension


37) Left ventricular hypertrophy is not associated with:

A.   AS.

B.   AI.

C.   MS.

D.   MI.

E.    VSD.


38) Which is not found in constrictive pericarditis:

A.   Pulmonary oedema.

B.   Raised JVP.

C.   Ascites.

D.   Pulsus paradoxcus.

E.    Pericardial knock.


39) Paroxysmal hypertension is classically found in:

A.   Coarctation of aorta.

B.   Eclampsia.

C.   Renal artery stenosis.

D.   Phaeochromocytoma.

E.    Autonomic neuropathy.


40) Cardiac arrest may be due to:

A.   Multiple ectopics.

B.   Atrial flutter.

C.   Pulseless ventricular tachycardia.

D.   Wenckebach block.

E.    Sinus bradycardia.


41) Diagnosis of AMI within 6 hrs depends on:

A.   CPK MB2/ CPK MB, > 1.5.

B.   Increased LDH3

C.   Rise of SGPT > 250 IU/L.

D.   Inverted T wave in ECG

E.    ɣ-GT


42) Retrosternal chest pain classically occurs in all except:

A.   Acute mediastinitis.

B.   Dissecting aneurysm.

C.   Bornholm disease.

D.   Unstable angina.

E.    Esophageal spasm.


43) CPK-MB is increased in all except:

A.   Myocarditis.

B.   Rhabdomyolysis.

C.   Post-AMI.

D.   Post-electrical cardioversion.

E.    Unstable angina.


44) Which enzyme rises earliest in AMI:

A.   SGPT.

B.   LDH

C.   SCOT.

D.   CPK.

E.    ɣ-GT


45) Reversed splitting of S2 is found in:

A.    LBBB.

B.     RBBB.

C.     Left ventricular pacing.

D.    Aortic regurgitation.

E.     ASD


46) All of the following drugs may be used in congestive cardiac failure except:

A.    Spironolactone

B.     Carvidelol

C.     Propranolol

D.    Digoxin

E.     Captopril


47) Treatment by heparin is best monitored by:

A.    Prothrombin time (PT).

B.     Clotting time (CT).

C.     Activated partial thromboplastin time (APTT).

D.    Fibrin degradation product (FDP).

E.     D-diamer.


48) All of the following may produce hemiplegia by cerebral embolism except:

A.    Mitral valve prolapse

B.     Atrial fibrillation

C.     Subacute bacterial endocarditis

D.    Right atrial myxoma.

E.     Hemiplegic migraine.


49) Drug of choice in acute management of PSVT is:

A.   Amiodarone

B.   Verapamil

C.   Metoprolol

D.   Adenosine

E.    Diosopyramide


50) Propranolol can be used in all except:

A.    Systemic hypertension.

B.     Congestive cardiac failure.

C.     Angina pectoris.

D.    Supraventricular tachyarrhythmias.

E.     Hypertrophic cardiomyopathy.


51) Heart valve commonly affected in IV drug abusers is:

A.    Pulmonary valve.

B.     Mitral valve.

C.     Tricuspid valve.

D.    Aortic valve.

E.     Left sided valves.


52) Ventricular fibrillation is best treated by:

A.    IV amiodarone.

B.     Carotid massage.

C.     Electrical cardioversion.

D.    IV lignocaine.

E.     IV β-blocker.


53) P-wave in ECG is absent in:

A.    Atrial fibrillation

B.     Artrial flutter.

C.     Hypokalaemia

D.    Paroxysmal supraventricular tachycardia..

E.     Nodal rhythm.


54) Verapamil is indicated in all except:

A.    Atrial fibrillation

B.     Acute left ventricular failure

C.     Supraventricular tachycardia    

D.    Angina pectoris

E.     Migraine prophylaxis.


55) Hyperthyroid heart disease is manifested by:

A.    Pericardial effusion

B.     Diminished cardiac output

C.     Prolonged circulation time      

D.    Paroxysmal atrial fibrillation

E.     Diastolic hypertension.


56) Which of the following is present in most of the patients of SBE:

A.    Murmur

B.     Osler's node

C.     Clubbing

D.    Splenomegaly

E.     Kussmaul’s sign


57) Graham Steel murmur is found in:

A.    Severe pulmonary hypertension

B.     Subacute bacterial endocarditis

C.     Idiopathic hypertrophic subaortic stenosis (IHSS)

D.    Tricuspid atresia

E.     Ankylosing spondylitis


58) Commonest heart valve abnormality revealed after AMI is:

A.    AI

B.     MI

C.     AS

D.    MS

E.     Ebstien’s anomaly


59) Pregnancy-associated hypertension should not be treated with:

A.   Labetalol

B.   Valsartan

C.   α-methyldopa

D.   Amlodipine

E.    Hydralazine


60) Accelerated hypertension should not have:

A.    Retinal hemorrhage

B.     Arterio-venous nipping

C.     'Silver-wire' arteries

D.    Papilloedema

E.     Loud first heart sound


61) Clinically, commonest type of shock is:

A.    Neurogenic

B.     Cardiogenic

C.     Septic

D.    Hypovolaemic

E.     Anaphylactic shock


62) JVP is usually increased in:

A.    Cardiogenic shock

B.     Hypovolaemic shock

C.     Anaphylactic shock

D.    Septic shock

E.     Addisonian crisis



Answer key :

1.     D

2.     B

3.     B

4.     C

5.     B

6.     B

7.     D

8.     C

9.     A

10.                        A

11.                        A

12.                        B

13.                        A

14.                        B

15.                        C

16.                        B

17.                        D

18.                        B

19.                        A

20.                        C

21.                        D

22.                        A

23.                        C

24.                         A

25.                        D

26.                        B

27.                            A

28.                        D             

29.                        B

30.                        B

31.                        C

32.                        A

33.                        C

34.                        B

35.                        D

36.                        A

37.                        C

38.                        A

39.                        D

40.                        C

41.                        A

42.                        C

43.                        B

44.                        D

45.                        A

46.                        C

47.                        C

48.                        D

49.                        D

50.                        B

51.                        C

52.                        C

53.                        A

54.                        B

55.                        D

56.                        A

57.                        A

58.                        B

59.                        B

60.                        D

61.                        D

62.                        A

MCQs part II

Last Updated on Monday, 12 November 2012 07:45


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