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Medical Semiology Dr. Leng Nara

An infographic depicting a medical professional examining a patient’s heart with diagrams of the cardiovascular system and a patient history form in the background.

Cardiology Patient Examination Quiz

Test your knowledge on the fundamentals of cardiology patient examination with this comprehensive quiz designed for medical students and professionals.

Learn about:

Cardiovascular functional symptoms
Diagnosis and interrogation techniques
NYHA classification of dyspnea

60 Questions15 MinutesCreated by DiagnosingHeart27

1. Examination of the cardiology patient including:

Interrogation

Physical examination

Complementary examination

All of the above

2. Which of the following are the steps of interrogation?

Which of the following are the steps of interrogation?

Search for personal and family history

Search for cardiovascular functional symptoms and relative to other organ

All of the above

3. Concerning the reason for the consultation:

Most often, the consultation is motivated by one or more cardio-vascular functional symptoms

Less often, the consultation is requested systematically to search cardiovascular involvement in the context of the general balance sheet

All of the above

None of the above

4. Which is not the cardiovascular risk factor in personal history?

High blood pressure

Tuberculosis

Diabetes

Hypercholesterolemia

Smoking

5. Which of the following are the hereditary concepts of acquired heart disease in family history?

Coronary insufficiency, high blood pressure

Primitive cardiomyopathy, hyperlipidemia

Sudden death.

All of the above

6. Which of the following are the cardiovascular functional symptoms?

Dyspnea, palpitations

Chest pain

Syncope and brief discomfort

All of the above

7. Which is not the cardiovascular functional symptom?

Palpitations

Headache

Chest pain

Dyspnea

8. Which of the following is the stage I of dyspnea (NYHA I) according to the classification of the New York Heart Association (NYHA) ?

Dyspnea for unusual major efforts: the patient has no discomfort in everyday life

Dyspnea for usual major efforts such as quick walking or uphill, climbing stairs (> 2 floors)

Dyspnea for some intense efforts of everyday life such as normal walking on level ground, climbing stairs (= 2 floors)

Permanent dyspnea at rest

9. Which of the following is the stage IV of dyspnea (NYHA IV) according to the classification of the New York Heart Association (NYHA) ?

Dyspnea for unusual major efforts: the patient has no discomfort in everyday life

Dyspnea for usual major efforts such as quick walking or uphill, climbing stairs (> 2 floors)

Dyspnea for some intense efforts of everyday life such as normal walking on level ground, climbing stairs (= 2 floors)

Permanent dyspnea at rest

10. Which of the following is the stage II of dyspnea (NYHA II) according to the classification of the New York Heart Association (NYHA) ?

Dyspnea for unusual major efforts: the patient has no discomfort in everyday life

Dyspnea for usual major efforts such as quick walking or uphill, climbing stairs (> 2 floors)

Dyspnea for some intense efforts of everyday life such as normal walking on level ground, climbing stairs (= 2 floors)

Permanent dyspnea at rest

11. Which of the following is the stage III of dyspnea (NYHA III) according to the classification of the New York Heart Association (NYHA) ?

Dyspnea for unusual major efforts: the patient has no discomfort in everyday life

Dyspnea for usual major efforts such as quick walking or uphill, climbing stairs (> 2 floors)

Dyspnea for some intense efforts of everyday life such as normal walking on level ground, climbing stairs (= 2 floors)

Permanent dyspnea at rest

12. Which of the following is not a character of dyspnea at rest:

Sleep with pillows or

Half sitting position or

Sitting in a chair

Sleep in the supine position or left lateral décubitus

13. The awareness of the patient of difficulty breathing requiring extra effort, with sensation of air hunger is called

Cough cardiac

Chest pain

Dyspnea

Hemoptysis

14. In the absence of lung disease, obesity, severe anemia, dyspnea is the earliest sign of

Pericarditis

Left ventricular failure and mitral stenosis.

Embolism and pulmonary infarction

Myocardial infarction

15. Dyspnea may develop to

Subacute pulmonary edema or acute pulmonary edema

Cardiac pseudo-asthma

All of the above

None of the above

16. Which of the following is not a character of acute pulmonary edema :

Spontaneous regression without drug (disappeared when the effort is stope)

Tachypnea with cyanosis, anxiety, sweating and sizzling laryngeal

Accompanied by incessant cough with pink frothy expectoration, sometimes hémoptoic

Crepitant rale on pulmonary auscultation at two breathing time and invasive upwardly both lung fields

17. Which of the following is not a character of subacute pulmonary edema :

Cardiovascular collapse and death occurred shortly in the absence of emergency therapeutic intervention

Lower intensity of functional symptoms with superficial polypnea, sizzling laryngeal

Hacking dry cough or sputum hemoptoic

Spontaneous regression without drug (disappeared when the effort is stope)

18. Which of the following is not a character of functional chest pain or psychogenic chest pain?

Chest pain unrelated to the cardiovascular system and accentuated by feeling hurt, periods of psychological stress and fatigue

Variable seat from one moment to the other with moderate intensity, unrelated to the effort and feeling of needle stick

Occurrence in elderly patients and in man

Occurrence in younger patients and in women

19. Which of the following are the main causes of chest pains in relation to cardiovascular system?

Coronary insufficiency: angina, myocardial infarction

Pericarditis and aortic dissection

Embolism and pulmonary infarction

All of the above

20. Concerning angina pectoris, which of the following statements is true?

It corresponds to a reversible ischemia, secondary to an imbalance between inputs and myocardial oxygen requirements.

Coronary atherosclerosis is the main cause

Angina of effort is the most common and most characteristic

All of the above

21. Which of the following is the character of typical angina (highly suggestive of coronary insufficiency)?

Constrictive pain

Triggered by effort

Relieved by Nitroglycerin immediate action

All of the above

22. Which of the following is not the pain of myocardial infarction

It corresponds to irreversible myocardial ischemia.

It differs from that of angina by intense pain and spontaneous pain

Duration of pain less than 20 minutes and nitro-sensible

Duration of pain longer than 20 minutes and nitro-resistant

23. Which of the following is not found in the pain of pericardial origin?

Increase in intensity with inspiration (essential distinctiveness from myocardial infarction).

Relieved by sitting position

Duration of pain less than 20 minutes and nitro-sensible

Related to the inflammation of envelope of the heart

24. The patient feels lacking a beat, he described as an impression of cardiac arrest, followed by a beat, sometimes painful. This character is found in:

Extrasystoles

Lipothymia

Syncope

Access tachycardia

25. The prodromes of general discomfort with sweating and incomplete loss of consciousness about a few minutes with progressive recovery. These characters are found in:

Extrasystoles

Lipothymia

Syncope

Access tachycardia

26. A sudden dissolution of muscle tone and consciousness resulting of complete loss of consciousness (a few seconds and immediate recovery) with chute by sudden decrease in cerebral blood flow is called:

Extrasystoles

Lipothymia

Syncope

Access tachycardia

27. The normal heart rate ranges from:

50-90 bpm

70-110 bpm

80-120 bpm

60-100 bpm

The heart rate for tachycardia is:

< 60 bpm

60-100 bpm

50-90 bpm

>100 bpm

29. The heart rate for bradycardia is:

< 60 bpm

60-100 bpm

80-120 bpm

>100 bpm

30. Concerning the symptoms related to the cardiovascular system, the abdominal pain may reflect:

Cracking of an aneurysm of the abdominal aorta

Ruptured spleen in infectious endocarditis

Hepatalgia of effort or rest by acute distension of the liver as part of a right heart failure

All of the above

31. Concerning the symptoms related to the cardiovascular system, the pain in the lower limbs may reflect:

Pain of arterial origin (ischemic pain): chronic arterial occlusive disease of the lower limbs is responsible for intermittent claudication

Pain of venous origin: the most severe form is venous thrombosis responsible for phlebitis

All of the above

None of the above

32. Unilateral calf cramp or thigh sometimes buttock, occurring in walking, especially at startup or when walking uphill and obliging the patient to stop after a fairly fixed distance (walking perimeter) is called:

Phlebitis

Intermittent claudication

Myositis

None of the above

33. Heaviness or cramp occurs spontaneously at a calf causing functional impotence with slight cyanosis of the foot, hanging leg, slight dilatation of the superficial veins, increasing local heat and a beginner edema. These symptoms are found in:

Phlebitis

Intermittent claudication

Myositis

None of the above

34. What is true concerning the apical impulse on palpation?

It is normally perceived as systolic flick punctiform of the fifth intercostal space on mid-clavicular line and corresponds to the left ventricle

Downward and/or leftward displacement corresponds to hypertrophy and /or dilatation of the left ventricle

Right displacement in case of dextrocardia and abolished when abundant pericardial effusion

All of the above

35. The physician perceives systolic heart beat when his thumb placing on the xiphoid of the patient and the patient in deep inspiration is called:

Harzer sign positive

Kernig’s sign positive

Brudzinski’s sign positive

None of the above

36. Where to listen for mitral area in cardiac auscultation?

Apex/5LICS

Left lower sternal border/4LICS

Right middle sternal border/2RICS

Left middle sternal border/2LICS

37. Where to listen for tricuspid area in cardiac auscultation?

Apex/5LICS

Left lower sternal border/4LICS

Right middle sternal border/2RICS

Left middle sternal border/2LICS

38. Where to listen for aortic area in cardiac auscultation?

Apex/5LICS

Left lower sternal border/4LICS

Right middle sternal border/2RICS

Left middle sternal border/2LICS

39. Where to listen for pulmonary area in cardiac auscultation?

Apex/5LICS

Left lower sternal border/4LICS

Right middle sternal border/2RICS

Left middle sternal border/2LICS

40. First heart sound (S1) correspond to:

Tricuspid and mitral valve snap shut & pulmonary and aortic valve just opened

Tricuspid and mitral valve snap shut & pulmonary and aortic valve snap shut

Pulmonary and aortic valve snap shut & tricuspid and mitral valve just opened

Pulmonary and aortic valve just opened & tricuspid and mitral valve just opened

41. Second heart sound (S2) correspond to:

Tricuspid and mitral valve snap shut & pulmonary and aortic valve just opened

Tricuspid and mitral valve snap shut & pulmonary and aortic valve snap shut

Pulmonary and aortic valve snap shut & tricuspid and mitral valve just opened

Pulmonary and aortic valve just opened & tricuspid and mitral valve just opened

42. According to the place and duration of murmurs in systole and diastole, proto (systolic or diastolic) is correspond to:

Beginning (of systolic or diastolic)

Middle (of systolic or diastolic)

End (of systolic or diastolic)

From beginning to end (of systolic or diastolic)

43. According to the place and duration of murmurs in systole and diastole, meso (systolic or diastolic) is correspond to:

Beginning (of systolic or diastolic)

Middle (of systolic or diastolic)

End (of systolic or diastolic)

From beginning to end (of systolic or diastolic)

44. According to the place and duration of murmurs in systole and diastole, tele (systolic or diastolic) is correspond to:

Beginning (of systolic or diastolic)

Middle (of systolic or diastolic)

End (of systolic or diastolic)

From beginning to end (of systolic or diastolic)

45. According to the place and duration of murmurs in systole and diastole, holo (systolic or diastolic) is correspond to:

Beginning (of systolic or diastolic)

Middle (of systolic or diastolic)

End (of systolic or diastolic)

From beginning to end (of systolic or diastolic)

46. Intensity of murmur follows on Levine’s ranges from:

1 to 6

1 to 3

1 to 4

1 to 5

47. Which of the following is the desired blood pressure for adults:

Systolic <90 mmHg, diastolic <60 mmHg

Systolic 90-119 mmHg, diastolic 60-79 mmHg

Systolic 120-139 mmHg, diastolic 80-89 mmHg

Systolic 140-159 mmHg, diastolic 90-99 mmHg

48. Which one of the following statements is correct regarding examination of the external jugular veins?

Normally, in decubitus position, bust slightly elevated (15-20 o), jugular veins are flat in inspiration and slightly filled in expiration

The jugular turgescence, it is swollen to the two time breathing, is a sign of venous hypertension

Both A and B

The jugular turgescence, it is only swollen in inspiration, is a sign of venous hypertension

49. Concerning cardiac pseudo-asthma, which of the following statements is false?

Cardiac pseudo-asthma occurs in the elderly, sometimes with a history of allergic asthma, but the cardiovascular examination is never normal

A first "asthma" in an elderly subject is cardiac origin until proven otherwise

Both A and B

Cardiac pseudo-asthma occurs in a young person and cardiovascular examination is normal

50. Concerning edema of cardiac origin, which of the following statements is true?

Cardiac edema is secondary to the right or congestive heart failure, responsible for abnormal water and sodium retention, increasing the extracellular circulating

The characters of symmetric, white, soft, pitting edema with signs of right heart failure, especially a jugular turgescence or hepato jugular reflux is a sign of cardiac edema

Regular monitoring of weight is a golden rule of cardiac failure. Any sudden weight gain of a few kg corresponds to fluid retention and must investigate the cause decompensated

All of the above

51. Which of the following is the invasive examination regarding the complementary examinations:

The right and left heart catheterization

The transthoracic Doppler echocardiography

Ambulatory ECG according to Holter method, called Holter ECG

The Doppler arterial or venous

52. Which of the following is the non-invasive examination regarding the complementary examinations:

Doppler echocardiography transoesophageal

Magnetic Resonance Imaging (MRI) of the heart and vessels

Myocardial scintigraphy, pulmonary scintigraphy

All of the above

The coronary venriculography

53. Ten electrodes are used for a:

12-lead ECG

10-lead ECG

08-lead ECG

06-lead ECG

54. Leads aVR, aVL and aVF are known as:

Augmented voltage leads

Bipolar limb leads

Both A and B

Precordial leads

55. Leads I, II and III are known as:

Augmented voltage leads

Bipolar limb leads

Both A and B

Precordial leads

56. What is a normal PR interval?

0.12 - 0.25 seconds

0.08 - 0.15 seconds

0.12 - 0.20 seconds

None of the above

57. Concerning ECG paper and timing, which one of the following statements is not correct?

1 small square = 0.04 sec

1 large square = 5 small square = 0.2 sec

30 large square = 3 sec

30 large square = 6 sec

58. Concerning ECG, we can calculate rate by:

Count the number of R waves in a 6 seconds rhythm strip, then multiply by 10

Find an R wave that lands on a bold line, then count the number of larges boxes to the next R wave. If the second R wave is 1 large box away the rate is 300, 2 boxes -150, 3 boxes - 100, 4 boxes - 75, 5 boxes - 60, 6 boxes - 50, etc

Both A and B

None of the above

59. Concerning the regularity of ECG, the rhythm is regular if the difference between the longest R-R interval in the ECG and the shortest R-R interval is less than:

0.12 second

0.15 second

0.20 second

None of the above

60. Concerning the axis of the ECG (the electrical axis of the heart), which one of the following statements is true?

Normal Axis if the QRS complex is up (positive) in lead I and downward (negative) in lead aVF

Normal Axis if the QRS complex is up (positive) in both leads (lead aVF and I)

Normal Axis if the QRS complex is downward (negative) in lead I and up (positive) in lead aVF

Normal Axis if the QRS complex is downward (negative) in both leads (lead aVF and I)

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