Medical Semiology Dr. Leng Nara
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 fun
ctional symptoms - Diagnosis and interrogation techniques
- NYHA classification of dyspnea
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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