دستیاری پزشکی و امتحانات پزشکی کانادا

Cardiology and CVS

1. The subendothelium is the most vulnerable

   segment of the heart from an ischemic

   standpoint. The major reason for this is:

      a) the highest oxygen utilization is in the

         subendocardium

      b) coronary flow to the subendocardium

         occurs almost completely during

         diastole whereas other regions receive

         some flow during systole as well

      c) the subendocardium has a diminished

         aerobic capacity

      d) there is less potential for

         collateralization to the

         subendocardium

      e) the ratio of capillary to myocyte is less

         in the subendocardium than in other

         regions

2. Impaired coronary flow reserve is associated

   with each of the following conditions

   EXCEPT:

       a) severe aortic stenosis

       b) severe systemic hypertension with left

          ventricular hypertrophy

       c) severe mitral stenosis in the presence

          of atrial fibrillation

       d) a totally occluded coronary artery but

          with excellent collateral supply from

          the contralateral (i.e. opposite)

          coronary artery

       e) an isolated 30% diameter stenosis of a

          coronary artery

3. Which of the following would NOT be part of

   your plan for the treatment of acute

   ventricular fibrillation?

      a) electrical defibrillation

      b) lidocaine

      c) epinephrine

      d) bretylium

      e) manganese

4. Which of the following is not an aggravating

   factor of congestive heart failure?

       a) hypertension

       b) thyrotoxicosis

       c) alcohol

       d) inactivity

       e) arrhythmia

5. Which of the following is true about

   congenital heart block in neonatal lupus

   erythematosus?

      a) it is associated with maternal anti-Ku

         autoantibodies

      b) it is transient

      c) the majority of patients will require a

         pacemaker

      d) there is no increased risk of connective

         tissue disease in adulthood

      e) the risk of mortality is small

6. Endocarditis in an I.V. drug user:

      a) is equally prevalent to that of the

         normal population

      b) is commonly located in the mitral valve

      c) is typically caused by S. pneumoniae

      d) is typically found on the tricuspid valve

      e) is typically found on the aortic valve,

         producing a systolic ejection murmur

7. Nitroglycerin administered sublingually may

   contribute to the relief of myocardial ischemic

   pain by each of the following mechanisms

   EXCEPT:

       a) coronary vasodilation

       b) decreased venous pooling resulting in

          increased cardiac preload

       c) reduced systemic vascular resistance

       d) reduced ventricular volume

8. A 48 year-old male is brought to the ED with

   CPR being administered. The ECG shows

   electrical activity present but you cannot

   palpate a carotid pulse. Which of the

   following is not on the differential for

   pulseless electrical activity?

       a) hypotension

       b) hypokalemia

       c) cardiac tamponade

       d) hypothermia

       e) tension pneumothorax