1. Diabetes mellitus

2. Left ventricular failure

3. Syncope

4. Advancing age

5. Nausea and vomiting

Answer: E* Nausea and vomiting

***) All of the followings are true regarding chest pain of myocardial infarction, except:

1. Duration more than 30 minutes

2. Associated with nausea

3. Relieved with sublingual nitrate

4. Not related to breathing

5. Left shoulder radiation

Answer: D* Not related to breathing

***) In acute myocardial infarction, all are true except:

1. Can be silent

2. Can lead to heart failure

3. May result in sudden death

4. Always treated conservatively

5. Pain relief is of utmost importance

Answer: D* Always treated conservatively

***) In myocardial infarction the following serum enzyme rises latest and remains elevated for the longest period:

1. SGOT

2. LDH

3. Alkaline phosphatase

4. CPK

5. Acid phosphatase

Answer: B* LDH

3. Management of Acute Coronary Syndrome.

***) 60 years old male presented with chest pain, ECG shows ST elevation in V1 V6, BP 165/95. The patient has an episode of upper GI bleeding 6 months ago, and the nearest cath lab is 2 hours away. Best next step: Q2012

1. Send him to cath lab immediately

2. Give him thrombolytic, because there is no contraindication

3. Don’t give him thrombolytic due to recent bleeding

4. Don’t give him thrombolytic due to high BP and recent bleeding

5. Don’t give him thrombolytic due to high BP

Answer: B* Give him thrombolytic, because there is no contraindication

***) All of the following about myocardial infarction are true, except:

1. May present with pulmonary edema

2. Streptokinase is used in management

3. Morphine is helpful

4. Captopril is contraindicated

5. Arrhythmias are the commonest cause of death in the first hour

Answer: D* Captopril is contraindicated

***) The management of unstable angina includes all of the following, except:

1. Aspirin

2. Anticoagulants

3. Digoxin

4. Nitrates

5. Beta blockers

Answer: C* Digoxin

***) All of the following are used in the treatment of acute myocardial infarction, except:

1. Morphine

2. Streptokinase

3. Nitroglycerin

4. Aspirin

5. Salbutamol

Answer: E* Salbutamol

4. Complications of Myocardial Infarction.

***) All of the followings are complications of myocardial infarction, except: Q2012

1. Rupture chorda tendeni

2. Mitral regurgitation

3. DVT

4. Pericarditis

5. Recurrent laryngeal nerve palsy

Answer: E* Recurrent laryngeal nerve palsy

***) All of the followings are complications of myocardial infarction, except:

1. Atrial fibrillation

2. Heart failure

3. Systemic embolization

4. Endocarditis

5. Papillary muscle rupture

Answer: D* Endocarditis

***) Myocardial rupture as a complication of myocardial infarction is most likely to occur during the:

1. 1^st Week

2. 2^nd Week

3. 3^rd Week

4. 4^th Week

5. 5^th Week

Answer: A*1^st Week

5. Arrhythmias.

***) Patient known to have Wolff-Parkinson-White (WPW) syndrome presented with atrial fibrillation, stable vitals. The best management is: Q2012

1. Verapamil IV

2. Digoxin IV

3. DC shock

4. Amiodarone IV

5. Diltiazem IV

Answer: D* Amiodarone IV

***) 50 years old male asthmatic presented with palpitations, BP 130/85, ECG showed narrow QRS complex, regular, absent P wave. The best management is: Q2012

1. Propranolol IV

2. Diltiazem IV

3. Adenosine IV

4. DC shock

5. Amiodarone IV

Answer: B* Diltiazem IV

***) All the followings are antiarrhythmics drugs, except: Q2012

1. Xylocaine

2. Terbutaline

3. Quinidine

4. Amiodarone

5. Procainamide

Answer: B* Terbutaline

***) Electrical cardioversion is a useful mode of therapy in each of the following, except:

1. Ventricular tachycardia

2. Ventricular fibrillation

3. Bradycardia due to hypothyroidism

4. Atrial fibrillation

5. Atrial flutter

Answer: C* Bradycardia due to hypothyroidism