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1-50years male pt , diabetic , hypertensive , admitted to ICCU with burning ,
retrosternal chest pain , sweating and nausea , his 12 lead ECG revieled ST segment
elevation in leads II , III , AVF , with HR 40bpm , BP 70/40 , HIS JVP –is raised , his
lung fields are clear .This patient diagnosis is .
a)acute anterior MI .
b) Acute inferior MI , complicated by RV infraction, complete heart block
c)Acute inferior MI , complicated by left ventricular failure
d) Acute non ST elevation MI.
e) Unstable angina.
2- the mainstay in the man agement of this patient is:

a) Clexane , Aspirin.
b)IV lasix.
c) IV dopamine.
d) IV fluid , atropine.
e) ACE inhibition and B blockers..
3-73 years old male patient admitted to ICCU with chest pain , heaviness in charach ter
sweating , vomiting , his ECG – showed ST elevation in leads I –AVL V1----V6 , 3
hours later the patient started to C/O dyspnea , orthopnea chest –full of crepitation,
BP 70/30 mmHg , this patient diagnosis is:
a) Acute anterolateral MI , complicated by LVF , Killip class II .
b) Acute anterolateral MI complicated by cardiac tamponade .
c) Acute anterolateral MI complicated by LVF , Killip class IV.
d) Acute anterior MI , complicated by pulmonary embolism.
e)Acute anterolateral MI complicated by RV infercation.
4- The mainstay in this patient management should include.

a)Streptokinase , IV fluids , Aspirin.
b) Streptokinase , ACE , inhibitors , B-blocker.
c) IV dopamine , possible inraaortic balloon.
d) clexane , fluid, B block.
e) B.blockers aspirin , nitroglycerin.
5-32 years old female patient , complaint of localized chest pain, fever 2 weeks after
acute viral flu like illness and she diagnosed to have dry pericarditis, her ECG findings
characterized by all of the the following, except:
a)concave upward ST elevation
b) diffuse ST elevation
c)PR depression.
d)Tall R wave V1---V2.
e) late dy namic changes..
6-75 years old female patient , diabetic , hypertensive , and known to have dyslipidemia ,
she was maintained on atenolol , B-Aspirin and atorvastatin , she was admitted to
ICCU with unstable angina , her 12 leads ECG pre admission showed ST depression
V1---V4 , she has continuous angina despite treatment , here cardiac enzymes - normal ,
this patient T I MI score is:
a) 2
b) 3.
c) 5.
d) 7.
e) 8.
7- 50 years old female patient diagnosed as DCM , all of the following are features of
dilated cardiomyopathy by Echo Doppler except:
a) Dilated all chambers.
b) global hypokinesia.
c) low EF.
d) pulmonary regurge.
e) MR , TR.
8-Optimal medical therapy in the treatment of congestive heart failure, include all of
the following except:
a) Frusemide.
B ) Aldactone.
c) ACE inhibitors..
d) b. blockers.
e) Aspirin.
9-all of the following are echo findings in patient with HCOM except:
a) Asymmetrical septal hypertrophy ( ASH).
B) Systolic anterior motion ( SAM ).
c) low EF .
d) MR.
e) obstruction of left ventricular out flow tract ( high gradient ).
10-Indication for ICD implantation in a patient with HOCM include all of the
following except:
a) Family history of sudden cardiac death.
b) resuscitated VT of VF.
C)VT on Holter monitor.
d) chest pain on effort.
e) Peak pressure drop during exercise.
11- 45 years old male patient hypertensive on ACE inhibition admitted to cardiology
department with palpitation started 2 weeks ago , his ECG showed AF with fast HR , his
BP was 130/80 , the best management for this patient is :
a) DC-Shock synchronized 200J.
B) DC-Shock as synchronized 150J.
c) Rate control and Rhythm control by amiodarone infusion.
d)Rate control, warfarin for 3 weeks, then trans esophageal echo.
e) Rate control and aspirin for life.
12- All of the following can be used in management of HOCM except:

a) propronolol.
b) Verapmil.
c) ICD.
d) Amiodarone.
e) Digoxin.
13-45 years old male patient , admitted to emergency room , with Wide complex
irregular tachycardia ,his deferential diagnosis include all of the following except:
a) AF , with LBBB.
b) AF , with RBBB.
c) AF with aberrant conduction.
d) ventricular tachycardia .
e) AF . with WPW syndrome
14- the most common cause of MS is :
a) degenerative.
b) Rheumatic.
c) congenital
d) collagen D.
e) Inflammatory
15-paradoxical pulse can be seen in which of the following :

a)hypertensive encephalopathy.
b)acute MI .
c)Massive pulmonary embolism.
d)pulmonary stenosis.
e)Dilated cardiomyopathy.
16-75 years old male patient , complaining of dizziness , dyspnea on effort by

examination , he has ejection systolic murmur at 2d Rt intercostal space , radiating,
to the carotids all of the following can be heart by auscultation except:
a) Muffled 2d heart sound.
b) Mid systolic murmur at the aortic area.
c)S3.
d)S4.
e)Ejection systolic chick.
17-All of the following are the auscultatory findings in a patient with ASD , except:
a)Ejection systolic murmur over pulmonary area.
b)Wide splitting of S2.
c)Fixed spitting of S2.
d)Ejection systolic murmur, due to shunt through atrial septal defect.
e)The murmur in not very loud.
18- When you measure the JVP , a patient with congestive heart failure , it was 4 cm
above sternal angel , which calculated JVP has this patient :
a)12cm.
b)10cm.
c)9cm.
d)7cm.
e)6cm.
19- 75 years old male patient , known to have , IHD , ischemic cariomyopathy,
presented with palpitation , dizziness , dyspnea , profuse sweating , his 12 leads
ECG –wide complex regular tachycardia , HR 220 bpm , BP 70/30 , the best
management is
a)Verapamil IV.
b)DC shock 50J assynchronized.
c)DC shock200 J synchronized.
d)Amiodarone IV.
e)Lidocaine IV.
20-all of the followings drugs , can cause prolongation of QT interval , except:

a) amiodarone.
b) digoxin.
C) Quinidin.
d) erythromycin.
e) antihistamines.
21) . ALL OF THE FOLLOWINGS ARE INDICATIONS FOR AORTIC VALVE
REPLACEMENT IN A PATIENT WITH AORTIC STENOSIS, EXCEPT:
A. SEVERE SYMPTOMS (DYSPNEA, SYNCOPY).
B. PATIEN GOING FOR OTHER CARDIAC SURGERY.
C . PEAK PRESSURE GRADIENT ACROSS AORTIC VALVE > 70 MMHG.
D. LEFT VETRICULAR HYPERTHROPHY.
E. AORTIC VALVE AREA LESS THAN 0.8.
22. 32 YEARS OLD FEMALE PATIENT, ADMITTED TO CARDIOLOGY

DEPARTMENT WITH PULMONARY OEDEMA BY EXAMINATION SHE
FOUND TO HAVE MITRAL STENOSIS , BY ECHO DOPPLER : THERE IS
MITRAL STENOSIS , VALVE AREA 0.9 , PEAK PRESSURE GRADIENT 30
MMHG , THE LEAFLETS ARE PLIABLE , SEVERE MITRAL REGURGE, , THE
BEST MANEGEMENT FOR THIS PT IS :
A. MEDICAL TREATMENT.
B. MITRAL VALVE REPLACEMENT .
C. OPEN COMMISSURETOMY.
D. BALLOON VALVOPLASTY.
E. NO TREATMENT AT THIS MOMENT.
23.A28 YEARS OLD FEMALE PATIENT, WITH A HISTORY OF RHEUMATIC

HEART DISEASE, ALL OF THE FOLLOWINGS ARE AUSCULLTATORY
FINDINGS IN MITRAL STENOSIS EXCEPT:
A. LOUD S1 .
B. MIDDIASTOLIC MURMUR.
C. WIDE SPLIT 2d HEART SOUND.
D. PRESYSTOLIC ACCENTUATION OF THE MURMUR.
E. OPENING SNAP.
24. A 50 YEARS OLD MALE PATIENT , ADMITTED TO ICCU ,WITH MASSIVE

ANTERIOR MI, COMPLICATED RUPTURE OF THE FREE WALL , ALL OF THE
FOLLOWING , ARE SIGNS OF CARDIAC TAMPONADE , EXCEPT:
A. CONGESTED NECK VEINS .
B. MUFFELED HEART SOUNDS .
C. WATER HUMER PULSE.
D. HYPOTENSION.
E. PARADOXICAL PULSE.
25. MECHANICAL COMPLICATIONS OF MYOCARDIAL INFARCTION ,

INCLUDE ALL OF THE FOLLOWING EXCEPT:
A. TRUE LV ANEURYSM.
B. RUPTURE PAPILLARY MUSCLE.
C. RUPTURE INERVENTRICULAR SEPTUM.
D.RUPTUR E OF THE FREE WALL.
E. PSEUDOANEURYSM.
26 . 35 YEARS OLD FEMALE PATIENT , PRESENTED WITH COMPLAINT OF

DYSPNEA , ORTHOPNEA, LL OEDEMA, THESE SYMPTOMS STARTED FEW
WEEKS AFTER DELEVARY, BY EXAMINATION SHE HAS IRRIGULARY
IRRIGULAR PULSE , RAISED JVP, CHEST X RAY , SHOWED CARDIOMEGALY
AND CONGESTED LUNGS, ECG – AF. ECHODOPPLER – GLOBAL HYPOKINESIA,
EF 18%, MR, TR, THIS PATIENT DIAGNOSIS AND MANEGMENT IS :
A.IDIOPATHIC DILATED CARIOMYOPATHY, FRUSEMIDE, B BLOCKERS ,

ASPIRIN.
B. PERIPARTIUM CARIOMYOPATHY, FRUSEMIDE , ALDACTONE, DIGOXIN,
RAMIPRIL WARFARIN.
C. PERIPARTIUM CMP, FRUSEMIDE, B BLOCKERS,ASPIRIN.
D. PERIPARTIUM CARDIOMYOPATHY , ALDACTONE, B BLOCKERS,
WARFARIN.
E. POST VIRAL CMP , CRT D IMPLANTATION.
27. ICD IMPLANTATION, IS INDICATED FOR ALL THESE PATIENTS EXCEPT:

A. HOCM,WITH FAMILY HISTORY OF SUDDEN CARDIAC DEATH.
B. DCM , WITH RECCURENT VT, VF.
C. VF, DUE TO HYPERKALEMIA.
D. HOCH, WITH SUSTAINED VT.
E. RECURENT VT, VF OF UNKNOWN CAUSE.
28. 68 YEARS OLD FEMALE PATIENT , ADMITTED TO ICCU WITH,

PROLONGED ANGINAL PAIN , SWEATING, HIS 12 LEADS ECG, SHOWED ST
SEGMENT DEPRESSION IN ANTEROSEPTAL LEADS, CARDIAC ENZYMES,
INCLUDING TROPONIN WAS HIGH, THIS PATIENT DIAGNOSIS AND
TREATMENT IS :
A. ACUTE ST ELEVATION MI, GIVE STREPTOKINASE.
B. NON ST ELEVATION MI, ASPIRIN 300 MG, CLOPIDOGREL 300MG, CLEXANE
2MG /KG/ DAY, B BLOCKERS,STATINS.
C. UNSTABLE ANGINA, ASPIRIN 300 MG , CLOPEDOGREL 300MG , CLEXANE
AND STATINS.
D. NON ST ELEVATION MI, STREPTOKINASE.
E. DISSECTING AORTIC ANEURYSM, URGENT SURGERY.
29. SIGNS OF RESTRICIVE CADIOMYOPATHY BY ECHO DOPPLER , INCLUDE

ALL OF THE FOLLOWING , EXCEPT:
A. DILATED BOTH ATREA.
B. RIGID WALLS.
C. RESTRECTIVE PATTERN DIASTOLIC DYSFUNCTION.
D, MR , TR.
E . VERY LOW EJECTION FRACTION.
30. 70 YEARS OLD MALE PATIENT , DIABETIC , HYPERTENSIVE, KNOWN TO

HAVE IHD, EFFORT ANGINA FOR 2 YEARS,FEW DAYS HIS ANGINA BECAME
ON MINIMAL EFFORT, EVEN AT REST, NO MORE RESPONSE TO
NITROGLYCERIN S /L AS BEFORE , SO HE WAS ADMITTED TO ICCU, HIS 12
LEADS ECG WAS NORMAL, CARDIAC ENZYMES INCLUDING TROPONIN
TWICE NORMAL , THIS PATIENT DIAGNOSIS AND TREATMENT IS :
A. NON ST ELEVATION MI, ASPIRIN , CLEXANE, B. BLOCKERS.
B. ACUTE STEMI, STREPTOKINASE.
C. UNSTABLE ANGINA (ANGINA DE NOVO),CLEXANE , ASPIRIN ,
CLOPEDOGREL.
D. POST MI ANGINA , CLEXANE, STATINS, B BLOCKERS , ASPIRIN.
E. UNSTABLE ( CRESSENDO ANGINA) , CLEXANE , ASPIRIN , CLOPEDOGREL ,
B . BLOCKERS , STATINS.
31. IN A PATIENT , WITH ACUTE MI ,SINGS OF SUCCESSFUL STREPTOKINASE

THERAPY , INCLUDE ALL OF THE FOLLOWINGS , EXCEPT :
A. RELIEF OF ANGINAL PAIN .
B. REGRESION OF ST SEGMENT ELEVATION .
C. DEVELOPMENT OF NEGATIVE T WAVE.
D. REPERFUSION ARRHYTHMIA.
E. EARLY PEAK OF CARDIAC ENZYMES.
32 IN A PATIENT WITH AORTIC REGURGE INDICATION FOR AORTIC

VALVE REPLACMENT , INCLUDE ALL OF THE FOLLOWINGS EXCEPT:
A. RECURENT PULMONARY OEDEMA.
B. EF LESS THAN 55%.
C. LEFT VENTRICLE SYSTOLIC DIAMETER > 40 MM.
D. OTHER CARDIAC SURGERY , LIKE CABG.
E. LEFT VENTRICLE SYSTOLIC DIAMETER > 55 MM.
33. RESCUE ANGIOGRAPHY IN A PATIENT WITH ACUTE CORONARY

SUNDROME , IS INDICATED FOR ALL THESE PATIENS EXCEPT:
A. POST MI ANGINA, DESPITE TREATMENT.
B. CARDIOGENIC SHOCK.
C. FAILURE OF STREPTOKINASE THERAPY.
D. DEVELOPMENT OF DRY PERICARDITIS.
34. ALLOF THE FOLLOWINGS ARE BRANCHES OF RIGHT CORONARY

ARTERY , EXCEPT:
A. BRANCH TO AV NODE .
B. RIGHT VENTRICULAR BRANCH.
C. OBTUSE MARGINAL BRANCH.
D. POSTERIOR DESSENDING ARTERY.
35. CAUSES OF TALL R WAVE IN LEADS V1-V2 , INCLUDE ALL OF THE

FOLLOWINGS , EXCEPT :
A. DORSAL MI.
B. RIGHT VENTRICULAR HYPERTHROPHY.
C. RBBB.
D. WPW SYNDROME.
E. LBBB.
36. 55YEARS OLD FEMALE PATIENT , WITH LONG STANDING HISTORY OF

Rh HD, RECENTLY SHE STARTED TO COPLAINT OF DYSPNEA, HEMOPTYSIS,
BY AUSCULTATION –LOUD FIRST HEART SOUND, MID DIASTOLIC
RUMBLING MURMUR,THE ECG OF THIS PT ,CAN INCLUDE ALL OF THE
FOLLOWING EXCEPT:
A. P. MITRALE.
B. MAY DEVELOPE AF.
C. RIGHT VENTRICULAR HYPERTHROPHY.
D. LEFT VENTRICULAR HYPERTHROPHY.
E. EXTRASYSTOLES.
37. 45 YEARS OLD MALE PATIENT ,UNDERWENT OPEN HEART SURGERY

FOR AORTIC VALVE REPLACEMENT, 2 WEEKS LATER ,HE DEVELOPE
FEVER, ECHO WAS DONE AND REVIELED VEGITATIONS ON AORTIC
VALVE , THE MOST LIKELY CAUSATIVE ORGANISM IS :
A. STREPTOCOCUS VIRIDANS.
B. STAPHYLOCOCUS EPIDERMIDIDS.
C. STREPTOCOCUS BOVIS.
D. FUNGAL INFECTION.
E. VIRAL INFECTION.
38. INDICATION FOR URGENT SURGERY , IN INFECTIVE ENDOCARDITIS,

INCLUDE ALL OF THE FOLLOWING , EXCEPT:
A. FAILURE OF MEDICAL TREATMENT.
B. BIG VEGITATIONS.
C. EMBOLIC COMPLICATIONS.
D. FISTULA FORMATION.
E. CAUSATIVE ORGANISM – VIRAL INFECTION.
39. PROPHYLAXIS AGAINST INFECTIVE ENDOCARDITIS THE MOST

INDICATED IN :
A. PATIENT WITH MITRAL VALVE PROLAPSE.
B. PATIENT , WITH PROSTHETIC VALVE GOING FOR DENTAL EXTRACTION.
C. PATIENT WITH ASD , GOING FOR SPONTANOUS VAGINAL DELEVARY.
D. MITRAL REGURGE , GOING FOR UPPER ENDOSCOPY.
E. PT , WITH PERMINANT PACEMAKER,
4O. ALL OF THE FOLLOWINGS ARE FINDINGS IN APT ,

WITH COMPLETE HEART BLOCK EXCEPT:
A. SLOW PULSE RATE .
B. WIDE PULSE PRESSURE.
C. DOMINANT V WAVE IN JVP.
D. CANNON A WAVE.
E. EJECTION SYSTOLIC MURMUR , IF THE CAUSE IS DEGENERATIVE.
41 Significant ventricular extrasystoles , include all of the following except :

A .multifocal.
B. frequent.
C. R on T.
D. late.
E. couplet.
ANS:
1. B
2. D
3. C
4. C
5. D
6.C
7.D.
8.E
9.C
10.D
11.D
12.E
13.D
14.B
15.C
16.C
17.D
18.C
19.C
20.B
21.D
22.D
23.C
24.C
25.A
26.B
27.C
28.B
29.E
30.E
31.C
32.C
33.D
34.C
35.E
36.D
37.B
38.E
39.B

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1-50years male pt , diabetic , hypertensive , admitted to ICCU with burning ,

2- the mainstay in the man agement of this patient is:

4- The mainstay in this patient management should include.

12- All of the following can be used in management of HOCM except:

15-paradoxical pulse can be seen in which of the following :

16-75 years old male patient , complaining of dizziness , dyspnea on effort by

20-all of the followings drugs , can cause prolongation of QT interval , except:

22. 32 YEARS OLD FEMALE PATIENT, ADMITTED TO CARDIOLOGY

23.A28 YEARS OLD FEMALE PATIENT, WITH A HISTORY OF RHEUMATIC

24. A 50 YEARS OLD MALE PATIENT , ADMITTED TO ICCU ,WITH MASSIVE

25. MECHANICAL COMPLICATIONS OF MYOCARDIAL INFARCTION ,

26 . 35 YEARS OLD FEMALE PATIENT , PRESENTED WITH COMPLAINT OF

A.IDIOPATHIC DILATED CARIOMYOPATHY, FRUSEMIDE, B BLOCKERS ,

27. ICD IMPLANTATION, IS INDICATED FOR ALL THESE PATIENTS EXCEPT:

28. 68 YEARS OLD FEMALE PATIENT , ADMITTED TO ICCU WITH,

29. SIGNS OF RESTRICIVE CADIOMYOPATHY BY ECHO DOPPLER , INCLUDE

30. 70 YEARS OLD MALE PATIENT , DIABETIC , HYPERTENSIVE, KNOWN TO

31. IN A PATIENT , WITH ACUTE MI ,SINGS OF SUCCESSFUL STREPTOKINASE

32 IN A PATIENT WITH AORTIC REGURGE INDICATION FOR AORTIC

33. RESCUE ANGIOGRAPHY IN A PATIENT WITH ACUTE CORONARY

34. ALLOF THE FOLLOWINGS ARE BRANCHES OF RIGHT CORONARY

35. CAUSES OF TALL R WAVE IN LEADS V1-V2 , INCLUDE ALL OF THE

36. 55YEARS OLD FEMALE PATIENT , WITH LONG STANDING HISTORY OF

37. 45 YEARS OLD MALE PATIENT ,UNDERWENT OPEN HEART SURGERY

38. INDICATION FOR URGENT SURGERY , IN INFECTIVE ENDOCARDITIS,

39. PROPHYLAXIS AGAINST INFECTIVE ENDOCARDITIS THE MOST

4O. ALL OF THE FOLLOWINGS ARE FINDINGS IN APT ,

41 Significant ventricular extrasystoles , include all of the following except :

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