Heart 10 coronary diseases 2

1. In a 40-year-old pregnant woman at 32 weeks with severe chest pain from one hour before with a
history of pre-pregnancy hypertension during

Pregnancy is well controlled and the ECG has a 2mm ST segment rise in V4-V1 leads. Which item do you
recommend?

A) Emergency angiography

B. Streptokinase administration within 30 minutes

C) Perform a CT scan to rule out pulmonary embolism and aortic dissection

D (administering aspirin, intravenous nitroglycerin and transferring to CCU for surveillance)

2. 74-year-old man complaining of severe retroviral pain that started one hour ago and has no pain
following active morphine administration.

has done. The ECG has a 3mmST climb on the I, AVL, V1 and V6 leads. He gives a history of stroke
embolism three years ago.

What is the next best move?

(A) Streptokinase B (Emergency Angiography C) (NSAID D) Angiography Recurrence

3. A 61-year-old man presented with a history of

long-term hypertension with two chest pain attacks
24 hours earlier. In ECG a piece of the sink
ST is seen with the reverse T-wave in V6-V4 leads.
The first troponin enzyme is normal. What is the
best early treatment? ) The most complete option
Select(
A (aspirin-beta-blocker-heparin B) (aspirin-beta-
blocker-heparin-IIIa-GpII inhibitor)
Aspirin-Clopidogrel-Nifedipine D (Aspirin-
Clopidogrel IIIa-GpII Inhibitor) and Immediate
Angiography
4. At what level of the heart is the presence of high
ST in leads II, III, AVF in the acute phase of
myocardial infarction?
(Anterior surface b) lateral surface c) lower surface
d (septum area)
5. Which of the following is an uncommon
complication of cardiac aneurysm following
myocardial infarction?
(A) embolism b) aneurysm rupture c) heart failure
d (arrhythmia)
6. Which one of the following helps reduce the size
of the infarct?
(A) Increase heart rate and blood pressure at a rate
of 60-50 min / min and a blood pressure of 105/65
mmHg
(Prescribing Afterload and Preload Reducing Drugs
(Thrombolytic administration at the appropriate
time)
D) Performing initial PCI at the appropriate time
7. Which of the following is a relative indication of
fibrinolytic consumption?
A) Long-term CPR A (CVA D) (Internal bleeding)
8. What is the most important mechanism by which
urea nitrate reduces coronary artery disease?
(A) by lowering the extruded b (by reducing the
pre-load
C) by reducing contraction; d) by reducing HR
9. Which of the following is found earlier in
peripheral blood at the time of MI and myocardial
necrosis?
Myoglobin B (Troponin T) (MB-CK D) (Troponin I)
10. A 60-year-old man was admitted to the emergency department with a diagnosis of myocardial
infarction. On examination, he has a BP of 80.50 and a hearing loss

It is clear and complains of chest pain. Which of the following do you recommend for the treatment of
this patient?

A (Intravenous beta-lacer for patient pain control B) Intravenous TNG for patient pain control

C) administration of norepinephrine to increase patient blood pressure d) administration of normal

saline to increase patient blood pressure

11. In a 76 year old patient with unstable angina. Which patient does not put the patient at high risk for
mortality?

(A) Longitudinal B (Gallop S4)

C (dl / 2nq.0 = TnI d) patient age

12. Which of the following drugs is not recommended in low risk unstable angina?

Aspirin B (ADP Inhibitor C) LMWH (IIIa-GpIIb Inhibitor)

13. 57-year-old man with severe chest pain who started 30 minutes ago referred to hospital emergency
room.
A stroke has been hospitalized. The following ECG visit was taken from the patient. Which treatment
would you recommend?

A heparin-Retaplase-Clopidogrel-ASA)

B Heparin-primary PCI-Clopidogrel-ASA)

C Heparin-Reraplase-ASA)

D Heparin-PrimaryPCI-Clopidogrel)

14. Which of the following types of angina is associated with localized coronary artery spasm?

A) unstable b) unstable c) prinsmetal d (NSTEMI

15. A 60-year-old man with unstable angina has been referred to the clinic. Changes in the ECG are
observed during pain attacks. Which one

The following actions are appropriate?

A) Outpatient appointment earlier for angiography B (hospitalization and follow-up and planning for
angiography)

(C) Perform an exercise test to confirm the diagnosis. (Determine the time for stress cardiography

16. Which of the ECG changes for MI elevation ST is diagnosed at the lower level of the heart?

V1 to V3 at ST elevation 1mm) a

III Lead and AVF at ST elevation 2mm b

VI and VII in ST elevation 2mm) c

VI VIII Lead at ST elevation 1.5 mm) d

17. Which of the following is NOT indicative of a fibrinolytic prescription if PCI is unavailable?

A. (74-year-old woman with 100/170 pressure with lower STEMI

B. A 68-year-old man with anterior STEMI and a history of cerebral hemorrhage 8 years ago

A 45-year-old man with 3mm depression ST in Lady VII and VI and R to S ratio greater than 1 in Lady V1
with benign brain tumor

A 88 year old man with anterior STEMI and a history of ischemic stroke 5 years ago
18-year-old 63-year-old man with a long history of hypertension and hyperlipidemia and smoking with
severe chest pain for 4 hours (

Nausea and perspiration is present. Examination of BP = 90/60 and PR = 70 min and JVP 4 cm above
calvicillus in 30 ° supine position (

It can be seen. Cardiac A4 and systolic murmur VI / II at apex. The lungs are clean. The peripheral pulses
are normal. ECG

The patient is shown below. The patient is given sublingual TNG and 325mg aspirin and intravenous
morphine. Two minutes later the patient's blood pressure went down

It drops to 70/30 and the heart rate is 60 / min. What is the most likely cause of a patient's hypotension?

A) Papillary Muscle Dysfunction B (Right Aortic Dissection)

C internal eart failure

D Cardiogenic shock (MI) Lower level of myocardium associated with RV infarction

19

Cardiogenic shock (MI) Lower level of myocardium associated with RV infarction

19. Patient 15 minutes after severe chest pain, perspiration, nausea and vomiting refer to
emergency department of one of the city hospitals.

It is CCU-equipped but lacks angiography. The nearest medical center equipped with a 5.2 hour
angiography unit

The hospital is far away. On examination, a 70-year-old man with a history of hypertension,
diabetes, and cigarette smoking is currently at risk of 120/70.

And it has a heart rate of about 60 minutes. Can be heard in pulmonary hearing aids and at ECG
elevation ST in leads II, III and AVF and lowering

The ST segment has the I and AVL leads.

What is the diagnosis?

(Anterior surface infarction B) lateral surface infarction

Lower infarct level (EN) Entropestal level infarct

20. What is the best treatment for the above patient?

 A. Intravenous fibrinolytic administration according to the protocol

(B) Transfer to equipped hospital and perform primary PCI

C (fibrinolytic and PCI not indicated because of high risk of infarction in this patient

(D) The patient should first be given a temporary pacemaker and then decide on the treatment

21. In echocardiography the above patient has EF = 35% and has hypokinesis changes at anterior,
inferior and lateral levels. Next action after

What is Stable?

A) Intravenous defibrillator administration (coronary angiography)

Exercise test alone. Exercise test and myocardial perfusion scan

22. Which of the following is a less common complication of left ventricular aneurysm during MI?

(A) arrhythmia b) aneurysm rupture c) heart failure d (systemic embolism)

23. Which of the following angina pains is considered unstable angina?

Morning angine) Cold pressure angine) C Post prandial) ‫ ب‬Nocturnal) ‫الف‬

24. Which of the following is exclusively a late complication of myocardial infarction?

Cardiac Arrhythmis) LV aneurism) Thromboembole C) Cardiac rupture a)

25. Patients present with chest pain. In preliminary investigations in the emergency department,
Nora's heart changes as the segment falls

ST has a heart in the front leads. Increased troponin. The patient's pain has now somewhat
improved. Which is the best diagnostic measure

Is?

Exercise Test B Thallium C (Coronary Angiography D) Cardiac MRI

26. Patients present with typical chest pain and symptoms of acute myocardial infarction. In the
electrocardiogram, the changes of the fragment uptake

ST has a heart anterior lead, the patient's pain started 15 minutes ago. The nearest hospital is within 5
minutes from home No angiography section. Which of the following treatments do you recommend for
the patient?

A. (Call other hospitals and get an appointment for PCI at the earliest opportunity

(B) CCU admission and injection of streptokinase

C) CCU admission and current MI treatments due to time-lapse of streptokinase injection

(Due to the patient's pain relief and response to current medications, only a non-streptokinase injection
can be used and Prepared patient opportunity for PCI.

27. Which one of the following treatments is not suitable for reducing the size of myocardial infarction?

A) beta-blocker B (nitroglycerin C compounds) beta-agonist drugs (antipalactic drugs)

28. Pain that is caused by excessive anger and is associated with sweating and shortness of breath under
the sternum, following TNG intake

Language has not improved either. Which of the following is the most likely diagnosis?

A) stable angina b) aortic artery rupture c) acute pulmonary embolism d (acute myocardial infarction)

29. A 50-year-old diabetic man presented to the emergency room two hours ago with HR = 100 and Bp =
90/100. On the ECG

He has elevation ST seen in leads V5-V1, I and aVl and ST decrease in leads II, III and AVf. Which is the
best treatment? ST

) elevation <1mm

A. Immediate angiography and, where possible, primary angioplasty

B) Immediate angiography and then bypass surgery

C (administration of anticoagulant, anti-platelet and beta-alkaline and angiography 24 hours later)

(Thrombolytic administration and then angiography within 24 hours

30-Which leads are considered in ECG for diagnosis of right ventricular infarction?

(AVR b) V9 c (II d (rV4

31-Which of the following is less relevant to angina?

A. Epigastric B Release to the Right Arm C Maxillary D Retroastral

32-year-old 45-year-old man presents to the emergency room with a retroventricular chest pain that
began 2 hours ago, and a fall in ECG

ST is seen in 1mm on the II, III, Avf, V6-V5. Which medication is not recommended for the patient?

Streptokinase B (Ethoxaparin C) Aspirin D (Clopidogrel)

33. Which of the following is not a classic feature of angina pectoris?

A) duration of pain b) quality of pain c) response to nitroglycerin d (intensity of pain in activity

34. A 40-year-old man presented to the emergency room complaining of severe chest pain. The patient's
pain began about three hours ago

to be continued. Which of the following is the most likely diagnosis of a patient's ECG?

Unstable Angina B (MI Elevation ST Non C) Lower Level Infarction D (Lateral Heart Wall Infarction)

35. In a patient with angina stable chronic with LVEF about 60% without cardiac valve involvement, on
physical examination at

Chest pain What are the most common sounds and murmurs that can be heard?

A (S3 and transient mitral regurgitation murmurs B) S4 and transient mitral regurgitation murmurs

C (S4 and transient aortic insufficiency murmurs S3 and transient aortic insufficiency murmurs

36. Cardiac troponin is elevated in all of the following cases except ...

(N) STEMI B (NSTEMI C) Unstable D (myocarditis)

37. What is the best cardiac marker test to diagnose myocardial infarction?

Myoglobin B (MB-CK) Troponin D (LDH)

38-A 53-year-old diabetic patient presented to the emergency room with chest pain and was taken on
ECG depression ST 3 mm.

Has V4-V1 leads. Cardiac enzymes Troponin Wei have been reported high. All the following actions are
recommended except ...

A) administration of aspirin b) administration of heparin c) administration of fibrinolytic d

(administration of clopidogrel)

39. Which one of the following is NOT an absolute fibrinolytic contraindication?

A (haemorrhagic CVA history B) traumatic CPR or longer than 10 minutes

C) Suspected aortic dissection (known as cerebrovascular disease)

40 patients A 35-year-old woman complains of chest pain during rest and activity that takes about 30
minutes. Acupuncture patient pain

Is. What is the most likely diagnosis?

Stable angina B (Atypical angina)

Unstable chest angina

41- Which is the most important diagnostic feature of ischemic heart pain?

A) b) time c) release d) activity and rest

42. Which of the following is not an acute coronary syndrome?

A43. What is the most important pathophysiological factor in the development of STEMI?

Dynamic obstruction and coronary pain (Plaque rupture or erosion) a

Secondary to increased myocardial o2 demand (Progressive obstruction) c

44. Which one of the following indicates pain from myocardial ischemia?

A. Chest pain that increases with activity and decreases with rest

(Pain lasts more than 30 minutes

C) pain exacerbated by deep breathing and tail

Pain that spreads to the edge of the trapezius muscle) unstable angina b) unstable angina c (NSTEMI d)
STEMI

45 - Which of the following is most commonly seen in Silent ischemia?

A) obese b) smokers c) elderly d) hyperlipidemia

46. All of the following are coronary vasodilators except ...

A) endothelin B (prostacyclin C) NO (adenosine)

47. Which of the following is the absolute contraindication to the use of fibrinolytic in STEMI myocardial
infarction?

A) prolonged cardiopulmonary resuscitation B (diabetic hemorrhagic retinopathy)

Aortic Dissection (Pregnancy)

48. A 65-year-old diabetic man presented with severe chest pain. In the ECG taken, the horizontal
depression changes to the ST segment It measures 3mm in V6-V3 leads. Cardiac enzymes Troponin I)
have been reported high. What action should he not take?

A) administration of aspirin b) administration of heparin c) administration of fibrinolytic d

(administration of clopidogrel)

49-Patients present with compressive chest pain, in the electrocardiogram we notice an elevation of ST
in all leads, probably
In which lead will the depression of this piece be seen?

AvR b (V1 c) aVL d (aVF