CARDIOLOGY MCQs WITH ANSWERS AND EXPLANATIONS

SET BY: SULEIMAN NDORO JNR

HEART FAILURE

1.Regarding heart failure, which statement is false?

A.      Right heart failure is commonly a consequence of left heart failure

B.      Acute heart failure results from myocardial infarction

C.      Pulmonary edema is the most severe form of ventricular failure

D.      The principal symptom of heart failure is shortness of breath

ANSWER C: The most severe form of ventricular failure is cardiogenic shock – the cardiac output is usually so low that poor tissue perfusion leads to a systemic acidosis, oliguria and cerebral hypoperfusion, causing the patient to be confused.

2. Which of the following is a radiographic finding of heart failure?

A.      Patchy shadowing

B.      Bat’s wing appearance

C.      Consolidation

D.      Cavitations

ANSWER: Chest radiography often shows cardiomegaly, increased pulmonary venous pressure (dilatation of the upper lobe veins and Kerley B lines), while pulmonary edema causes a ‘bat’s wing’ increase in shadowing around the hilum.

3. Which of the following is not a minor Framingham’s criterion for diagnosing heart failure?

A.      Pleural effusion

B.      Dyspnea on ordinary exertion

C.      Tachycardia (˃120bpm)

D.      Rales

ANSWER D: Minor criteria of Framingham are as follows: Nocturnal cough, dyspnea on ordinary exertion, pleural effusion, tachycardia, bilateral ankle edema, hepatomegaly

4. Which one of the following is not a major criterion for diagnosis of heart failure?

A.      Weight loss ˃6.5 kgs in 3 days in response to treatment

B.      Paroxysmal nocturnal dyspnea

C.      Neck vein distension

D.      S3 gallop

ANSWER A: Weight loss of ˃4.5 kgs in 5 days in response to treatment is the criteria and not loss of ˃6.5 kgs in 3 days. Other major criteria include: acute pulmonary edema, cardiomegaly, hepatojugular reflex, neck vein distension, paroxysmal nocturnal dyspnea/orthopnea, pulmonary rales, 3^rd heart sound (S3 gallop rhythm).

5. The following are causes of high output heart failure, except:

A.      Polythermia

B.      Beriberi

C.      Pulmonary hypertension

D.      Pregnancy

ANSWER C: Underlying causes of high output heart failure include: Anaemia, systemic arteriovenous fistula, hyperthyroidism, beriberi heart disease, Paget disease of bone, Albright syndrome, multiple myeloma, pregnancy, glomerulonephritis, polycythemia vera, carcinoid syndrome.