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1. An 50 y.o. male arrives the ER, complaining about chest pain for the last 8 hours, which of
the following tests should be done to rule out ACS ?
A. Serial E.C.G and Cardiac enzymes
B. Serial E.C.G, Cardiac enzymes, and Cardiac stress test
C. Serial E.C.G, Cardiac enzymes, and Chest XR
D. Serial E.C.G, Cardiac enzymes, and Echocardiography.

2. Which of the following is not expected to elevate CPK?

A. Rhabdomyolysis
B. Non ST-elevation MI
C. Hyperthyroidism
D. Hypothyroidism

3. When is elevated Troponin level least likely?

A. 10 days after A.M.I.
B. ST elevations on E.C.G., 4 hours after onset of chest-pain
C. Sudden death, Returned to NSR after defibrillation X 3
D. Non ST-elevation MI

4. What is not essential part of the ER treatment for AMI?

A. Morphine
B Oxygen supplement (if Hypoxic)
C. IV Heparine
D. ACE-inhibitors
E. Beta-blockers

5. Which of the following patients should not get Nitrates?

A. Blood pressure 100/60
B. Pt. took Viagra 2 days ago
C. Rt. Ventricle MI
D. Chronic HTN, with 3 other anti-hypertensive drugs already taken.

?What is not part of initial evaluation of patient with newly diagnosed HTN .6
.A E.C.G
B. Echocardiography
C. Creatinine clearance
D. BP measurement on both hands
E. ABI = Ankle Brachial Index

7. Which of the following statement is false?

A. Chronic atrial fibrillation is usually secondary to IHD
B. Maintaining sinus rhythm might be critical in patient with heart failure.
C. Young patient with lone AF don't benefit from anti-coagulation therapy.
D. rate control can be achieved with either Ca+2 or beta-blockers.

89. A patient with COPD, CHF, and Chronic renal failure is admitted to your ward with
worsening dyspnea and orthopnea of 2 days. Which of the following would not help in
establishing the diagnosis?
A. D-dimmer
B. pro-BNP
C. Troponin

9. Which of the following physical finding is not associated with worse prognosis?
A. S3
B. S4
C. Basilar rales
D. Holo-systolic murmur
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10. A patient arrives the ER with palpitation and dyspnea. The patient BP is 100/70, Sat – 94%.
The following ECG is obtained. What is your initial treatment?
A. Cardioversion (synchronized, 100j)
B. Adenosine
C. Amiodarone
D. Digoxine

11. Which of the following drugs for A. Fib affects the rhythm, rather than rate?
A. Digoxin
B. Ca+2 blocker
C. Beta-blocker
D. Amiodarone

12. A 72 y.o. woman is admitted to the ER with dyspnea, and no chest pain. The patient is known to
suffer from CHF, HTN and ESRD, with hemodialysis. Her vitals are: HR-110, BP-170/100, RR-
30, Sat-88%. The patient is diagnosed with pulmonary edema. Which of the following is not
essential pert of her treatment:
A. Nitrate
B. Furosamide
C. O2
D. Aspirin
E. Morphine

13. A 45 y.o. woman is admitted because of dyspnea. She is otherwise healthy. Her ABGs are as
followed: pH – 7.47, pCO2 – 30, pO2 – 50, Sat – 87%, HCO3 – 22. Chest XR was normal. ECG
is unremarkable, except for tachycardia. What's your diagnosis?
A. Respiratory acidosis d/t hyperventilation
B. Metabolic acidosis (d/t hypoxia and tissue ischemia) with respiratory compensation.
C. Respiratory alkalosis (d/t hyperventilation), compensated by metabolic acidosis.
D. Metabolic alkalosis, with concomitant respiratory alkalosis.

Match the patient with your initial choice for anti-hypertensive drug?
A. D.A.S.H diet and exercise
B. Enalapril
C. Bisoprolol
D. Disothiazide

14. 60 y.o. BP 160/100, with left ventricle hypertrophy

15. 35 y.o. BP 130/80, with DM type I, and normal Kidney
16. 70 y.o. BP 160/80, with newly discovered BP

Match the E.C.G below with the physical finding:

17. Distant heart sound, Increased JVP, BP – 70/40
18. Canon A wave on JVP
19. Displaced, enlarged PMI, Systolic murmur, Diamond shaped
20. Paradoxical splitting of S2.
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