MDE CVS 2010

1. Anterior tibial artery?
2. Most common site of DVT
3. as a pathologist, you must examine av bundle histologically. In which of the following tissue sample will you find the av bundle?

4. artery to the AV node arise from?
a. circumflex artery
b. RCA
c. right marginal
d. anterior interventricular
e. posterior interventricular

14. Congenital heart disease karena kegagalan arteriopulmonary septum tumbuh secara spiral?
a. left atrium
b. right strium
c. interatrial septum
d. muscular interventricular septum
e. membranous interventricular septum

untuk no 21-25: GAMBAR lapisan pembuluh darah arteri-vena
21. Endothelium
22. Internal elastic lamina
23. muscular layer
24. external elastic lamina
25. tunica adventitia

Untuk nomor 26-
26.endocardium mitral valve
27. endocardium ventricle
28. subendocardium

a.LDH
b.SGOT
c. DGBH
d. CKMB
e. Troponin
31.this test can assist in diagnosing reinfarction
32. this test is characteristically for qualitative test
33. remain 12th day post infarct
36. mass exam is better than activity exam

A. Mg
B. Na
C. Ca
D. Potassium
E. Cl
41. Fisiologis Ca antagonis
42. Jumlah yang banyak pada mineral ini dapat menyebabkan kontraksi otot
43. Paling banyak di extracellular
44. Coenzim
45. Kation paling banyak di intracellular

a. low sensitivity
b.low specificity
c. high sensitivity
d. high specificity
e. high sensitivity and high specificity
46. it is used as a screening test
47. it is used as a diagnostic test
48. if the result is negative, there is no disease
49. if the result is positive, there is a disease
50. it is only theoretical test

51. One of WHO diagnostic criteria for AMI
a. ECG
b. treadmill
c. X-Ray
d. Echocardiography
e. Cardiac perfusion

a. ECG
b. Treadmill
c. Chest X-Ray
d. Echocardiography
e. Cardiac perfusion scan
53. Check size of myocard damage
54. Test if ECG is failed to show abnormality
55. Measure size of heart

68. If HR = 90 bpm, EDV = 150, CO = 6.3 L/min, ESV ?
a. unknown
b. 220
c. 200
d. 80
e. 60

70. 1st heart sound
a. ventricular filling
b. closure aortic & pulmonary valve
c. vibration ventricular wall on systole
d. closure mitral & tricuspid valves
e. retrograde vena cava

71. 4th heart sound

104. heart auscultastion of ASD
a. wide split &fixed S2
B. narrow split S2
c. loud split S2
d. paradoxical split
e. normally splitting S2

124. A 24 y.o man goes to the atletic field. HE runs for 1 hour. Physiologic CVS changes?
a. decrease pulmonary arterial resistance
b. increase pulmonary arterial pressure
c. increase total peripheral resistance
d. decrease diastolic pressure
e. increase SV

128. symptom of large VSD?
Ans : poor feeding, rapid breathing

129. Cause of subacute IE?
a. S. epidermidis
b. S. Viridans
c. S. aureus

132. The most important cause of secondary pulmonary hypertension is…
a. chirosis of liver
b. scleroderma
c. pulmonary thromboembolism
d. COPD
e. Schistosomiasis

133. 31 years old woman come to ER: progressive dyspnea, no fever over 1 week. She has delivered spontaneously 4th baby 5 weeks ago. No health problem before except mild hypertension. Diagnosis dyspnea :
a. Dilated cardiomyopathy
b. Restrictive cardiomyopathy
c. Hypertrophy cardiomyopathy
d. Pulmonary embolism
e. Pulmonary infarction

136. Pasien dating ke ER dengan keluhan dyspnea on moderate activity. Ada thrill di apex. P2 accentuated. Diagnosis?
a. mitral regurgitation
b. mitral stenosis
c. aortic regurgitation
d. aortic stenosis
e. tricuspid stenosis

139. unstable angina is characterized by…
a. angina after exercise
b. angina relieve by sublingual nitrate
c. angina <10 minutes
d. first onset angina
e. angina relieved by rest

141. Thrombolytic paling tepat diberikan pada pasien?
a. ST depression
b. new bundle branch block
c. T inverted
d. non diagnose change
e. blocked atrioventricular

142. A patient w/ symptoms of AMI has ST segment depression of 2 mm on the ECG lead I&AVL, this may reflect
a. inferior wall infarction
b. anterior wall infarction
c. anteroseptal wall infarction
d. high lateral wall infarction
e. anterolateral wall infarction

145. Spironolactone
a. IV administration
d. water soluble potassium interfensi
e. reducing CHF

146. function of risk stratification in CAD?
a. looking for risk stratification
b. choosing 1st or secaondary prevention
c.
d.choosing appropriate treatment
e.

147. What is the following patient of heart failure who needs β-adrenergic bloacker
a. ?
b. class III NYCA heart failure
c. sinus rhythm + rate = 40 bpm
d. advance heart block
e. patient  depression

151. MoA amiodarone
a. blocking Na channel
b. blocking Ca channel
c. blocking K channel

152. Acute pericarditis…

153. ER  chest pain+fever ; pericardial friction rub; ↑ WBC + ESR
Acute pericarditis presentation?
a. pain onset crescendo
b. more comfortable in recumbence
c. abnormal S3 & S4
d. Pulmonary congestion in sever pericarditis
e. Rubs last hours to days

156. WOTF statement is true about physical finding in acute pericarditis?
a. Acute pericarditis produces retrosternal pain.
b. Pericardial friction rub is the hallmark of acute pericarditis.
c. Pericardial pain is almost always relieved by lying down.
d. Most pericardial friction rub are louder during expiration.
e. The friction rub is best heard while the patient is lying down.

157. PE cardiac tamponade:
a. arterial hypotension, wide pulse pressure
b.prominent basal rales and dyspnea
c. a rapid X descent, pulsus paradoxus, arterial hypotension
d. rapid X and Y descent, tachycardia
e. normal JVP, pulsus alternans
159. Pathophysiology of constrictive pericarditis :
a. Increased cardiac index of consequence of impaired filling
b. Normal EF and contraction
c. Ventricular filling occurs in every early diastole
d. Isovolumetric relaxation → increased period
e. …? Venous return during diastole ↑??

160. WTOF statement about pericardiocentesis is TRUE…
a. An anti-inflammatory agent is recommended prior to pericardiocentesis
b. Surgical intervention (pericardial window) usually better than percutaneous pericardiocentesis
c. size of effusion is well correlated w/ probability of successfully obtaining pericardial fluid
d. IV hydration should be initiated before threatened tamponade is diagnosed
e. pericardiocentesis especially useful in which a loculated effusion is present

162. patient present w/ systemic embolic event 1mo after MV replacement. For the past 1 week experience febrile. Blood culture, what organism?
a. S.viridans
B. S. aureus
c. Staphilococcus epidermidis
d. E. fecalis
e. Candida albicans

168. Thrombolytic therapy Is primarily indicated to patients with AMI whose ECG shows:
a. ST elevation
b. ST depression
c. T wave inversion
d. Pathologic Q wave
e. any ECG changes

171. definitive diagnosis CAD
a. coronary angiography
b. resting ECG
c. Exercise ECG
d. Cardiac enzyme
e. Echocardiography

172. factor most important in pulmonary hypertension in COPD
a. Loss small vessel inmost vascular regions
b. emphysema & lung destruction
c. pulmoany vasculature constriction due to hypoxia
d. ↑ CO from polycythemia
e. ↑ blood viscosity secondary to hypoxia

175. in the training phase a rehabilitation program following MI, a conditioning program is used to increase the physical work capacity. This conditioning program is one..
a. passively
b. passive active
c. assistive
d. actively
e. active resistive

176. in the training phase, target HR fot exercise training is:
a. 55-65% of maximal HR
b. 65-75% of maximal HR
c. 75-85% of maximal HR
d. 85-95% of maximal HR
e. 95-100% of maximal HR

194. Cardiac phenotypic changes result to alteration of cardiac cells metabolic rates, such as :
a. decrease calcium removal
b. increase cardiac contractility
c. decrease cardiac relaxation
d. decrease perfusion pressure
e. increase stiffness of the heart

?. Gangguan genetic metabolism mucopolysaccharides menyebabkan…
a. CHD
b. VHD
c. RHD

? Pulmonary vasodilator? Nitric Oxide