Important MCQ’s For Cardiovascular in NEET SS Medicine

Q1. A 50-year-old man with a history of alcohol abuse presents with shortness of breath and pedal oedema on and off for five days. An electrocardiogram shows findings consistent with myocarditis. Which of the following is a risk factor for the development of myocarditis in this patient?

1. Hypertension

2. Hyperlipidemia

3. Chronic alcohol abuse

4. Diabetes Mellitus

Ans. 3) Chronic alcohol abuse 

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Q2. A 47-year-old man presents with chest pain and palpitations for the last two hours. ECG shows sinus tachycardia with nonspecific ST-T wave changes. Which of the following tests is most likely done to confirm the diagnosis of myocarditis?

1. Cardiac catheterisation
2. Echocardiography
3. Cardiac MRI
4. Myocardial biopsy

Ans. 4) Myocardial biopsy 

Q3. A 25-year-old woman presents with chest pain, shortness of breath, and fatigue. She is diagnosed with myocarditis based on elevated cardiac enzymes and echocardiographic evidence of decreased left ventricular function. Which gender is more commonly affected by myocarditis?

1. Female

2. Male

3. Myocarditis affects both genders equally

4. Myocarditis affects both genders equally 

Ans. 1) Female 

Q4. A 33-year-old man presents with fever, fatigue, and shortness of breath for three days. He has been diagnosed with myocarditis and started on appropriate treatment. Which of the following complications is the patient at risk for?

1. Atrial fibrillation

2. Heart Failure

3. Pulmonary embolism

4. Stroke

Ans. 2) Heart failure

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Q5. A 35-year-old man presents with dyspnea on exertion, fatigue, and leg swelling for the past four days. Echocardiography shows dilated left ventricle and decreased ejection fraction. Which of the following is the most likely cause of his cardiomyopathy?

1. Hypertrophic cardiomyopathy

2. Dilated cardiomyopathy

3. Restrictive cardiomyopathy

4. Arrhythmogenic right ventricular cardiomyopathy 

Ans. 2) Dilated cardiomyopathy 

Q6. A 70-year-old man presents with fatigue, shortness of breath, and lower extremity oedema for one week. Echocardiography shows normal left ventricular size and function but increased left atrial size. Right heart catheterisation reveals elevated pulmonary artery pressure. Which of the following is the most likely diagnosis?

1. Hypertrophic cardiomyopathy

2. Dilated cardiomyopathy

3. Restrictive cardiomyopathy

4. Arrhythmogenic right ventricular cardiomyopathy

Ans. 3) Restrictive cardiomyopathy 

Q7. A 45-year-old African American man presents with chest pain and shortness of breath. Echocardiography shows left ventricular hypertrophy with preserved systolic function. His medical history is significant for hypertension and diabetes mellitus. Which of the following is the most likely diagnosis considering racial predilections?

1. Non-ischemic cardiomyopathy with left ventricular hypertrophy

2. Dilated cardiomyopathy

3. Hypertrophic cardiomyopathy

4. Restrictive cardiomyopathy 

Ans. 1) Non-ischemic cardiomyopathy with left ventricular hypertrophy

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Q8. A 45-year-old man presents with shortness of breath and chest pain. He has a history of hypertension and high cholesterol. An echocardiogram shows an ejection fraction of 30%. The cardiologist suspects cardiomyopathy and orders laboratory tests. Which of the following is the lab diagnostic test for cardiomyopathy?

1. Brain natriuretic peptide (BNP)

2. Cardiac troponin I

3. Creatine kinase-MB (CK-MB)

4. Genetic testing

Ans. 4) Genetic testing

Q9. A 19-year-old male presents in the medical emergency room with acute left-sided chest pain for the last 3 hours. Pain is sharp, limited to the anterior chest, worsens with recumbent position, and improves with sitting upright. On examination, blood pressure is 90/60mmHg and heart rate 100/min. His JVP is raised, and precordial auscultation reveals a pericardial friction rub with muffled heart sounds. ECG shows low amplitude complexes and electrical alternans. He is subsequently diagnosed with acute pericarditis complicated with massive pericardial effusion. What is the normal physiologic amount of pericardial fluid in the pericardial sac? 

1. Up to 200 ml

2. Up to 50 ml

3. Up to 250 ml

4. Up to 300 ml 

Ans. 2) Up to 50 ml 

Q10. A 45-year-old woman presents in the medical emergency room with gradually progressive exertional dyspnea and bilateral pedal swelling from the last 3 weeks. Her past history is significant for CA breast, for which she currently receives radiotherapy. Examination reveals normal vital signs, raised JVP, bilateral pedal pitting oedema, tender hepatomegaly and bilateral fine basal lung crackles. Auscultation of the precordium reveals a pericardial knock. She is diagnosed with constrictive pericarditis secondary to radiation exposure. What is the characteristic abnormality expected in the jugular venous waveform? 

1. Large a wave

2. Absent x descent

3. Slow y descent

4. Prominent y descent

Ans. 4) Prominent y descent

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Q11. A 12-year-old boy is brought to the pediatric emergency room with palpitations and chest pain for the last 30 minutes. He previously had multiple emergency visits with similar complaints but could not have a proper evaluation. On examination, his blood pressure is 70/40 mmHg, heart rate is 129/min; respiratory rate is 29/min and a GCS of 14/15. His ECG shows an incomplete right bundle branch block, and a chest x-ray reveals a shifting of cardiac silhouette leftwards. A bedside echo shows an enlarged right ventricle. He receives inotropic support, but he dies. A post-mortem autopsy is done, which confirms the complete congenital absence of the pericardium. Which of the following structures does the pericardium embryologically develop from?

 1. Right horn of sinus venosus

2. Left horn of sinus venosus

3. Endocardial cushions

4. Septum transversum

Ans. 4) Septum transversum

Q12. A 21-year-old man presents in the medical emergency room with sudden onset left-sided chest pain for the last 2 hours. He describes his pain as sharp, non-radiating, that worsens with lying flat and improves with sitting upright. He recently had a fever, rhinorrhea, myalgias and cough. On examination, he is vitally stable, and precordial auscultation reveals a scratchy sound throughout the cardiac cycle at the left sternal border. Considering the underlying diagnosis, what is the typical ECG finding in this condition?

1. Diffuse ST elevation with convexity upwards

2. Diffuse ST elevation with concavity upwards

3. Diffuse ST depression in all leads

4. ST elevation in the anterior leads 

Ans. 2) Diffuse ST elevation with concavity upwards

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Q13. A 20-year-old man presents in the medical emergency room with shortness of breath and bilateral pedal swellings from the last 2 days. He has a previous history of malignant melanoma for the last 2 years, for which he didn't take any treatment. On examination, his blood pressure is 80/60 mmHg, his heart rate is 110/min, and respiratory rate is 26/min. His JVP is raised with a paradoxical rise during inspiration. Heart sounds are muffled, and pulsus paradoxus is present. Considering the underlying diagnosis, which of the following echocardiographic findings is highly sensitive for this condition?

1. Left atrial inversion sign

2. Right atrial inversion sign

3. McConnell's sign

4. 60/60 sign 

Ans. 2) Right atrial inversion sign

Q14. A 21-year-old man presents in the medical emergency room with dyspnea, abdominal distension and bilateral pedal swellings from the last week. It is associated with a preceding one-month history of weight loss, fever and anorexia. On physical examination, his blood pressure is 70/40 mmHg, his heart rate is 109/min, his respiratory rate is 28/min, and his temperature is 101°F. He has raised JVP, which falls paradoxically in inspiration. A precordial auscultation reveals muffled heart sounds. A pulsus paradoxus is present. A chest x-ray shows cardiomegaly with right apical consolidation. Considering the likely diagnosis, what is the best management of this patient's presentation?

1. Start antituberculous treatment

2. Therapeutic pericardiocentesis and antituberculous treatment

3. Therapeutic pericardiocentesis and NSAIDs

4. Therapeutic pericardiocentesis and prednisolone 

Ans. 2) Therapeutic pericardiocentesis and antituberculous treatment 

Q15. A 57-year-old man presents in the cardiac emergency room with chest discomfort, fever and malaise for the last 3 days. He describes his pain as sharp, non-radiating and pleuritic pain that worsens with lying flat and improves with bending forward. He is currently recovering from an acute myocardial infarction 3 weeks back. On examination, his vital signs are normal, and auscultation of the precordium reveals a pericardial friction rub. His ECG shows diffuse ST elevation with concavity upwards. His WBC count, ESR and CRP is raised. Considering the likely possibility, which of the following drugsṭ should be given?

1. Ibuprofen

2. Aspirin

3. Prednisolone

4. Heparin

Ans. 2) Aspirin

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