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Test questions
You must choose at least one correct answer for each question. It is also possible that there
are more than one right answers for one question.
1. Which of the following is a changeable risk factor of coronary artery disease?
A. age
B. genetics
C. hypertension
D. smoking
2. Which appears the earliest in case of ischemia?
A. ST segment depression
B. myocardial necrosis
C. diastolic dysfunction
D. systolic dysfunction
3. Which limits oxygen supply?
A. fever
B. coronary stenosis
C. anemia
D. critical bradycardia
4. Which myocardial area is most exposed to the risk of ischemia?
A. subendocardial region
B. epicardial region
C. the whole wall
D. apex of the heart
5. Which mechanism plays an important role in stable coronary artery disease?
A. plaque
B. thrombus
C. vasospasm
D. embolization
6. Which is NOT true for stable coronary artery disease?
A. It is usually caused by the atherosclerotic stenosis of coronary vessels.
B. Thrombus formation on a ruptured plaque plays an important role.
C. Angina is a common symptom.
D. Risk of severe complication is high, thus emergency treatment is required.
7. Chronic ischemia may lead to:
A. AV block
B. reduction of pump function
C. hypertrophy of myocardium
D. dilation of left ventricle
8. Which coronary branch supplies the anterior wall of the left ventricle?
A. RCA
B. LAD
C. Cx
D. PDA
9. Which belongs to stable coronary artery disease?
A. effort angina
B. crescendo angina
C. acute myocardial infarction
D. microvascular angina
10. The patient regularly experiences squeezing chest pain after going up one floor that ceases
after resting. Which condition is suspected?
A. vasospastic angina
B. typical angina pectoris
C. crescendo angina
D. microvascular angina
11. Characteristic for stable angina pectoris:
A. Always appears for the same physical exercise
B. Weather changes, front may provoke it
C. Emotional stress may aggravate it
D. May be provoked by hypertensive crisis.
12. Characteristic of Prinzmetal angina:
A. Calcium channel blockers relieve the acute attack.
B. It is often accompanied by migraine or Raynaud phenomenon.
C. It is caused by vasospasm.
D. ST elevation is not present during the attack.
13. Characteristic of unstable angina:
A. First occurance of angina pectoris should be considered unstable, and also when
angina occurs at rest or at minimal exertion.
B. During chest pain ST depression can be detected on ECG but sometimes ST
elevation may also occur.
C. Often symmetrical negative T wave develops, or pseudonormalization of T wave can
be observed in postischemic condition.
D. The value of CK-MB, Troponin-T and I is always increased, but it is not as high as in the
case of myocardial infarction.
14. According to the classification of the Canadian Cardiovascular Society (CCS), which
class does angina that occurs at low intensity workload and considerably limits everyday
activity belong to?
A. CCS I
B. CCS II
C. CCS III
D. CCS IV
15. In case of suspicion of coronary artery disease, which tests should be performed by all
means ?
A. exercise ECG
B. 12-lead resting ECG
C. echocardiography
D. taking case history, complaints and physical examination
16. Which of the following is an anatomical imaging method?
A. exercise ECG
B. coronary angiography
C. coronary CT angiography
D. echocardiography
17. Which statement is INCORRECT?
A. In case of normal resting ECG, ischemia can be excluded.
B. Transthoracic echocardiography can reveal left ventricular function, segmental wall
motion disorders and diastolic dysfunction as well.
C. Exercise ECG is of diagnostic value in case of horizontal or downsloping ST depression
≥0.1 mV at 60 or 80 ms after J-point in one or more than one leads.
D. Diagnostic value of ST segment alteration in recovery is poor.
18. Which test is recommended next for a patient with atrial fibrillation and left bundle branch
block who walks hard because of knee arthrosis?
A. coronary CT angiography
B. exercise ECG
C. stress myocardial perfusion scintigraphy
D. coronary angiography
19. At which pre-test probability is stress ECG recommended?
A. <15%
B. 15-65%
C. 65-85%
D. >85%
20. How can resting echocardiography help the diagnostics of coronary artery disease?
A. Ejection fraction helps to assess the risk of patient.
B. By visualizing the stenosis of coronary vessels.
C. Detecting the segments with wall motion disorder may help to identify the culprit
lesion.
D. To assess the viability of akinetic wall segments.
21. Which medication is recommended to be temporarily stopped before exercise ECG if the
test is aimed to establish the diagnosis of coronary artery disease?
A. beta blocker
B. trimetazidine
C. ACE inhibitor
D. Ca channel blocker
22. Which method is suitable to assess myocardial viability?
A. stress myocardial perfusion SPECT using 99mTc-MIBI isotope
B. gadolinium contrast cardiac MR
C. dobutamine stress echocardiography
D. coronary angiography
23. What is the next recommended examination for a patient with typical angina and reduced
ejection fraction?
A. exercise ECG
B. coronary angiography
C. stress myocardial perfusion scintigraphy
D. coronary CT angiography
24. For which patient is coronary angiography recommended?
A. young female with stabbing chest pain at rest lasting for seconds
B. middle aged male with hypertension, diabetes, without wall motion disorder on
resting echocardiography but with extensive transient perfusion defect of the
anterior wall on scintigraphy
C. cachectic patient with metastasizing colon tumor and NSTEMI
D. 65-year-old patient with typical angina and ejection fraction of 40%
25. Choose the correct answer.
A. Complete physical inactivity is recommended for patients with previous myocardial
infarction, PCI or CABG.
B. Decrease in the daily salt consumption (<5 gr) is advised for patients with coronary
artery disease.
C. The BMI goal is 20-25 kg/m2, where total mortality is the lowest.
D. Hormone replacement therapy (oestrogen) is recommended in women over 60 years for
primary or secondary prevention of coronary artery disease.
26. The goal for serum LDL cholesterol in high risk cardiovascular patients:
A. less than 3.5 mmol/l
B. less than 2.5 mmol/l
C. less than 1.8 mmol/l
D. 3 mmol/l is acceptable in case of low dose statin therapy
27. Recommended blood pressure in coronary artery disease:
A. systolic value 140 mmHg, diastolic value 90 mmHg
B. systolic value 150 mmHg, diastolic value 90 mmHg
C. in diabetic population below 140/85 mmHg
D. in diabetic population below 135/80 mmHg
28. Which group of drugs has both antianginal effect and improve survival?
A. statins
B. beta blockers
C. nitrates
D. Ca channel blockers
29. Which drugs are recommended in first line treatment of stable angina?
A. aspirin
B. trimetazidine
C. statins
D. short acting nitrates used on demand
30. Which statement is correct?
A. Target heart rate in stable coronary artery disease is around 55-60 beats per
minute.
B. Target heart rate in stable coronary artery disease is around 65-75 beats per minute.
C. Ivabradine can be used in stable coronary artery disease, if patient has sinus rhythm
and target heart rate cannot be reached with beta blocker.
D. Ivabradine can be used in stable coronary artery disease, if patient has atrial fibrillation
and target heart rate cannot be reached with beta blocker.
31. Which medication is recommended for angina of mainly vasospastic origin?
A. metoprolol (beta blocker)
B. amlodipine (Ca channel blocker)
C. rosuvastatin (statin)
D. nitroglycerin spray (short acting nitrate)
32. Which statement is correct?
A. Single antiplatelet therapy is sufficient after BMS stent implantation.
B. Lifelong dual antiplatelet therapy is required after DES stent implantation.
C. Dual antiplatelet therapy is necessary for 12 months after acute coronary syndrome,
even if no stent was implanted.
D. No antiplatelet therapy is needed 2 years after stent implantation.
33. Which statement is correct?
A. Routine measurement of platelet aggregation is essential to assess the effectiveness of
antiplatelet therapy.
B. Dual altiplatelet therapy (aspirin+clopidogrel) is required after stent implantation.
C. Ticlopidine is not recommended in cease of neutropenia or thrombocytopenia.
D. Aspirin reversibly inhibits thromboxane A2 synthesis.
34. Which revascularization method may lead to stent thrombosis?
A. POBA
B. BMS
C. DES
D. CABG
35. In which case is CABG the preferred method of revascularization?
A. severely calcified stenosis of the left main
B. significant three vessel disease
C. significant isolated Cx stenosis
D. spastic coronary vessels without organic stenosis