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Started on Wednesday, 20 May 2020, 4:01 PM

State Finished
Completed on Wednesday, 20 May 2020, 4:59 PM
Time taken 58 mins 17 secs

Question 1 Which of the following statements regarding Normal ECG are correct? (select one
Complete correct answer)
Marked out of 1
Select one:
A. Normal q waves are biphasic in leads II and V1, with duration <0.04 sec
B. RR interval is the time between the two consecutive atrial depolarization.
C. P wave is downward deflection in most leads except AVR.
D. ST segment represents completed ventricular myocardial depolarization, and

Question 2 Which of the following statements is true regarding Normal ECG? (select correct
Complete answer)
Marked out of 1
Select one:
A. PR interval reflects right and left atrial depolarization with duration > 0.2 sec
B. QT interval is the time between the beginning of ventricular depolarization and
the end of ventricular repolarization with duration >0.48 sec
C. A q wave is the initial upward deflection in QRS complex reflecting normal
ventricular septal activation (depolarization), which typically can be seen in II,
standard leads, and V1,V6 precordial leads
D. Across precordial leads, S wave decreases and R wave increases from V1 to
V6 leads, equalizing either in V3 or V4 leads

Question 3 The second heart sound (S2) is produced by: (select one correct answer)
Complete
Marked out of 1 Select one:
A. Closure of atrioventricular valves in the beginning of systole
B. Opening of Aortic and pulmonic valves in the beginning of diastole
C. Closure of Semilunar valves in the beginning of diastole
D. Opening of mitral and tricuspid valves in the beginning of diastole

Question 4 A 19-year-old college student presents to your office for a regular check-up. She has no
Complete medical problems. She does not smoke. On auscultation of her heart, you hear a split
of S2 sound during inspiration at the 2nd left parasternal interspace. What is the most
Marked out of 1
likely cause of this split? (select the correct answer)

Select one:
A. Pulmonic stenosis
B. Pulmonary hypertension
C. Physiologic
D. Mitral regurgitation
Question 5 Diastolic murmurs are present in: (select correct answer)
Complete
Marked out of 1 Select one:
A. Pulmonary regurgitation
B. Aortic and Pulmonic stenosis
C. Mitral regurgitation
D. Tricuspid regurgitation

Question 6 CONSOLIDATION findings include: (select correct answer)

Complete
Marked out of 1 Select one:
A. Pleural friction rub
B. Bronchial breath sounds
C. Wheezes or rhonchi
D. Vesicular breath sound

Question 7 Which of the following statements is true concerning the Heart Sounds? (select correct
Complete answer)
Marked out of 1
Select one:
A. The second heart sound (S2) is split into two components during expiration
B. The second heart sound (S2) is split into two components during inspiration
C. The third heart sound (S3) is always pathological
D. The third heart sound (S3) is audible in late diastole

Question 8 Characteristics of BRONCHIAL BREATH SOUNDS include: (select correct answers)

Complete
Marked out of 1 Select one:
A. Normally heard over the lung parenchyma
B. Heard during pneumonia due to consolidation (over the affected area)
C. Inspiratory and expiratory sounds are equal in length and there is a short
silence gap in-between

Question 9 The first heart sound (S1) is produced by: (select one correct answer)
Complete
Marked out of 1 Select one:
A. Closure of mitral and tricuspid valves in the beginning of diastole
B. Closure of atrioventricular valves in the beginning of systole
C. Opening of mitral and tricuspid valves in the beginning of systole
D. Opening of aortic and pulmonic valves in the beginning of systole

Question 10 Which of the following statements regarding Normal ECG are correct? (select one
Complete correct answer)
Marked out of 1
Select one:
A. Normal P wave may be notched or biphasic in leads II and V1, with the initial
component reflecting right atrial depolarization, followed by the left atrial
component.
B. Normally, the largest R of the QRS complex are seen in left precordial leads
C. J point is the point at which the q wave ends and R wave begins.
D. Normal PR interval encompasses time of right and left ventricular depolarization
and AV nodal delay.
Question 11 AIRWAY OBSTRUCTION findings include: (select correct answer)
Complete
Marked out of 1 Select one:
A. Fine crackles
B. Bronchial breath sounds
C. Wheezes or rhonchi
D. Pleural friction rub

Question 12 Characteristics of RHONCHI include: (select correct answer)

Complete
Marked out of 1 Select one:
A. Discontinuous, intermittent, late inspiratory sound persistent breath to breath
B. Typically heard during chronic bronchitis
C. Typically heard during early left ventricular failure
D. Indicates a partial obstruction of the larynx or trachea, and demands immediate
attention

Question 13 A 79-year old patient was admitted to the hospital for medical care. On auscultation of
Complete his/her heart you hear a low pitched, uniquely shaped diastolic murmur heard best at
the apex together with an "opening snap". Which of the following is the most likely
Marked out of 1
cause of this murmur? (select one correct answer)

Select one:
A. Aortic regurgitation
B. Pulmonic Stenosis
C. Mitral stenosis
D. Pulmonic regurgitation

Question 14 Characteristics of BRONCHIAL BREATH SOUNDS include: (select correct answer)

Complete
Marked out of 1 Select one:
A. Heard during airway obstruction (COPD, Asthma)
B. Inspiratory and expiratory sounds are equal in length without short silence gap
in-between
C. Expiratory sounds last longer than inspiratory sounds
D. Soft and relatively low pitched

Question 15 The second heart sound (S2) is produced by: (select correct answer)
Complete
Marked out of 1 Select one:
A. Closure of mitral and tricuspid valves in the beginning of systole
B. Closure of Aortic and pulmonic valves in the beginning of diastole
C. Opening of Aortic and pulmonic valves in the beginning of diastole
D. Closure of aortic and pulmonic valves in the beginning of systole

Question 16 A 6-year-old child presents with his parents for a regular checkup. He has normal
Complete growth and development and is appropriately physically active. On auscultation of his
heart, you hear with you bell of stethoscope a low-pitched S3 sound at the apex. What
Marked out of 1
is the most likely cause of this sound? (select correct answer)

Select one:
A. Mitral regurgitation
B. Physiologic
C. Aortic regurgitation
D. Mitral stenosis
Question 17 Characteristics of COURSE CRECKLES include: (select correct answer)
Complete
Marked out of 1 Select one:
A. Caused by airway opening and secretions in airways, and clear after coughing
B. Discontinuous, intermittent, late inspiratory sound persistent breath to breath
C. Commonly heard during consolidation of the lung
D. Typically heard during airway obstruction (COPD, Asthma)

Question 18 AIRWAY OBSTRUCTION findings include: (select correct answer)

Complete
Marked out of 1 Select one:
A. Fine crackles
B. Decreased breath sound
C. Bronchial breath sounds
D. Pleural friction rub

Question 19 Which of the following statements is true concerning the Heart Sounds? (select correct
Complete answer)
Marked out of 1
Select one:
A. The second heart sound (S2) is split into two components during expiration
B. The fourth heart sound (S4) normally is audible in elderly women
C. The third heart sound (S3) is audible in late diastole
D. The fourth heart sound (S4) is audible in late diastole

Question 20 Which of the following statements regarding Normal ECG are correct? (select one
Complete correct answer)
Marked out of 1
Select one:
A. P wave is narrow (<0.04 sec) and short <2mm (<25% the amplitude of the R
wave) and reflects ventricular septal depolarization
B. Small or insignificant q wave is usually seen in leads III, II, V5 and V6 leads
C. T wave usually takes the opposite direction as the QRS complex (discordance)
except in the right precordial leads.

Question 21 A 66-year-old patient was admitted to the hospital for medical care. On auscultation of
Complete his/her heart you hear a holosystolic, uniform, high pitched murmur heard best at the
apex, radiating to the axilla. Which of the following is the most likely cause of this
Marked out of 1
murmur? (select one correct answer)

Select one:
A. Mitral stenosis
B. Tricuspid regurgitation
C. Mitral regurgitation
D. Pulmonic Stenosis
E. Aortic regurgitation

Question 22 Characteristics of COURSE CRECKLES include: (select correct answers)

Complete
Marked out of 1 Select one:
A. Continuous low pitched, snore-like sounds typically produced due to airway
secretions
B. Typically disappears when inflamed pleural surfaces are separated by fluid
C. Discontinuous scattered "bubbling" sounds in early inspiration and perhaps
expiration heard during chronic bronchitis
D. Indicates a partial obstruction of the larynx or trachea, and demands immediate
attention
Question 23 Characteristics of BRONCHOVESICULAR BREATH SOUNDS include: (select two
Complete orrect answer)
Marked out of 1
Select one:
A. There is no silence gap between inspiratory and expiratory sounds
B. Inspiratory sounds last longer than expiratory sounds
C. Inspiratory and expiratory sounds are equal in length
D. Expiratory sounds last longer than inspiratory sounds

Question 24 Characteristics of FINE CRECKLES include: (select correct answers)

Complete
Marked out of 1 Select one:
A. Discontinuous, intermittent, late inspiratory sound persistent breath to breath
B. Creaking or grating sounds heard during inspiration and expiration
C. Typically heard during airway obstruction (COPD, Asthma)
D. Clear after coughing

Question 25 The first heart sound (S1) is produced by: (select correct answer)
Complete
Marked out of 1 Select one:
A. Closure of mitral and tricuspid valves in the beginning of diastole
B. Closure of mitral and tricuspid valves in the beginning of systole
C. Opening of mitral and tricuspid valves in the beginning of systole
D. Opening of aortic and pulmonic valves in the beginning of systole

Question 26 Which of the following statements regarding ECG features of Left Axis Deviation is
Complete correct? (select the correct answer)
Marked out of 1
Select one:
A. The QRS are both positively deflected in Lead I and AVF
B. The QRS complex for Lead I is positively deflected but the QRS in AVF is
negatively deflected
C. The QRS in Lead I and in aVF are both negatively deflected
D. The QRS complex in Lead I is negatively deflected but the QRS in aVF is
positively deflected

Question 27 A 74-year-old patient was admitted to the hospital for medical care. On auscultation of
Complete his/her heart you hear a systolic, creshendo-decreshendo, high pitched murmur located
at the right upper sternal border, which radiates to the carotid arteries. Which of the
Marked out of 1
following is the most likely cause of this murmur? (select one correct answer)

Select one:
A. Tricuspid regurgitation
B. Aortic regurgitation
C. Aortic Stenosis
D. Mitral stenosis
E. Pulmonic Stenosis

Question 28 Which of the following statements regarding Heart's Electrical Axis is correct? (select
Complete one correct answer)
Marked out of 1
Select one:
A. Normal axis: -90° to -180°
B. Left axis deviation: -30° to -180°
C. Normal axis: -30° to +90°
D. Extreme axis deviation: +90° to +180°
Question 29 ADVENTITIUS LUNG SOUNDS include: (select correct answer)
Complete
Marked out of 1 Select one:
A. Bronchial sound
B. Crackles
C. Egophony
D. Murmur

Question 30 Systolic murmurs are present in: (select correct answers)

Complete
Marked out of 1 Select one:
A. Aortic regurgitation
B. Mitral and Tricuspid stenosis
C. Mitral and Tricuspid regurgitation
D. Pulmonic regurgitation

Question 31 Characteristics of FINE CRECKLES include: (select correct answer)

Complete
Marked out of 1 Select one:
A. Continuous, high pitched, musical, whistling sound, suggesting airway
obstruction
B. Typically change when body position is altered
C. Discontinuous, lower pitched, less intense "bubbling" sounds of longer duration
D. Heard during consolidation, suggesting pneumonia

Question 32 A 67-year-old patient was admitted to the hospital for medical care. On auscultation of
Complete his/her heart you hear a high pitched, early diastolic, decreshendo murmur heard best
at the left lower sternal border and at end-expiration with the patient sitting up and
Marked out of 1
leaning forward. Which of the following is the most likely cause of this murmur? (select
one correct answer)

Select one:
A. Pulmonic regurgitation
B. Aortic regurgitation
C. Aortic Stenosis
D. Tricuspid regurgitation
E. Mitral regurgitation

Question 33 Which of the following statements regarding ECG features of Extreme Axis Deviation is
Complete correct? (select one correct answer)
Marked out of 1
Select one:
A. The QRS are both positively deflected in Lead I and AVF
B. The QRS complex for Lead I is positively deflected but the QRS in AVF is
negatively deflected
C. The QRS in Lead I and in aVF are both negatively deflected
D. The QRS complex in Lead I is negatively deflected but the QRS in aVF is
positively deflected

Question 34 Characteristics of WHEEZES include: (select correct answers)

Complete
Marked out of 1 Select one:
A. Discontinuous sound, suggesting consolidation
B. Typically disappears when inflamed pleural surfaces are separated by fluid
C. Typically heard during airway obstruction (COPD, Asthma)
D. Continuous snore-like sounds of low frequency, suggesting secretions in the
larger airways
Question 35 Characteristics of VESICULAR BREATH SOUNDS include: (select correct answer)
Complete
Marked out of 1 Select one:
A. Louder and higher in pitch
B. Inspiratory sounds last longer than expiratory sounds
C. Expiratory sounds last longer than inspiratory sounds
D. There is a short silence gap between inspiratory and expiratory sounds.

Question 36 Characteristics of STRIDOR include: (select correct answer)

Complete
Marked out of 1 Select one:
A. ypically heard during late expiration
B. Entirely or predominantly inspiratory sound, demanding immediate attention
C. Typically heard during pneumonia
D. Typically heard during left ventricular failure

Question 37 Which of the following statements regarding Heart's Electrical Axis is correct? (select
Complete the correct answer)
Marked out of 1
Select one:
A. Normal axis: -30° to -90°
B. Left axis deviation: -90° to -180°
C. Right axis deviation: +90° to +180°
D. Extreme axis deviation: -30° to +90°

Question 38 Which of the following statements regarding ECG is correct? (select correct answers)
Complete
Marked out of 1 Select one:
A. The PR interval is the time between the beginning of atrial depolarization and
the beginning of ventricular depolarization with duration of 0.12-0.20 sec.
B. QT interval is the time between the beginning of atrial depolarization and the
end of ventricular depolarization.
C. Normal q waves are wide (>0.04 sec) and deep >2mm (>25% the amplitude of
the R wave)
D. QRS complex reflects right ventricular depolarization with duration of <0.12 sec

Question 39 Characteristics of PLEURAL FRICTION RUB include: (select correct answer)

Complete
Marked out of 1 Select one:
A. Clear after coughing
B. Discontinuous or continuous sound typically heard during inspiration and
expiration
C. Typically heard during early inspiration
D. Typically heard during airway obstruction (COPD, Asthma)

Question 40 Which of the following statements regarding Normal ECG are correct? (select one
Complete correct answer)
Marked out of 1
Select one:
A. The PR interval is the time between the beginning of atrial depolarization and
the end of ventricular repolarization with duration of 0.12-0.20 sec.
B. T wave is usually smooth and rounded and normally is always upright in leads I,
II, V3-6, and always inverted (negative) in lead aVR.
C. QT interval is the time between the end of ventricular depolarization and the
beginning of atrial depolarization.
D. ST segment reflects right and left atrial repolarization and is followed by the
downward deflection of T wave
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