This document contains multiple choice questions about the cardiovascular system. It tests knowledge of topics like risk factors for atherosclerosis, characteristics of fatty streaks in the aorta, predisposing factors for thrombosis, complications of myocardial infarction, and characteristics of ketone bodies. The questions cover lipids and lipoproteins including their roles in transporting fats, characteristics of different lipoproteins, and lipoprotein disorders. Additional topics include markers for myocardial infarction, risk factors for coronary heart disease, statin medications, and lecithin cholesterol acyltransferase deficiency.

1. CARDIOVASCULAR SYSTEM
MULTIPLE CHOICE QUESTIONS
BY
Dr KHALED SALEH ALGARIRI
2014

2. WHICH IS TRUE OR FALSE?
The following are major risk factors for the
development of atherosclerosis:
A. cigarette smoking
B. diabetes mellitus
C. hypocholesterolaemia
D. hypertension
E. female sex
Ans T T F T F

3. WHICH IS TRUE OR FALSE?
Fatty streaks in the aorta
A. contain lipid which is predominantly extracellular
B. often appear in the first year of life
C. Contain a proliferation of smooth muscle cells
D. are rare in Third World populations
E. are usually greater than 10 mm in diamete
Ans F T F T F

4. WHICH IS TRUE OR FALSE?
Predisposing factors for intravascular thrombosis
A. myocardial infarction
B. factor VIII deficiency
C. bed rest
D. thrombophilia
E. heart failure
ANS T F T T T

5. WHICH IS TRUE OR FALSE?
The following may be complications of myocardial
infarction cerebral infarction
A. haematuria
B. myocardial rupture
C. ventricular fibrillation
D. hypertension
Ans T T T F

6. WHICH IS TRUE OR FALSE?
The following are major risk factors for the
development of atherosclerosis:
A. cigarette smoking
B. diabetes mellitus
C. hypocholesterolaemia
D. hypertension
E. female sex
Ans T T F T F

7. Which of the following is not essential fatty acids?
(A) Oleic acid
(B) Linoleic acid
(C) Arachidonic acid
(D) Linolenic acid

8. When choline of lecithin is replaced by
ethanolamine, the product is
(A) Spingomyelin
(B) Cephalin
(C) Plasmalogens
(D) Lysolecithin

9. The essential fatty acids retard
(A) Atherosclerosis
(B) Diabetes mellitus
(C) Nepritis
(D) Oedema

10. The majority of absorbed fat appears in the
forms of
(A) HDL
(B) Chylomicrone
(C) VLDL
(D) LDL

11. All the following statements correctly describe ketone
bodies except
(A) They may result from starvation
(B) They are present at high levels in uncontrolled
diabetes
(C) They include—OH β-butyrate and acetone
(D) They are utilized by the liver during long term
starvation

12. All the following statements regarding ketone bodies are
true except
(A) They may result from starvation
(B) They are formed in kidneys
(C) They include acetoacetic acid and acetone
(D) They may be excreted in urine

13. Ketosis in partly ascribed to
(A) Over production and Glucose
(B) Under production of Glucose
(C) Increased carbohydrate utilization
(D) Increased fat utilization

14. Why do patients with diabetes mellitus develop hyperlipidemia?
A. Because they have increases in low density lipoproteins (LDL) and
triglycerides ( TG)
B. Because they have decreased low density lipoproteins (LDL) and increased
triglycerides (TG)
C. Because they have decreased low density lipoproteins (LDL) and increased
high density lipoproteins (HDL)
D. Because they have increased high density lipoproteins (-HDL) and decreased
triglycerides (TG)

15. _____ are manufactured by the liver and primarily contains
cholesterol and protein.
A. Very-low-density lipoproteins (VLDL)
B. Low-density lipoproteins (LDL)
C. High-density lipoproteins (HDL)
D. Triglycerides (TG)

16. Which of the following risk factors is associated
with a twofold increase in the risk for coronary
artery disease death and up to a sixfold risk for
stroke?
A. Diabetes mellitus
B. Hypertension
C. Obesity
D. High alcohol consumption

17. Which value may be protective for the development of
atherosclerosis ?
A. High values of very-low-density lipoproteins (VLDL)
B. High values of low-density lipoproteins (LDL)
C. High values of high-density lipoproteins (HDL)
D. High values of triglycerides (TG)

18. Which lab test is an indirect measure of atherosclerotic
plaque?
A. Homocysteine
B. Low-density lipoproteins (LDL)
C. Erythrocyte sedimentation rate (ESR)
D. C reactive protein (CPR)

19. When scar tissue replaces the myocardium after a
myocardial infarction (MI), the forming scar tissue is
very mushy and vulnerable to injury at about day
_____ after MI.
A. 5 to 9
B. 10 to 14
C. 15 to 20
D. 20 to 30

20. An individual is demonstrating elevated levels of troponin,
creatine kinase (CK), and lactic dehydrogenase (LDH).
These elevated levels indicate:
A. myocardial ischemia.
B. hypertension.
C. myocardial infarction.
D. coronary artery disease.

21. Which of the following is NOT one of the risk
factors for coronary heart disease?
A.hypertension
B.high serum cholesterol
C.cigarette smoking
D.alcohol consumption

22. A 34-year-old female has been diagnosed with type 1 hyperlipidemia.
Which of the following lipoprotein concentration is elevated in such
disorder ?*
A. VLDL
B IDL
C. LDL
D. Chylomicrons
E. All of the above

23. In Abetalipoproteinemia (a rare disease), lipoproteins
containing Apo B are not formed and lipid droplets
accumulate in the intestine and liver. Which of the following
lipoproteins does not contain Apo B protein?
A. LDL
B. IDL
C. HDL
D.Chylomicrons
E. Lp(a)

24. Which of the following apo proteins is an activator of LCAT?
a) Apo A
b) Apo B
c) Apo C II
d) Apo A- I
e) Apo E

25. A patient with hereditary type I hyperlipidemia presents
with elevated levels of chylomicrons and VLDL
triglycerides in the blood. The main function of the
chylomicrons in circulation is to do which of the
following?
A.Transport lipids from the liver
B.Transport dietary lipids from the intestine to target
tissues
C.Transport cholesterol from IDL to LDL
D.Act as a receptor for triacylglycerols in the liver
E. Bind cholesterol esters exclusively

26. A teenage boy presents with moderate to severe epigastric pain.
Physical examination reveals extensive eruptive xanthomas and
hepatosplenomegaly. A blood sample reveals milky plasma. Which of
the following is the most likely lipoprotein to be elevated in this
patient ‘s plasma?
a) Chylomicrons
b) Chylomicron remnants
c) HDL
d) IDL
e) LDL

27. A 25-year-old female was referred to a lipid research center for
investigation of moderate hypertriglyceridemia because the
plasma lipid and lipoprotein profiles showed abnormalities.
Both HDL and LDL were more buoyant and showed
elevations in TG content with the mass of TG approximately
the same as that of cholesterol. A deficiency in which of the
following is the most likely cause of this patient’ s lipid
abnormality?
A. Lecithin-cholesterol acyltransferase (LCAT)
B. Lipoprotein lipase
C. Apoprotein C-II
D. Hepatic lipase
E. Apoprotein B-100

28. A 60 -year-old woman presents with chest pain
radiating to her left arm. She is diagnosed with
Myocardial infarction and is prescribed a statin
medication. Statins inhibit HMG Co A reductase.
How does inhibition of HMG Co A reductase
cause lowering of cholesterol and LDL levels ?
a) It increase serum level of HDL
b) It decreases serum level of LDL by promoting catabolism
c) It inhibits the formation of LDL from IDL
d) It inhibits the rate limiting step in cholesterol biosynthesis
e) It inhibits synthesis of LDL receptors.

29. A 23-year-old female presents with low red blood cell count,
corneal opacities and kidney insufficiency. She is diagnosed
with
lecithin: cholesterol acyl transferase (LCAT) deficiency. In
which of
the following reactions LCAT is involved ?
a) Transfer of cholesterol esters from HDL to VLDL
b) Hydrolysis of HDL
c) Uptake of cholesterol from liver cells
d) Converting cholesterol to Cholesteryl esters
e) Promoting uptake of HDL in to liver cells

30. THANK YOU