MCQs of myocardial infarction with answers

Myocardial Infarction—50 MCQs with Answers

Section 1: Basic Concepts (1–10)

  1. Which of the following arteries is most commonly occluded in myocardial infarction?
    A. Left circumflex artery
    B. Right coronary artery
    C. Left anterior descending artery
    D. Posterior descending artery
    ✅ Answer: C

  2. Myocardial infarction is most commonly caused by:
    A. Coronary artery spasm
    B. Embolism
    C. Atherosclerotic plaque rupture with thrombus
    D. Vasculitis
    ✅ Answer: C

  3. Which enzyme rises earliest after MI?
    A. Troponin I
    B. CK-MB
    C. Myoglobin
    D. LDH
    ✅ Answer: C

  4. Which cardiac marker remains elevated the longest after an MI?
    A. Myoglobin
    B. Troponin I
    C. CK-MB
    D. AST
    ✅ Answer: B

  5. Which of the following ECG changes is seen in the early stage of MI?
    A. ST depression
    B. T-wave inversion
    C. ST elevation
    D. U waves
    ✅ Answer: C

  6. The term “silent MI” refers to:
    A. MI without ECG changes
    B. MI without elevated enzymes
    C. MI without chest pain
    D. MI with heart murmurs only
    ✅ Answer: C

  7. Atypical presentation of MI is common in:
    A. Young males
    B. Diabetic patients
    C. Smokers
    D. Athletes
    ✅ Answer: B

  8. Which of the following is not a classical symptom of MI ?
    A. Chest pain
    B. Diaphoresis
    C. Cough
    D. Nausea
    ✅ Answer: C

  9. Which condition mimics MI on ECG?
    A. Pericarditis
    B. Asthma
    C. Bronchitis
    D. Aortic aneurysm
    ✅ Answer: A

  10. Which complication is most commonly associated with anterior wall MI?
    A. Bradycardia
    B. Mitral valve prolapse
    C. Left ventricular failure
    D. Pulmonary embolism
    ✅ Answer: C

Section 2: Diagnosis & ECG (11–20)

  1. Inferior wall MI shows ST elevation in:
    A. V1–V4
    B. V5–V6
    C. II, III, aVF
    D. I, aVL
    ✅ Answer: C

  2. Anterior wall MI is best seen in which ECG leads?
    A. V1–V4
    B. II, III, aVF
    C. aVR
    D. V5–V6
    ✅ Answer: A

  3. Troponin I becomes detectable in blood within:
    A. 30 minutes
    B. 1 hour
    C. 3–4 hours
    D. 24 hours
    ✅ Answer: C

  4. Which of the following ECG changes indicates transmural infarction?
    A. T wave inversion
    B. ST depression
    C. ST elevation
    D. Prolonged QT interval
    ✅ Answer: C

  5. Persistent ST elevation after MI may suggest:
    A. Reinfarction
    B. Ventricular aneurysm
    C. Heart block
    D. Pericarditis
    ✅ Answer: B

  6. Which of the following is not a cardiac marker?
    A. CK-MB
    B. LDH
    C. CRP
    D. Troponin
    ✅ Answer: C

  7. What is the gold standard diagnostic test for coronary artery blockage?
    A. CT angiography
    B. Echocardiography
    C. Coronary angiography
    D. Chest X-ray
    ✅ Answer: C

  8. ST depression in chest leads may indicate:
    A. Anterior MI
    B. Posterior MI
    C. Inferior MI
    D. Pericarditis
    ✅ Answer: B

  9. Which lab value is most specific for myocardial necrosis?
    A. ESR
    B. CRP
    C. Troponin I
    D. SGPT
    ✅ Answer: C

  10. A Q wave on ECG is indicative of:
    A. Recent MI
    B. Old infarction
    C. Angina
    D. Arrhythmia
    ✅ Answer: B

Section 3: Management (21–35)

  1. The first drug given in suspected MI is:
    A. Morphine
    B. Aspirin
    C. Beta-blocker
    D. Atorvastatin
    ✅ Answer: B

  2. MONA is the acronym for
    A. Morphine, Oxygen, Nitroglycerin, Aspirin
    B. Magnesium, Oxygen, Nitrate, Atropine
    C. Morphine, Omeprazole, Nitroglycerin, Amiodarone
    D. Metoprolol, Oxygen, Nicotine, Aspirin
    ✅ Answer: A

  3. Which thrombolytic agent is commonly used in MI?
    A. Warfarin
    B. Streptokinase
    C. Digoxin
    D. Furosemide
    ✅ Answer: B

  4. PCI is best performed within:
    A. 24 hours
    B. 12 hours
    C. 6 hours
    D. 90 minutes
    ✅ Answer: D

  5. Which of the following is an absolute contraindication to thrombolysis?
    A. Recent surgery
    B. Hypertension
    C. Age > 70
    D. Male gender
    ✅ Answer: A

  6. Beta-blockers in MI help by:
    A. Increasing heart rate
    B. Increasing blood pressure
    C. Reducing myocardial oxygen demand
    D. Enhancing clot formation
    ✅ Answer: C

  7. ACE inhibitors in MI are useful to:
    A. Decrease platelet aggregation
    B. Prevent ventricular remodeling
    C. Increase contractility
    D. Lower LDL cholesterol
    ✅ Answer: B

  8. Which of the following is used to relieve chest pain in MI?
    A. Paracetamol
    B. Ibuprofen
    C. Morphine
    D. Ranitidine
    ✅ Answer: C

  9. Which of the following drugs reduces mortality in MI patients?
    A. Digoxin
    B. Aspirin
    C. Furosemide
    D. Diazepam
    ✅ Answer: B

  10. Nitrates in MI act by:
    A. Increasing preload
    B. Vasoconstriction
    C. Reducing preload and afterload
    D. Slowing heart rate
    ✅ Answer: C

  11. Which antiplatelet is commonly combined with aspirin in MI?
    A. Atorvastatin
    B. Clopidogrel
    C. Warfarin
    D. Amiodarone
    ✅ Answer: B

  12. The preferred intervention for ST-elevation MI is
    A. Thrombolysis
    B. PCI
    C. CABG
    D. Medical management
    ✅ Answer: B

  13. Immediate goal in acute MI treatment is
    A. Stabilize renal function
    B. Restore coronary blood flow
    C. Manage hypertension
    D. Increase heart rate
    ✅ Answer: B

  14. Statins in post-MI patients help to:
    A. Increase HDL only
    B. Reduce pain
    C. Stabilize plaques and reduce cholesterol
    D. Prevent arrhythmia
    ✅ Answer: C

  15. The benefit of oxygen therapy in MI is greatest when:
    A. Oxygen saturation is > 95%
    B. O2 sat < 90%
    C. O2 sat = 100%
    D. No benefit is observed
    ✅ Answer: B

Section 4: Complications & Special Scenarios (36–50)

  1. A 60-year-old with MI collapses with ventricular fibrillation. First step?
    A. Start aspirin
    B. Give oxygen
    C. Start CPR and defibrillate
    D. Call for help only
    ✅ Answer: C

  2. Dressler's syndrome occurs:
    A. During MI
    B. Immediately after PCI
    C. 1–8 weeks after MI
    D. Before MI
    ✅ Answer: C

  3. Which is not a complication of MI?
    A. Heart failure
    B. Atrial fibrillation
    C. Appendicitis
    D. Cardiogenic shock
    ✅ Answer: C

  4. Cardiogenic shock is defined by:
    A. Low BP and low cardiac output
    B. High BP and tachycardia
    C. Normal BP and fever
    D. High cardiac output and bradycardia
    ✅ Answer: A

  5. Common cause of death within the first hour of MI:
    A. Heart failure
    B. Pericarditis
    C. Ventricular fibrillation
    D. Pulmonary embolism
    ✅ Answer: C

  6. Which gender has more atypical MI symptoms?
    A. Males
    B. Females
    C. Both equally
    D. Children only
    ✅ Answer: B

  7. Which electrolyte imbalance increases the risk of arrhythmia in MI?
    A. Hypernatremia
    B. Hypokalemia
    C. Hypercalcemia
    D. Hypoglycemia
    ✅ Answer: B

  8. A patient post-MI develops a new murmur. Likely cause?
    A. Pericarditis
    B. Papillary muscle rupture
    C. Atrial septal defect
    D. Pleural effusion
    ✅ Answer: B

  9. What is the most appropriate lifestyle change post-MI?
    A. High-fat diet
    B. Avoid exercise
    C. Smoking cessation
    D. Daily alcohol
    ✅ Answer: C

  10. Reinfarction is best detected by:
    A. New Q waves
    B. Recurrent chest pain
    C. Repeat troponin rise
    D. ST flattening
    ✅ Answer: C

  11. What imaging confirms wall motion abnormalities post-MI?
    A. X-ray
    B. CT scan
    C. Echocardiography
    D. MRI brain
    ✅ Answer: C

  12. Sudden cardiac arrest in MI is most often due to:
    A. Asystole
    B. Ventricular arrhythmia
    C. Bradycardia
    D. Heart block
    ✅ Answer: B

  13. MI in the elderly often presents with:
    A. Classic chest pain
    B. Coughing and sneezing
    C. Confusion or syncope
    D. Diarrhea
    ✅ Answer: C

  14. Post-MI pericarditis is treated with:
    A. NSAIDs
    B. Aspirin and morphine
    C. Heparin
    D. Thrombolytics
    ✅ Answer: A

  15. Which is the best predictor of long-term outcome after MI?
    A. Size of infarction
    B. Number of stents
    C. Type of aspirin used
    D. Blood group
    ✅ Answer: A


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