7622956
Frage 1
Frage
A 45 year old male patient presents with abrupt severe chest pain, flank pain, and syncope. Physical exam reveals asymmetric extremity blood pressure. Percussion of the lungs is dull and there is decreased tactile fremitus. On ausculatation you hear a decrescendo diastolic murmur best heard at the lower left sternal border. It has a blowing quality and is heard best when patient is leaning forward. CT with contrast shows a displaced trachea and pleural effusion. Which diagnosis is most likely?
Antworten
-
Coarctation of the aorta
-
Thoracic aortic aneurysm
-
Aortic dissection
-
MI
-
PE
Frage 2
Frage
An 80 year old female presented to the emergency room with an MI. Prior medical history includes hypertension, and no prior history of angina. On the 3rd day EKG and physical exam showed abrupt pulseless electrical activity. Shortly after she died. What is the likely complication?
Antworten
-
Free wall rupture
-
Ventricular septal defect
-
Papillary muscle rupture
-
Ventricular wall aneurysm
-
Congestive heart failure
Frage 3
Frage
What is the most common peripheral aneurysm?
Antworten
-
Femoral artery
-
Popliteal artery
-
Carotid artery
-
Brachial artery
Frage 4
Frage
What is the most common cause of abdominal aortic aneurysm?
Antworten
-
Marfan's syndrome
-
Bicuspid aortic valve
-
Atherosclerosis
-
Aortic stenosis
-
STEMI
Frage 5
Frage
A 35 year old female presents to the ED with dyspnea, hoarseness, hemoptysis, and lower leg edema. Clinical examination shows a loud S1 with an opening snap and rumbling mid-diastolic murmur. EKG shows left atrial enlargement and right ventricular hypertrophy. Chest x ray confirms this and shows interstitial edema. What is the likely diagnosis?
Antworten
-
Bacterial endocarditis
-
Tricuspid stenosis
-
Mitral regurgitation
-
Aortic stenosis
-
Mitral stenosis
Frage 6
Frage
What can cause a decreased amplitude of P-waves, increase in PR interval, bradycardia in the form of AV block, and even an absence of P waves eventually leading to a "sine wave."
Antworten
-
Hypokalemia
-
Hyperkalemia
-
Hypocalcemia
-
Hypercalcemia
Frage 7
Frage
Which of the following is the most common cause of multifocal atrial tachycardia?
Antworten
-
Fever
-
MI
-
Valve disease
-
Lung disease
-
Low Mg/K
Frage 8
Frage
Which of the following ventricular septal defects can you expect to close spontaneously more so than the others?
Antworten
-
Perimembranous
-
Muscular
-
Inlet
-
Supracristal
Frage 9
Frage
An EKG shows a U wave which occurs just after the T-wave and is of smaller amplitude than the T-wave. Further, there is flattening of the T-wave and ST-depression. What does this indicate?
Antworten
-
Hypokalemia
-
Hyperkalemia
-
Hypocalcemia
-
Hypercalcemia
Frage 10
Frage
High uric acid and glucose intolerance are typical of which type of lipid disorder according to Fredrickson classification?
Antworten
-
Type I
-
Type IIa
-
Type IIb
-
Type III
Frage 11
Frage
Electrical altercans is a finding on EKG of alternating amplitude of QRS complexes. Which of these diseases is most associated with this finding?
Antworten
-
Atrial septal defect
-
Patent ductus arteriosus
-
Pericarditis
-
Myocarditis
-
NSTEMI
Frage 12
Frage
Which of the following is NOT a component of long term medical management of MI?
Antworten
-
Beta blockers
-
Statins
-
Aspirin
-
Calcium channel blockers
-
P2Y12 blockers
-
ACEi
Frage 13
Frage
What is the greatest source of the biomarker CPK?
Antworten
-
Skeletal muscle
-
Myocardial
-
Brain
-
Lungs
-
Kidneys
Frage 14
Frage
What pathology causes the greatest absolute number of ascending (thoracic) aortic dissections?
Antworten
-
Marfan's Symdrome
-
Bicuspid aortic valve
-
Coarctation of the aorta
-
Mitral valve stenosis
Frage 15
Frage
A 70 year old female presents with ascites, edema, and jaundice. Physical exam shows JVD and hepatomegaly. Auscultation reveals a decrescendo diastolic rumble at the lower left sternal border that is louder with inspiration. What is the likely diagnosis?
Antworten
-
Mitral stenosis
-
Mitral regurgitation
-
Mitral valve prolapse
-
Tricuspid stenosis
-
tricuspid regurgitation
Frage 16
Frage
A shortened QT interval, shortened ST segment, and Osborn waves (J waves) can be caused by?
Antworten
-
Hypokalemia
-
Hyperkalemia
-
Hypocalcemia
-
Hypercalcemia
Frage 17
Frage
Which of the following is the most common ventricular septal defect?
Antworten
-
Perimembranous
-
Muscular
-
Inlet/Posterior
-
Supracristal
Frage 18
Frage
Which is the most common form of lipid disorder according to the Fredrickson Lipid Classification?
Antworten
-
Type I
-
Type IIa
-
Type IIb
-
Type III
-
Type IV
-
Type V
Frage 19
Frage
Peaked T waves best seen in the precordial leads, widening of QRS complexes, and sometimes ST depression may indicate.
Antworten
-
Hypokalemia
-
Hyperkalemia
-
Hypocalcemia
-
Hypercalcemia
Frage 20
Frage
A 60 year old male with a prior medical history of pulmonary hypertension presents with ascites and lower extremity edema. Physical exam reveals an elevated JVP and a large pulsatile liver. Auscultation shows a holosystolic murmur at lower left sternal border that is louder with inspiration. Which of the following is most likely
Antworten
-
Mitral regurgitation
-
Mitral valve prolapse
-
Aortic stenosis
-
Aortic regurgitation
-
Tricuspid regurgitation
Frage 21
Frage
A posterior wall MI involves which artery?
Antworten
-
RCA
-
LAD
-
Circumflex
-
RCA and Circumflex
-
LAD and RCA
-
LAD and circumflex
Frage 22
Frage
What is the most common etiology of mitral stenosis?
Antworten
-
Pulmonary hypertension
-
Infective endocarditis
-
Mitral annular calcification
-
Rheumatic heart disease
Frage 23
Frage
Which of the following would be first line treatment for acute AV node Reentry Tachycardia?
Antworten
-
Adenosine
-
Lidocain
-
Amiodarone
-
Digoxin
-
Atropine
Frage 24
Frage
A 60 year old male complains of a cramping sensation in his calf after walking 50 feet or so. When he stops, the pain goes away. The pain returns upon walking. What term best describes these symptoms?
Antworten
-
Thromangitis obliterans
-
Claudication
-
Collateralization
-
Compartment syndrome
Frage 25
Frage
What is the most common visceral aneurysm?
Antworten
-
Splenic
-
Celiac
-
SMA
-
IMA
-
Renal
Frage 26
Frage
What is the standard antimicrobial therapy for bacterial endocarditis prophylaxis?
Antworten
-
Penicillin
-
Amoxicillin
-
Clindamycin
-
Azithromycin
-
Ceftriaxone
Frage 27
Frage
A 35 year old patient recovering from a cold presents with dyspnea, orthopnea and edema. Physical exam shows elevated JVP, peripheral edema, and crackles. Auscultation reveals a displaced PMI and an S3 sound. EKG shows ST elevation. Chest x ray shows cardiomegaly, pulmonary congestion and thickened sub-plueral interlobular septa (Kerley B lines). Which of these diagnoses is most reasonable?
Antworten
-
STEMI
-
Pericarditis
-
Constrictive pericarditis
-
Coarctation of the aorta
-
Myocarditis
Frage 28
Frage
Peripheral neuropathy is most often associated with which type of lipid disorder?
Antworten
-
Type I
-
Type IIa
-
Type IIb
-
Type III
-
Type IV
-
Type V
Frage 29
Frage
A patient with a history of TB presents with peripheral edema, and ascites. Physical exam reveals hepatomegaly, elevated JVP. Kussmaul's sign (Increased JVP on inspiration) is positive but no pulsus paradoxus is noted. On auscultation a high pitched heart sound is noted during diastole. Which of the following can most reasonably explain these findings
Antworten
-
Hypertrophic cardiomyopathy
-
Dilated cardiomyopathy
-
Myocarditis
-
Cardiac tamponade
-
Constrictive pericarditis
Frage 30
Frage
A patient presents with weakness, dyspnea and pulmonary edema. Auscultation reveals a blowing holosystolic murmur, immediately after S1 that radiates to the axilla. Based off this information alone, which of the following is most likely
Antworten
-
Mitral stenosis
-
Mitral regurgitation
-
Mitral valve prolapse
-
Aortic stenosis
-
Aortic regurgitation
Frage 31
Frage
Which of the following presentations of cardiomyopathy is most common?
Antworten
-
Ischemic dilated cardiomyopathy
-
Non-ischemic dilated cardiomyopathy
-
Hypertrophic non-dilated cardiomyopathy
-
Restrictive/Infiltrative cardiomyopathy
Frage 32
Frage
Which of the following Fredrickson Lipid Classification categories involved familial lipoprotein lipase (LPL) deficiency resulting in high triglycerides and chylomicrons. Signs include pancreatitis, lipemia retinalis, hepatosplenomegaly and eruptive xanthomas.
Antworten
-
Type I
-
Type III
-
Type IV
-
Type V
Frage 33
Frage
A lateral wall MI involves which artery?
Antworten
-
RCA
-
LAD
-
Circumflex
-
LAD and RCA
-
LAD and circumflex
Frage 34
Frage
Which of the following tests is the gold standard for diagnosing mitral regurgitation?
Antworten
-
CXR
-
ECG
-
ECHO
-
Cardiac catheterization
-
Magnetic resonance angiogram
Frage 35
Frage
A prominent S4 and a crescendo-decrescendo murmur at LLSB (similar to AS but not as RUSB)( that does not radiate to the carotids and increases on expiration (more blood fills LV) would make you most concerned for?
Antworten
-
Dilated Cardiomyopathy
-
Hypertrophic cardiomyopathy
-
Restrictive cardiomyopathy
-
Pericarditis
-
Myocarditis
Frage 36
Frage
A patient presents with fatigue, dyspnea and chest pain. EKG shows diffuse ST elevation. He is hypotensive with pressure varying from inspiration to expiration. In addition, physical exam reveals muffled heart sounds and elevated JVP that increases on inspiration. Chest x ray shows cardiomegaly resembling a water-bottle. Which of the following is the most likely diagnosis?
Antworten
-
Constrictive pericarditis
-
Cardiac tamponade
-
STEMI
-
Prinzmetal's angina
-
Myocarditis
Frage 37
Frage
In western countries, what is the most common valvular heart disease?
Antworten
-
Mitral stenosis
-
Tricuspid stenosis
-
Aortic stenosis
-
Pulmonic stenosis
Frage 38
Frage
Premature atherosclerosis, corneal arcus and tendon xanthomas are signs of which type of lipid disorder?
Antworten
-
Type I
-
Type IIa
-
Type IIb
-
Type III
Frage 39
Frage
What is the most common cause of valvular heart disease in developing countries
Antworten
-
Mitral stenosis
-
Mitral valve prolapse
-
Tricuspid stenosis
-
Tricuspid regurgitation
-
Aortic stenosis
Frage 40
Frage
Which class of drugs is most commonly indicated for treatment of hypertrophic cardiomyopathy?
Antworten
-
Statins
-
Beta blockers
-
Diuretics
-
ACEi
Frage 41
Frage
A mid-systolic click followed by a late systolic murmur is virtually diagnostic for which of the following diseases?
Antworten
-
Mitral valve stenosis
-
Mitral valve regurgitation
-
Mitral valve prolapse
-
Aortic stenosis
-
Aortic regurgitation
Frage 42
Frage
Which of the following is the most common etiology of tricuspid regurgitation?
Antworten
-
Trauma
-
Congenital abnormalities
-
Right ventricular dilation
-
Bacterial endocarditis
Frage 43
Frage
A 60 year old male smoker with COPD and hypertension presents with abdominal pain and lower back pain. Physical exam reveals a pulsatile abdomen and "blue toes." Which of the following tests is the gold standard for evaluating and diagnosing this pathology?
Antworten
-
EKG
-
Ultrasound
-
CXR
-
CT
-
MRI
Frage 44
Frage
Which of the following complications from acute MI is the most common cause of mortality
Antworten
-
Arrhythmia
-
Congestive heart failure
-
Recurrent infarction
-
Septal rupture
-
Ventricular wall aneurysm
Frage 45
Frage
Which of the following is the most common congenital heart defect?
Antworten
-
Patent ductus arteriosus
-
Atrial septal defect
-
Ventricular septal defect
-
Patent ductus venosum
Frage 46
Frage
A 58 year old female presents with dyspnea, angina and multiple cases of syncope. Auscultation reveals a systolic, high pitched, crescendo-decrescendo murmur that radiates to the carotids. Further, pulusus parvus and tardus is noted. What is the most likely diagnosis?
Antworten
-
Aortic stenosis
-
Pulmonic stenosis
-
Tricuspid stenosis
-
Mitral stenosis
Frage 47
Frage
In an aneurysm below the inguinal ligament, what is the most common complication?
Antworten
-
Rupture
-
Embolization
-
Thrombosis
-
Dissection
Frage 48
Frage
Which of the following would NOT be an indication for bacterial endocarditis prophylaxis?
Antworten
-
Prosthetic heart valves
-
Hypertrophic cardiomyopathy
-
Prior history of infective endocarditis
-
Complex cyanotic congenital heart disease
Frage 49
Frage
If you suspect a patient with HIV has non-ischemic dilated cardiomyopathy myocarditis, what test would best confirm your diagnosis?
Antworten
-
TEE
-
EKG
-
Heart biopsy
-
CT scan with contrast
-
Magnetic resonance angiogram
Frage 50
Frage
Operating on an AAA is indicated in an otherwise healthy individual when it gets larger than _______?
Antworten
-
5cm
-
5.5cm
-
6cm
-
6.5cm
-
7cm
Frage 51
Frage
What is standard risk factor reduction therapy for asymptomatic carotid disease?
Antworten
-
Aspirin, Statin, ACEi
-
Coumadin, Statin
-
Beta blocker, Statin, ACEi
-
Loop diuretics, Statin, ACEi
Frage 52
Frage
Which of the following arrhythmias would NOT present with a narrow QRS and irregular rhythm?
Antworten
-
Afib
-
MAT
-
Aflutter
-
VT
Frage 53
Frage
Carotid endarterectomy surgery is indicated at what level of stenosis?
Antworten
-
50%
-
60%
-
70%
-
80%
-
90%
Frage 54
Frage
A patient with CHF presents for further work up. Chest x ray shows cardiomegaly, pulmonary edema and rib notching. Which of the following would be a reasonable cause of his CHF?
Antworten
-
Hypoplastic left heart syndrome
-
Aortic valve stenosis
-
Myocarditis
-
Cardiac tamponade
-
Coarctation of the aorta
Frage 55
Frage
A 39 year old male presents with claudication, Raynaud's phenomenon and digital ulceration. Which of the following would be most reasonable?
Antworten
-
Acute arterial occlusion
-
Thromboangitis obliterans (Buerger Disease)
-
DVT
-
Chronic venous insufficiency
-
Abdominal aortic aneurysm
Frage 56
Frage
An inferior wall MI involves which artery?
Antworten
-
RCA
-
LAD
-
Circumflex
-
RCA and circumflex
-
LAD and RCA
-
LAD and circumflex
Frage 57
Frage
A patient comes to the clinic on follow up from an acute ST segment elevation myocardial infarction (STEMI). Examination reveals a new systolic heart murmur. Which of the following is the best explanation for this finding?
Antworten
-
Acute aortic stenosis from infarction
-
Acute tricuspid regurgitation from infarction
-
Acute mitral regurgitation from infarction
-
Acute mitral stenosis from infarction
Frage 58
Frage
A 53 yo healthy male undergoes an exercise stress test, running on a treadmill until a maximum exertion is obtained. Which of the following statements correctly describes the effects of autonomic nerve activity on the cardiovascular system in this healthy individual?
Antworten
-
Inhibition of parasympathetic nerves decreases total peripheral resistance
-
Inhibition of parasympathetic nerves increases heart rate
-
Inhibition of parasympathetic nerves increases total peripheral resistance
-
Stimulation of parasympathetic nerves decreases the strength of cardiac contractions
-
Stimulation of sympathetic nerves decreases the strength of cardiac contractions
Frage 59
Frage
A three year old female presents for a well-child visit and was found to have rough, continuous murmur hear over the left pulmonary area. What is this murmur?
Antworten
-
Aortic stenosis
-
Patent ductus arteriosis
-
Mitral regurgitation
-
Pulmonic stenosis
Frage 60
Frage
A 21 year old woman presents to the clinic with complaints of palpitations and a headache. On physical exam, the patient is anxious and diaphoretic with a blood pressure of 175/105 mm Hg and a heart rate of 122 b[m. ECG demonstrates sinus tachycardia. Based on this presentation, what is a likely diagnosis.
Antworten
-
Supraventricular tachycardia
-
Acute coronary syndrome
-
Aortic dissection
-
Pheochromocytoma
Frage 61
Frage
Which of the following radiographic findings is associated with tetralogy of Fallot?
Antworten
-
Decrease in right ventricular size
-
Rib notching
-
Increased pulmonary vascular markings
-
Boot shaped heart
Frage 62
Frage
What is the cardiac ausculatory hallmark of an atrial septal defect?
Antworten
-
Paradoxical split S2
-
Wide, fixed split S2
-
Systolic ejection murmur second right intercostal space
-
Holosystolic murmur heard a apex that radiates to axilla
Frage 63
Frage
A 53 year old man with history of tobacco presents to the emergency department complaining of severe, ripping, substernal chest pain that radiates to his back. His blood pressure is 175/92 mm Hg. Chest X-ray reveals a widened mediastinum, What is his most likely diagnosis.
Antworten
-
Acute coronary syndrome
-
Pneumothorax
-
Aortic dissection
-
Mitral stenosis
Frage 64
Frage
An 81 year old woman with a 10 year history of well-controlled atrial fibrillation complains of a 6-day history of fatigue, dyspnea, and a 10 pound weight gain. She denies angina or diaphoresis. Based on this history what is the most likely diagnosis?
Antworten
-
Acute coronary syndrome
-
Heart failure
-
Sinus tachycardia
-
Cardiac tamponade
Frage 65
Frage
A 67 year old male with history of coronary artery disease with prior myocardial infarction and stable, chronic heart failure returns tot he clinic for follow up. Which of the following medication regimens is most appropriate for him?
Antworten
-
Aspirin, metoprolol, valsartan, clopidogrel, morphine, diuretic
-
Heparin, atenolol, atorvastatin, clonidine, nitroglycerine
-
Amlodipine, Lisinopril, aspirin, valsartan, atorvastatin, diuretic, metoprolol
-
Aspirin, metoprolol, Lisinopril, atorvastatin, diuretic, nitroglycerin
Frage 66
Frage
A 37 year old diabetic patient with history of paroxysmal atrial fibrillation and hypertension presents with sudden onset of severe pain in his left arm. On physical examination, the left arm is cool and pale with nonpalpable radial and ulnar pulses. What is the most likely cause for his pain?
Antworten
-
Atherosclerotic peripheral vascular disease
-
Venous stasis disease
-
Raynaud syndrome
-
Arterial embolization
Frage 67
Frage
Which of the following is the most likely cause of paradoxical splitting of S2?
Antworten
-
Pulmonic stenosis
-
Left bundle branch block
-
Atrial septal defect
-
Right ventricular failure
Frage 68
Frage
Orthostatic hypotension is defined as a drop in systolic blood pressure of at least ____________ or a drop of diastolic blood pressure of at least _________________ within 3 minutes of standing from the sitting position.
Antworten
-
10 mm Hg; 20 mm Hg
-
10 mm Hg; 5 mm Hg
-
20 mm Hg; 10 mm Hg
-
5 mm Hg; 10 mm Hg
Frage 69
Frage
A 47 year old male presents with shortness of breath. On physical examination, the patient is sitting upright with moderately labored breathing, marked jugular venous distention (JVD), bilateral pulmonary rales, and a S3 gallop. Blood pressure is 120/90 and heart rate is 110 bpm. Chest x-ray shows pulmonary congestion. ECG demonstrates sinus tachycardia with low voltage QRS. Which class of medication should be given to this patient immediately to improve symptoms.
Antworten
-
Ace inhibitors
-
Beta blockers
-
Calcium channel blockers
-
Diuretics
Frage 70
Frage
Which of the following medications is used to control the ventricular rate during an acute event of rapid atrial fibrillation?
Antworten
-
Beta blocker
-
Digoxin
-
Warfarin
-
Nitroglycerin
Frage 71
Frage
Which of the following is a contraindication for an exercise treadmill stress test.
Antworten
-
Mild aortic stenosis
-
Unstable angina
-
Previous myocardial infarction
-
Nonspecific ECG changes
Frage 72
Frage
Which of the following antiarrhythmic drugs most potently blocks sodium channel current in the myocardium?
Antworten
-
Flecainide
-
Procainamide
-
Amiodarone
-
Lidocaine
Frage 73
Frage
According to the American Diabetes Association, risk reduction for cardiovascular events in patients with diabetes can be achieved by the use of:
Antworten
-
Beta blockers
-
Statins
-
Cholesterol absorption inhibitors
-
Aldosterone
Frage 74
Frage
A 58 year old female with history of Type 2 diabetes mellitus presents for routine follow up. Which of the following would have the LEAST impact on prevention of her risk of developing macrovascular complications from diabetes?
Antworten
-
Strict control of blood glucose levels
-
HMG-CoA reductase inhibitor therapy
-
Estrogen/progestin combination therapy
-
ACEi to control her hypertension
Frage 75
Frage
Secondary [prevention of an St-elevation myocardial infarction should include which of the following measures?
Antworten
-
Estrogen therapy
-
ACEi
-
Folate or Vitamin B6
-
Calcium channel blockers
Frage 76
Frage
An increase in which of the following factors is most likely to increase the preload?
Antworten
-
Arterial vascular tone
-
Stroke volume
-
Heart rate
-
Intravascular volume
Frage 77
Frage
Which is the mechanism by which cardiac tamponade impedes cardiac output?
Antworten
-
Decreased inflow of blood to ventricles
-
Decreased pressure in pericardium
-
Increased pressure decreases sinus rhythm
-
Increase in end-diastolic volume
Frage 78
Frage
Which of the following is used to describe diastolic dysfunction?
Antworten
-
Increased afterload
-
Decreased preload
-
Decreased stroke volume
-
Decreased ventricular myocardial compliance
Frage 79
Frage
A 37 year old woman with a history of hypertension presents to the emergency department with complaints of shortness of breath. She was placed on a telemetry monitor. What is your diagnosis?
Antworten
-
Normal sinus rhythm
-
Atrial fibrillation
-
Sinus tachycardia
-
Nodal rhythm
Frage 80
Frage
A 29 year old man presents with extreme fatigue and shortness of breath. What is the abnormality noted in the ECG?
Antworten
-
Complete AV Block
-
Type II second degree AV block
-
Junctional rhythm
-
Atrial fibrillation
Frage 81
Frage
You have started your patient who has giant cell arteritis on her glucocorticoid therapy. Which of the following laboratory studies would be used to monitor her response to this therapy?
Antworten
-
Cardiac enzymes
-
Sedimentation rate
-
Rheumatoid factor
-
Complete blood cell count
Frage 82
Frage
A 50 year old woman presents to the office with a 1 week history of substernal chest pain. The symptoms occur with climbing the stairs in her home and with moderate-paced walking. The pain is relieved with rest, She denies any current chest pain. Her physical examination and ECG are normal. What I the nest test you would order?
Antworten
-
Exercise treadmill stress test
-
Cardiac enzymes
-
Radionuclide stress myocardial perfusion imaging
-
Echocardiogram
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