Quiz
Clinical Cardiology Multiple Choice Questions
Fragen in diesem Quiz (82)
1A 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?
- ACoarctation of the aorta
- BThoracic aortic aneurysm
- CAortic dissection
- DMI
- EPE
2An 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?
- AFree wall rupture
- BVentricular septal defect
- CPapillary muscle rupture
- DVentricular wall aneurysm
- ECongestive heart failure
3What is the most common peripheral aneurysm?
- AFemoral artery
- BPopliteal artery
- CCarotid artery
- DBrachial artery
4What is the most common cause of abdominal aortic aneurysm?
- AMarfan's syndrome
- BBicuspid aortic valve
- CAtherosclerosis
- DAortic stenosis
- ESTEMI
5A 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?
- ABacterial endocarditis
- BTricuspid stenosis
- CMitral regurgitation
- DAortic stenosis
- EMitral stenosis
6What 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."
- AHypokalemia
- BHyperkalemia
- CHypocalcemia
- DHypercalcemia
7Which of the following is the most common cause of multifocal atrial tachycardia?
- AFever
- BMI
- CValve disease
- DLung disease
- ELow Mg/K
8 Which of the following ventricular septal defects can you expect to close spontaneously more so than the others?
- APerimembranous
- BMuscular
- CInlet
- DSupracristal
9An 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?
- AHypokalemia
- BHyperkalemia
- CHypocalcemia
- DHypercalcemia
10High uric acid and glucose intolerance are typical of which type of lipid disorder according to Fredrickson classification?
- AType I
- BType IIa
- CType IIb
- DType III
11Electrical altercans is a finding on EKG of alternating amplitude of QRS complexes. Which of these diseases is most associated with this finding?
- AAtrial septal defect
- BPatent ductus arteriosus
- CPericarditis
- DMyocarditis
- ENSTEMI
12 Which of the following is NOT a component of long term medical management of MI?
- ABeta blockers
- BStatins
- CAspirin
- DCalcium channel blockers
- EP2Y12 blockers
- FACEi
13What is the greatest source of the biomarker CPK?
- ASkeletal muscle
- BMyocardial
- CBrain
- DLungs
- EKidneys
14What pathology causes the greatest absolute number of ascending (thoracic) aortic dissections?
- AMarfan's Symdrome
- BBicuspid aortic valve
- CCoarctation of the aorta
- DMitral valve stenosis
15A 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?
- AMitral stenosis
- BMitral regurgitation
- CMitral valve prolapse
- DTricuspid stenosis
- Etricuspid regurgitation
16A shortened QT interval, shortened ST segment, and Osborn waves (J waves) can be caused by?
- AHypokalemia
- BHyperkalemia
- CHypocalcemia
- DHypercalcemia
17Which of the following is the most common ventricular septal defect?
- APerimembranous
- BMuscular
- CInlet/Posterior
- DSupracristal
18Which is the most common form of lipid disorder according to the Fredrickson Lipid Classification?
- AType I
- BType IIa
- CType IIb
- DType III
- EType IV
- FType V
19Peaked T waves best seen in the precordial leads, widening of QRS complexes, and sometimes ST depression may indicate.
- AHypokalemia
- BHyperkalemia
- CHypocalcemia
- DHypercalcemia
20A 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
- AMitral regurgitation
- BMitral valve prolapse
- CAortic stenosis
- DAortic regurgitation
- ETricuspid regurgitation
21A posterior wall MI involves which artery?
- ARCA
- BLAD
- CCircumflex
- DRCA and Circumflex
- ELAD and RCA
- FLAD and circumflex
22What is the most common etiology of mitral stenosis?
- APulmonary hypertension
- BInfective endocarditis
- CMitral annular calcification
- DRheumatic heart disease
23Which of the following would be first line treatment for acute AV node Reentry Tachycardia?
- AAdenosine
- BLidocain
- CAmiodarone
- DDigoxin
- EAtropine
24A 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?
- AThromangitis obliterans
- BClaudication
- CCollateralization
- DCompartment syndrome
25What is the most common visceral aneurysm?
- ASplenic
- BCeliac
- CSMA
- DIMA
- ERenal
26What is the standard antimicrobial therapy for bacterial endocarditis prophylaxis?
- APenicillin
- BAmoxicillin
- CClindamycin
- DAzithromycin
- ECeftriaxone
27A 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?
- ASTEMI
- BPericarditis
- CConstrictive pericarditis
- DCoarctation of the aorta
- EMyocarditis
28Peripheral neuropathy is most often associated with which type of lipid disorder?
- AType I
- BType IIa
- CType IIb
- DType III
- EType IV
- FType V
29A 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
- AHypertrophic cardiomyopathy
- BDilated cardiomyopathy
- CMyocarditis
- DCardiac tamponade
- EConstrictive pericarditis
30A 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
- AMitral stenosis
- BMitral regurgitation
- CMitral valve prolapse
- DAortic stenosis
- EAortic regurgitation
31Which of the following presentations of cardiomyopathy is most common?
- AIschemic dilated cardiomyopathy
- BNon-ischemic dilated cardiomyopathy
- CHypertrophic non-dilated cardiomyopathy
- DRestrictive/Infiltrative cardiomyopathy
32Which 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.
- AType I
- BType III
- CType IV
- DType V
33A lateral wall MI involves which artery?
- ARCA
- BLAD
- CCircumflex
- DLAD and RCA
- ELAD and circumflex
34Which of the following tests is the gold standard for diagnosing mitral regurgitation?
- ACXR
- BECG
- CECHO
- DCardiac catheterization
- EMagnetic resonance angiogram
35A 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?
- ADilated Cardiomyopathy
- BHypertrophic cardiomyopathy
- CRestrictive cardiomyopathy
- DPericarditis
- EMyocarditis
36A 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?
- AConstrictive pericarditis
- BCardiac tamponade
- CSTEMI
- DPrinzmetal's angina
- EMyocarditis
37In western countries, what is the most common valvular heart disease?
- AMitral stenosis
- BTricuspid stenosis
- CAortic stenosis
- DPulmonic stenosis
38Premature atherosclerosis, corneal arcus and tendon xanthomas are signs of which type of lipid disorder?
- AType I
- BType IIa
- CType IIb
- DType III
39What is the most common cause of valvular heart disease in developing countries
- AMitral stenosis
- BMitral valve prolapse
- CTricuspid stenosis
- DTricuspid regurgitation
- EAortic stenosis
40Which class of drugs is most commonly indicated for treatment of hypertrophic cardiomyopathy?
- AStatins
- BBeta blockers
- CDiuretics
- DACEi
41A mid-systolic click followed by a late systolic murmur is virtually diagnostic for which of the following diseases?
- AMitral valve stenosis
- BMitral valve regurgitation
- CMitral valve prolapse
- DAortic stenosis
- EAortic regurgitation
42Which of the following is the most common etiology of tricuspid regurgitation?
- ATrauma
- BCongenital abnormalities
- CRight ventricular dilation
- DBacterial endocarditis
43A 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?
- AEKG
- BUltrasound
- CCXR
- DCT
- EMRI
44Which of the following complications from acute MI is the most common cause of mortality
- AArrhythmia
- BCongestive heart failure
- CRecurrent infarction
- DSeptal rupture
- EVentricular wall aneurysm
45Which of the following is the most common congenital heart defect?
- APatent ductus arteriosus
- BAtrial septal defect
- CVentricular septal defect
- DPatent ductus venosum
46A 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?
- AAortic stenosis
- BPulmonic stenosis
- CTricuspid stenosis
- DMitral stenosis
47In an aneurysm below the inguinal ligament, what is the most common complication?
- ARupture
- BEmbolization
- CThrombosis
- DDissection
48Which of the following would NOT be an indication for bacterial endocarditis prophylaxis?
- AProsthetic heart valves
- BHypertrophic cardiomyopathy
- CPrior history of infective endocarditis
- DComplex cyanotic congenital heart disease
49If you suspect a patient with HIV has non-ischemic dilated cardiomyopathy myocarditis, what test would best confirm your diagnosis?
- ATEE
- BEKG
- CHeart biopsy
- DCT scan with contrast
- EMagnetic resonance angiogram
50Operating on an AAA is indicated in an otherwise healthy individual when it gets larger than _______?
- A5cm
- B5.5cm
- C6cm
- D6.5cm
- E7cm
51What is standard risk factor reduction therapy for asymptomatic carotid disease?
- AAspirin, Statin, ACEi
- BCoumadin, Statin
- CBeta blocker, Statin, ACEi
- DLoop diuretics, Statin, ACEi
52Which of the following arrhythmias would NOT present with a narrow QRS and irregular rhythm?
- AAfib
- BMAT
- CAflutter
- DVT
53Carotid endarterectomy surgery is indicated at what level of stenosis?
- A50%
- B60%
- C70%
- D80%
- E90%
54A 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?
- AHypoplastic left heart syndrome
- BAortic valve stenosis
- CMyocarditis
- DCardiac tamponade
- ECoarctation of the aorta
55A 39 year old male presents with claudication, Raynaud's phenomenon and digital ulceration. Which of the following would be most reasonable?
- AAcute arterial occlusion
- BThromboangitis obliterans (Buerger Disease)
- CDVT
- DChronic venous insufficiency
- EAbdominal aortic aneurysm
56An inferior wall MI involves which artery?
- ARCA
- BLAD
- CCircumflex
- DRCA and circumflex
- ELAD and RCA
- FLAD and circumflex
57A 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?
- AAcute aortic stenosis from infarction
- BAcute tricuspid regurgitation from infarction
- CAcute mitral regurgitation from infarction
- DAcute mitral stenosis from infarction
58A 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?
- AInhibition of parasympathetic nerves decreases total peripheral resistance
- BInhibition of parasympathetic nerves increases heart rate
- CInhibition of parasympathetic nerves increases total peripheral resistance
- DStimulation of parasympathetic nerves decreases the strength of cardiac contractions
- EStimulation of sympathetic nerves decreases the strength of cardiac contractions
59A 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?
- AAortic stenosis
- BPatent ductus arteriosis
- CMitral regurgitation
- DPulmonic stenosis
60A 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.
- ASupraventricular tachycardia
- BAcute coronary syndrome
- CAortic dissection
- DPheochromocytoma
61Which of the following radiographic findings is associated with tetralogy of Fallot?
- ADecrease in right ventricular size
- BRib notching
- CIncreased pulmonary vascular markings
- DBoot shaped heart
62What is the cardiac ausculatory hallmark of an atrial septal defect?
- AParadoxical split S2
- BWide, fixed split S2
- CSystolic ejection murmur second right intercostal space
- DHolosystolic murmur heard a apex that radiates to axilla
63A 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.
- AAcute coronary syndrome
- BPneumothorax
- CAortic dissection
- DMitral stenosis
64An 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?
- AAcute coronary syndrome
- BHeart failure
- CSinus tachycardia
- DCardiac tamponade
65A 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?
- AAspirin, metoprolol, valsartan, clopidogrel, morphine, diuretic
- BHeparin, atenolol, atorvastatin, clonidine, nitroglycerine
- CAmlodipine, Lisinopril, aspirin, valsartan, atorvastatin, diuretic, metoprolol
- DAspirin, metoprolol, Lisinopril, atorvastatin, diuretic, nitroglycerin
66A 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?
- AAtherosclerotic peripheral vascular disease
- BVenous stasis disease
- CRaynaud syndrome
- DArterial embolization
67Which of the following is the most likely cause of paradoxical splitting of S2?
- APulmonic stenosis
- BLeft bundle branch block
- CAtrial septal defect
- DRight ventricular failure
68Orthostatic 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.
- A10 mm Hg; 20 mm Hg
- B10 mm Hg; 5 mm Hg
- C20 mm Hg; 10 mm Hg
- D5 mm Hg; 10 mm Hg
69A 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.
- AAce inhibitors
- BBeta blockers
- CCalcium channel blockers
- DDiuretics
70Which of the following medications is used to control the ventricular rate during an acute event of rapid atrial fibrillation?
- ABeta blocker
- BDigoxin
- CWarfarin
- DNitroglycerin
71Which of the following is a contraindication for an exercise treadmill stress test.
- AMild aortic stenosis
- BUnstable angina
- CPrevious myocardial infarction
- DNonspecific ECG changes
72Which of the following antiarrhythmic drugs most potently blocks sodium channel current in the myocardium?
- AFlecainide
- BProcainamide
- CAmiodarone
- DLidocaine
73According to the American Diabetes Association, risk reduction for cardiovascular events in patients with diabetes can be achieved by the use of:
- ABeta blockers
- BStatins
- CCholesterol absorption inhibitors
- DAldosterone
74A 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?
- AStrict control of blood glucose levels
- BHMG-CoA reductase inhibitor therapy
- CEstrogen/progestin combination therapy
- DACEi to control her hypertension
75Secondary [prevention of an St-elevation myocardial infarction should include which of the following measures?
- AEstrogen therapy
- BACEi
- CFolate or Vitamin B6
- DCalcium channel blockers
76An increase in which of the following factors is most likely to increase the preload?
- AArterial vascular tone
- BStroke volume
- CHeart rate
- DIntravascular volume
77Which is the mechanism by which cardiac tamponade impedes cardiac output?
- ADecreased inflow of blood to ventricles
- BDecreased pressure in pericardium
- CIncreased pressure decreases sinus rhythm
- DIncrease in end-diastolic volume
78Which of the following is used to describe diastolic dysfunction?
- AIncreased afterload
- BDecreased preload
- CDecreased stroke volume
- DDecreased ventricular myocardial compliance
79A 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?
- ANormal sinus rhythm
- BAtrial fibrillation
- CSinus tachycardia
- DNodal rhythm
80A 29 year old man presents with extreme fatigue and shortness of breath. What is the abnormality noted in the ECG?
- AComplete AV Block
- BType II second degree AV block
- CJunctional rhythm
- DAtrial fibrillation
81You 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?
- ACardiac enzymes
- BSedimentation rate
- CRheumatoid factor
- DComplete blood cell count
82A 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?
- AExercise treadmill stress test
- BCardiac enzymes
- CRadionuclide stress myocardial perfusion imaging
- DEchocardiogram
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- 1 PA School Quiz am Clinical Cardiology Multiple Choice Questions, erstellt von Elle Ashe am 10/02/2017.
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- Elle Ashe
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- English
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