Mehlman Cardiology Practice Exam

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• In the setting of left main coronary artery disease, a single-vessel involvement qualifies for bypass grafting.
• Arterial insufficiency is most commonly caused by which disease process?
• Which finding supports cor pulmonale in a patient with COPD?
• Which findings are included in the JONES criteria for rheumatic fever?
• Which maneuver increases venous return to the heart?
• A patient with STEMI two days ago now has a central friction rub. What is the most likely diagnosis?
• If functional testing shows severe ischemia, what is the typical next step in management?
• Which vessel size is primarily affected in polyarteritis nodosa?
• An 13-year-old with Hb 7 g/dL and tachycardia presents with a 2/6 mid-systolic murmur at the upper right sternal border; the likely diagnosis is?
• Statins lower LDL primarily through which mechanism?
• ST elevations in leads II, III, aVF indicate occlusion of which vessel?
• Tricuspid stenosis sounds like which condition?
• Which of the following is NOT listed as a potential cause of dilated cardiomyopathy?
• In a hypertensive emergency, sodium nitroprusside primarily causes which hemodynamic change?
• Procainamide is associated with which drug-induced condition?
• In diastolic dysfunction, which of the following is typically true?
• Normal splitting of S2 occurs with which sequence?
• Mitral regurgitation involves which heart valve?
• What is the most common cause of carotid plaques?
• Failure of closure of the foramen ovale results in which condition?
• Which combination best describes empiric therapy for HAP/VAP to cover both MRSA and Pseudomonas?
• S4 can rarely be associated with right ventricular hypertrophy in which condition?
• In congenital rubella syndrome, which cardiovascular defect is classically associated?
• Approximately what proportion of mitral stenosis cases are attributable to rheumatic fever?
• During pregnancy, the risk of symptomatic mitral stenosis increases due to what physiologic change?
• In an 80-year-old patient with stroke or TIA, what is the next best step to evaluate for an embolic source?
• What is the most common cause of right heart failure?
• Microscopic polyangiitis is most commonly associated with which ANCA pattern?
• What is the most common cause of mitral regurgitation?
• The atrioventricular (AV) node is located on the posteroinferior interatrial septum near which structure?
• PCWP best reflects pressure in which chamber?
• Isolated hematuria with p-ANCA positivity suggests which vasculitis?
• Which heart sound is commonly associated with hypertrophic cardiomyopathy?
• What auscultatory features are typical of mitral stenosis?
• Arterial insufficiency treatment sequence?
• What is the typical sequence of initiating therapies in chronic heart failure?
• Paroxysmal nocturnal dyspnea differs from orthopnea how?
• Which cardiomyopathy is primarily associated with diastolic dysfunction due to LV hypertrophy?
• Which murmur is holosystolic?
• Which murmur can present as a late-peaking systolic murmur with an ejection click?
• In an aortic dissection involving the ascending aorta, initial management includes which combination?
• An individual recently diagnosed with endocarditis develops an intracranial aneurysm. What is the most likely diagnosis?
• In an IV drug user with suspected infective endocarditis, which valve is most commonly infected?
• Polyarteritis nodosa is associated with infection in about 30% of patients. Which infection is most commonly linked?
• ST elevations in leads V1, V2, V3 indicate occlusion of which vessel?
• Which class of diuretics is most commonly associated with hypokalemia due to potassium wasting?
• Isolated left heart failure is primarily manifested by which finding?
• If the patient has an abnormal baseline ECG (e.g., BBB), what stress testing should be used?
• How do you close a patent ductus arteriosus pharmacologically?
• Which non-dihydropyridine calcium channel blocker is particularly used for rate control in atrial fibrillation when beta-blockers are contraindicated?
• Which murmur is best described as a diastolic decrescendo murmur following an opening snap?
• In a 40-year-old man with a history of rheumatic fever as a child and a rumbling diastolic murmur, which finding in childhood history is most likely?
• In constrictive pericarditis, calcification on chest X-ray is seen in about what fraction of patients?
• Paradoxical splitting of S2 is most characteristic of which condition?
• During inspiration, which murmurs tend to worsen?
• During rest and exercise, is coronary blood flow greater in systole or diastole?
• Mobitz II is defined by:
• Which regimen best covers MRSA and an anti-pseudomonal agent for HAP/VAP?
• The mechanism most consistent with cor pulmonale involves what pathophysiology?
• Which pulse finding is typical of aortic regurgitation?
• Diffuse ST-segment elevations on ECG are most consistent with which diagnosis?
• Which drug is NOT a Type Ib Na channel blocker?
• Which murmur has an opening snap followed by a diastolic murmur?
• For pulmonary arterial hypertension, which class of medication is often effective in responders?
• In a 12-year-old male with fever, sore throat, painful joints, annular skin rash, and a heart murmur, which murmur is most likely?
• Expiration affects the right heart by reducing venous return to the right atrium. Which option best describes this effect?
• Aortic stenosis auscultation is best described as which of the following?
• A 32-year-old woman with SLE and a diastolic rumbling murmur. What is the most characteristic valvular lesion?
• Which congenital heart defect is described as the most common?
• What determines whether a pericardial effusion becomes tamponade?
• In mitral stenosis, the opening snap is followed by which type of diastolic murmur?
• Post-reperfusion idioventricular arrhythmia is associated with which mechanism?
• If an 80-year-old patient with stroke has a normal ECG, which test is most appropriate to detect paroxysmal atrial fibrillation?
• Which adverse effect is associated with amiodarone therapy?
• Which murmurs are commonly observed in connective tissue disorders?
• Which findings would you expect in pulmonary hypertension on physical examination and imaging?
• What is the primary reason for starting furosemide in heart failure patients?
• Which AV block type is most likely to progress to complete heart block and may necessitate pacing?
• Which test is used to noninvasively assess carotid plaques?
• Which murmur is described as to-and-fro?
• Digoxin MOA?
• In a patient with stable angina triggered by climbing stairs, what is the recommended next step in evaluation?
• Which of the following is listed as an infectious cause of third-degree AV block?
• Which heart sound marks the onset of systole?
• The coronary sinus is located between the openings of which structures?
• What is the structural heart change in hypertrophic obstructive cardiomyopathy?
• Renal angiography in polyarteritis nodosa typically shows which pattern?
• If calcium channel blockers fail to control PAH, which treatment options may be used?
• What is the typical heart rate in third-degree AV block?
• Which statement about bile acid sequestrants is true?
• Which is the next pharmacologic step after vagal maneuvers fail to terminate stable SVT?
• Which auscultatory finding is most characteristic of mitral valve prolapse?
• Which statement best describes how the Valsalva maneuver decreases blood in the heart?
• Timolol's topical use for glaucoma is due to which effect?
• Which description corresponds to Grade 1 heart sounds?
• Osler-Weber-Rendu (hereditary hemorrhagic telangiectasia) has which inheritance pattern?
• A punched-out ulcer on the foot with intermittent claudication suggests which condition?
• What is the hemodynamic sequence by which chronic lung disease leads to cor pulmonale?
• When nitrates are given arterially, which effect predominates?
• What does hypertrophic obstructive cardiomyopathy (HOCM) murmur sound like?
• Dysphagia and hoarseness caused by a dilated cardiac structure; which chamber is dilated?
• Which agent is a penicillin-class anti-pseudomonal beta-lactam?
• Which metabolite is included in the CHALK acronym describing skeletal muscle blood flow regulation?
• Primary pulmonary hypertension is most commonly associated with which genetic finding?
• Which class shortens the action potential duration and preferentially acts on ischemic tissue?
• Dressler syndrome after myocardial infarction is best described as pericarditis due to which mechanism?
• Familial hyperchylomicronemia is associated with deficiency of which protein?
• What is the major side-effect of naproxen?
• ST depressions in leads V1, V2, V3 suggest occlusion of which vessel?
• Empiric therapy for hospital-acquired or ventilator-associated pneumonia must cover which pathogens?
• In a child, a rumbling murmur heard in the neck that disappears when the child is supine and the neck rotated indicates which benign murmur?
• The combination of hematuria, hemoptysis, and sinusitis suggests which disease?
• First-degree AV block is defined by a PR interval longer than:
• A newborn is cyanotic at birth; before surgery, what should be given to maintain systemic perfusion?
• If pericarditis is infectious, which etiology is most likely?
• Where is pericardial fluid secreted into?
• Subacute endocarditis is most commonly associated with which scenario?
• S3 is most commonly associated with which condition?
• Second-degree Mobitz II or third-degree AV block: which intervention?
• Anti-Scl-70 antibodies are most characteristic of which condition?
• Which triad is classically observed in cardiac tamponade?
• Which diagnostic test is best to detect paroxysmal atrial fibrillation after a stroke when a single ECG is normal?
• What is the genetic cause of hypertrophic obstructive cardiomyopathy?
• Inspiration tends to reduce left atrial preload, softening left-sided murmurs. Which statement best describes this effect?
• In the management of pheochromocytoma, which sequence is recommended when initiating alpha and beta blockade?
• Serous pericarditis is commonly associated with which autoimmune disease?
• Varicose veins with a painful palpable cord by the ankle—what is the appropriate treatment?
• Which condition is a contraindication to beta-blocker therapy?
• S3 heart sound is best described as which of the following?
• In heart failure management, after optimizing ACEi/ARB and diuresis, which drug class is added next to further reduce mortality if EF remains low?
• Atrioventricular septal defect is also known as what?
• The most common cause of death from a fall or motor vehicle accident is which traumatic event?
• What is the leading cause of death in hypertrophic obstructive cardiomyopathy?
• Expiration tends to intensify left-sided murmurs because it increases which preload?
• Which murmur is best described as midsystolic crescendo-decrescendo heard at the right upper sternal border?
• In a child with a heart tumor, the most likely diagnosis is cardiac rhabdomyoma, which is usually associated with which condition?
• Hand-grip maneuver primarily increases afterload, causing what happens to LV blood?
• In a sudden death scenario in a middle-aged patient with known heart disease, which is the most likely cause?
• Which medication is most commonly associated with hypokalemia in cardiovascular patients?
• Granulomatosis with polyangiitis commonly involves which organ systems?
• In a patient with COPD who also has heart disease, elevated PCWP suggests what about RH failure?
• Mitral regurgitation classically presents as which murmur?
• In a patient with blunt trauma and widening mediastinum on imaging, what is the next best diagnostic test to evaluate for aortic injury?
• What is pulsus paradoxus?
• A 78-year-old patient with congestive heart failure and hypertension develops atrial fibrillation. CHADS2 score is 4. What is the preferred anticoagulation?
• A 44-year-old patient presents with hematuria, hemoptysis, and head/ENT involvement. Which vasculitis is most likely?
• On chest radiograph, which finding supports dilated cardiomyopathy?
• Ostium primum atrial septal defect is associated with which condition?
• Evolution PCSK9 inhibitors MOA?
• A palpable thrill refers to which of the following statements?
• What is the most common underlying cause of aortic dissection?
• Which scenario besides three-vessel disease is commonly considered for bypass grafting when diabetes is present?
• What is the classic symptomatic triad for aortic stenosis?
• Which murmur has a diastolic opening snap?
• What best differentiates restrictive cardiomyopathy from constrictive pericarditis?
• Which statement differentiates tamponade from simple pericardial effusion?
• Class IA antiarrhythmics affect risk of torsades de pointes how?
• Which murmurs worsen with inspiration due to increased venous return to the right heart?
• For nitrates, what is the main hemodynamic effect?
• Which agent is used to keep the ductus arteriosus open?
• Which murmur is pandiastolic and loudest in early diastole?
• In a neonate with truncus arteriosus, which cell population is most likely absent during cardiac development?
• Which test is most diagnostic for carcinoid syndrome presenting with valvular disease?
• Pulmonic stenosis is classically associated with Noonan syndrome. Which option correctly pairs this association?
• Which statement best describes mitral valve prolapse (MVP)?
• Which antibiotic is a carbapenem commonly used for broad-spectrum coverage including Pseudomonas in hospital-acquired pneumonia?
• Which statement best describes the relationship between hypertension and carotid atherosclerosis?
• A 29-year-old woman presents with exertional dyspnea, an S3 gallop, a laterally displaced apex, cardiomegaly on chest radiograph, Kerley B lines, and an ejection fraction of 30% on echocardiography. What is the most likely diagnosis?
• A 45-year-old man with a long smoking history presents with JVD and peripheral edema. Imaging shows signs consistent with chronic lung disease. The dx is:
• What is naproxen?
• A red dot on the tongue or fingernail is a sign associated with which hereditary condition?
• In atrial fibrillation, embolic strokes most commonly originate from thrombus in which site?
• Pneumonia is considered community-acquired pneumonia (CAP) when the presentation occurs within 48 hours of hospital admission. Which option best reflects this guideline?
• A patient presents with alternating tachycardia and bradycardia. Which condition is most likely?
• Which of the following is a Type Ic Na channel blocker?
• Which murmur has a mid-systolic click?
• Which vasculitis presents with asthma and eosinophilia?
• A 28-year-old male IV drug user presents with fever and a 2/6 holosystolic murmur at the left sternal border. What is the most likely description of the valvular vegetation?
• Where does the murmur of aortic stenosis commonly radiate?
• Which statement best differentiates venous insufficiency ulcers from arterial insufficiency ulcers?
• First-line treatment for venous insufficiency?
• The coronary sinus lies between the openings of which structures?
• Which ANCA is associated with Wegener granulomatosis?
• Isolated right heart failure is usually caused by what?
• A patient with STEMI 2-6 weeks prior now presents with central friction rub. What is the most likely diagnosis?
• Which hemodynamic profile is typical of septic shock?
• Which statement correctly describes carotid sinus baroreceptor autoregulation?
• Varicose veins are related to venous insufficiency how?
• A 68-year-old man with type 2 diabetes, a dilated heart on chest X-ray, an S3, and a 2/6 holosystolic murmur over the left chest most likely has which diagnosis?
• Which heart sound marks the onset of diastole?
• Which mechanism best explains ischemia-induced mitral regurgitation?
• A 33-year-old woman at 20 weeks gestation presents with new-onset dyspnea, crackles in both lungs, and a diastolic rumbling murmur. What is the most likely diagnosis?
• In congestive heart failure with reduced ejection fraction, which pattern best describes LV stroke volume, left atrial pressure, and total peripheral resistance?
• Which statement is true about MVP?
• In arterial insufficiency management, when is cilostazol considered?
• The carotid sinus baroreceptors transmit afferent signals primarily through which cranial nerve?
• Which statement about Osler-Weber-Rendu (hereditary hemorrhagic telangiectasia) is true?
• Which finding is most characteristic of mitral stenosis on auscultation?
• Where does the pathogenesis of atherosclerosis begin in the arterial wall?
• Expiration tends to intensify left-sided murmurs by increasing which preload?
• Which statement best describes how chronic lung diseases contribute to pulmonary hypertension and cor pulmonale?
• A 34-year-old woman with anti-Scl-70 antibodies has heart involvement. Which diagnosis is most likely?
• Which artery typically supplies the inferior portion of the heart?
• A 40-year-old man with a history of rheumatic fever in childhood is most likely to have which murmur now?
• Which statement best reflects propranolol's effect relevant to portal hypertension?
• The sinoatrial (SA) node is located at the junction of which structures?
• Rheumatic fever is a type II hypersensitivity reaction directed against which bacterial component?
• New-onset murmur with fever. What is the most likely diagnosis?
• Which agent is a beta-lactam with anti-pseudomonal activity commonly used in HAP/VAP?
• Which antibiotic is an aminoglycoside used as anti-pseudomonal coverage?
• If a coarctation occurs proximal to the ductus arteriosus insertion on the descending aorta, what is the term used?
• Which two organ systems are classically affected in Goodpasture syndrome?
• Mobitz II AV block is characterized by:
• Which of the following are infectious causes of third-degree AV block?
• Familial hypertriglyceridemia is best explained by which mechanism?
• A 22-year-old male presents with central chest pain after heavy cocaine use, worse when leaning back and better when leaning forward. What is the most likely diagnosis?
• Orlistat MOA?
• Which cephalosporin has reliable anti-pseudomonal activity?
• Cold exposure leads to which combination of changes in central blood volume, ADH, and ANP?
• What is a typical description of the ventricular septal defect (VSD) murmur?
• Which hemodynamic profile is expected in neurogenic shock with adrenal crisis?
• Pulmonic stenosis in exam vignettes is best described as which murmur and physiologic feature?
• What are the important arrows for systolic dysfunction?
• Which electrolyte disturbance predisposes to digoxin toxicity?
• Which syndrome is classically defined by a triad of cardiac myxoma, perioral melanosis, and endocrine hypersecretion?
• Which murmur is holosystolic and extends throughout systole?
• In intravenous drug user endocarditis, which valve is most commonly involved?
• Which murmur is holodiastolic (pandiastolic)?
• Ivabradine reduces heart rate by inhibiting which current?
• Disopyramide is particularly noted for which characteristic among class IA agents?
• Ranolazine is best described as what?
• Before starting the exercise regimen in arterial insufficiency therapy, what must be done?
• Which measurement is typically elevated in left heart failure?
• Which chromosomal condition is Turner syndrome associated with in the context of aortic stenosis?
• What toxicity monitoring is essential when using sodium nitroprusside in hypertensive emergencies?
• Which description best characterizes a mitral valve prolapse murmur?
• Mobitz I (Wenckebach) is characterized by:
• Propranolol has a notable use in the prophylaxis of esophageal variceal bleeding due to what effect?
• Which hemodynamic profile characterizes cardiogenic shock?
• In evaluating arterial insufficiency, what is the recommended initial test and the subsequent step?
• Heyde syndrome is the combination of aortic stenosis and what condition?
• Inpatient CAP non‑ICU empiric therapy typically includes which of the following?
• Which artery supplies the apex of the heart?
• An asymptomatic patient with a carotid bruit and 60% carotid occlusion should be managed with which approach?
• A 55-year-old man with hypertension presents with a carotid bruit on examination. What is the next best step to evaluate for carotid plaques?
• A 44-year-old man with hematuria and hemoptysis most strongly suggests which syndrome?
• AS can be familial with which inheritance pattern?
• What kind of left ventricular hypertrophy does aortic stenosis cause?
• Which complication is associated with cutaneous Group A Streptococcus infections but not rheumatic fever?
• Which maneuver decreases venous return and cardiac preload?
• Which statement best describes the effect of labetalol in aortic dissection when blood pressure is low?
• Which murmur is associated with fixed splitting of S2?
• Young child with hypocalcemia and harsh systolic murmur at the left sternal border; Dx?
• The fossa ovalis represents the site of closure of which fetal opening?
• In traumatic rupture, which radiographic finding is most associated with the injury?
• In familial hypercholesterolemia with very high total cholesterol, which mechanism best explains a total cholesterol in the 700–1000 mg/dL range?
• Splitting of S1 is most commonly seen in which condition?
• Restrictive cardiomyopathy is characterized by which of the following?
• Which drug is listed as the first-line anti-arrhythmic for AFib in the absence of structural heart disease?
• The pericardial cavity is formed by which structures?
• Paradoxical splitting of S2 occurs when which component is delayed?
• S1 heart sound corresponds to the closure of which valves?
• Which antiarrhythmic is first-line to treat atrial fibrillation in the absence of structural heart disease?
• If a patient with outpatient CAP has used antibiotics within the last three months, which empiric therapy is suggested?
• What term describes the severe renal disease seen in Wegener, Goodpasture, or microscopic polyangiitis?
• A posterior myocardial infarction may show reciprocal ST-segment depression in which ECG leads?
• Isolated right heart failure commonly presents with which finding?
• Carcinoid syndrome can cause which cardiac valvular lesion?
• During exhalation, which murmurs tend to worsen?
• Hypokinesis of the apex on echocardiography suggests injury to which artery?
• Which class includes potassium channel blockers such as amiodarone, dronedarone, sotalol, ibutilide, and dofetilide?
• Systemic sclerosis is most closely associated with which pericardial finding?
• What is the mechanism of action of ezetimibe?
• Atrial septal defect (ASD) classically presents with which auscultatory finding and mechanism?
• Repairing a VSD typically results in what change in pressures across the chambers?
• Which beta-lactam antibiotic has MRSA activity?
• Which two murmurs are commonly observed in individuals with connective tissue disorders?
• In an aortic dissection involving the descending aorta, the recommended pharmacologic management is which?
• Which statement best describes the relationship between left and right heart failure?
• Rupture of the aorta in blunt trauma most commonly occurs at which location?
• Fixed splitting of S2 is most associated with which defect?
• Which condition is a connective tissue disorder associated with increased risk of aortic dissection?
• Which mediator is associated with cardiac pain in angina?
• A mother with an autoimmune disease has a child with congenital heart block. Which maternal condition is most commonly associated?
• In a 12-year-old with fever and a 2/6 holosystolic murmur over the left chest, as an adult what murmur might develop later?
• If a patient cannot exercise, which stress test is used?
• What is the treatment for beta-blocker overdose?
• In a patient in their 50s–60s with high blood pressure and a TIA/stroke or retinal artery occlusion, what is the next best diagnostic test?
• Which is a contraindication to beta-blocker therapy?
• Which description best characterizes the pulse in aortic stenosis?
• Which are notable adverse effects of spironolactone?
• Myositis and rhabdomyolysis risk increases when fibrates are used with statins due to which mechanism?
• Which murmur is characteristic of a patent ductus arteriosus?
• A parasternal heave is most commonly due to which finding?
• Which test confirms venous insufficiency?
• An 18-year-old male athlete presents with a 2/6 midsystolic murmur at the right upper sternal border, 2nd intercostal space, paradoxical splitting of S2, and no change in the murmur with Valsalva. Dx?
• Inferior wall myocardial infarction is most commonly due to occlusion of which artery?
• Which symptom is classically associated with digoxin toxicity?
• Which vasculitis is typically associated with p-ANCA positivity and lacks granulomatous inflammation?
• Endocrine hypersecretion in Carney complex can manifest as which of the following?
• Causes of left heart failure include which of the following?
• In atrial fibrillation with a valvular lesion, what is the preferred anticoagulation strategy?
• In suspected traumatic rupture of the thoracic aorta, what is a key initial management step to reduce injury risk?
• Which scenario is an indication to pursue coronary artery bypass grafting in addition to considering revascularization plans?
• Which drugs are non-dihydropyridine calcium channel blockers?
• Congestive heart failure is defined as which combination?
• Which statement best distinguishes acute rheumatic fever from infective endocarditis?
• A 65-year-old man with 2-3 days of severe chest pain presents with a visible pulsation above the manubrium, tracheal deviation, and a murmur at the right second intercostal space. What is the most likely diagnosis?
• What is the mechanism of action of spironolactone?
• How is digoxin toxicity treated?
• In third-degree AV block:
• Which mutation is associated with primary pulmonary hypertension?
• In a patient with unstable SVT or VT who is comatose or unconscious, the appropriate immediate treatment is:
• What are major side effects commonly associated with beta-blockers?
• What imaging modality confirms venous insufficiency by showing stasis and/or occlusive disease?
• In an adult with a left atrial tumor presenting with a diastolic rumble that abates when the patient is positioned on his right side while leaning diagonally, which tumor is most likely?
• ST elevations in leads V4, V5, V6 indicate occlusion of which vessel?
• Which statement best describes acute endocarditis?
• Myxomatous degeneration refers to which process?
• Which statement about tricuspid regurgitation in carcinoid heart disease is true?
• Which combination among common heart failure medications is NOT shown to reduce mortality?
• In VSD, a diastolic rumble can be heard in addition to the holosystolic murmur due to movement across which phase?
• Which statement best defines cor pulmonale?
• Empiric therapy for pneumonia requiring ICU admission is best described by which regimen?
• If a patient on furosemide remains clinically fluid-overloaded, what is a common next-step diuretic addition?
• Quinidine can cause cinchonism. Which symptoms define cinchonism?
• Fetal alcohol syndrome with a heart–lung fistula is due to which mechanism?
• When nitrates are given intravenously, which effect best explains the reduction in venous return and preload?
• Which drug is an oxazolidinone used for MRSA coverage in HAP/VAP?
• S2 heart sound corresponds to the closure of which valves?
• Papillary muscle rupture leading to mitral regurgitation most commonly occurs after which event?
• Wider splitting of S2 is most likely to occur in which situation?
• Which beta-blocker also antagonizes alpha receptors?
• A patient develops pneumonia 72 hours after hospital admission. How is this pneumonia classified?
• Hand-grip tends to decrease the intensity of which murmur?
• Which agent is an endothelin-1 receptor antagonist used in pulmonary arterial hypertension?
• What is the current name for Churg-Strauss?
• If 99% of mitral stenosis is due to prior rheumatic fever, what else can cause it?
• Fibrate drugs lower triglycerides primarily by which mechanism?
• Differentiation between ASD and VSD based on pO2 changes involves which of the following pairs indicating ASD?
• Coarctation of the aorta is more common in which group?
• A 30-year-old man with red eyes and progressive hearing loss (tinnitus/vertigo) is most consistent with which syndrome?
• An 8-year-old patient with fever and tachycardia presents with a 2/6 mid-systolic murmur at the upper right sternal border; the most likely diagnosis is?
• A 25-year-old with cystic fibrosis presents with JVD and edema. The most likely diagnosis is:
• Rheumatic fever involves antibodies that cross-react with which component of Group A Streptococcus due to molecular mimicry?
• Mechanism for Goodpasture syndrome involves antibodies against which target?
• Late-peaking systolic murmur with an ejection click?
• Which drug is a dopamine-1 receptor agonist used in hypertensive emergencies to maintain renal perfusion by dilating renal arterioles?
• Ulcers on the medial malleolus with leg hyperpigmentation are most consistent with which condition?
• Orthopnea is reflective of LV decompensation; which statement best describes this condition?
• What is the current name for Wegener granulomatosis?
• A postmenopausal woman experiences a stress trigger and shows ballooning of the left ventricle on echocardiography. What is the most likely diagnosis?
• Which best describes the hemodynamic profile of hypovolemic shock?
• In a patient over 75 with good blood pressure who experiences a TIA or stroke, what is the next best diagnostic step?
• What is a typical empiric treatment approach for suspected endocarditis?
• First-line treatment for varicose veins?
• In aortic regurgitation, left ventricular hypertrophy is best described as which type?
• Timolol is commonly used as a topical solution for glaucoma. Which option lists Timolol in the context of its use?
• Which statement about MVP is true?
• A neonate with supravalvular aortic stenosis is associated with which syndrome?
• A child with an idiopathic arrhythmia disorder experiences a seizure-like episode; what is the most likely diagnosis?
• How is HOCM treated to prevent the heart rate from becoming too fast?
• If a blood culture grows MSSA, what is the recommended antibiotic change?
• In suspected infective endocarditis, which step should be performed before starting antibiotics?
• Which statement is true about Timolol in glaucoma management?
• Which syndrome is associated with supravalvular aortic stenosis and elfin-like facies?
• What is the normal range for left ventricular ejection fraction?
• Serous pericarditis is typically associated with which infectious agent?
• Which structure is closest to the atrioventricular (AV) node?
• What cross-sectional area threshold prompts aortic valve replacement in bicuspid valve disease?
• In septic shock, what is the typical status of the pulmonary capillary wedge pressure (PCWP)?
• Which medications commonly used in cardiovascular disease can cause hyperkalemia?
• If a patient does not have a bicuspid valve, AS can still occur due to what process in the elderly?
• If a patient is symptomatic from carotid disease and has 60% carotid occlusion, which management is most appropriate?
• Tricuspid regurgitation in intravenous drug users is best described as which murmur characteristic?
• An older woman with diabetes has high potassium, elevated BUN and creatinine, and a central friction rub on exam. What is the most likely diagnosis and recommended immediate treatment?
• How does decreased preload affect the murmur of aortic stenosis?
• Which antibiotic is an anti-pseudomonal beta-lactam commonly used in HAP/VAP?
• In a patient with Marfan syndrome, if you hear no abnormal sounds over the aortic valve region, to which area should you move the stethoscope next to assess for the midsystolic click of mitral valve prolapse?
• Which congenital lesion best explains diminished lower-extremity perfusion and cold legs with preserved upper-extremity flow?
• Hypertrophic obstructive cardiomyopathy (HOCM) is best described as:
• Which statement about ostium secundum ASD is true?
• Which of the following is a class IA antiarrhythmic?
• Which condition is classically associated with a high ejection fraction due to high-output states such as arteriovenous shunts?
• In a 55-year-old man with hypertension and a transient ischemic attack, what is the next best diagnostic step?
• On duplex ultrasound, which finding is most consistent with venous insufficiency?
• What percent of people over age 80 have atrial fibrillation?
• Which organism is NOT classified as part of the HACEK group?
• Management for first-degree AV block or Mobitz I (Wenckebach) is to:
• A patient with fever, strawberry tongue, and a salmon-colored rash is diagnosed with scarlet fever. Which treatment is used to prevent rheumatic fever?
• Traumatic rupture management depends on the involved aortic segment. Which statement is accurate?
• Which statement best describes a key pathologic feature of polyarteritis nodosa?
• A 34-year-old woman with ulnar deviation and MCP/PIP joint pain presents with a heart problem consistent with pericarditis. Which diagnosis best fits this scenario?
• Rupture of the aorta in blunt trauma is most likely at which site?
• In a cyanotic newborn with a PDA, what is the effect of an open PDA?
• Which of the following is NOT an anti-pseudomonal agent?
• A notable blood pressure difference between the arms most strongly suggests which diagnosis?
• Sacubitril is a neprilysin inhibitor used in combination with an ARB for heart failure. What is its primary action?
• Which statement NOT observed in left ventricular hypertrophy?
• AS is classically associated with which valve abnormality?
• Takotsubo cardiomyopathy is also known as ballooning of the left ventricle.
• A known side effect of ivabradine is what?
• Which statement best describes NSAID-induced edema mechanism?
• A patient with back pain, hypercalcemia, renal insufficiency, and a grossly fibrotic-appearing heart is most consistent with which diagnosis?
• Fixed splitting of S2 is classically associated with which defect?
• If confusion develops after administration of sodium nitroprusside in a hypertensive emergency, what is the likely cause?
• Pulmonic regurgitation murmurs are best described as which of the following?
• Which finding is commonly seen in dilated cardiomyopathy on presentation?
• Mitral stenosis is most commonly caused by which etiology?
• A narrow-complex tachycardia most likely represents which rhythm?
• Which therapy is commonly used as an antiarrhythmic for ventricular tachycardia?
• When is spironolactone added to heart failure therapy in relation to ACE inhibitors and beta-blockers?
• Naproxen-induced edema is primarily due to increased reabsorption of which solute in the proximal tubule?
• Where is the murmur of aortic stenosis best heard?
• Before starting amiodarone, which baseline tests are recommended?
• Which hemodynamic profile is typical for septic shock?
• Statins' mortality benefit is attributed to which additional effect besides lowering LDL?
• What is the recommended antidote for beta-blocker overdose?
• Which echocardiographic finding would support a diagnosis of pulmonary arterial hypertension?
• A 40-year-old man with a remote history of rheumatic fever and a rumbling diastolic murmur with a right ventricular S4. What is the most likely diagnosis?
• Empiric outpatient therapy for community-acquired pneumonia is typically a macrolide such as azithromycin. Which of the following is an appropriate choice?
• Which murmur exhibits both pansystolic and pandiastolic components?
• Which drug is NOT a class III antiarrhythmic?
• Carotid sinus massage has its primary effect on the heart by increasing which autonomic input?
• A 33-year-old woman at 38 weeks gestation presents with prominent bilateral ankle edema and dyspnea. What is the diagnosis?
• The posterior descending artery most commonly arises from which artery?
• Inspiration tends to worsen right-sided murmurs due to what hemodynamic change?
• Which ANCA is most commonly associated with Churg-Strauss?
• Congestive heart failure is defined as the combination of which?
• Which vasculitis is characterized by asthma and eosinophilia?
• S4 heart sound is best described as which of the following?
• Infective endocarditis complicated by septic embolus causing focal neurologic symptoms, what is the initial management?
• Polyarteritis nodosa is best described as which type of vasculitis?
• A 44-year-old with epistaxis since adolescence, a red dot on the tongue, dyspnea, and an ejection fraction of 75-80% presents for evaluation. What is the most likely diagnosis?
• Libman-Sacks endocarditis is associated with which antibodies?
• Calcification of a congenitally bicuspid aortic valve typically begins in which decade of life?
• Which drug is a dopamine-1 receptor agonist used in hypertensive emergencies to maintain renal perfusion by dilating renal arterioles?
• Cogan syndrome is best described as which type of disease?
• What is the characteristic auscultation pattern for aortic regurgitation?
• Which imaging modality most accurately confirms traumatic injury to the aorta after a suspected rupture?
• Which statement is true about management of venous disorders?
• Atrioventricular septal defect is commonly seen in which chromosomal condition?
• Nasal septal perforation and sinusitis are characteristic of which vasculitis?
• Familial hyperchylomicronemia is most commonly associated with deficiency of which protein?
• Which drug is typically avoided in the medical management of a descending aortic dissection?
• A wide-complex tachycardia most likely represents which arrhythmia?
• Which substances are main regulators of coronary blood flow?
• Familial hypercholesterolemia is most commonly due to which defect?
• Cor pulmonale describes right heart failure due to which condition?
• In left heart failure, which hemodynamic parameter is increased?
• In hypovolemia, what happens to carotid sinus signaling and heart rate?
• Which fluoroquinolone is commonly used for pneumonia, including HAP?
• In superficial thrombophlebitis along a varicose vein, which treatment is indicated?
• Given an end-systolic volume of 100 mL and an end-diastolic volume of 190 mL, what is the ejection fraction in percent?
• In a patient with suspected traumatic aortic injury and hypotension, which medication is preferred to reduce shear forces on the aorta?
• In a patient with a bicuspid aortic valve, what is the recommended next step in management?
• Which murmur is continuous machinery-like?
• Which murmur is mid-systolic with a crescendo-decrescendo pattern?
• Which statement describes the interaction between nitrates and PDE-5 inhibitors like sildenafil?
• Which symptom is commonly seen in dilated cardiomyopathy?
• Which of the following best characterizes mitral valve prolapse syndrome?