Mehlman Cardiology Practice Exam

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