CARDIOLOGY EXAM

Which of the following is true regarding anginal pain?

Which of the following is true regarding acute pericarditis?

A 54-year-old female presents to your office with reduced ejection fraction. She has dyspnea upon exertion. Which of the following would help confirm your suspicion of heart failure?

A 58-year-old man presents to the emergency department with severe, crushing chest pain that radiates to his left arm. The pain began 30 minutes ago. He is diaphoretic, and his blood pressure is 160/95 mm Hg. Troponin is elevated. An ECG reveals ST-segment elevation in leads II, III, and aVF. Alteplase is initiated. Which of the following is its mechanism of action?

A 55-year-old male presents to the cardiology clinic with a history of aortic regurgitation. He reports worsening fatigue, dyspnea on exertion, and occasional palpitations. On physical examination, a diastolic decrescendo murmur is heard at the left sternal border. An echocardiogram reveals severe aortic regurgitation with left ventricular dilation and preserved systolic function. Which of the following is the definitive treatment for this patient’s condition?

A) Initiate angiotensin-converting enzyme (ACE) inhibitor therapy B) Prescribe loop diuretics C) Administer prophylactic antibiotics for dental procedures D) Refer for aortic valve replacement surgery E) Start calcium channel blocker therapy

A 35-year-old female presents to the dermatology clinic with concerns about the appearance of her legs. She reports noticing the development of visible, bulging veins in her lower legs over the past few months. She occasionally experiences mild discomfort and heaviness in her legs, especially after prolonged periods of standing. On physical examination, there are dilated, tortuous veins visible in both lower legs, with no signs of skin changes or ulceration. Her blood pressure is 120/80 mmHg, heart rate 72 bpm, respiratory rate 16 breaths per minute, and temperature 98.6°F (37°C). Which of the following is the most likely initial symptom at the onset of the disease course?

A 63-year-old man PMH notable for HTN and DM2 presents to the emergency department c/o chest pain for twenty minutes. The pain is localized to the left chest and extends to the jaw and left arM. He has never experienced anything like this before. He denies HA, cough, abdominal pain, NVD, fevers, chills, nightsweats, or malaise. He has a 30 pack-year history of smoking cigarettes. He drinks 4-5 beers socially on the weekends for the last 10 years. He spends no time walking or exercising, per the patient. On exam, is a diaphoretic and distressed male with dyspea. His vital signs are as follows: blood pressure 132/84 mmHg, pulse 110 beats per minute, and respirations 22 breaths per minute, and BMI is 35.53kg/m^2. Lungs are clear to auscultation bilaterally and there are normal S1 and S2 sounds. There is no JVD, abdominal distention, or peripheral edema. Considering the patient’s history, which factor poses the greatest risk for an acute myocardial infarction?

A 40-year-old female with a PMH notable for untreated streptococcal pharyngitis during childhood presents to the outpatient internal medicine clinic with a newly diagnosed cardiac murmur. She endorses fatigue, shortness of breath on exertion, and low-grade fever recently that has since resolved. Her blood pressure is 132/86 mmHg, heart rate is 88 beats per minute, respiratory rate is 18 breaths per minute, and temperature is 98.6°F (37°C). On auscultation, a rumbling, low-pitched diastolic murmur is heard best at the apex. The murmur increases with exercise and decreases with squatting. An electrocardiogram (ECG) shows evidence of left atrial enlargement, and a chest X-ray reveals prominent pulmonary markings. Laboratory tests show an elevated erythrocyte sedimentation rate (ESR). Which of the following is the most likely diagnosis?

A 45-year-old female presents to her primary care physician for a routine check-up. Her blood pressure is 126/78 mmHg, heart rate is 82 beats per minute, respiratory rate is 16 breaths per minute, and temperature is 98.6°F (37°C). On physical examination, a murmur is noted that radiates to the carotids and is accentuated with Valsalva maneuver and standing. The rest of the physical examination is unremarkable. Which of the following physical exam findings is most consistent with the patient’s presentation?

Which of the following is true regarding a patient moving from a supine position to a standing position?

Autorhythmicity is the responsibility of which of the following cells?

Which of the following are the primary source of vascular resistance, due to the greatest pressure drop (ΔP)?

Which of the following is the most common cause of restrictive cardiomyopathy?

Which of the following will provide the definitive diagnosis of hypertrophic cardiomyopathy?

Which of the following is the most common cardiomyopathy?

Which of the following is the most common cause of dilated cardiomyopathy?

Which of the following is most likely affected in dilated cardiomyopathy?

A 6 month old infant is brought to the specialty pediatric cardiology office by his parents. They are worried that he was turning blue recently so they decided to bring him to a specialist. PE reveals tachypnea and tachycardia and a single S2 sound. Further workup includes EKG, CXR, and echo. The cardiologist diagnoses the infant boy with tricuspid atresia. Which of the following is the most likely pathophysiology commonly seen in this patient?

A 9 month old infant is brought to the specialty pediatric cardiology office by his parents. They are worried that he is not feeding well and tires quickly. They mentioned he was turning blue recently so they decided to bring him to a specialist. PE reveals tachypnea and tachycardia and a single S2 sound. Further workup includes EKG, CXR, and echo. The EKG shows left ventricular hypertrophy and a completely underdeveloped right ventricle. A patent ductus arteriosus is present which allows for shunting from the right side of the heart to the left. Based on the presumed diagnosis, which of the following is the most common presentation of an infant?

A 9 month old infant is brought to the specialty pediatric cardiology office by his parents. They are worried that he is not feeding well and tires quickly. They mentioned he was turning blue recently so they decided to bring him to a specialist. PE reveals tachypnea and tachycardia and a single S2 sound. Further workup includes EKG, CXR, and echo. The EKG shows left ventricular hypertrophy and a completely underdeveloped right ventricle. A patent ductus arteriosus is present which allows for shunting from the right side of the heart to the left. Which of the following is the most likely diagnosis?

A full-term newborn is evaluated in the NICU for persistent central cyanosis noted shortly after delivery. The infant exhibits tachypnea but remains hemodynamically stable with no significant murmur on auscultation. Oxygen saturation remains low despite administration of 100% supplemental oxygen. Chest x-ray reveals a narrow mediastinum with increased pulmonary vascular markings. Echocardiography confirms that the aorta arises from the right ventricle while the pulmonary artery originates from the left ventricle. Which of the following best explains the pathophysiology behind the persistent hypoxemia observed in this infant?