Mehlman Cardiology Practice Exam

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