HLTH module 5 cardio system questions

Question 1

The basic pathophysiological change associated with essential hypertension is:

Answer 1

Increased systemic vasoconstriction

Question 2

While working at a downtown clinic, you see a 25-year-old female who complains of fever. She reports a 20-year history of smoking and intravenous drug use. Which one of the following conditions are you most concerned about?

Answer 2

Infective endocarditis

Question 3

You called to the bedside of a 58-year-old woman who presented to the clinic with a fever and headache. She has pain in her jaw when chewing. You hear a bruit when listening over her temporal artery. The most likely underlying diagnosis is:

Answer 3

Giant-cell arteritis

Question 4

After a long day in the cardiology clinic, you reflect upon the patients you have seen. There have been a wide variety of presentations and resultant diagnoses, including an 18-year-old college student studying for exams who complained that he could hear his heart beating forcefully, especially when lying down. Which one of the following best describes this condition?

Answer 4

Palpitations

Question 5

You have a student with you during your pediatric rotation. You ask her to assess the heart sounds of a young girl who has a ventricular septal defect. The student correctly identifies the murmur as:

Answer 5

Holosystolic

Question 6

Aortic stenosis means the aortic valve:

Answer 6

Cannot fully open during systole.

Question 7

A colleague asks you to assess an electrocardiogram (ECG) that he feels is abnormal. You notice wide QRS complexes and peaked T waves. Which one of the following lab values are likely to be abnormal?

Answer 7

Potassium

Question 8

You receive a call from a patient who is on nitroglycerin for angina. He has been without pain during his normal daily activities and has only had to use his medications two or three times in the past month. Based on these symptoms, how would you classify his condition?

Answer 8

Stable angina

Question 9

A 35-year-old patient is brought in to your urgent care clinic at 9 pm. The patient is complaining, in his own words, of “feeling anxious, a little dizzy, and like my heart is racing.” He is a tax accountant and has been working night and day to get all the returns completed before the tax deadline. He has been consuming large amounts of coffee and sleeping little. He explains that the stress continues to increase as the deadline looms. As part of your workup, you get an electrocardiogram (ACG) that reveals a heart rate of 280 beats per minute with a “sawtooth” appearance. His pulse is slower at 70–80 beats per minute. What is the most likely diagnosis for this patient?

Answer 9

atrial flutter

Question 10

During your neonatology rotation, you assess a newborn infant who is lethargic, feeding poorly, and in mild respiratory distress. On auscultation, you hear a halosystolic murmur with a mild thrill associated. You sit in with the ultrasonographer, who confirms your suspicion that this is the most common type of congenital heart disease. Which one of the following is this child dealing with?

Answer 10

Ventricular septal defect (VSD)

Question 11

Significant signs of right-sided congestive heart failure include:

Answer 11

Edematous feet and legs with hepatomegaly.

Question 12

The term intermittent claudication refers to:

Answer 12

Ischemic muscle pain in the legs, particularly with exercise

Question 13

In the ER, you assess a patient that you think may be having a myocardial infarction. After stabilizing the patient, you assess his blood work. It is now two hours after his initial symptoms began. Which one of the following would you expect to be at its peak level?

Answer 13

myoglobin

Question 14

When listening to the heart sounds of a new clinic patient, you hear a systolic ejection murmur that extends up both sides of the patient’s neck. Of the following, which one is the most likely murmur you hear?

Answer 14

aortic stenosis

Question 15

During you neonatal rotation, you see a newborn with a patent ductus arteriosus (PDA). During rounds, the attending physician asks you what the best medication is to help close the PDA. You respond:

Answer 15

indomethacin

Question 16

Your attending physician calls you to the bedside of a patient who, the physician says, has an aortic aneurysm. As you head to the patient’s room, you quickly review the common locations of such lesions. You recall that the most common location is:

Answer 16

distal abdominal region

Question 17

You have been following a patient who presented three months ago with elevated blood pressure. Despite some dietary and lifestyle changes, his hypertension remains. You decide to start a calcium channel blocker. Which one of the following medications is in that class?

Answer 17

verapamil

Question 18

One of your patients asks to see you about his risk for heart disease. His 46-year-old brother recently died from a myocardial infarction. In your discussion with the patient, which one of the following do you mention as a modifiable risk factor?

Answer 18

hypertension

Question 19

A mother brings her 2-year-old child into your clinic, concerned that the child has intermittent blue spells. These spells are often helped when the child squats down. What is the most likely underlying condition?

Answer 19

tetralogy of fallot

Question 20

During teaching rounds, you are taken to the bedside of a patient who has cyanotic finger and palms that are made worse with cold weather. The most likely diagnosis of this patient is:

Answer 20

raynaud’s disease

Question 21

In the ER, you assess a patient that you think may have had a myocardial infarction. He has just returned home from a four-day camping trip with his wife. He reports having had mild chest pain and shortness of breath after chopping wood on the first day. His symptoms resolved, but he did not have the same amount of energy as he usually does and had mild recurring symptoms if he over-exerted himself. He takes oral medications for Type II diabetes mellitus. After stabilizing the patient, you assess his blood work. It is now more than 72 hours since his initial symptoms began. Which one of the following would you expect to be at its peak level?

Answer 21

Lactate dehydrogenase

Question 22

While working at a downtown clinic, you see a 25-year-old female who complains of fever. She reports a 20-year history of smoking and intravenous drug use. You suspect she may have infective endocarditis. The most likely causative organism is:

Answer 22

s aureus

Question 23

During your neonatology rotation, you assess a newborn infant who is lethargic, feeding poorly, and in mild respiratory distress. On auscultation, you hear a halosystolic murmur with a mild thrill associated. You confirm the infant has a ventricular septal defect that will require surgery, given its size and current effects on the normal circulation

Answer 23

pulmonary hypotension

Question 24

You are visiting your 62-year-old uncle, who has followed your career and, like all good family members, has a medical question for you. He tells you that for years now, every time he goes out into the cold, his hands turn first white and then blue with decreased sensation. When he then warms them, they turn first red and then back to their normal colour. You suggest he talk to his doctor about:

Answer 24

raynaud’s disease

Question 25

While working at a downtown clinic, you see a 25-year-old female who complains of fever. She reports a 20-year history of smoking and intravenous drug use. You suspect she may have infective endocarditis. Which valve is most likely affected?

Answer 25

tricuspid valve

Question 26

A friction rub is associated with:

Answer 26

pericarditis

Question 27

After a long day in the cardiology clinic, you reflect upon the patients you have seen. There have been a wide variety of presentations and resultant diagnoses, including a 48-year-old man who complained of chest pain with exertion. The pain resolved on its own with rest. Which one of the following best describes this condition?

Answer 27

angina pectoris

Question 28

During hospital rounds, you are asked by the attending physician how cardiac symptoms and murmurs change with positioning. She asks what type of retrosternal pain is made worse by lying down, and you answer:

Answer 28

pericarditis

Question 29

During teaching rounds, you are taken to the bedside of a patient who has cyanotic fingernail beds with splinter hemorrhages. The most likely diagnosis of this patient is:

Answer 29

Subacute bacterial endocarditis.

Question 30

Shock follows a myocardial infarction when:

Answer 30

A large portion of the myocardium is damaged

Question 31

A 46-year-old male comes to the urgent care clinic you are working at, complaining of severe pain in his chest that began while he was sitting at home eating breakfast. The pain radiated to his left shoulder and arm and lasted 15 minutes before resolving completely. He reports having had similar pain in the past, for which he received a full workup by a cardiologist, which included an echocardiogram and exercise stress testing. These tests showed normal findings. He was prescribed nitroglycerin, which has helped with the one recurrence of symptoms he has had. The most likely diagnosis is:

Answer 31

Prinzmetal’s angina

Question 32

You see a patient in the ER who had collapsed at home after rising from the couch. He is now alert and reports progressive dyspnea and bilateral lower leg swelling. He is obese and had a myocardial infarction three years ago. On auscultation, you hear a third heart sound (S3). The most likely diagnosis is:

Answer 32

CHF

Question 33

Which of the following is considered to be the most dangerous arrhythmia?

Answer 33

ventricular fibrillation

Question 34

A 35-year-old patient is brought into your urgent care clinic at 9 pm. The patient is complaining of, as he says, “feeling anxious, a little dizzy, and like my heart is racing.” He is a tax accountant and has been working night and day to get all the returns completed before the tax deadline. He has been consuming large amounts of coffee and sleeping little. He explains that the stress continues to increase as the deadline looms. As part of your workup, you get an electrocardiogram (ACG) that reveals a heart rate between 320 and 350 beats per minute with an absence of p waves and irregularly irregular ventricular contractions. What is the most likely diagnosis for this patient?

Answer 34

atrial fibrillation

Question 35

You receive a call from a patient who is on nitroglycerin for angina. He had been without pain during his normal daily activities up until two weeks ago. Since that time, any exertion, including walking up the stairs, is causing him chest pain, and he has been taking increased amounts of nitroglycerin. Based on these symptoms, how would you classify his angina?

Answer 35

unstable angina

Question 36

While at a soccer game, you witness the collapse of a 27-year-old man. You immediately assess him and find him asystolic. Despite your exhaustive efforts and those of the responding fire and EMT professionals, it is not possible to revive him. What is the most likely underlying pathology leading to his death?

Answer 36

Hypertrophic cardiomyopathy

Question 37

When listening to the heart sounds of a new clinic patient, you hear a murmur. Reflecting upon the patient’s history, this is not unexpected, as he reports having rheumatic fever as a child. Of the following, which one is most likely as the murmur you hear?

Answer 37

mitral stenosis

Question 38

During you neonatal rotation, you see a newborn with a patent ductus arteriosus (PDA). During rounds, the attending physician asks you what the best medication is to help close the PDA. You respond:

Answer 38

Indomethacin