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cardiology packrat exam 2024 with end –term with 242 questions and answers correct answers
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cardiology packrat exam 2024 with end –term with 242questions and answers correct answers
1. History & Physical/Cardiology
Which of the following conditions would cause a positive
Kussmaul's sign on physical examination?
Answers
A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis - ✔✔ANSW✔✔..(u) A. Left ventricular failure results in the
back-up of blood
into the left atrium and then the pulmonary system so it would
not be associated with Kussmaul's sign.
(u) B. Pulmonary edema primarily results in increased
pulmonary pressures rather than having effects on the venous
inflow into the heart.
(u) C. Coarctation of the aorta primarily affects outflow from
the heart due to the stenosis resulting in delayed and decreased
femoral pulses; it has no effect on causing Kussmaul's sign.
(c) D. Kussmaul's sign is an increase rather than the normal
decrease in the CVP during inspiration. It is most often caused
by severe right-sided heart failure; it is a frequent finding in
patients with constrictive pericarditis or right ventricular
infarction.
18. Diagnosis/Cardiology
A 63 year-old male is admitted to the hospital with an exacerbation of
COPD. The electrocardiogram shows an irregularly, irregular rhythm at
a rate of 120/minute with at least three varying P wave morphologies.
These electrocardiogram findings are most suggestive of
Answers
A. atrial fibrillation.
B. multifocal atrial tachycardia.
C. atrioventricular junctional rhythm.
D. third degree heart block. - ✔✔ANSW✔✔..(u) A. Atrial fibrillation is an irregularly,
irregular
rhythm with no definable P waves.
(c) B. Multifocal atrial tachycardia is seen most
,commonly in patients with COPD.
Electrocardiogram findings include an irregularly,
irregular rhythm with a varying PR interval and
various P wave morphologies (Three or more foci).
(u) C. Atrioventricular junctional rhythm is an
escape rhythm, because of depressed sinus node
function, with a ventricular rate between 40-
60/minute.
(u) D. Third degree heart block presents with a wide
QRS at a rate less than 50/minute and blocked
atrial impulses.
19. Health Maintenance/Cardiology
A 72 year-old female is being discharged from the hospital following an
acute anterolateral wall myocardial infarction. While in the hospital the
patient has not had any dysrhythmias
or hemodynamic compromise. discharge medications?
Answers
A. Warfarin (Coumadin)
B. Captopril (Capoten)
C. Digoxin (Lanoxin)
D. Furosemide (Lasix)
Which of the following medications should be a part of her - ✔✔ANSW✔✔..(u) A.
Warfarin is not indicated since there is no
role for anticoagulation in this patient.
(c) B. ACE inhibitors have been shown to decrease
left ventricular hypertrophy and remodeling to
allow for a greater ejection fraction.
(u) C. The patient does not have any dysrhythmias
so Lanoxin is not indicated.
(u) D. The patient does not have any hemodynamic
compromise or indicators of CHF.
20. Health Maintenance/Cardiology
A 44 year-old male with a known history of rheumatic fever at age 7 and
heart murmur is scheduled to undergo a routine dental cleaning. The
murmur is identified as an opening snap murmur. Patient has no
known drug allergies. What should this patient receive for antibiotic
prophylaxis prior to the dental cleaning?
Answers
A. This patient does not require antibiotic prophylaxis for a routine
dental cleaning.
B. This should receive Pen VK 250 mg p.o. QID for 10 days after the
procedure.
C. This patient should receive Amoxicillin 3.0 gms. p.o. 1 hour before the
procedure and then 1.5 gm. 6 hours after the procedure.
,D. This patient should receive Erythromycin 250 mg QID for 1 day before
the procedure and then 10 days after the procedure. - ✔✔ANSW✔✔..(h) A. See C for
explanation.
(u) B. See C for explanation.
(c) C. These are the current recommendations from
the American Heart Association if the patient is not
allergic to penicillin.
(u) D. See C for explanation.
21. Health Maintenance/Cardiology
A 36 year-old female presents for a refill of her oral contraceptives. She
admits to smoking one pack of cigarettes per day. She should be
counseled with regard to her risk of
Answers
A. venous thrombosis.
B. varicose veins.
C. atherosclerosis.
D. peripheral edema. - ✔✔ANSW✔✔..(c) A. Women over age 35 who smoke are at
increased risk for the development of venous
thrombosis.
(u) B. Varicose veins are the result of pressure
overload on incompetent veins and not due to the
use of oral contraceptives.
(a) C. The defined risks of atherosclerosis includes
smoking, but does not include the use of oral
contraceptives.
(u) D. There is no relationship between the use of
oral contraceptives and the development of
peripheral edema.
2. History & Physical/Cardiology
Anginal chest pain is most commonly described as which of the
following?
Answers
A. Pain changing with position or respiration
B. A sensation of discomfort
C. Tearing pain radiating to the back
D. Pain lasting for several hours - ✔✔ANSW✔✔..(u) A. Pain changing with position or
respiration is suggestive
of pericarditis.
(c) B. Myocardial ischemia is often experienced as a sensation
of discomfort lasting 5-15 minutes, described as dull, aching
or pressure.
(u) C. Tearing pain with radiation to the back represents aortic
dissection.
, (u) D. Chest pain lasting for several hours is more suggestive
for myocardial infarction.
3. History & Physical/Cardiology
Eliciting a history from a patient presenting with dyspnea due
to early heart failure the severity of the dyspnea should be
quantified by
Answers
A. amount of activity that precipitates it.
B. how many pillows they sleep on at night.
C. how long it takes the dyspnea to resolve.
D. any associated comorbidities. - ✔✔ANSW✔✔..(c) A. The amount of activity that
precipitates dyspnea should
be quantified in the history.
(u) B. Orthopnea or paroxysmal nocturnal dyspnea can be
quantified by how many pillows a patient needs to sleep on to
be comfortable.
(u) C. How long dyspnea takes to resolve or associated
comorbidities has no bearing on quantifying the severity of
dyspnea.
(u) D. See answer C above.
4. History & Physical/Cardiology
A 25 year-old female presents with a three-day history of chest
pain aggravated by coughing and relieved by sitting. She is
febrile and a CBC with differential reveals leukocytosis. Which
of the following physical exam signs is characteristic of her
problem?
Answers
A. Pulsus paradoxus
B. Localized crackles
C. Pericardial friction rub
D. Wheezing - ✔✔ANSW✔✔..(u) A. Pulsus paradoxus is a classic finding for cardiac
tamponade.
(u) B. Localized crackles are associated with pneumonia and
consolidation, not pericarditis.
(c) C. Pericardial friction rub is characteristic of an
inflammatory pericarditis.
(u) D. Wheezing is characteristic for pulmonary disorders,
such as asthma.
5. History & Physical/Cardiology
A 65 year-old white female presents with dilated tortuous veins
on the medial aspect of her lower extremities. Which of the
following would be the most common initial complaint?
Answers
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