HSS Cardiology Review

Front

A 33 year old presents to the office with a complaint of palpitations. There is no history of any significant heart disease in the past and symptoms begin and end abruptly on their own. What is the most likely explanation for these symptoms?

Back

Supraventricular Tachycardia

Front

You are auscultating the heart of a 31-year-old patient and hear a systolic murmur which is loudest at the second right intercostal space. You ask the patient to stand and then squat while you continue to auscultate and notice that the murmur gets louder as the patient stands and decreases in intensity as he reaches a squatting position. Which of the following is most consistent with this description? Aortic Stenosis, Hypertrophic Cardiomyopathy, Pulmonic Stenosis, Aortic Regurgitation

Back

Hypertrophic Cardiomyopathy

Front

Which of the following statements most closely describes the point of maximum impulse or PMI?
Options:
Sustained diastolic beat in the 5th interspace at the mid-axillary line,
Sustained systolic beat in the 4th interspace at the mid-axillary line,
Brief systolic beat in the 5th interspace at the mid-clavicular line,
Brief diastolic beat inferior to the xyphoid process at the mid-sternal line

Back

Brief systolic beat in the 5th interspace at the mid-clavicular line

Front

Which of the following heart sounds occurs after the mitral valve opens, with rapid ventricular filling? S1, S2, S3, S4

Back

S3

Front

A 62 y/o with a history of stable angina presents with mild chest pain and shortness of breath. Pulse rate is 142 bpm and irregularly irregular, and BP is 90/50 mmHg. EKG reveals erratic, disorganized atrial activity with no P waves that is also irregularly irregular. What is the immediate treatment of choice?

Back

Cardioversion

Front

On evaluation of a newborn infant, a continuous, rough, machinery-like murmur is heard on cardiac auscultation. What is the drug of choice to administer to this infant?

Back

Indomethacin

Front

A 4 year-old patient has a harsh, holosystolic, grade III/VI cardiac murmur at the left sternal border with wide radiation and fixed split S2. There is no change with position or respiration. What is the most likely diagnosis? Options: Innocent murmur, Aortic regurgitation, Patent ductus arteriosus, Ventricular septal defect

Back

Ventricular septal defect

Front

A 38 y/o patient with a resolving URI develops fever, pleuritic substernal chest pain, and shortness of breath that is worse while lying down and better when sitting up and leaning forward. A pericardial friction rub is noted on exam. Which of the following would most strongly support the suspected diagnosis? Options: Positive ASO titer, Cardiomegaly on CXR, Diffuse ST elevations on EKG, Gram-positive diplococci on sputum smear

Back

Diffuse ST elevations on EKG

Front

A 45 y/o patient was recently diagnosed with angina by their PCP. The patient is a smoker, does not exercise, still consumes a high-fat and high-sodium diet, and is obese. Which lifestyle change will have the best long-term improvement to this patient's cardiac risk profile?

Back

Smoking cessation

Front

A patient with a PMH of CAD and DM2 has a fasting LDL cholesterol of 175 mg/dL, HDL 35 mg/dL, and triglycerides 255 mg/dL. What is the treatment of choice?

Back

Atorvastatin