10 USMLE Cardiology Quick Review Questions with Answers (Set 3)

These 10 quick USMLE review questions test high-yield facts that show up again and again on the exam: hypertrophic cardiomyopathy, ruptured aortic aneurysm, LDL cholesterol, orthostatic hypotension, mitral stenosis, beta-blockers after MI, pulmonary embolism, atherosclerosis, DVT and familial hypercholesterolemia. Each question includes the correct answer.

Written by Dr. Ray Makar, MD, author of the Repeated USMLE Questions eBook series.

Prefer video? Watch daily USMLE case questions on MedFocus by Dr. Ray on YouTube.

How to use this page: read the question, pick your answer, then tap Show Answer and Explanation.

Questions

Question 1. A 19-year-old man presents with syncope, dyspnea and chest pain with exercise. A crescendo-decrescendo murmur without carotid radiation is heard over the left sternal border. What is the most likely diagnosis?

A- Aortic stenosis
B- Hypertrophic cardiomyopathy
C- Mitral stenosis
D- Myocardial infarction

B- Hypertrophic cardiomyopathy- an aortic systolic murmur without carotid radiation is diagnostic of left ventricular hypertrophy which is most likely caused by cardiomyopathy at this age.
The correct answer is B

 

Question 2. A 60-year-old woman presents with severe tearing abdominal pain, nausea and dizziness. The patient is pale and lethargic with blood pressure of 80/50 and diffuse abdominal tenderness. There is no past history of similar episodes. What is the next step?

A- Amylase and lipase levels
B- Exploratory laparotomy
C- Laparoscopy
D- Ultrasound

B- Exploratory laparotomy- This is emergency and could be ruptured aortic aneurysm with no time should be wasted for other procedures.
The correct answer is B

 

Question 3. Which of the following is the most important risk factor for coronary artery disease?

A- High LDL cholesterol
B- High total cholesterol
C- Low HDL cholesterol
D- Obesity

A- High LDL cholesterol- All of the above are risk factor for coronary artery disease but the most dangerous one is elevation of LDL cholesterol.
The correct answer is A

 

Question 4. A 65-year-old man complains of lightheadedness when he gets off bed in the morning. He takes metoprolol and hydrochlorothiazide. Which of the following is the cause of his complaint?

A- Antihypertensive therapy
B- Aortic stenosis
C- Hypertension
D- Vasovagal reflex

A- Antihypertensive therapy- I know it is an easy question but this one teaches you to be aware not to choose any choice if it is not included in the scenario. This symptom can happen with any of the other three but nothing is mentioned in the case about them.
The correct answer is A

 

Question 5. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography?

A- Dilated cardiomyopathy
B- Left ventricular hypertrophy
C- Mitral stenosis
D- Right ventricular hypertrophy

C- Mitral stenosis- This is most likely atrial fibrillation caused by mitral stenosis. Other choices are mostly associated with ventricular arrhythmias.
The correct answer is C

 

Question 6. An old patient underwent percutaneous coronary intervention due to anterior myocardial infarction. Now, his ejection fraction is 45. Which of the following medications increases his survival?

A- Atenolol
B- Digoxin
C- Furosemide
D- Lisinopril

A- Atenolol- Beta blockers increase survival rate in post-myocardial infarction patients with low ejection fraction. They reduce oxygen demand and arrhythmias.
The correct answer is A

 

Question 7. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis?

A- Bundle branch block
B- Cor pulmonale
C- Myocardial infarction
D- Pulmonary embolism

D- Pulmonary embolism- Most common cause of chest pain in post-operative settings due to immobilization after surgery.
The correct answer is D

 

Question 8. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests show high LDL cholesterol and low HDL cholesterol. Which of the following is the most likely vascular abnormality involved in this condition?

A- Atherosclerosis
B- Deep venous thrombosis
C- Hyperplastic arteriosclerosis
D- Medial calcific sclerosis

A- Atherosclerosis- This patient has multiple risk factors of atherosclerosis such as smoking, high blood pressure, high LDL cholesterol and low HDL cholesterol.
The correct answer is A

 

Question 9. A 58-year-old woman was hospitalized for 10 days after cholecystectomy. Today, examination reveals swelling and tenderness of her right leg. Diagnosis of femoral vein thrombosis is confirmed. Which of the following is the precipitating factor most likely contributes to this condition?

A- Effect of medications
B- Immobilization
C- Septicemia
D- Surgical complication

B- Immobilization- The most common cause of DVT in this age group is immobilization. Swelling and tenderness of her right leg supports this factor.
The correct answer is B

 

Question 10. A 30-year-old man presents to the emergency room with excruciating chest pain and shortness of breath for an hour. Past, surgical and familial histories are unremarkable except that his father died of a heart attack at the age of 32. Imaging studies and laboratory tests confirm the diagnosis of myocardial infarction. What is the most likely precipitation factor contributing to his condition?

A- Alcohol abuse
B- Atherosclerosis
C- Familial hypercholesterolemia
D- Type II diabetes

C- Familial hypercholesterolemia- This is the most common cause of coronary artery diseases in young age.
The correct answer is C

 

High-yield points from this set

  • Exertional syncope in a young athlete = hypertrophic cardiomyopathy.
  • Unstable ruptured AAA: straight to the operating room.
  • LDL cholesterol is the main lipid risk factor for coronary disease.
  • Chest pain 2 days after hip surgery = pulmonary embolism until proven otherwise.

Keep practicing

Leave a Comment