12 USMLE Cardiology Quick Review Questions with Answers (Set 4)

These 12 quick USMLE review questions test high-yield facts that show up again and again on the exam: ruptured aortic aneurysm, unstable angina, LDL targets in diabetes, pulmonary embolism, transposition of the great arteries, xanthomas, fish oils, atheroma formation and sudden death in diabetes. 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. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis?

A- Acute mesenteric ischemia
B- Acute myocardial infarction
C- Pulmonary embolism
D- Rupture of abdominal aortic aneurysm

D- Rupture of abdominal aortic aneurysm- This is a typical case. Other conditions have different presentations.
The correct answer is D

 

Question 2. Which of the following correctly describes unstable angina?

A- Angina following strenuous exercise
B- Angina occurs at rest
C- Angina relieved by rest

B- Angina occurs at rest- New onset angina occurs or worsens at rest.
The correct answer is B

 

Question 3. Which of the following is the target LDL in a patient with diabetes?

A- Less than 70
B- 70-100
C- 100-130
D- More than 130

A- Less than 70- This is the bad cholesterol. The higher the level of LDL, the higher is the risk of coronary heart disease and stroke.
The correct answer is A

 

Question 4. A 70-year-old man with a history of paraplegia develops sudden pleuritic chest pain. A chest CT scan shows a hemorrhagic wedge-shaped pleural based area localized in the right lower lobe. Which of the following is the most likely cause of this lesion?

A- Atherosclerosis
B- Embolism
C- Inflammation
D- Thrombosis

B- Embolism- This is a typical case of pulmonary embolism due to less movement and sudden chest pain. It is confirmed by the CT scan.
The correct answer is B

 

Question 5. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart?

A- Left atrium
B- Left ventricle
C- Right atrium
D- Right ventricle

B- Left ventricle- TOG is a cyanotic heart disease in which the pulmonary artery arises from the left ventricle while the aorta arises from the right ventricle.
The correct answer is B

 

Question 6. An 80-year-old woman develops chest pain on the second day after hysterectomy. Which of the following is the most likely diagnosis?

A- Acute pericarditis
B- Myocardial infarction
C- Pulmonary infarction
D- Right bundle branch block

C- Pulmonary infarction- This is the most common postoperative complication in elderly patients.
The correct answer is C

 

Question 7. A CT scan of the chest shows a focal, wedge-shaped area of hemorrhage in a segment of the lung. Which of the following is the most likely cause of this finding?

A- Arteriosclerosis
B- Atherosclerosis
C- Embolism
D- Thrombosis

C- Embolism- This is a typical presentation of pulmonary infarction. An embolus from the venous circulation, most commonly arising in large leg veins, has lodged in a peripheral pulmonary arterial branch. Arterial supply to the lung does not provide enough oxygenation to prevent infarction, but does provide blood which results in hemorrhagic area.
The correct answer is C

 

Question 8. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions?

A- Diabetes mellitus
B- Familial hypercholesterolemia
C- Pseudogout
D- Systemic lupus erythematosus

B- Familial hypercholesterolemia- this condition is characterized by slowly growing hard subcutaneous nodule with normal skin due to disturbance in lipid metabolism and high cholesterol levels leading to cholesterol deposits.
The correct answer is B

 

Question 9. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients?

A- Beef products
B- Fish oils
C- Saturated fat
D- Sugar-free snacks

B- Fish oils- They reduce platelet aggregation and arachidonic acid metabolites. Sugar-free snacks are healthy but don’t have direct effect as fish oils increase the level of HDL.
The correct answer is B

 

Question 10. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as the aorta and carotid?

A- Cholesterol breakdown
B- Endothelial dysfunction
C- Hypoxemia
D- Regular blood flow

B- Endothelial dysfunction- Blood flow is turbulent at these areas, which allows initiation of atherogenesis through endothelial dysfunction and infiltration of lipids.
The correct answer is B

 

Question 11. Which of the following pathological signs is the first visible one in atheroma formation?

A- Calcification
B- Fatty streak
C- Hemorrhage
D- Thrombus

B- Fatty streak- This is the first pathological sign seen initiating atheroma formation. It is formed on the arterial intimal surface. Other choices will be seen later in the process. Fatty streak is usually reversible.
The correct answer is B

 

Question 12. Which of the following is the most common cause of sudden death in patients with diabetes mellitus?

A- Cerebral hemorrhage
B- Gangrene
C- Hyperosmolar coma
D- Myocardial infarction

D- Myocardial infarction- Atherosclerosis that leads to myocardial infarction is the leading cause of death in patients with diabetes mellitus.
The correct answer is D

 

High-yield points from this set

  • Unstable angina = angina at rest, new-onset or worsening angina.
  • Target LDL in diabetes with high risk is below 70 mg/dL.
  • Wedge-shaped hemorrhagic lung infarct = pulmonary embolism.
  • The fatty streak is the earliest visible lesion of atherosclerosis.

Keep practicing

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