11 USMLE Cardiology Quick Review Questions with Answers (Set 6)

These 11 quick USMLE review questions test high-yield facts that show up again and again on the exam: transposition of the great arteries, ruptured aortic aneurysm, complications after MI, atrial fibrillation stroke, ejection fraction, risk factors, ductus-dependent lesions, rheumatic heart disease, axis deviation, aortic stenosis and cardiac monitoring. 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. Transposition of great vessels is incompatible with life unless it is accompanied by which one of the following conditions?

A- Aortic stenosis
B- Tetralogy of Fallot
C- Truncus arteriosus
D- Ventricular septal defect

D-Ventricular septal defect- Transposition of great vessels is incompatible with life unless there is any shunt allow mixing of blood such as PDA or VSD.
The correct answer is D

 

Question 2. An unstable patient presents to the ER with suspected ruptured abdominal aortic aneurysm. Which of the following is the test of choice for this condition?

A- Abdominal CT scan
B- Abdominal ultrasonography
C- MRI of the abdomen
D- Plain abdominal x-ray

B- Abdominal ultrasonography- It provides quick bedside results faster than other choices. CT scan and x-ray are not accurate in detecting the rupture due to intestinal gas and other factors. MRI can’t be done on bedside
The correct answer is B

 

Question 3. A patient who survived acute myocardial infarction 12 hours ago called the ambulance for sudden dizziness and sweating. He died on his way to the hospital. Which of the following is the most likely cause of death in this patient?

A- Cardiac arrhythmia
B- Dressler syndrome
C- Papillary muscle rupture
D- Ventricular aneurysm

A-Cardiac arrhythmia- It occurs within few hours after MI and it is the most important cause of death in MI. Dressler syndrome occurs several weeks after and don’t cause sudden death as in this patient. Papillary muscle rupture occurs 2-7 days after infarction and results in mitral regurgitation. Ventricular aneurysm can occur weeks to months following MI.
The correct answer is A

 

Question 4. A 64-year-old male presents to the ER with sudden left-sided paralysis. The patient had a history of a compound fractured femur 2 months ago. His medical history includes myocardial infarction and atrial fibrillation. Which one of the following is most likely responsible for this patient’s condition?

A- Fat embolism
B- Thromboembolism from the left atrium
C- Thromboembolism from the right ventricle
D- Venous thromboembolism from the deep leg veins

B-Thromboembolism from the left atrium- Fat embolism usually occurs 1-3 days following severe compound fractures. Thromboembolism from the right side of the heart and venous system travel to the lung and can’t get past it to the brain. Emboli to the brain and other organs come from embolism from left atrium, a complication of atrial fibrillation.
The correct answer is B

 

Question 5. Which one of the following tests is the best initial test to evaluate ejection fraction is a case of congestive heart failure?

A- Holter monitor
B- Nuclear ventriculography
C- Transesophageal echocardiography
D- Transthoracic echocardiography

D- Transthoracic echocardiography- It is the best initial test. Nuclear ventriculography is the most accurate test but not the initial. TEE is more accurate in evaluating cardiac valve function and diameter.
The correct answer is D

 

Question 6. Which one of the following is the most common risk factor for coronary artery diseases?

A- Diabetes mellitus
B- Family history of CAD
C- Hyperlipidemia
D- Hypertension
E- Tobacco smoking

D- Hypertension- Hypertension affects 20% of total population which makes it the most common risk factor for CAD. Diabetes is the worst risk factor but it is not as common as hypertension.
The correct answer is D

 

Question 7. In cases of Tetralogy of Fallot with pulmonary atresia, the patients benefit from maintaining patency of ductus arteriosus. Which of the following drugs can be used to maintain ductal patency?

A- Betamethasone
B- Epinephrine
C- Indomethacin
D- Prostaglandin E1

D- Prostaglandin E1- Prostaglandin E1 such as alprostadil is the only one on the list that maintains patent ductus arteriosus. Indomethacin induces closing it. A and B don’t have any rule in that.
The correct answer is D

 

Question 8. Which of the following are considered the most likely affected valves in cases of rheumatic heart disease?

A- Aortic and pulmonic valves
B- Aortic and tricuspid valves
C- Mitral and aortic valves
D- Mitral and tricuspid valves

C- Mitral and aortic valves- These are the most likely valves affected in rheumatic heart disease. Tricuspid valve is the most likely affected valve in intravenous drug abuse.
The correct answer is C

 

Question 9. Which one of the following conditions most likely shows right axis deviation on electrocardiogram (ECG)?

A- Anterolateral myocardial infarction
B- Inferior myocardial infarction
C- Left ventricular hypertrophy
D- Ventricular tachycardia

A- Anterolateral myocardial infarction- It is the only one on the list that most likely shows right axis deviation. The other choices most likely show left axis deviation.
The correct answer is A

 

Question 10. A 68-year-old man is brought to the emergency room after he experienced syncope and shortness of breath while he was mowing the lawn. Records from previous visits show that his vital signs are pulse 70/min and blood pressure of 120/80. Cardiac examination shows a soft second heart sound and a systolic ejection murmur radiates to the carotid arteries. Which of the following is the most likely blood pressure of this patient at this time?

A- 120/80 mmHg
B- 110/60 mmHg
C- 106/80 mmHg
D- 100/40 mmHg

C- 106/80 mmHg- This condition is most likely aortic stenosis. Because the amount of blood ejected through the aorta is reduced due to aortic stenosis, systolic pressure will go down. Diastolic blood pressure should be normal so; blood pressure of 106/80 is the most predicted one.
The correct answer is C

 

Question 11. Which one of the following tests is the best way to monitor cardiovascular changes in a case of Marfan syndrome?

A- Coronary angiography
B- Echocardiogram
C- Electrocardiogram (ECG)
D- Pulmonary function tests

B- Echocardiogram- It is the only one on the above choices that can detect aortic root dilatation or aneurysm formation which are the common cardiac changes in a case of Marfan syndrome.
The correct answer is B

 

High-yield points from this set

  • Transposition of the great arteries needs a shunt (VSD, ASD or PDA) to survive.
  • Unstable suspected AAA rupture: bedside ultrasound.
  • Arrhythmia is the most common cause of death in the first hours after MI.
  • Rheumatic heart disease most often affects the mitral and aortic valves.

Keep practicing

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