10 USMLE Cardiology and Respiratory Quick Review Questions with Answers (Set 1)

These 10 quick USMLE review questions test high-yield facts that show up again and again on the exam: atrial septal defect, tetralogy of Fallot, aortic stenosis, chest pain, heart failure, echocardiography, aortic aneurysm, endocarditis prophylaxis, chronic bronchitis and lung physiology. 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. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures?

A- Ostium primum
B- Ostium secundum
C- Septum primum
D- Septum secundum

D- Septum secundum- The foramen ovale is created by the incomplete development of the septum secundum, which leaves an opening that allows right-to-left shunting in the fetus. Abnormal resorption of the septum primum can also lead to secundum-type ASDs, but the foramen ovale itself exists because the septum secundum does not fully close.
The correct answer is D

 

Question 2. Which of the following is the most likely developmental defect associated with tetralogy of Fallot?

A- Anterosuperior displacement of the infundibular septum
B- Bicuspid pulmonary artery
C- Patent ductus arteriosus
D- Transportation of the great vessels

A- Anterosuperior displacement of the infundibular septum
The correct answer is A

 

Question 3. Which of the following is the initial treatment of a significant aortic stenosis?

A- Balloon valvuloplasty
B- Furosemide
C- Hydrochlorothiazide
D- Valve replacement

D- Valve replacement- In significant aortic stenosis, the only definitive and appropriate treatment is aortic valve replacement. Diuretics such as furosemide or hydrochlorothiazide can worsen the condition by reducing preload, and balloon valvuloplasty is not recommended because the valve typically re-stenoses. For severe disease, even when asymptomatic, valve replacement is the correct management when intervention is required.
The correct answer is D

 

Question 4. A 61-year-old man presents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step?

A- Aspirin
B- Coronary angiography
C- Echocardiography
D- Thallium stress test

A- Aspirin- It is life saving in cases of coronary disease. Other options may be needed later but not as urgent as aspirin.
The correct answer is A

 

Question 5. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States?

A- Alcohol
B- Atherosclerosis
C- Diabetes
D- Rheumatic heart disease

B- Atherosclerosis- CHF with systolic impairment is mainly caused by ischemic cardiomyopathy due to coronary atherosclerosis.
The correct answer is B

 

Question 6. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy?

A- Arterial blood gas
B- Echocardiography
C- Electrocardiogram (ECG)
D- MRI of the chest

B- Echocardiography- It is the only test to rule out CHF. Other tests are not specific
The correct answer is B

 

Question 7. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT?

A- Male gender
B- Increased aortic wall stress
C- Smoking
D- Uncontrolled hypertension

A- Male gender- Rupture of AAA is increased more in females than males.
The correct answer is A

 

Question 8. A 1-year-old boy with a diagnosis of a stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered before this procedure?

A- Amoxicillin
B- Ampicillin
C- Azithromycin
D- No medication

D- No medication- Recent recommendations of American Heart Association only require prophylactic antibiotics for cases of previous history of endocarditis, prosthetic valves, heart transplant patients and severe cyanotic heart diseases.
The correct answer is D

 

Question 9. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis?

A- Abundant mucus with plugging of the bronchioles
B- Caseating granuloma
C- Non-caseating granuloma
D- Interstitial fibrosis

A- Abundant mucus with plugging of the bronchioles- Chronic bronchitis is a lung condition where the airways make too much mucus for a long time. On biopsy, you would see a lot of mucus blocking the bronchioles. This is what causes the long-term cough and breathing problems.
The correct answer is A

 

Question 10. Which of the following statements is correct regarding the apex of the upright lung compared to its base?

A- Alveoli are more compliant at the apex than at the base
B- Alveoli are smaller at the apex than at the base
C- Blood perfusion is lower at the apex than at the base
D- Ventilation/perfusion ratio is lower at the apex than at the base

C- Blood perfusion is lower at the apex than at the base- In the upright lung, gravity causes less blood flow to the apex and more to the base. Apex alveoli are larger and less compliant, and the V/Q ratio is actually higher at the apex, not lower.
The correct answer is C

 

High-yield points from this set

  • Severe symptomatic aortic stenosis is treated with valve replacement.
  • Give aspirin to every patient with suspected acute coronary syndrome.
  • Small VSDs do not need endocarditis prophylaxis.
  • At the lung apex, both ventilation and perfusion are lower, but V/Q is higher.

Keep practicing

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