Cardiovascular system

Practice questions
QUESTION 1
A 65-year-old man presents to the clinic with complaints of shortness of breath
and fatigue. His medical history includes hypertension and hyperlipidemia. An
echocardiogram reveals a decrease in the opening of the aortic valve. This
condition, known as aortic stenosis, is most likely to cause which of the
following hemodynamic changes?
A- decreased afterload
B- decreased preload
C- increased afterload
D- increased cardiac output
E- Increased stroke volume
A 65-year-old man presents to the clinic with complaints of shortness of
breath and fatigue. His medical history includes hypertension and
hyperlipidemia. An echocardiogram reveals a decrease in the opening of
the aortic valve. This condition, known as aortic stenosis, is most likely
to cause which of the following hemodynamic changes?
A- decreased afterload
B- decreased preload
C- increased afterload
D- increased cardiac output
Increased stroke volume
QUESTION 2
A 65-year-old male presents with a history of shortness of breath on
exertion and fatigue. Physical examination reveals a blowing,
pansystolic murmur best heard at the apex. Echocardiography confirms
a diagnosis of severe mitral regurgitation. Which of the following best
describes the hemodynamic alterations associated with this condition?
A- Increased left ventricular preload and decreased afterload
B- Decreased left ventricular preload and increased afterload
C- Decreased both left ventricular preload and afterload
D- Increased both left ventricular preload and afterload
E- No change in left ventricular preload and afterload
QUESTION 2
A 65-year-old male presents with a history of shortness of breath on
exertion and fatigue. Physical examination reveals a blowing,
pansystolic murmur best heard at the apex. Echocardiography confirms
a diagnosis of severe mitral regurgitation. Which of the following best
describes the hemodynamic alterations associated with this condition?
A- Increased left ventricular preload and decreased afterload
B- Decreased left ventricular preload and increased afterload
C- Decreased both left ventricular preload and afterload
D- Increased both left ventricular preload and afterload
E- No change in left ventricular preload and afterload
QUESTION 3
A 65-year-old female presents with shortness of breath and fatigue on
exertion. On examination, she has a mid-diastolic murmur best heard at
the cardiac apex. An echocardiogram shows thickened mitral valve
leaflets with decreased opening. Which of the following would most
likely be observed in this patient's left heart pressure-volume loop?
A- Increased left ventricular end-diastolic pressure
B- Decreased left ventricular end-diastolic volume
C- Decreased left ventricular end-systolic volume
D- Increased left ventricular end-systolic volume
E- Decreased left ventricular end-diastolic pressure
QUESTION 4
A 45-year-old male presents with a complaint of shortness of breath and
a sensation of a rapid, irregular heartbeat. On examination, the
physician notes a diastolic decrescendo murmur heard best along the left
sternal border. An echocardiogram confirms the diagnosis of aortic
regurgitation. What is the most likely physiological change in this
patient?
A-Increased afterload
B-Decreased stroke volume
C-Increased preload
D-Decreased cardiac output
E-Decreased heart rate
QUESTION 4
A 45-year-old male presents with a complaint of shortness of breath and
a sensation of a rapid, irregular heartbeat. On examination, the
physician notes a diastolic decrescendo murmur heard best along the left
sternal border. An echocardiogram confirms the diagnosis of aortic
regurgitation. What is the most likely physiological change in this
patient?
A-Increased afterload
B-Decreased stroke volume
C-Increased preload
D-Decreased cardiac output
E-Decreased heart rate
QUESTION 5
A 42-year-old man visits a clinic for a regular health check-up. During
the physical examination, the physician places the stethoscope on the
left lower sternal border and hears a sound immediately after the second
heart sound. It is high pitched, short, and is best heard in expiration.
Which of the following best describes this heart sound?
A-S1 heart sound
B-S2 heart sound
C-S3 heart sound
D-S4 heart sound
E- Opening snap
QUESTION 5
A 42-year-old man visits a clinic for a regular health check-up. During
the physical examination, the physician places the stethoscope on the
left lower sternal border and hears a sound immediately after the second
heart sound. It is high pitched, short, and is best heard in expiration.
Which of the following best describes this heart sound?
A-S1 heart sound
B-S2 heart sound
C-S3 heart sound
D-S4 heart sound
E- Opening snap
QUESTION 6
A 65-year-old man presents to the emergency department with severe
chest pain. An EKG reveals ST segment elevation in leads II, III, and
aVF. Which of the following arteries is most likely occluded?
• Posterior descending artery
• Left anterior descending artery
• Left circumflex artery
• Right coronary artery
• Left main coronary artery
QUESTION 6
A 65-year-old man presents to the emergency department with severe
chest pain. An EKG reveals ST segment elevation in leads II, III, and
aVF. Which of the following arteries is most likely occluded?
• Posterior descending artery
• Left anterior descending artery
• Left circumflex artery
• Right coronary artery
• Left main coronary artery
• Correct answer d: Right coronary artery.
• The location of ST segment elevations on an EKG can help determine
which coronary artery is occluded. In this case, leads II, III, and aVF
correspond to the inferior wall of the heart, which is most commonly
supplied by the right coronary artery. The intention of the question is to test
the understanding of the relationship between EKG findings and coronary
circulation. Option A, Left anterior descending artery, is incorrect because it
primarily supplies the anterior wall of the heart. Option B, Left circumflex
artery, is incorrect because it primarily supplies the lateral wall of the heart.
Option D, Left main coronary artery, is incorrect because occlusion would
typically cause ST elevations in multiple leads. Option E, Posterior
descending artery, is incorrect because it is a branch of the right coronary
artery and its occlusion would not typically cause ST elevations in leads II,
III, and aVF. Learning Objective: Understand the correlation between EKG
changes and the coronary artery involved in a myocardial infarction.
QUESTION 7
A 55-year-old male presents with chest pain that started while he was
climbing stairs. The pain has subsided after rest. Electrocardiogram
shows no significant changes. His physician educates him about the
importance of adequate coronary blood flow. Which of the following
factors primarily determines coronary blood flow?
• Heart rate
• Blood pressure
• Vascular resistance
• Blood viscosity
• Blood volume
QUESTION 7
A 55-year-old male presents with chest pain that started while he was
climbing stairs. The pain has subsided after rest. Electrocardiogram
shows no significant changes. His physician educates him about the
importance of adequate coronary blood flow. Which of the following
factors primarily determines coronary blood flow?
• Heart rate
• Blood pressure
• Vascular resistance
• Blood viscosity
• Blood volume
• Correct answer C: Vascular resistance is the primary determinant of
coronary blood flow. It is regulated by local metabolic demands of the
myocardium and systemic neurohumoral factors. When metabolic
demand increases, as in physical activity, coronary vessels dilate to
increase blood flow. This case presents a probable scenario of stable
angina, where an increase in demand exceeds the supply. Answer A is
incorrect because heart rate alone does not determine coronary blood
flow. Answer B is incorrect as blood pressure can influence, but is not
the primary determinant of coronary blood flow. Answer D is incorrect
as blood viscosity plays a role in coronary blood flow but does not
primarily determine it. Answer E is incorrect as blood volume has an
impact, but again it's not the primary determinant of coronary blood
flow. Learning Objective: The question aims to test the understanding
of the primary determinants of coronary blood flow and its
physiological regulation in response to varying metabolic demands.
QUESTION 8
A 58-year-old man comes to the emergency department with crushing
substernal chest pain radiating to the left arm. His ECG shows ST-
segment elevation in leads V1 to V4. Which of the following changes is
most likely associated with this patient's condition?
• Right ventricular infarction
• Inferior wall myocardial infarction
• Anterior wall myocardial infarction
• Posterior wall myocardial infarction
• Lateral wall myocardial infarction
QUESTION 8
A 58-year-old man comes to the emergency department with crushing
substernal chest pain radiating to the left arm. His ECG shows ST-
segment elevation in leads V1 to V4. Which of the following changes is
most likely associated with this patient's condition?
• Right ventricular infarction
• Inferior wall myocardial infarction
• Anterior wall myocardial infarction
• Posterior wall myocardial infarction
• Lateral wall myocardial infarction
• Correct answer C: Anterior wall myocardial infarction. The patient's
ECG findings show ST-segment elevation in leads V1 to V4, which is
indicative of an anterior wall myocardial infarction. This is typically
due to a blockage in the left anterior descending artery. Answer A is
incorrect because right ventricular infarction would show ST-segment
elevations in the right-sided leads. Answer B is incorrect because
inferior wall myocardial infarction would show ST-segment elevations
in leads II, III, and aVF. Answer D is incorrect because posterior wall
myocardial infarction often presents with ST-segment depression in
the precordial leads. Answer E is incorrect because lateral wall
myocardial infarction would show ST-segment elevations in leads I,
aVL, V5, and V6. Learning Objective: This question is intended to test
the student's ability to interpret ECG findings and associate them with
specific types of myocardial infarction.
QUESTION 9
A 21-year –old man presents to his provider for a routine check up. He
says he only had one episode of flu 2 months ago and has never had any
other illness. He has been training regularly for his college football
tournament. His blood pressure is 110/70 mm Hg, pulse is 69/min,
respirations are 17/min. he has a heart sound coinciding with rapid
filling of ventricles and no murmurs. No other physical findings. Which
of the following best describes the heart sound?
A- Opening snap
B- fourth heart sound
C- mid-systolic click
D- second heart sound
E- third heart sound
QUESTION 9
A 21-year –old man presents to his provider for a routine check up. He
says he only had one episode of flu 2 months ago and has never had any
other illness. He has been training regularly for his college football
tournament. His blood pressure is 110/70 mm Hg, pulse is 69/min,
respirations are 17/min. he has a heart sound coinciding with rapid
filling of ventricles and no murmurs. No other physical findings. Which
of the following best describes the heart sound?
A- Opening snap
B- fourth heart sound
C- mid-systolic click
D- second heart sound
E- third heart sound
QUESTION 10
A 32-Year-old woman comes to the physician's clinic for a regular
check up. She does not have any complains and mentions that she has
started to train for an upcoming marathon and hydrates exclusively with
electrolyte solutions as well as taking ‘electrolyte supplements’ given by
a fellow marathoner. Both of her parents are hypertensive. Vital signs
include heart rate 55/min, respirations are 16/min, blood pressure is
120/88 mm Hg. Rest of physical examination is normal. ECG shows
abnormal waves in precordial leads. Which of the following mechanical
event does the abnormal waves represent?
A- Ventricular depolarization
B- period between ventricular depolarization and repolarization
C- ventricular repolarization
D- atrial depolarization
E- atrial repolarization.
A- Ventricular depolarization
B- period between ventricular depolarization and repolarization
C- ventricular repolarization
D- atrial depolarization
E- atrial repolarization.