MCCQE1 Practice Test Exam Study
Guide with Detailed Study Questions
with Elaborate Answers | Latest
Edition
1. STABLE angina definiton - ANSWER substernal "gripping" chest pain or
pressure on exertion, relieved w/ rest or NTG
2. One vessel disease treatment - ANSWER Tx β-blocker + aspirin + nitrates
3. two vessel treatment - ANSWER Tx β-blocker + aspirin + nitrates vs PTCA
OR CABG
4. three vessel disease - ANSWER Tx CABG
5. DCM management - ANSWER echo and CXR to diagnose and tx for CHF
AN HEART TXP
6. HCM presentation - ANSWER exertional dyspnea and sudedn deaht,
murmur enhanced by decrease preload eg handgrip and valsalva
7. HCM dx - ANSWER echo and family hx, asx aoid exercise, sx beta
blcokers vs myomectomy vs pacemaker implantaiton
8. RCM dx - ANSWER INFILITRAITON OF MYOCARDIUM AUSING
DEREASED OCMPLICANCE, TX IS UNDERLYING CAUSE
,9. MYOCARDITIS - ANSWER USAULYL ASYMPTOMATIC, PRESNET
WITH EVER, CHEST PAIN AND PERICARDITIS
10.DX OF MYOCARDITIS - ANSWER d increase cardiac enzymes, increase
in ESR and tx underlying cause
11.dc of acute pericaridtis and tx - ANSWER dx EKG (diffuse ST elevation +
PR dePRession) • Tx NSAIDs
• pericarditis + uremia → Tx hemodialysis
12.pericardial effusion, presentation, tx and dx - ANSWER muffled heart
sounds, soft PMI, ±pericardial friction rub
13.Dx echo (gold standard), CXR shows "water • bottle" silhouette
• small/asx → repeat echo in 1-2 wks
• rapidly developing → pericardiocentesis
14.cardiac tamponade dx and tx - ANSWER pulsus paradoxus + Beck's triad
(hypotension, JVD, muffled heart sounds)
15.Dx echo (gold standard), EKG shows electrical • alternans
• nonhemorrhagic, stable → close monitoring
• nonhemorrhagic, unstable →
• pericardiocentesis
• hemorrhagic → ER thoracotomy
16.loud S1, opening snap w/ late diastolic rumble and etiology - ANSWER
mitral stenosis..Etiology: rheumatic heart disease (MCC)
,17.what is involved in a pharmacological stress test - ANSWER : IV
adenosine, dipyridamole, or dobutamine can stress the heart in place of
exercise
18.The cardiac markers- when do they pick which is most specific? -
ANSWER CK-MB: peaks in 24 hrs and lasts 2-3 days, good for recurrence
Troponin I: peaks in 24 hrs and lasts 1-2 weeks, most specific
19.Difference between left-sided and right-sided CHF? - ANSWER Left-sided
CHF: dyspnea, orthopnea, PND
Right-sided CHF: pitting edema, hepatic congestion, JVD, ascites
20.NYHA classificaitons in order - ANSWER NYHA class I: sx only w/
vigorous activity (e.g. sports) NYHA class II: sx w/ moderate activity (e.g.
stairs)
NYHA class III: sx w/ ADLs NYHA class IV: sx at rest
21.CHF classes and treatment - ANSWER class I → Tx loop diuretic + ACE
inhibitor • class II-III → add β-blocker
• class IV → add digoxin
22.what is PAC and how do we treat? - ANSWER early P wave that looks
differently than other P waves, tx is reassurance
23.Afib - ANSWER acute, stable → anticoagulate + • rate control w/ Ca-
blockers
• then cardioversion
24.MAT - ANSWER ooks like AFib but the P waves are variable, need 3
different P waves for dx
, 25.ETIOLOGY OF MAT - ANSWER Etiology: end-stage COPD (MCC)
26.wpw, what is the characteristic wave and how do we treat - ANSWER
"delta wave" reflects accessory conduction pathway from atria to ventricles,
tx is ablation
27.VTACH TRAETMENT - ANSWER Sustained VTach: lasts >30 sec,
always symptomatic
Nonsustained VTach: lasts <30 sec, usually asx
Torsades de pointes: rapid, polymorphic VTach due to QT prolongation
28.sustained → Tx IV amiodarone • nonsustained → reassurance • torsades →
Tx IV mag sulfate
29.VFIB tx - ANSWER • Tx immediate defib + CPR, then • continue IV
amiodarone
30.sinus brady tx - ANSWER usually insignificant; if sx → Tx • atropine
(blocks vagus nerve)
31.first degree meaning and tx - ANSWER PR interval >0.2 .. needs
reassurance
systolic crescendo-decrescendo murmur following opening snap, "parvus et
tardus"; triad of angina, syncope, dyspnea AND ETIOLOGY - ANSWER
aortic stenosis... Etiology: calcified tricuspid valve (old), calcified bicuspid
aortic valve (young)
Px: usually asx until old age, then 1-3 yrs after development of sx
Guide with Detailed Study Questions
with Elaborate Answers | Latest
Edition
1. STABLE angina definiton - ANSWER substernal "gripping" chest pain or
pressure on exertion, relieved w/ rest or NTG
2. One vessel disease treatment - ANSWER Tx β-blocker + aspirin + nitrates
3. two vessel treatment - ANSWER Tx β-blocker + aspirin + nitrates vs PTCA
OR CABG
4. three vessel disease - ANSWER Tx CABG
5. DCM management - ANSWER echo and CXR to diagnose and tx for CHF
AN HEART TXP
6. HCM presentation - ANSWER exertional dyspnea and sudedn deaht,
murmur enhanced by decrease preload eg handgrip and valsalva
7. HCM dx - ANSWER echo and family hx, asx aoid exercise, sx beta
blcokers vs myomectomy vs pacemaker implantaiton
8. RCM dx - ANSWER INFILITRAITON OF MYOCARDIUM AUSING
DEREASED OCMPLICANCE, TX IS UNDERLYING CAUSE
,9. MYOCARDITIS - ANSWER USAULYL ASYMPTOMATIC, PRESNET
WITH EVER, CHEST PAIN AND PERICARDITIS
10.DX OF MYOCARDITIS - ANSWER d increase cardiac enzymes, increase
in ESR and tx underlying cause
11.dc of acute pericaridtis and tx - ANSWER dx EKG (diffuse ST elevation +
PR dePRession) • Tx NSAIDs
• pericarditis + uremia → Tx hemodialysis
12.pericardial effusion, presentation, tx and dx - ANSWER muffled heart
sounds, soft PMI, ±pericardial friction rub
13.Dx echo (gold standard), CXR shows "water • bottle" silhouette
• small/asx → repeat echo in 1-2 wks
• rapidly developing → pericardiocentesis
14.cardiac tamponade dx and tx - ANSWER pulsus paradoxus + Beck's triad
(hypotension, JVD, muffled heart sounds)
15.Dx echo (gold standard), EKG shows electrical • alternans
• nonhemorrhagic, stable → close monitoring
• nonhemorrhagic, unstable →
• pericardiocentesis
• hemorrhagic → ER thoracotomy
16.loud S1, opening snap w/ late diastolic rumble and etiology - ANSWER
mitral stenosis..Etiology: rheumatic heart disease (MCC)
,17.what is involved in a pharmacological stress test - ANSWER : IV
adenosine, dipyridamole, or dobutamine can stress the heart in place of
exercise
18.The cardiac markers- when do they pick which is most specific? -
ANSWER CK-MB: peaks in 24 hrs and lasts 2-3 days, good for recurrence
Troponin I: peaks in 24 hrs and lasts 1-2 weeks, most specific
19.Difference between left-sided and right-sided CHF? - ANSWER Left-sided
CHF: dyspnea, orthopnea, PND
Right-sided CHF: pitting edema, hepatic congestion, JVD, ascites
20.NYHA classificaitons in order - ANSWER NYHA class I: sx only w/
vigorous activity (e.g. sports) NYHA class II: sx w/ moderate activity (e.g.
stairs)
NYHA class III: sx w/ ADLs NYHA class IV: sx at rest
21.CHF classes and treatment - ANSWER class I → Tx loop diuretic + ACE
inhibitor • class II-III → add β-blocker
• class IV → add digoxin
22.what is PAC and how do we treat? - ANSWER early P wave that looks
differently than other P waves, tx is reassurance
23.Afib - ANSWER acute, stable → anticoagulate + • rate control w/ Ca-
blockers
• then cardioversion
24.MAT - ANSWER ooks like AFib but the P waves are variable, need 3
different P waves for dx
, 25.ETIOLOGY OF MAT - ANSWER Etiology: end-stage COPD (MCC)
26.wpw, what is the characteristic wave and how do we treat - ANSWER
"delta wave" reflects accessory conduction pathway from atria to ventricles,
tx is ablation
27.VTACH TRAETMENT - ANSWER Sustained VTach: lasts >30 sec,
always symptomatic
Nonsustained VTach: lasts <30 sec, usually asx
Torsades de pointes: rapid, polymorphic VTach due to QT prolongation
28.sustained → Tx IV amiodarone • nonsustained → reassurance • torsades →
Tx IV mag sulfate
29.VFIB tx - ANSWER • Tx immediate defib + CPR, then • continue IV
amiodarone
30.sinus brady tx - ANSWER usually insignificant; if sx → Tx • atropine
(blocks vagus nerve)
31.first degree meaning and tx - ANSWER PR interval >0.2 .. needs
reassurance
systolic crescendo-decrescendo murmur following opening snap, "parvus et
tardus"; triad of angina, syncope, dyspnea AND ETIOLOGY - ANSWER
aortic stenosis... Etiology: calcified tricuspid valve (old), calcified bicuspid
aortic valve (young)
Px: usually asx until old age, then 1-3 yrs after development of sx
