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Cardiology PACKRAT Questions 100% Correct Answers Verified Latest 2024 Version

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Cardiology PACKRAT Questions | 100% Correct Answers | Verified | Latest 2024 Version 1. History & Physical/Cardiology Which of the following conditions would cause a positive Kussmaul's sign on physical examination? Answers A. Left ventricular failure B. Pulmonary edema C. Coarctation of the aorta D. Constrictive pericarditis - (u) A. Left ventricular failure results in the back-up of blood into the left atrium and then the pulmonary system so it would not be associated with Kussmaul's sign. (u) B. Pulmonary edema primarily results in increased pulmonary pressures rather than having effects on the venous inflow into the heart. (u) C. Coarctation of the aorta primarily affects outflow from the heart due to the stenosis resulting in delayed and decreased femoral pulses; it has no effect on causing Kussmaul's sign. (c) D. Kussmaul's sign is an increase rather than the normal decrease in the CVP during inspiration. It is most often caused by severe right-sided heart failure; it is a frequent finding in patients with constrictive pericarditis or right ventricular infarction. 2. History & Physical/Cardiology Anginal chest pain is most commonly described as which of the following? Answers A. Pain changing with position or respirationB. A sensation of discomfort C. Tearing pain radiating to the back D. Pain lasting for several hours - (u) A. Pain changing with position or respiration is suggestive of pericarditis. (c) B. Myocardial ischemia is often experienced as a sensation of discomfort lasting 5-15 minutes, described as dull, aching or pressure. (u) C. Tearing pain with radiation to the back represents aortic dissection. (u) D. Chest pain lasting for several hours is more suggestive for myocardial infarction. 3. History & Physical/Cardiology Eliciting a history from a patient presenting with dyspnea due to early heart failure the severity of the dyspnea should be quantified by Answers A. amount of activity that precipitates it. B. how many pillows they sleep on at night. C. how long it takes the dyspnea to resolve. D. any associated comorbidities. - (c) A. The amount of activity that precipitates dyspnea should be quantified in the history. (u) B. Orthopnea or paroxysmal nocturnal dyspnea can be quantified by how many pillows a patient needs to sleep on to be comfortable. (u) C. How long dyspnea takes to resolve or associated comorbidities has no bearing on quantifying the severity of dyspnea. (u) D. See answer C above.4. History & Physical/Cardiology A 25 year-old female presents with a three-day history of chest pain aggravated by coughing and relieved by sitting. She is febrile and a CBC with differential reveals leukocytosis. Which of the following physical exam signs is characteristic of her problem? Answers A. Pulsus paradoxus B. Localized crackles C. Pericardial friction rub D. Wheezing - (u) A. Pulsus paradoxus is a classic finding for cardiac tamponade. (u) B. Localized crackles are associated with pneumonia and consolidation, not pericarditis. (c) C. Pericardial friction rub is characteristic of an inflammatory pericarditis. (u) D. Wheezing is characteristic for pulmonary disorders, such as asthma. 5. History & Physical/Cardiology A 65 year-old white female presents with dilated tortuous veins on the medial aspect of her lower extremities. Which of the following would be the most common initial complaint? Answers A. Pain in the calf with ambulation B. Dull aching heaviness brought on by periods of standing C. Brownish pigmentation above the ankle D. Edema in the lower extremities - (u) A. Patients with deep venous thrombosis (DVT) may present with complaints of pain in the calf with ambulation. Secondary varicosities may result from DVT's.(c) B. Dull aching heaviness or a feeling of fatigue brought on by periods of standing is the most common complaint of patients presenting initially with varicosities. (u) C. Stasis Dermatitis and edema are most suggestive of chronic venous insufficiency. (u) D. See C for explanation. 6. History & Physical/Cardiology A 22 year-old male received a stab wound in the chest an hour ago. The diagnosis of pericardial tamponade is strongly supported by the presence of Answers A. pulmonary edema. B. wide pulse pressure. C. distended neck veins. D. an early diastolic murmur. - (u) A. Pulmonary edema may result with low output states as seen with myocardial contusions, but it is not strongly suggestive of tamponade. (u) B. Wide pulse pressure is seen in conditions of high stroke volume such as aortic insufficiency or hyperthyroidism. Narrow pulse pressure is seen with cardiac tamponade. (c) C. Cardiac compression will manifest with distended neck veins and cold clammy skin. (u) D. The onset of diastolic murmur is suggestive of valvular disease, not tamponade. 7. Diagnostic Studies/Cardiology Cardiac nuclear scanning is done to detect Answers A. electrical conduction abnormalities.B. valvular abnormalities. C. ventricular wall dysfunction. D. coronary artery patency/occlusion. - (u) A. An EKG is used to determine electrical conduction abnormalities. (u) B. An echocardiogram is a non-invasive test used to determine valvular abnormalities and wall motion. (c) C. Visualization of the cardiac wall can be done with cardiac nuclear scanning. This is done to determine hypokinetic areas from akinetic areas. (u) D. Patency or occlusion is assessed with cardiac catheterization (invasive). 8. Diagnostic Studies/Cardiology A 72 year-old male with a new diagnosis of congestive heart failure and atrial fibrillation, develops episodes of hemodynamic compromise secondary to increased ventricular rate. A decision to perform elective cardioversion is made and the patient is anticoagulated with heparin. Which test should be ordered to assess for atrial or ventricular mural thrombi? Answers A. Electrocardiogram B. Chest x-ray C. Transesophageal Echocardiogram D. C-reactive protein - (u) A. Electrical conduction will not assess for mural thrombi. (u) B. A chest x-ray will not visualize the left atria and ventricles to assess for mural thrombi. (c) C. Transesophageal echocardiography allows for determination of mural thrombi that may have resulted from atrial fibrillation. (u) D. C-reactive protein is not going to give you any information regarding thrombi. This test is used to identify the presence of inflammation.

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Cardiology PACKRAT Questions | 100% Correct
Answers | Verified | Latest 2024 Version
1. History & Physical/Cardiology
Which of the following conditions would cause a positive
Kussmaul's sign on physical examination?
Answers
A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta

D. Constrictive pericarditis - ✔✔(u) A. Left ventricular failure results in the back-up of blood
into the left atrium and then the pulmonary system so it would
not be associated with Kussmaul's sign.
(u) B. Pulmonary edema primarily results in increased
pulmonary pressures rather than having effects on the venous
inflow into the heart.
(u) C. Coarctation of the aorta primarily affects outflow from
the heart due to the stenosis resulting in delayed and decreased
femoral pulses; it has no effect on causing Kussmaul's sign.
(c) D. Kussmaul's sign is an increase rather than the normal
decrease in the CVP during inspiration. It is most often caused
by severe right-sided heart failure; it is a frequent finding in
patients with constrictive pericarditis or right ventricular
infarction.


2. History & Physical/Cardiology
Anginal chest pain is most commonly described as which of the
following?
Answers
A. Pain changing with position or respiration

,B. A sensation of discomfort
C. Tearing pain radiating to the back

D. Pain lasting for several hours - ✔✔(u) A. Pain changing with position or respiration is suggestive
of pericarditis.
(c) B. Myocardial ischemia is often experienced as a sensation
of discomfort lasting 5-15 minutes, described as dull, aching
or pressure.
(u) C. Tearing pain with radiation to the back represents aortic
dissection.
(u) D. Chest pain lasting for several hours is more suggestive
for myocardial infarction.


3. History & Physical/Cardiology
Eliciting a history from a patient presenting with dyspnea due
to early heart failure the severity of the dyspnea should be
quantified by
Answers
A. amount of activity that precipitates it.
B. how many pillows they sleep on at night.
C. how long it takes the dyspnea to resolve.

D. any associated comorbidities. - ✔✔(c) A. The amount of activity that precipitates dyspnea should
be quantified in the history.
(u) B. Orthopnea or paroxysmal nocturnal dyspnea can be
quantified by how many pillows a patient needs to sleep on to
be comfortable.
(u) C. How long dyspnea takes to resolve or associated
comorbidities has no bearing on quantifying the severity of
dyspnea.
(u) D. See answer C above.

,4. History & Physical/Cardiology
A 25 year-old female presents with a three-day history of chest
pain aggravated by coughing and relieved by sitting. She is
febrile and a CBC with differential reveals leukocytosis. Which
of the following physical exam signs is characteristic of her
problem?
Answers
A. Pulsus paradoxus
B. Localized crackles
C. Pericardial friction rub

D. Wheezing - ✔✔(u) A. Pulsus paradoxus is a classic finding for cardiac
tamponade.
(u) B. Localized crackles are associated with pneumonia and
consolidation, not pericarditis.
(c) C. Pericardial friction rub is characteristic of an
inflammatory pericarditis.
(u) D. Wheezing is characteristic for pulmonary disorders,
such as asthma.


5. History & Physical/Cardiology
A 65 year-old white female presents with dilated tortuous veins
on the medial aspect of her lower extremities. Which of the
following would be the most common initial complaint?
Answers
A. Pain in the calf with ambulation
B. Dull aching heaviness brought on by periods of standing
C. Brownish pigmentation above the ankle

D. Edema in the lower extremities - ✔✔(u) A. Patients with deep venous thrombosis (DVT) may
present with complaints of pain in the calf with ambulation.
Secondary varicosities may result from DVT's.

, (c) B. Dull aching heaviness or a feeling of fatigue brought on
by periods of standing is the most common complaint of
patients presenting initially with varicosities.
(u) C. Stasis Dermatitis and edema are most suggestive of
chronic venous insufficiency.
(u) D. See C for explanation.


6. History & Physical/Cardiology
A 22 year-old male received a stab wound in the chest an hour
ago. The diagnosis of pericardial tamponade is strongly
supported by the presence of
Answers
A. pulmonary edema.
B. wide pulse pressure.
C. distended neck veins.

D. an early diastolic murmur. - ✔✔(u) A. Pulmonary edema may result with low output states as
seen with myocardial contusions, but it is not strongly
suggestive of tamponade.
(u) B. Wide pulse pressure is seen in conditions of high stroke
volume such as aortic insufficiency or hyperthyroidism.
Narrow pulse pressure is seen with cardiac tamponade.
(c) C. Cardiac compression will manifest with distended neck
veins and cold clammy skin.
(u) D. The onset of diastolic murmur is suggestive of valvular
disease, not tamponade.


7. Diagnostic Studies/Cardiology
Cardiac nuclear scanning is done to detect
Answers
A. electrical conduction abnormalities.

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