PACKRAT 5 EXAM SCRIPT 2026
COMPLETE QUESTIONS ACCURATE
ANSWERS
◉ Hypertrophic Cardiomyopathy (HOCM). Answer: Sudden death in
athlete
◉ Atrial Septal Defect. Answer: Fixed, widely splitting of S2
*ballerina split in a tutu
acyanotic
◉ Coarctation of the Aorta. Answer: X-ray, Rib notching, 3 sign
Acyanotic
◉ Patent Ductus Arteriosus (PDA). Answer: Machine like murmur
◉ Tetralogy of Fallot. Answer: Cyanosis with crying of feeding
◉ Ventricular Septal Defect (VSD). Answer: Holosytolic murmur at the
left lower sternal border
,HolLOW
◉ Cardiogenic Shock. Answer: Hypotensive
Cool
Clammy skin
MI
◉ Atrial Fibrillation. Answer: Irregularly irregular rhythm
◉ Atrial Flutter. Answer: Sawtooth pattern
◉ AV Block. Answer: Long PR interval
◉ 2nd degree AV block: Mobitz 1
Wenckebach. Answer: Progressively lengthening PR interval
*Longer, longer, longer, DROP...
◉ 2nd degree AV block: Mobitz 2. Answer: Dropped QRS without
lengthening
*If some p's don't get through then you have...
,◉ Third Degree Block. Answer: Independent P wave and QRS complex
*If P's and Q's don't agree then you have a....
◉ Paroxysmal Supraventricular Tachycardia. Answer: Narrow complex
tachycardia
◉ Stable Angina. Answer: Chest pain relieved with rest
◉ Prinzmetal Angina. Answer: Diffuse ST segment elevations, coronary
artery spasm
◉ ACS (acute coronary syndrome). Answer: Unstable angina, STEMI,
NSTEMI, Morphine, Nitrates, loading dose of P2y12 (antiplatelets)
◉ Cocaine induced MI. Answer: Don't give beta blockers, give
benzodiazepines
◉ Aortic Aneurysm. Answer: Tobacco
Ultrasound > 65
◉ Aortic Dissection. Answer: Tearing chest pain & Wide mediastinum
- Marfan Syndrome
, - Ehlers Danlos Syndrome
◉ Giant cell arteritis. Answer: Jaw claudication, visual disturbance, > 50
years old, Elevated ESR
◉ Peripheral Artery Disease (PAD). Answer: - Leg pain relieved with
rest
- Cilostazol (antiplatelet) helps improve symptoms. Suppresses platelet
aggregation and is a direct vasodilator.
◉ Superficial Thrombophlebitis. Answer: Palpable cord
◉ DVT. Answer: - Virchow's Triad (endothelial injury, stasis of blood
flow, and hypercoagulability)
- Unilateral LE swelling, pain & erythema
- Positive Homan's sign
+Homan's sign is calf pain with passive dorsiflexion of the foot
◉ Murmurs. Answer: Squatting/leg raise/handgrip INCREASES the
sound of all murmurs except MVP and Hypertrophic cardiomyopathy
◉ Aortic stenosis. Answer: Systolic murmur heard at the 2nd right
intercostal space, radiates to the neck
COMPLETE QUESTIONS ACCURATE
ANSWERS
◉ Hypertrophic Cardiomyopathy (HOCM). Answer: Sudden death in
athlete
◉ Atrial Septal Defect. Answer: Fixed, widely splitting of S2
*ballerina split in a tutu
acyanotic
◉ Coarctation of the Aorta. Answer: X-ray, Rib notching, 3 sign
Acyanotic
◉ Patent Ductus Arteriosus (PDA). Answer: Machine like murmur
◉ Tetralogy of Fallot. Answer: Cyanosis with crying of feeding
◉ Ventricular Septal Defect (VSD). Answer: Holosytolic murmur at the
left lower sternal border
,HolLOW
◉ Cardiogenic Shock. Answer: Hypotensive
Cool
Clammy skin
MI
◉ Atrial Fibrillation. Answer: Irregularly irregular rhythm
◉ Atrial Flutter. Answer: Sawtooth pattern
◉ AV Block. Answer: Long PR interval
◉ 2nd degree AV block: Mobitz 1
Wenckebach. Answer: Progressively lengthening PR interval
*Longer, longer, longer, DROP...
◉ 2nd degree AV block: Mobitz 2. Answer: Dropped QRS without
lengthening
*If some p's don't get through then you have...
,◉ Third Degree Block. Answer: Independent P wave and QRS complex
*If P's and Q's don't agree then you have a....
◉ Paroxysmal Supraventricular Tachycardia. Answer: Narrow complex
tachycardia
◉ Stable Angina. Answer: Chest pain relieved with rest
◉ Prinzmetal Angina. Answer: Diffuse ST segment elevations, coronary
artery spasm
◉ ACS (acute coronary syndrome). Answer: Unstable angina, STEMI,
NSTEMI, Morphine, Nitrates, loading dose of P2y12 (antiplatelets)
◉ Cocaine induced MI. Answer: Don't give beta blockers, give
benzodiazepines
◉ Aortic Aneurysm. Answer: Tobacco
Ultrasound > 65
◉ Aortic Dissection. Answer: Tearing chest pain & Wide mediastinum
- Marfan Syndrome
, - Ehlers Danlos Syndrome
◉ Giant cell arteritis. Answer: Jaw claudication, visual disturbance, > 50
years old, Elevated ESR
◉ Peripheral Artery Disease (PAD). Answer: - Leg pain relieved with
rest
- Cilostazol (antiplatelet) helps improve symptoms. Suppresses platelet
aggregation and is a direct vasodilator.
◉ Superficial Thrombophlebitis. Answer: Palpable cord
◉ DVT. Answer: - Virchow's Triad (endothelial injury, stasis of blood
flow, and hypercoagulability)
- Unilateral LE swelling, pain & erythema
- Positive Homan's sign
+Homan's sign is calf pain with passive dorsiflexion of the foot
◉ Murmurs. Answer: Squatting/leg raise/handgrip INCREASES the
sound of all murmurs except MVP and Hypertrophic cardiomyopathy
◉ Aortic stenosis. Answer: Systolic murmur heard at the 2nd right
intercostal space, radiates to the neck
