PANCE LATEST EXAMS TEST PAPER QUESTIONS
AND ANSWERS SURE A+
✔✔What is the name of the syndrome that involves pericarditis several days after a
myocardial infarction? - ✔✔Dressler syndrome
✔✔Define paradoxical pulse. - ✔✔There is a large difference in pulse pressure between
inhalation an exhalation.
✔✔A patient presents to the ER with chest pain. An
EKG shows diffuse ST elevations in almost all of the
leads. What is the most likely diagnosis? - ✔✔Pericarditis
✔✔Define pulsus alternans. - ✔✔EKG waveform changes from beat to beat.
✔✔What is the definitive treatment for cardiac
tamponade? - ✔✔Pericardiocentesis
✔✔On physical exam you hear a harsh systolic
murmur along the right sternal border. What is the
most likely diagnosis? - ✔✔Aortic stenosis
,✔✔A wide pulse pressures with a blowing diastolic
decrescendo murmur at the right 2nd intercostal
space should make you think of what diagnosis? - ✔✔Aortic regurgitation
✔✔What is the best location to hear problems with the
aortic valve? - ✔✔2nd right intercostal space
✔✔Where is disease of the pulmonary valve best
heard? - ✔✔2nd left intercostal space
✔✔What two antibiotics are used for empiric treatment
of endocarditis? - ✔✔Vancomycin and ceftriaxone together are first line empiric
treatment.
✔✔What two valvular issues do patients with Marfan's
syndrome often have? - ✔✔Aortic regurgitation and mitral valve prolapse (you can tell
them apart by where they are heard).
✔✔What are the two main causes of aortic stenosis? - ✔✔Congenital bicuspid valve
and calcification of the valve secondary to coronary artery disease.
✔✔An elderly patient presents with dyspnea, angina
and syncope on exertion. The EKG is normal. What
is the most likely diagnosis? - ✔✔Aortic stenosis
✔✔On auscultation you hear a harsh blowing
pansystolic murmur at the apex. What is the most
likely diagnosis? - ✔✔Mitral regurgitation
✔✔You suspect mitral regurgitation. What is the most
accurate way to prove your diagnosis? - ✔✔Transesophageal echo
✔✔A patient with mitral valve prolapse will often have
what physical characteristics? - ✔✔Thin female
✔✔What is the best patient position to hear aortic
regurge and aortic stenosis? - ✔✔Sitting up and leaning forward.
✔✔Are most pulmonary valve problems congenital or
acquired? - ✔✔95% are congenital
✔✔What is Tietze syndrome? - ✔✔costochondritis
,✔✔What is the therapeutic range for INR following an
organic valve replacement? - ✔✔2 to 3
✔✔A 60 year old male presents to the ED with severe
dizziness and back pain. His blood pressure is
dropping and you can feel an abdominal pulsatile
mass on physical exam. What is the most likely
diagnosis? - ✔✔Ruptured aortic aneurysm
✔✔A patient complains of severe crushing chest
pain. EKG shows ST segment elevations. All labs
including troponins and CK-MB are negative. What
is the most likely diagnosis? - ✔✔Prinzmetal's angina
✔✔In a patient with aortic stenosis, will the PMI be
medially displaced, normal or laterally displaced? - ✔✔It will be laterally displaced due
to
left ventricular hypertrophy.
✔✔Name two things that would constitute a positive
stress test. - ✔✔A drop in blood pressure, a new
arrhythmia, an increase in angina
symptoms, ST depressions
✔✔Clot busting drugs should be used within 3 hours of
which two cardiac events? - ✔✔STEMI and new left bundle branch
block.
✔✔What is the initial treatment for a myocardial
infarction? - ✔✔MONA - Morphine, oxygen,
nitroglycerin and aspirin
✔✔Where is disease of the mitral valve best heard? - ✔✔At the apex
✔✔List three catastrophic complications of a
myocardial infarction. - ✔✔Papillary muscle rupture, myocardial wall rupture and left
ventricular aneurysm.
✔✔An EKG shows a regular heart rate of 200 bpms.
QRS is narrow. What is the most likely diagnosis? - ✔✔Supraventricular tachycardia
✔✔A patient has just received a cardiac stent. How
long will he be on aspirin and clopidogrel? - ✔✔One year
, ✔✔What is the most common cause of sudden death? - ✔✔Ventricular fibrillation
✔✔Acute endocarditis is most commonly caused by
what organism? - ✔✔Staph Aureus
✔✔List three congential heart diseases. - ✔✔Atrial septal defect (ASD), ventricular
septal defect (VSD), coarctation of the aorta, patent ductus arteriosus (PDA), tetralogy
of Fallot.
✔✔A chest x-ray shows a "3" sign with notching of the
ribs. What is the most likely diagnosis? - ✔✔Coarctation of the aorta.
✔✔What is the appropriate treatment for a patent
ductus arteriosus. - ✔✔Indomethacin
✔✔A Blalock procedure is used to correct what
congenital heart condition? - ✔✔Tetralogy of Fallot
✔✔You hear a loud, harsh pulmonary murmur along
the left sternal border. What is the most likely
diagnosis? - ✔✔Ventricular septal defect
✔✔Where on your patient should you listen for the
murmur associated with an atrial septal defect? - ✔✔At the left second or third
interspace.
✔✔List two risk factors for an aortic dissection? - ✔✔Hypertension, Marfan's syndrome,
bicuspid aortic valve, pregnancy.
✔✔A patient presents to the ED with tearing chest
pain radiating to his back. What is the most likely
diagnosis? - ✔✔Aortic dissection
✔✔What imaging needs to be done before taking a
patient to the OR with an aortic aneurysm - ✔✔CT (echo may be used as initial study,
but CT is need for surgery).
✔✔The accessory pathway known as the James bundle
should make you think of what syndrome? - ✔✔Lown-Ganong-Levine syndrome
✔✔Who is more likely to have an aortic aneurysm
males or females? - ✔✔Males are eight times as likely to have an aortic aneurysm.
AND ANSWERS SURE A+
✔✔What is the name of the syndrome that involves pericarditis several days after a
myocardial infarction? - ✔✔Dressler syndrome
✔✔Define paradoxical pulse. - ✔✔There is a large difference in pulse pressure between
inhalation an exhalation.
✔✔A patient presents to the ER with chest pain. An
EKG shows diffuse ST elevations in almost all of the
leads. What is the most likely diagnosis? - ✔✔Pericarditis
✔✔Define pulsus alternans. - ✔✔EKG waveform changes from beat to beat.
✔✔What is the definitive treatment for cardiac
tamponade? - ✔✔Pericardiocentesis
✔✔On physical exam you hear a harsh systolic
murmur along the right sternal border. What is the
most likely diagnosis? - ✔✔Aortic stenosis
,✔✔A wide pulse pressures with a blowing diastolic
decrescendo murmur at the right 2nd intercostal
space should make you think of what diagnosis? - ✔✔Aortic regurgitation
✔✔What is the best location to hear problems with the
aortic valve? - ✔✔2nd right intercostal space
✔✔Where is disease of the pulmonary valve best
heard? - ✔✔2nd left intercostal space
✔✔What two antibiotics are used for empiric treatment
of endocarditis? - ✔✔Vancomycin and ceftriaxone together are first line empiric
treatment.
✔✔What two valvular issues do patients with Marfan's
syndrome often have? - ✔✔Aortic regurgitation and mitral valve prolapse (you can tell
them apart by where they are heard).
✔✔What are the two main causes of aortic stenosis? - ✔✔Congenital bicuspid valve
and calcification of the valve secondary to coronary artery disease.
✔✔An elderly patient presents with dyspnea, angina
and syncope on exertion. The EKG is normal. What
is the most likely diagnosis? - ✔✔Aortic stenosis
✔✔On auscultation you hear a harsh blowing
pansystolic murmur at the apex. What is the most
likely diagnosis? - ✔✔Mitral regurgitation
✔✔You suspect mitral regurgitation. What is the most
accurate way to prove your diagnosis? - ✔✔Transesophageal echo
✔✔A patient with mitral valve prolapse will often have
what physical characteristics? - ✔✔Thin female
✔✔What is the best patient position to hear aortic
regurge and aortic stenosis? - ✔✔Sitting up and leaning forward.
✔✔Are most pulmonary valve problems congenital or
acquired? - ✔✔95% are congenital
✔✔What is Tietze syndrome? - ✔✔costochondritis
,✔✔What is the therapeutic range for INR following an
organic valve replacement? - ✔✔2 to 3
✔✔A 60 year old male presents to the ED with severe
dizziness and back pain. His blood pressure is
dropping and you can feel an abdominal pulsatile
mass on physical exam. What is the most likely
diagnosis? - ✔✔Ruptured aortic aneurysm
✔✔A patient complains of severe crushing chest
pain. EKG shows ST segment elevations. All labs
including troponins and CK-MB are negative. What
is the most likely diagnosis? - ✔✔Prinzmetal's angina
✔✔In a patient with aortic stenosis, will the PMI be
medially displaced, normal or laterally displaced? - ✔✔It will be laterally displaced due
to
left ventricular hypertrophy.
✔✔Name two things that would constitute a positive
stress test. - ✔✔A drop in blood pressure, a new
arrhythmia, an increase in angina
symptoms, ST depressions
✔✔Clot busting drugs should be used within 3 hours of
which two cardiac events? - ✔✔STEMI and new left bundle branch
block.
✔✔What is the initial treatment for a myocardial
infarction? - ✔✔MONA - Morphine, oxygen,
nitroglycerin and aspirin
✔✔Where is disease of the mitral valve best heard? - ✔✔At the apex
✔✔List three catastrophic complications of a
myocardial infarction. - ✔✔Papillary muscle rupture, myocardial wall rupture and left
ventricular aneurysm.
✔✔An EKG shows a regular heart rate of 200 bpms.
QRS is narrow. What is the most likely diagnosis? - ✔✔Supraventricular tachycardia
✔✔A patient has just received a cardiac stent. How
long will he be on aspirin and clopidogrel? - ✔✔One year
, ✔✔What is the most common cause of sudden death? - ✔✔Ventricular fibrillation
✔✔Acute endocarditis is most commonly caused by
what organism? - ✔✔Staph Aureus
✔✔List three congential heart diseases. - ✔✔Atrial septal defect (ASD), ventricular
septal defect (VSD), coarctation of the aorta, patent ductus arteriosus (PDA), tetralogy
of Fallot.
✔✔A chest x-ray shows a "3" sign with notching of the
ribs. What is the most likely diagnosis? - ✔✔Coarctation of the aorta.
✔✔What is the appropriate treatment for a patent
ductus arteriosus. - ✔✔Indomethacin
✔✔A Blalock procedure is used to correct what
congenital heart condition? - ✔✔Tetralogy of Fallot
✔✔You hear a loud, harsh pulmonary murmur along
the left sternal border. What is the most likely
diagnosis? - ✔✔Ventricular septal defect
✔✔Where on your patient should you listen for the
murmur associated with an atrial septal defect? - ✔✔At the left second or third
interspace.
✔✔List two risk factors for an aortic dissection? - ✔✔Hypertension, Marfan's syndrome,
bicuspid aortic valve, pregnancy.
✔✔A patient presents to the ED with tearing chest
pain radiating to his back. What is the most likely
diagnosis? - ✔✔Aortic dissection
✔✔What imaging needs to be done before taking a
patient to the OR with an aortic aneurysm - ✔✔CT (echo may be used as initial study,
but CT is need for surgery).
✔✔The accessory pathway known as the James bundle
should make you think of what syndrome? - ✔✔Lown-Ganong-Levine syndrome
✔✔Who is more likely to have an aortic aneurysm
males or females? - ✔✔Males are eight times as likely to have an aortic aneurysm.
