MKSAP 17 Cardiovascular Medicine
UPDATED ACTUAL Exam Questions and
CORRECT Answers
What are the diagnostic criteria for left anterior fascicular block? (3) - CORRECT
ANSWER - 1. QRS: 80-120ms
2. Left axis deviation
3. Poor R wave progression
LAF more common than LPF due to fibers being thinner
What are the diagnostic criteria for left posterior fascicular block? (2) - CORRECT
ANSWER - 1. QRS: 80-120ms
2. Right axis deviation
What is a bivasicular block? What does this correlate to in the heart? - CORRECT
ANSWER - left anterior or posterior fascicular block PLUS a RBBB
correlates- conduction through only 1 fascicle in the ventricles (may get symptoms of syncope)
What is a trifascicular block? What does this signify? - CORRECT ANSWER -
bifascicular block plus a 1st degree block
signifies poor conduction through the remaining conducting fascicle in the ventricle
What is rate dependent aberrancy? - CORRECT ANSWER -
What is typical vs atypical atrial flutter? - CORRECT ANSWER -
,What is the prevalence of American adults have some form of CVD? - CORRECT
ANSWER - more than 1 in 3
10% in those aged 20-39
70% in those aged 60-79
2/3 men will develop CVD in their lifetime and 1/3 of women
What is the mortality in heart failure in 5 years? - CORRECT ANSWER - nearly 50%
What are some risk factor/epidemiology characteristics of cardiovascular disease in women? -
CORRECT ANSWER - women have a higher mortality rate after MI: 26% in women vs
19% in men older than 45 years
incidence of and mortality from stroke is highest among women, with the highest among black
women
women have a higher prevalence of risk factors for CVD, including elevated cholesterol levels,
diabetes mellitus, HTN, and inactivity (only tobacco use if higher among men)
women have "atypical" symptoms more frequently than men, including nausea, SOB, and
unusual fatigue (more than 2/3 of women who die suddenly from CAD either did not recognize
the symptoms or had no previous symptoms)
women undergo fewer revascularization procedures than men, with 25% of CABG surgeries and
nearly 33% of PCI's occurring in women
What ethnic groups have the highest rate of heart disease? - CORRECT ANSWER -
American Indians and Alaska Natives (12.7%)
,followed by whites (11.1%), blacks (10.7%), Hispanics or Latinos (8.6%) and Asians (7.4%)
What % of Americans older than 40 years have peripheral arterial disease? - CORRECT
ANSWER - 8.5%; with highest prevalence among older persons, non-Hispanic blacks, and
women
What population is most affected by heart failure? - CORRECT ANSWER - African
Americans at a rate of 4.6/1000 person-years, followed by Hispanic, white, and Chinese
Americans
What ethnic group has the highest rate of HTN? - CORRECT ANSWER - Blacks (33.4%;
higher in black women); followed by American Indians or Alaska Natives (25.8%), whites
(23.3%), Hispanics or Latinos (22.2%) and Asians (18.7%)
Blacks have the highest prevalence of two or more cardiovascular risk factors (48.7%)
the prevalence of risk factors is increased with decreasing levels of education and income
What ethnic groups have the highest level of obesity and lack of physical activity? - CORRECT
ANSWER - Hispanic/Latino adults and non Hispanic blacks
What is considered a family history of premature CAD which significantly increases the risk of
CVD? - CORRECT ANSWER - male <45 years
female <55 years
having a parents with premature CAD doubles risk of MI in men and increases risk in women by
70%
CAD in a sibling increases risk by 50%
, What % of the risk for MI has been attributed to modifiable risk factors? - CORRECT
ANSWER - 90%
What are the most significant modifiable risk factors for CAD? (3) - CORRECT
ANSWER - 1. Elevated cholesterol levels
2. Smoking
3. Psycho-social stressors
What is the attributable risk for MI for each of the 9 risk factors? - CORRECT ANSWER -
1. Elevated cholesterol levels (highest)
2. Smoking
3. Psycho-social stressors
4. Diabetes
5. HTN
6. Abdominal Obesity
7. No alcohol intake
8. Inadequate Exercise
9. Irregular consumption of fruits and vegetables
What % of adults older than 20 years have total cholesterol levels >240? - CORRECT
ANSWER - 14%
approximately 6% of adults are estimated to have undiagnosed hypercholesterolemia
What specific cholesterol levels cause increased risk for CAD? - CORRECT ANSWER -
elevated LDL
low HDL
UPDATED ACTUAL Exam Questions and
CORRECT Answers
What are the diagnostic criteria for left anterior fascicular block? (3) - CORRECT
ANSWER - 1. QRS: 80-120ms
2. Left axis deviation
3. Poor R wave progression
LAF more common than LPF due to fibers being thinner
What are the diagnostic criteria for left posterior fascicular block? (2) - CORRECT
ANSWER - 1. QRS: 80-120ms
2. Right axis deviation
What is a bivasicular block? What does this correlate to in the heart? - CORRECT
ANSWER - left anterior or posterior fascicular block PLUS a RBBB
correlates- conduction through only 1 fascicle in the ventricles (may get symptoms of syncope)
What is a trifascicular block? What does this signify? - CORRECT ANSWER -
bifascicular block plus a 1st degree block
signifies poor conduction through the remaining conducting fascicle in the ventricle
What is rate dependent aberrancy? - CORRECT ANSWER -
What is typical vs atypical atrial flutter? - CORRECT ANSWER -
,What is the prevalence of American adults have some form of CVD? - CORRECT
ANSWER - more than 1 in 3
10% in those aged 20-39
70% in those aged 60-79
2/3 men will develop CVD in their lifetime and 1/3 of women
What is the mortality in heart failure in 5 years? - CORRECT ANSWER - nearly 50%
What are some risk factor/epidemiology characteristics of cardiovascular disease in women? -
CORRECT ANSWER - women have a higher mortality rate after MI: 26% in women vs
19% in men older than 45 years
incidence of and mortality from stroke is highest among women, with the highest among black
women
women have a higher prevalence of risk factors for CVD, including elevated cholesterol levels,
diabetes mellitus, HTN, and inactivity (only tobacco use if higher among men)
women have "atypical" symptoms more frequently than men, including nausea, SOB, and
unusual fatigue (more than 2/3 of women who die suddenly from CAD either did not recognize
the symptoms or had no previous symptoms)
women undergo fewer revascularization procedures than men, with 25% of CABG surgeries and
nearly 33% of PCI's occurring in women
What ethnic groups have the highest rate of heart disease? - CORRECT ANSWER -
American Indians and Alaska Natives (12.7%)
,followed by whites (11.1%), blacks (10.7%), Hispanics or Latinos (8.6%) and Asians (7.4%)
What % of Americans older than 40 years have peripheral arterial disease? - CORRECT
ANSWER - 8.5%; with highest prevalence among older persons, non-Hispanic blacks, and
women
What population is most affected by heart failure? - CORRECT ANSWER - African
Americans at a rate of 4.6/1000 person-years, followed by Hispanic, white, and Chinese
Americans
What ethnic group has the highest rate of HTN? - CORRECT ANSWER - Blacks (33.4%;
higher in black women); followed by American Indians or Alaska Natives (25.8%), whites
(23.3%), Hispanics or Latinos (22.2%) and Asians (18.7%)
Blacks have the highest prevalence of two or more cardiovascular risk factors (48.7%)
the prevalence of risk factors is increased with decreasing levels of education and income
What ethnic groups have the highest level of obesity and lack of physical activity? - CORRECT
ANSWER - Hispanic/Latino adults and non Hispanic blacks
What is considered a family history of premature CAD which significantly increases the risk of
CVD? - CORRECT ANSWER - male <45 years
female <55 years
having a parents with premature CAD doubles risk of MI in men and increases risk in women by
70%
CAD in a sibling increases risk by 50%
, What % of the risk for MI has been attributed to modifiable risk factors? - CORRECT
ANSWER - 90%
What are the most significant modifiable risk factors for CAD? (3) - CORRECT
ANSWER - 1. Elevated cholesterol levels
2. Smoking
3. Psycho-social stressors
What is the attributable risk for MI for each of the 9 risk factors? - CORRECT ANSWER -
1. Elevated cholesterol levels (highest)
2. Smoking
3. Psycho-social stressors
4. Diabetes
5. HTN
6. Abdominal Obesity
7. No alcohol intake
8. Inadequate Exercise
9. Irregular consumption of fruits and vegetables
What % of adults older than 20 years have total cholesterol levels >240? - CORRECT
ANSWER - 14%
approximately 6% of adults are estimated to have undiagnosed hypercholesterolemia
What specific cholesterol levels cause increased risk for CAD? - CORRECT ANSWER -
elevated LDL
low HDL
