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Cardiology Clinical Medicine
Assignment Questions with
Answers 2025
*Answer: A
• According to Smartypance and Professor Miliron's pathophysiology lecture, Mitral stenosis is
often associated with Rheumatic fever. Further, according to smartypance, it is a non-radiating
(typically) diastolic murmur that is heard best at the apex of the heart with the bell of the
stethoscope (low pitch) and it is characterized by an opening snap just after S2. Mitral stenosis is
commonly associated with dyspnea upon exertion (as well as orthopnea, paroxysmal nocturnal
dyspnea, etc.)*
• Answer choice: B o Mitral Regurgitation is incorrect because it is asystolicmurmur (Professor
Miliron's lecture) typically with a high pitch blowing holosystolic murmur at apex with split S2 that
radiates to the axilla (Smartypance).
• Answer choice: C o Ventricular Septal Defect is another systolic murmur best heard over Erb's
point. According to smartypance the murmur is loud, holosystolic along the left sternal bo -
A 20-year-old male presents to your primary care office for a work required physical.
Reviewing past medical history, you learn he had rheumatic fever as a teenager. His only complaint
today during the physical is occasional exertional dyspnea. During the auscultation of his heart you
notice a non-radiating, diastolic, rumbling murmur with an opening snap after S2, heard best with the
bell of your stethoscope at the apex of his heart. Based on this information what do you think is
causing the murmur?
A.) Mitral Stenosis
B.) Mitral Regurgitation
C.) Ventricular Septal Defect
D.) Pulmonary stenosis
E.) Not enough information
A) [P-waves are usually hard to discern due to the rapid rate of >100bpm]
B) [supraventricular, meaning the issue is occurring above the ventricles and reflects rapid activation
of the ventricles which would show a narrow QRS complex]
C) [while there is a narrow QRS complex in psvts, the rhythm is usually regular. This description
would be more consistent with A-Fib]
D) [this would be more indicative of a PVC, where psvts originate above the ventricles]
E) [this would be more indicative of a 2nd degree heart block. Psvts do not show an issue with
blockage] -
A 55 y/o woman comes to the ER with complaints of sudden lightheadedness, sweating, and
heart palpitations. An EKG is performed and shows evidence of paroxysmal supraventricular
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tachycardia (PSVT). Which one of the following choices is a common key identifying feature seen on
EKG to know this is a PSVT?
A. P-waves are distinct and can be easily seen marching out on the EKG
B. The QRS is narrow, meaning the arrhythmia originates within or above the Bundle of His
C. The QRS complex would be narrow with an irregularly irregular rhythm
D. A wife QRS complex occurring earlier than expected with an inverted T-wave following
E. A sudden drop of QRS complex due to the ventricles not conducting all of the atrial impulses
The correct answer is D. Aortic stenosis is most clearly heard at the second intercostal space at the
right sternal border. This would be heart during systole because during this phase of the cardiac cycle
blood is being sent through the aortic and pulmonic valves, if the aortic valve is stenosed then the
restricted blood flow will create an aortic stenosis murmur. -
A 47y/o M arrives to your office for evaluation of new onset dizziness. Patient states that he
walks two miles every morning but over the last week he has noticed a feeling of dizziness when he
completes the last portion of his walk which is a "pretty steep incline." Patient states the dizziness
resolves once he stops walking but he wants to make sure it is nothing serious. You suspect that the
patient may be experiencing aortic stenosis, if your suspicions are correct where on the chest would
you hear this murmur and what phase of blood pressure would it occur in?
A. 2nd intercostal space LSB; diastole
B. 4th intercostal space RSB; diastole
C. 3rd intercostal space RSB; systole D. 2nd intercostal space RSB; systole
a. Bradycardia is LESS than 60 bpm, ST elevation MUST be "elevation at the J-point in 2
anatomically contiguous leads ≥1mm in all leads except V2-V3," this axis is normal
b. This is NSR, but LVH is diagnosed popularly with: V1 S-wave PLUS V5-V6 R-wave ≥35mm, or R +
S in any V lead >45mm, this axis is normal.
*c. NSR is 60 - 100bpm, absent criteria for LVH/RVH, with axis between 0º - 90º*
d. Bradycardia is LESS than 60 bpm, RVH is popularly diagnosed with: V1-V2 "tall R-waves"; V5-
V6 "deep S-waves"; V1 R-wave >7mm; showing an R:S ratio >1 in V1 and V2 suggests RVH. RAD is
when the axis is between 90º and 180º.
e. Torsades de pointes is a polymorphic VT that is >100bpm and often results from QT-
prolongation just before tdp and then death! -
You just began your 15th hour of your ER rotation on the first day. A 19 y/o male comes in
who just ate some random mushrooms off the sidewalk and is now scared his stupidity might kill him.
You immediately obtain this EKG. What do you see?
A. Bradycardia, mild ST elevation, normal axis
b. NSR (normal sinus rhythm), LVH, normal axis
c. NSR, normal LV, normal axis
d. Bradycardia, RVH, RAD
e. Torsades de Pointes
Answer: B
Why all the others are wrong
Inferior wall
a. ECG: Q waves & ST elevation in leads II, III, and AVF
b. Coronary artery: RCA, left circumflex
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Lateral wall
a. ECG: ST elevation in the lateral leads (I, avl, V5-6)
b. Coronary Artery: Left circumflex
Posterior wall
a. ECG: ST depression in V1 to V3
b. Coronary artery: RCA, left circumflex -
Patient presents to the emergency room with crushing chest pain. Patient has Q wave
abnormalities and ST elevation in leads I, avl, and V2 through V6. What coronary artery is the patient
having an MI in?
a. RCX
b. LAD
c. LCX
d. RCA
Answer: C
Information including picture was taken from Clinical Medicine's Arrhythmia powerpoint. The
question only asks about the rate of the EKG strip which can easily be determined by counting the big
boxes between neighboring QRS complexes and divide this into 300 (taken from Clin Med EKG
powerpoint) -
23 year old Cristal is at your office getting an annual check-up. She does not state any
changes in health and states that she feels "just fine". What observation could be made on rate when
interpreting the EKG strip below:
A. Sinus Rhythm
B. Non-specific Cardiomyopathy
C. Sinus Bradycardia
D. Cannot be determined with the strip alone
Answer: C
The normal conduction of the heart starts at the SA node which then goes to the AV node and pauses,
and then down the bundle of His, and lastly to the right and left Purkinje fibers. Any conduction
pathway besides this would be out of the 'norm'. -
A 25 year old comes into the ER with complaints of chest pain. After a quick EKG to look at
the heart everything appears to be normal. What is the normal electrical conduction pathway through
the heart?
A. SA node, AV node, Purkinje fibers, to bundle of His
B. AV node, SA node, bundle of His, to Purkinje fibers
C. SA node, AV node, bundle of His, to Purkinje fibers
D. AV node, SA node, Purkinje fibers, to bundle of His
E. SA node, bundle of His, AV node, Purkinje fibers
C) Defibrillate -
A patient is brought in by EMS unconscious/unresponsive. You bring them in to the
resuscitation room, hook them up to a 12 lead EKG, and see this arrhythmia at roughly 350 BPM. You
know the patient is not being perfused adequately and you decide that the MOST appropriate action
is....
A. Blood transfusion
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Cardiology Clinical Medicine
Assignment Questions with
Answers 2025
*Answer: A
• According to Smartypance and Professor Miliron's pathophysiology lecture, Mitral stenosis is
often associated with Rheumatic fever. Further, according to smartypance, it is a non-radiating
(typically) diastolic murmur that is heard best at the apex of the heart with the bell of the
stethoscope (low pitch) and it is characterized by an opening snap just after S2. Mitral stenosis is
commonly associated with dyspnea upon exertion (as well as orthopnea, paroxysmal nocturnal
dyspnea, etc.)*
• Answer choice: B o Mitral Regurgitation is incorrect because it is asystolicmurmur (Professor
Miliron's lecture) typically with a high pitch blowing holosystolic murmur at apex with split S2 that
radiates to the axilla (Smartypance).
• Answer choice: C o Ventricular Septal Defect is another systolic murmur best heard over Erb's
point. According to smartypance the murmur is loud, holosystolic along the left sternal bo -
A 20-year-old male presents to your primary care office for a work required physical.
Reviewing past medical history, you learn he had rheumatic fever as a teenager. His only complaint
today during the physical is occasional exertional dyspnea. During the auscultation of his heart you
notice a non-radiating, diastolic, rumbling murmur with an opening snap after S2, heard best with the
bell of your stethoscope at the apex of his heart. Based on this information what do you think is
causing the murmur?
A.) Mitral Stenosis
B.) Mitral Regurgitation
C.) Ventricular Septal Defect
D.) Pulmonary stenosis
E.) Not enough information
A) [P-waves are usually hard to discern due to the rapid rate of >100bpm]
B) [supraventricular, meaning the issue is occurring above the ventricles and reflects rapid activation
of the ventricles which would show a narrow QRS complex]
C) [while there is a narrow QRS complex in psvts, the rhythm is usually regular. This description
would be more consistent with A-Fib]
D) [this would be more indicative of a PVC, where psvts originate above the ventricles]
E) [this would be more indicative of a 2nd degree heart block. Psvts do not show an issue with
blockage] -
A 55 y/o woman comes to the ER with complaints of sudden lightheadedness, sweating, and
heart palpitations. An EKG is performed and shows evidence of paroxysmal supraventricular
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tachycardia (PSVT). Which one of the following choices is a common key identifying feature seen on
EKG to know this is a PSVT?
A. P-waves are distinct and can be easily seen marching out on the EKG
B. The QRS is narrow, meaning the arrhythmia originates within or above the Bundle of His
C. The QRS complex would be narrow with an irregularly irregular rhythm
D. A wife QRS complex occurring earlier than expected with an inverted T-wave following
E. A sudden drop of QRS complex due to the ventricles not conducting all of the atrial impulses
The correct answer is D. Aortic stenosis is most clearly heard at the second intercostal space at the
right sternal border. This would be heart during systole because during this phase of the cardiac cycle
blood is being sent through the aortic and pulmonic valves, if the aortic valve is stenosed then the
restricted blood flow will create an aortic stenosis murmur. -
A 47y/o M arrives to your office for evaluation of new onset dizziness. Patient states that he
walks two miles every morning but over the last week he has noticed a feeling of dizziness when he
completes the last portion of his walk which is a "pretty steep incline." Patient states the dizziness
resolves once he stops walking but he wants to make sure it is nothing serious. You suspect that the
patient may be experiencing aortic stenosis, if your suspicions are correct where on the chest would
you hear this murmur and what phase of blood pressure would it occur in?
A. 2nd intercostal space LSB; diastole
B. 4th intercostal space RSB; diastole
C. 3rd intercostal space RSB; systole D. 2nd intercostal space RSB; systole
a. Bradycardia is LESS than 60 bpm, ST elevation MUST be "elevation at the J-point in 2
anatomically contiguous leads ≥1mm in all leads except V2-V3," this axis is normal
b. This is NSR, but LVH is diagnosed popularly with: V1 S-wave PLUS V5-V6 R-wave ≥35mm, or R +
S in any V lead >45mm, this axis is normal.
*c. NSR is 60 - 100bpm, absent criteria for LVH/RVH, with axis between 0º - 90º*
d. Bradycardia is LESS than 60 bpm, RVH is popularly diagnosed with: V1-V2 "tall R-waves"; V5-
V6 "deep S-waves"; V1 R-wave >7mm; showing an R:S ratio >1 in V1 and V2 suggests RVH. RAD is
when the axis is between 90º and 180º.
e. Torsades de pointes is a polymorphic VT that is >100bpm and often results from QT-
prolongation just before tdp and then death! -
You just began your 15th hour of your ER rotation on the first day. A 19 y/o male comes in
who just ate some random mushrooms off the sidewalk and is now scared his stupidity might kill him.
You immediately obtain this EKG. What do you see?
A. Bradycardia, mild ST elevation, normal axis
b. NSR (normal sinus rhythm), LVH, normal axis
c. NSR, normal LV, normal axis
d. Bradycardia, RVH, RAD
e. Torsades de Pointes
Answer: B
Why all the others are wrong
Inferior wall
a. ECG: Q waves & ST elevation in leads II, III, and AVF
b. Coronary artery: RCA, left circumflex
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Lateral wall
a. ECG: ST elevation in the lateral leads (I, avl, V5-6)
b. Coronary Artery: Left circumflex
Posterior wall
a. ECG: ST depression in V1 to V3
b. Coronary artery: RCA, left circumflex -
Patient presents to the emergency room with crushing chest pain. Patient has Q wave
abnormalities and ST elevation in leads I, avl, and V2 through V6. What coronary artery is the patient
having an MI in?
a. RCX
b. LAD
c. LCX
d. RCA
Answer: C
Information including picture was taken from Clinical Medicine's Arrhythmia powerpoint. The
question only asks about the rate of the EKG strip which can easily be determined by counting the big
boxes between neighboring QRS complexes and divide this into 300 (taken from Clin Med EKG
powerpoint) -
23 year old Cristal is at your office getting an annual check-up. She does not state any
changes in health and states that she feels "just fine". What observation could be made on rate when
interpreting the EKG strip below:
A. Sinus Rhythm
B. Non-specific Cardiomyopathy
C. Sinus Bradycardia
D. Cannot be determined with the strip alone
Answer: C
The normal conduction of the heart starts at the SA node which then goes to the AV node and pauses,
and then down the bundle of His, and lastly to the right and left Purkinje fibers. Any conduction
pathway besides this would be out of the 'norm'. -
A 25 year old comes into the ER with complaints of chest pain. After a quick EKG to look at
the heart everything appears to be normal. What is the normal electrical conduction pathway through
the heart?
A. SA node, AV node, Purkinje fibers, to bundle of His
B. AV node, SA node, bundle of His, to Purkinje fibers
C. SA node, AV node, bundle of His, to Purkinje fibers
D. AV node, SA node, Purkinje fibers, to bundle of His
E. SA node, bundle of His, AV node, Purkinje fibers
C) Defibrillate -
A patient is brought in by EMS unconscious/unresponsive. You bring them in to the
resuscitation room, hook them up to a 12 lead EKG, and see this arrhythmia at roughly 350 BPM. You
know the patient is not being perfused adequately and you decide that the MOST appropriate action
is....
A. Blood transfusion
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