Cardiology
Final Test Review
(Questions & Solutions)
2025
1
,1. A 50-year-old male presents with exertional dyspnea and paroxysmal
nocturnal dyspnea. Echocardiogram reveals dilatation and impaired
contraction of both ventricles. Which is the most likely diagnosis?
A) Hypertrophic cardiomyopathy
B) Restrictive cardiomyopathy
C) Dilated cardiomyopathy
D) Constrictive pericarditis
ANS: C
Rationale: The clinical presentation and echocardiogram findings are
classic for dilated cardiomyopathy.
2. Which genetic mutation is most commonly associated with
hypertrophic cardiomyopathy?
A) MYH7
B) CFTR
C) FBN1
D) PKD1
ANS: A
Rationale: The MYH7 mutation, coding for β-myosin heavy chain, is
frequently implicated in HCM.
3. In restrictive cardiomyopathy, which hemodynamic finding is most
typical?
A) Increased ejection fraction
B) Kussmaul's sign
C) Reduced ventricular wall thickness
D) Hyperdynamic apex beat
ANS: B
Rationale: Kussmaul’s sign, a paradoxical rise in JVP on inspiration, is
common due to impaired ventricular filling.
2
, 4. A teenager with a family history of sudden cardiac death collapses
during exercise. Echocardiogram shows asymmetric septal hypertrophy.
Which pharmacologic therapy is first-line?
A) Digoxin
B) Beta-blocker
C) ACE inhibitor
D) Hydralazine
ANS: B
Rationale: Beta-blockers reduce myocardial contractility, decreasing risk
of outflow tract obstruction.
5. A patient with alcohol use disorder develops heart failure symptoms.
Which form of cardiomyopathy is most likely?
A) Dilated
B) Hypertrophic
C) Restrictive
D) Takotsubo
ANS: A
Rationale: Alcohol is a known toxin leading to dilated cardiomyopathy via
direct myocardial injury.
CONDUCTION DISORDERS/DYSRHYTHMIAS
6. A 68-year-old female presents with palpitations and ECG reveals
absent P-waves and irregularly irregular rhythm. Most likely diagnosis?
A) Atrial fibrillation
B) Ventricular tachycardia
C) Sinus tachycardia
D) Atrial flutter
ANS: A
Rationale: Atrial fibrillation is characterized by absent P waves and an
irregularly irregular rhythm.
3
Final Test Review
(Questions & Solutions)
2025
1
,1. A 50-year-old male presents with exertional dyspnea and paroxysmal
nocturnal dyspnea. Echocardiogram reveals dilatation and impaired
contraction of both ventricles. Which is the most likely diagnosis?
A) Hypertrophic cardiomyopathy
B) Restrictive cardiomyopathy
C) Dilated cardiomyopathy
D) Constrictive pericarditis
ANS: C
Rationale: The clinical presentation and echocardiogram findings are
classic for dilated cardiomyopathy.
2. Which genetic mutation is most commonly associated with
hypertrophic cardiomyopathy?
A) MYH7
B) CFTR
C) FBN1
D) PKD1
ANS: A
Rationale: The MYH7 mutation, coding for β-myosin heavy chain, is
frequently implicated in HCM.
3. In restrictive cardiomyopathy, which hemodynamic finding is most
typical?
A) Increased ejection fraction
B) Kussmaul's sign
C) Reduced ventricular wall thickness
D) Hyperdynamic apex beat
ANS: B
Rationale: Kussmaul’s sign, a paradoxical rise in JVP on inspiration, is
common due to impaired ventricular filling.
2
, 4. A teenager with a family history of sudden cardiac death collapses
during exercise. Echocardiogram shows asymmetric septal hypertrophy.
Which pharmacologic therapy is first-line?
A) Digoxin
B) Beta-blocker
C) ACE inhibitor
D) Hydralazine
ANS: B
Rationale: Beta-blockers reduce myocardial contractility, decreasing risk
of outflow tract obstruction.
5. A patient with alcohol use disorder develops heart failure symptoms.
Which form of cardiomyopathy is most likely?
A) Dilated
B) Hypertrophic
C) Restrictive
D) Takotsubo
ANS: A
Rationale: Alcohol is a known toxin leading to dilated cardiomyopathy via
direct myocardial injury.
CONDUCTION DISORDERS/DYSRHYTHMIAS
6. A 68-year-old female presents with palpitations and ECG reveals
absent P-waves and irregularly irregular rhythm. Most likely diagnosis?
A) Atrial fibrillation
B) Ventricular tachycardia
C) Sinus tachycardia
D) Atrial flutter
ANS: A
Rationale: Atrial fibrillation is characterized by absent P waves and an
irregularly irregular rhythm.
3
