Cardiology – ROSH UPDATED ACTUAL Questions and CORRECT Answers
1. B. total choles- Which of the following sets of parameters is most consistent with recommended
terol <200, HDL levels on the lipid panel of a healthy person?
>60, LDL <100,
TRIG <150 A. total cholesterol <175, HDL >50, LDL <75, TRIG <100
B. total cholesterol <200, HDL >60, LDL <100, TRIG <150
C. total cholesterol <225, HDL >70, LDL <125, TRIG <200
D. total cholesterol <175, HDL >50, LDL <75, TRIG <100
2. B. compression A 54-year-old woman presents to the clinic with an ulcer over her left lateral ankle.
therapy Physical exam reveals nonpitting edema and the ulcer shown above. What is the
most appropriate initial treatment for the underlying condition?
A. antibiotics
B. compression therapy
C. skin grafting
D. wet-to-dry dressings
3. C. mitral regurgi- A 78-year-old woman presents to the emergency department with sudden-onset
tation dyspnea, weakness, and altered mental status. Her vital signs show a blood
pressure of 78/45 mm Hg, pulse of 117 bpm, temperature of 100.4°F, and
respirations of 19 breaths per minute. She is alert and oriented to person and
place but appears confused about time and situation. Physical exam reveals a thin
woman in acute distress with chest pain. Arterial pulses are rapid and thready with
low amplitude. Auscultation along the left sternal border and apex of the heart
reveals a systolic, soft, low-pitched decrescendo murmur without thrill radiating
to the axilla. Which acute issue is the most likely diagnosis?
A. aortic dissection
, B. aortic stenosis
C. mitral regurgitation
D. MVP
4. B. kale A 54-year-old woman is being discharged on warfarin after being admitted for
new-onset atrial fibrillation. Which of the following foods should she be advised
to avoid while on warfarin?
A. bananas
B. kale
C. oats
D. pasta
5. A. ankle-brachial A 52-year-old man with a history of diabetes mellitus type 2 and cigarette smoking
index presents to your clinic with a six-month history of worsening leg pain. The patient
reports his pain is worse when walking and improved with rest. Physical exam
reveals decreased hair growth over the distal extremities and bilateral diminished
dorsalis pedis pulses. What is the most appropriate diagnostic test to establish
the suspected diagnosis?
A. ankle-brachial index
B. CTA of the lower ext
C. duplex US
D. MRA of the lower ext
6. A. obtain a fast- A 45-year-old woman presents to her primary care provider for her annual
ing lipid profile checkup. Vital signs are T 98.8°F (37.1°C), BP 128/74 mm Hg, HR 84 bpm, RR 18
breaths per minute, and pulse oximetry 100% on room air. Her body mass index
is 37. She was diagnosed with type 2 diabetes mellitus five months ago. Her most
recent hemoglobin A1C of 7.4% was done by her endocrinologist two months ago.
Her past medical and surgical history is otherwise unremarkable. She is currently
taking metformin, insulin glargine, and a multivitamin. Which of the following is
the most appropriate next step in the management of this patient?
, A. obtain a fasting lipid profile
B. prescribe a third diabetes medication
C. prescribe aspirin 81 mg PO once daily
D. recheck HbA1c
7. A. amlodipine A 66-year-old man with a history of severe COPD, nonalcoholic steatohepatitis,
and single-vessel coronary artery disease presents to your clinic with worsening
angina. He reports that, over the last month, he has been getting two to three
anginal episodes a week that are improved with sublingual nitroglycerin and rest.
Vital signs show HR of 74 beats per minute and BP of 136/84 mm Hg. Physical
exam is unremarkable. A recent echocardiogram showed an ejection fraction of
55%. What is the most appropriate treatment for this patient?
A. amlodipine
B. lisinopril
C. propranolol
D. ranolazine
8. D. sawtooth pat- A 65-year-old woman with a history of COPD presents to your clinic with multiple
tern waves presyncopal events over the past three months. You obtain ECG and initiate
treatment with metoprolol. The pathophysiology of the disease that is causing the
symptoms in your patient is a single excitable electrical focus in the left or right
atrium. Which of the following most accurately describes the ECG findings in this
dysrhythmia?
A. delta waves
B. irregularly irregular R-R intervals
C. multiple P wave morphologies
D. sawtooth pattern waves
9. C. pericardial A 65-year-old man with a past medical history of non-small cell lung cancer who
knock was treated with radiation therapy and chemotherapy presents to the emergency
, department with a three-day history of shortness of breath, fatigue, and swelling
in his legs. Physical exam reveals hypotension, elevated jugular venous distension,
and 2+ pitting edema bilaterally. Echocardiogram reveals a thickened pericardi-
um. Which of the following physical exam findings would you expect to find, given
the suspected diagnosis?
A. displaced point of maximal impulse
B. muffled heart sounds
C. pericardial knock
D. S3 gallop
10. C. procainamide A 55-year-old man presents to his primary care provider for palpitations and mild
100 mg IV dyspnea. His past medical history is significant for dilated cardiomyopathy. An ECG
done in the oflce is shown above. Vital signs in the oflce are T 98.8°F (37.1°C),
BP 116/70 mm Hg, HR 165 bpm, and RR 22 breaths per minute. He is taken to
the emergency department for a full cardiac workup. His ECG is unchanged from
earlier. CBC, CMP, magnesium, and serial troponins are within normal limits. The
patient is alert and oriented. Vitals are T 98.8°F (37.1°C), BP 122/72 mm Hg, HR
170 bpm, RR 24 breaths per minute, and pulse oximetry 97% on room air. Which
of the following is the most appropriate next step in management?
A. atropine 1 mg IV
B. catheter ablation
C. procainamide 100 mg IV
D. synchronized cardioversion
11. D. renal artery Which of the following conditions is most likely to be discovered in a patient being
stenosis evaluated for secondary hypertension?
A. grave's disease
1. B. total choles- Which of the following sets of parameters is most consistent with recommended
terol <200, HDL levels on the lipid panel of a healthy person?
>60, LDL <100,
TRIG <150 A. total cholesterol <175, HDL >50, LDL <75, TRIG <100
B. total cholesterol <200, HDL >60, LDL <100, TRIG <150
C. total cholesterol <225, HDL >70, LDL <125, TRIG <200
D. total cholesterol <175, HDL >50, LDL <75, TRIG <100
2. B. compression A 54-year-old woman presents to the clinic with an ulcer over her left lateral ankle.
therapy Physical exam reveals nonpitting edema and the ulcer shown above. What is the
most appropriate initial treatment for the underlying condition?
A. antibiotics
B. compression therapy
C. skin grafting
D. wet-to-dry dressings
3. C. mitral regurgi- A 78-year-old woman presents to the emergency department with sudden-onset
tation dyspnea, weakness, and altered mental status. Her vital signs show a blood
pressure of 78/45 mm Hg, pulse of 117 bpm, temperature of 100.4°F, and
respirations of 19 breaths per minute. She is alert and oriented to person and
place but appears confused about time and situation. Physical exam reveals a thin
woman in acute distress with chest pain. Arterial pulses are rapid and thready with
low amplitude. Auscultation along the left sternal border and apex of the heart
reveals a systolic, soft, low-pitched decrescendo murmur without thrill radiating
to the axilla. Which acute issue is the most likely diagnosis?
A. aortic dissection
, B. aortic stenosis
C. mitral regurgitation
D. MVP
4. B. kale A 54-year-old woman is being discharged on warfarin after being admitted for
new-onset atrial fibrillation. Which of the following foods should she be advised
to avoid while on warfarin?
A. bananas
B. kale
C. oats
D. pasta
5. A. ankle-brachial A 52-year-old man with a history of diabetes mellitus type 2 and cigarette smoking
index presents to your clinic with a six-month history of worsening leg pain. The patient
reports his pain is worse when walking and improved with rest. Physical exam
reveals decreased hair growth over the distal extremities and bilateral diminished
dorsalis pedis pulses. What is the most appropriate diagnostic test to establish
the suspected diagnosis?
A. ankle-brachial index
B. CTA of the lower ext
C. duplex US
D. MRA of the lower ext
6. A. obtain a fast- A 45-year-old woman presents to her primary care provider for her annual
ing lipid profile checkup. Vital signs are T 98.8°F (37.1°C), BP 128/74 mm Hg, HR 84 bpm, RR 18
breaths per minute, and pulse oximetry 100% on room air. Her body mass index
is 37. She was diagnosed with type 2 diabetes mellitus five months ago. Her most
recent hemoglobin A1C of 7.4% was done by her endocrinologist two months ago.
Her past medical and surgical history is otherwise unremarkable. She is currently
taking metformin, insulin glargine, and a multivitamin. Which of the following is
the most appropriate next step in the management of this patient?
, A. obtain a fasting lipid profile
B. prescribe a third diabetes medication
C. prescribe aspirin 81 mg PO once daily
D. recheck HbA1c
7. A. amlodipine A 66-year-old man with a history of severe COPD, nonalcoholic steatohepatitis,
and single-vessel coronary artery disease presents to your clinic with worsening
angina. He reports that, over the last month, he has been getting two to three
anginal episodes a week that are improved with sublingual nitroglycerin and rest.
Vital signs show HR of 74 beats per minute and BP of 136/84 mm Hg. Physical
exam is unremarkable. A recent echocardiogram showed an ejection fraction of
55%. What is the most appropriate treatment for this patient?
A. amlodipine
B. lisinopril
C. propranolol
D. ranolazine
8. D. sawtooth pat- A 65-year-old woman with a history of COPD presents to your clinic with multiple
tern waves presyncopal events over the past three months. You obtain ECG and initiate
treatment with metoprolol. The pathophysiology of the disease that is causing the
symptoms in your patient is a single excitable electrical focus in the left or right
atrium. Which of the following most accurately describes the ECG findings in this
dysrhythmia?
A. delta waves
B. irregularly irregular R-R intervals
C. multiple P wave morphologies
D. sawtooth pattern waves
9. C. pericardial A 65-year-old man with a past medical history of non-small cell lung cancer who
knock was treated with radiation therapy and chemotherapy presents to the emergency
, department with a three-day history of shortness of breath, fatigue, and swelling
in his legs. Physical exam reveals hypotension, elevated jugular venous distension,
and 2+ pitting edema bilaterally. Echocardiogram reveals a thickened pericardi-
um. Which of the following physical exam findings would you expect to find, given
the suspected diagnosis?
A. displaced point of maximal impulse
B. muffled heart sounds
C. pericardial knock
D. S3 gallop
10. C. procainamide A 55-year-old man presents to his primary care provider for palpitations and mild
100 mg IV dyspnea. His past medical history is significant for dilated cardiomyopathy. An ECG
done in the oflce is shown above. Vital signs in the oflce are T 98.8°F (37.1°C),
BP 116/70 mm Hg, HR 165 bpm, and RR 22 breaths per minute. He is taken to
the emergency department for a full cardiac workup. His ECG is unchanged from
earlier. CBC, CMP, magnesium, and serial troponins are within normal limits. The
patient is alert and oriented. Vitals are T 98.8°F (37.1°C), BP 122/72 mm Hg, HR
170 bpm, RR 24 breaths per minute, and pulse oximetry 97% on room air. Which
of the following is the most appropriate next step in management?
A. atropine 1 mg IV
B. catheter ablation
C. procainamide 100 mg IV
D. synchronized cardioversion
11. D. renal artery Which of the following conditions is most likely to be discovered in a patient being
stenosis evaluated for secondary hypertension?
A. grave's disease
