MEDSTUDY.COM
Cardiology PACKRAT EXAM
STUDY GUIDE LATEST
UPDATE (graded A+)
1. History & Physical/Cardiology
Which of the following conditions would cause a positive
Kussmaul's sign on physical examination?
Answers
A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis - ANSWER (u) A. Left ventricular failure results in
the back-up of blood
into the left atrium and then the pulmonary system so it would
not be associated with Kussmaul's sign.
(u) B. Pulmonary edema primarily results in increased
pulmonary pressures rather than having effects on the venous
inflow into the heart.
(u) C. Coarctation of the aorta primarily affects outflow from
the heart due to the stenosis resulting in delayed and decreased
,MEDSTUDY.COM
femoral pulses; it has no effect on causing Kussmaul's sign.
(c) D. Kussmaul's sign is an increase rather than the normal
decrease in the CVP during inspiration. It is most often caused
by severe right-sided heart failure; it is a frequent finding in
patients with constrictive pericarditis or right ventricular
infarction.
2. History & Physical/Cardiology
Anginal chest pain is most commonly described as which of the
following?
Answers
A. Pain changing with position or respiration
B. A sensation of discomfort
C. Tearing pain radiating to the back
D. Pain lasting for several hours - ANSWER (u) A. Pain changing with position
or respiration is suggestive
of pericarditis.
(c) B. Myocardial ischemia is often experienced as a sensation
of discomfort lasting 5-15 minutes, described as dull, aching
or pressure.
,MEDSTUDY.COM
(u) C. Tearing pain with radiation to the back represents aortic
dissection.
(u) D. Chest pain lasting for several hours is more suggestive
for myocardial infarction.
3. History & Physical/Cardiology
Eliciting a history from a patient presenting with dyspnea due
to early heart failure the severity of the dyspnea should be
quantified by
Answers
A. amount of activity that precipitates it.
B. how many pillows they sleep on at night.
C. how long it takes the dyspnea to resolve.
D. any associated comorbidities. - ANSWER (c) A. The amount of activity that
precipitates dyspnea should
be quantified in the history.
(u) B. Orthopnea or paroxysmal nocturnal dyspnea can be
quantified by how many pillows a patient needs to sleep on to
be comfortable.
(u) C. How long dyspnea takes to resolve or associated
, MEDSTUDY.COM
comorbidities has no bearing on quantifying the severity of
dyspnea.
(u) D. See answer C above.
4. History & Physical/Cardiology
A 25 year-old female presents with a three-day history of chest
pain aggravated by coughing and relieved by sitting. She is
febrile and a CBC with differential reveals leukocytosis. Which
of the following physical exam signs is characteristic of her
problem?
Answers
A. Pulsus paradoxus
B. Localized crackles
C. Pericardial friction rub
D. Wheezing - ANSWER (u) A. Pulsus paradoxus is a classic finding for cardiac
tamponade.
(u) B. Localized crackles are associated with pneumonia and
consolidation, not pericarditis.
(c) C. Pericardial friction rub is characteristic of an
inflammatory pericarditis.
Cardiology PACKRAT EXAM
STUDY GUIDE LATEST
UPDATE (graded A+)
1. History & Physical/Cardiology
Which of the following conditions would cause a positive
Kussmaul's sign on physical examination?
Answers
A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis - ANSWER (u) A. Left ventricular failure results in
the back-up of blood
into the left atrium and then the pulmonary system so it would
not be associated with Kussmaul's sign.
(u) B. Pulmonary edema primarily results in increased
pulmonary pressures rather than having effects on the venous
inflow into the heart.
(u) C. Coarctation of the aorta primarily affects outflow from
the heart due to the stenosis resulting in delayed and decreased
,MEDSTUDY.COM
femoral pulses; it has no effect on causing Kussmaul's sign.
(c) D. Kussmaul's sign is an increase rather than the normal
decrease in the CVP during inspiration. It is most often caused
by severe right-sided heart failure; it is a frequent finding in
patients with constrictive pericarditis or right ventricular
infarction.
2. History & Physical/Cardiology
Anginal chest pain is most commonly described as which of the
following?
Answers
A. Pain changing with position or respiration
B. A sensation of discomfort
C. Tearing pain radiating to the back
D. Pain lasting for several hours - ANSWER (u) A. Pain changing with position
or respiration is suggestive
of pericarditis.
(c) B. Myocardial ischemia is often experienced as a sensation
of discomfort lasting 5-15 minutes, described as dull, aching
or pressure.
,MEDSTUDY.COM
(u) C. Tearing pain with radiation to the back represents aortic
dissection.
(u) D. Chest pain lasting for several hours is more suggestive
for myocardial infarction.
3. History & Physical/Cardiology
Eliciting a history from a patient presenting with dyspnea due
to early heart failure the severity of the dyspnea should be
quantified by
Answers
A. amount of activity that precipitates it.
B. how many pillows they sleep on at night.
C. how long it takes the dyspnea to resolve.
D. any associated comorbidities. - ANSWER (c) A. The amount of activity that
precipitates dyspnea should
be quantified in the history.
(u) B. Orthopnea or paroxysmal nocturnal dyspnea can be
quantified by how many pillows a patient needs to sleep on to
be comfortable.
(u) C. How long dyspnea takes to resolve or associated
, MEDSTUDY.COM
comorbidities has no bearing on quantifying the severity of
dyspnea.
(u) D. See answer C above.
4. History & Physical/Cardiology
A 25 year-old female presents with a three-day history of chest
pain aggravated by coughing and relieved by sitting. She is
febrile and a CBC with differential reveals leukocytosis. Which
of the following physical exam signs is characteristic of her
problem?
Answers
A. Pulsus paradoxus
B. Localized crackles
C. Pericardial friction rub
D. Wheezing - ANSWER (u) A. Pulsus paradoxus is a classic finding for cardiac
tamponade.
(u) B. Localized crackles are associated with pneumonia and
consolidation, not pericarditis.
(c) C. Pericardial friction rub is characteristic of an
inflammatory pericarditis.
