Guide: Cardiology & Critical Care Q&A
Bank
Description:
Ace your PAEA Emergency Medicine End-of-Rotation exam with this targeted 2026 question
bank. This guide is meticulously crafted with high-yield practice questions covering the most-
tested topics: heart failure management (HFrEF vs. HFpEF), acute coronary syndrome
(ACS) protocols, EKG rhythm interpretation, and shock management. Each question
includes detailed Answer Explanations aligned with current guidelines to ensure you
understand the "why" behind every choice, reinforcing critical thinking for your EOR and
PANCE. Based on the official PAEA blueprint, this resource focuses precisely on what you need
to know—from aortic stenosis and atrial fibrillation to sepsis and toxicology emergencies.
Stop stressing and start mastering the material. Download your free high-yield question guide now and
boost your confidence for exam day!
, 2026 Physician Assistant PANCE Review: Cardiology & Emergency
Medicine Q&A
1. A 68-year-old patient with a history of diabetes and hypertension presents with progressive
shortness of breath. An echocardiogram reveals reduced contractility and a dilated left ventricle.
Which of the following underlying conditions is the most common etiology for this form of heart
failure?
a) Hypertrophic Cardiomyopathy
b) Uncontrolled Hypertension
c) Coronary Artery Disease
d) Viral Myocarditis
Answer: c) Coronary Artery Disease
Explanation: Coronary Artery Disease (CAD), leading to myocardial infarction and ischemic
damage, is the most prevalent cause of systolic heart failure, which is characterized by impaired
ventricular contraction and dilation.
2. A patient's cardiac workup demonstrates a normal ejection fraction but findings of a thickened
left ventricular wall and an audible S4 gallop. This clinical picture is most consistent with which
pathophysiologic process?
a) Systolic Heart Failure
b) Diastolic Heart Failure
c) High-Output Heart Failure
d) Right-Sided Heart Failure
Answer: b) Diastolic Heart Failure
Explanation: Diastolic heart failure, or heart failure with preserved ejection fraction (HFpEF),
involves impaired ventricular relaxation and filling. The thick ventricular wall and S4 gallop
(caused by atrial contraction against a stiff ventricle) are classic features, unlike the dilated
ventricle and S3 gallop seen in systolic failure.
, 3. Which of the following patient presentations is most characteristic of High-Output Heart Failure?
a) A patient with a history of multiple myocardial infarctions and a low cardiac output state.
b) A patient with chronic, severe anemia who develops signs of heart failure despite elevated
cardiac output.
c) A patient with long-standing hypertension who develops dyspnea on exertion and pulmonary
edema.
d) A patient with tricuspid valve disease presenting with jugular venous distension and
peripheral edema.
Answer: b) A patient with chronic, severe anemia who develops signs of heart failure despite
elevated cardiac output.
Explanation: High-output heart failure occurs when the body's metabolic demands exceed the
heart's ability to supply adequate blood flow, even though cardiac output is normal or high.
Severe anemia, thyrotoxicosis, and arteriovenous shunts are classic causes that create this high-
demand state.
4. According to the New York Heart Association (NYHA) Functional Classification, a patient who
is comfortable at rest but experiences symptoms like fatigue or palpitations with less than
ordinary physical activity would be classified as:
a) Class I
b) Class II
c) Class III
d) Class IV
Answer: c) Class III
Explanation: NYHA Class III is defined by a marked limitation of physical activity. The patient
is comfortable at rest, but less than ordinary activity (e.g., walking short distances) provokes
symptoms.
5. Which combination of medications has been demonstrated to reduce mortality in patients with
heart failure with reduced ejection fraction (HFrEF) and should be initiated in stable patients?
a) Furosemide and Digoxin
b) Ivabradine and Nesiritide