USMLE step 2 EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS LATEST UPDATE!!!!

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Exam Solution
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Usmle step 2 Cardiology 2026 A+ GRADE ASSURED CO
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MPLETE SOLUTIONS AND VERIFIED ANSWERS (E72D9) zm zm zm zm zm




QUESTION 1 zm




Hypertrophic cardiomyopathy-Valsava, abrupt standing, Nitroglycerin-
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increase or decrease murmur
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ANSWER

↓ preload, ↑ murmur
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QUESTION 2 zm




Hypertrophic cardiomyopathy-sustained hand grip, squatting, passive leg raise-
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increase or decrease murmur
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ANSWER

↑Afterload, ↓murmur zm




QUESTION 3 zm




Holosystolic murmur at the left lower sternal border
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ANSWER

ventricular septal defect zm zm




QUESTION 4 zm




Pulmonary hypertension zm




ANSWER

↑ pulmonary artery and ↑ right atrial pressures
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,QUESTION 5 zm




left side heart dysfunction
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ANSWER

pulmonary capillary wedge pressure zm zm zm




QUESTION 6 zm




↑ PCWP + ↑ right sided presure
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ANSWER

left-sided heart failture leading to right sided heart failure
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QUESTION 7 zm




Normal PCWP+ ↑ right sided pressure
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ANSWER

intrinsic pulmonary process (pulmonary embolism)
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QUESTION 8 zm




Aortic disecctionzm




ANSWER

severe back pain radiating to the back, significant hypertension, decresendo disatolic murmur of aort
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ic regurgitation (chest exam reveals bibasilar crackles )and elevated creatinine of 2.1 mg/dl. Transeo
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phageal echocardiagram for diagnosis.
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QUESTION 9 zm




Aortic regurgitation (can be due to bicuspid aortic valve)
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ANSWER

early decrescendo diastolic murmur
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QUESTION 10 zm




Valsava maneuver or abrupt standing_____the intensity of hypertrophic cardiomyopath
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y
ANSWER

Valsalva maneuver or abrupt standing decreases preload and increase the intensity of the murmur
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, QUESTION 11 zm




Handgrip, squatting or leg elevation____the intensity of hypertrophic cardiomyopathy
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ANSWER

increases venous return and preload and decrease the intensity of the murmur
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QUESTION 12 zm




Pts with ventricular fibrillation or pulseless ventricular tachycardio should be manage
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d with immediate______
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ANSWER

defibrillation



QUESTION 13 zm




Pts with hemodynamic instability due to narrow or wide QRS complex tachyarrhythmi
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a (e.g atrial fibrillation, atrial flutter, VT with pulse) should be managed with______
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ANSWER

synchronized cardioversion zm




QUESTION 14 zm




Supravavular aortic stenosis zm zm




ANSWER

-congenital left ventricular outflow tract obstruction -
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systolic murmur best heard at the first intercostal space -
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develop left ventricular hypertrophy and exterional angiona due to increased myocardial oxygen de
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mand during exercise
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QUESTION 15 zm




Acute uremic pericarditis
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ANSWER

pts have advanced renal failure (blood urea nitrogen > 60 mg/dl) and present with pleuric chest pai
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n that is worse in supine position and improves with sitting up, also a pericardial friction rub (high
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frequency grating or squeaking sound best heard at the left sternal border with pts leaning forward)
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. The classic ECG finding of diffuse ST elevation is typically absent due to lack of myocardial inflam
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mation.