Questions & Answers 2026 | 200+
Comprehensive Review
,Cardiology
1. A 62-year-old patient presents with substernal chest pressure that began 30
minutes ago while mowing the lawn. The pain radiates to the left arm and is
associated with diaphoresis and nausea. What is the priority action?
A. Schedule an outpatient stress test
B. Prescribe an antacid
C. Obtain a 12-lead ECG immediately
D. Reassure the patient and reassess in 24 hours
Answer: C. Obtain a 12-lead ECG immediately.
Rationale: Acute chest pain concerning for acute coronary syndrome requires
immediate ECG evaluation, ideally within 10 minutes of presentation.
2. A patient with hypertension has an average home blood pressure of 154/96
mmHg despite lifestyle modifications. Which medication class is an appropriate
first-line option?
A. Alpha-1 blocker
B. Thiazide-type diuretic
C. Loop diuretic
D. Nitrate
Answer: B. Thiazide-type diuretic.
Rationale: Thiazide-type diuretics, ACE inhibitors/ARBs, and calcium-channel
blockers are commonly recommended first-line antihypertensive classes.
,3. Which finding is most characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Jugular venous distention
Answer: C. Pulmonary crackles.
Rationale: Left-sided heart failure causes pulmonary congestion, which can
produce dyspnea and bibasilar crackles.
4. A patient taking lisinopril develops persistent dry cough. Which medication is an
appropriate alternative?
A. Losartan
B. Propranolol
C. Furosemide
D. Diltiazem
Answer: A. Losartan.
Rationale: ARBs such as losartan provide renin-angiotensin system blockade
without the increased bradykinin-associated cough seen with ACE inhibitors.
5. Which symptom is most suggestive of peripheral arterial disease?
, A. Calf pain with walking that resolves with rest
B. Bilateral leg swelling that worsens at night
C. Warm feet with bounding pulses
D. Calf pain that improves when the leg is elevated
Answer: A. Calf pain with walking that resolves with rest.
Rationale: Intermittent claudication is classic for peripheral arterial disease and
results from exercise-induced ischemia.
6. A patient with atrial fibrillation has a rapid ventricular response. Which
medication can be used for ventricular rate control in a stable patient?
A. Metoprolol
B. Epinephrine
C. Atropine
D. Adenosine as long-term therapy
Answer: A. Metoprolol.
Rationale: Beta blockers such as metoprolol are commonly used for ventricular
rate control in atrial fibrillation.
7. Which ECG finding is classically associated with atrial fibrillation?
A. Regular rhythm with narrow QRS complexes
B. Sawtooth flutter waves