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An 8-year-old girl has an undiagnosed large ventricular septal defect. Which of the following is the most likely long term complication?
A 55-year-old man has a 2 week history of exertional dyspnea. Blood pressure 90/74 mm Hg, pulse 98/min/regular. Carotid upstroke is slow. Bibasilar rales are heard. An apical lift and 3/6 aortic ejection murmur are noted. Which of the following is the most likely diagnosis associated with the dyspnea?
A 13-year-old boy has exertional angina pectoris without dyspnea. Examination shows normal vital signs, bisferiens carotid arterial pulse, apical lift, 2/6 ejection murmur just medial to the apex, and lungs clear to auscultation. Which of the following medications should be taken by the patient?
A 66-year-old man has pericardial tamponade caused by uremic pericarditis. Which of the following is the most likely sign to be noted on examination?
A 70-year-old man who has a prosthetic aortic valve is to undergo gum surgery. He has no allergies. Which of the following is the preferred agent in endocarditis prophylaxis?
A 14-year-old boy has hypertrophic obstructive cardiomyopathy with dyspnea. Which of the following is the pathophysiologic abnormality that causes the dyspnea?
Which of the following is not a common cardinal finding in all types of shock?
When performing a pre-sports physical in the adolescent age group, a murmur with which of the following qualities indicates a risk for sudden death during exercise?
Documentation of heart murmurs should include all of the following except?
Which of the following heart sounds is likely to be heard in a patient with active angina and no evidence of heart failure?
The second heart sound (S2) marks the onset of what cardiac event and consists of what valve closures?
Acute pericarditis is characterized by which of the following findings?
A 32-year-old man has tendinous xanthomas on his elbows. He is most likely to have which of the following conditions?
A 72-year-old man has an acute myocardial infarction complicated by pulmonary edema. Which of the following is the pathophysiologic basis causing the pulmonary congestion?
A 2-week-old male infant is in right heart failure related to congenital heart disease. Which of the following is the most likely sign of the heart failure to be present upon examination?
A 66-year-old man has a 10 day history of exertional anterior chest pressure. Angina pectoris is diagnosed. Which of the following co-existing medical conditions is a contraindication to metoprolol therapy?
A 56-year-old woman has a 4 month history of poor concentration, forgetfulness, constipation, and dry skin. Hypothyroidism is diagnosed. Which of the following is the most likely electrocardiographic abnormality to be noted?
A 22-year-old man with no significant medical history is noted to have occasional extra beats on a routine pre-employment physical examination. The patient is asymptomatic, and the remainder of the examination is normal without murmurs. An electrocardiogram shows normal sinus rhythm, occasional premature ventricular contractions (PVCs), and no other abnormalities. 24-Hour Holter monitoring discloses normal sinus rhythm with approximately 5 PVCs/minute. Which of the following is the most appropriate management for this patient?
A 72-year-old woman with a medical history of long-standing hypertension and old myocardial infarction (MI) arrives at the emergency department with complaints of dyspnea on exertion and three-pillow orthopnea. Her physical examination discloses bibasilar rales going one-half up the posterior lung fields and a prominent S3 gallop. Which of the following is the most appropriate initial treatment at this time?
An 88-year-old man with a medical history of hypertension arrives at the office complaining of dyspnea on exertion. His physical examination discloses JVD, bibasilar rales, an S3 gallop, and pitting ankle edema. A chest x-ray (CXR) shows cardiomegaly, and an echocardiogram shows a left ventricular ejection fraction (LVEF) of 55%. Which of the following is the most likely diagnosis?
Which of the following is a classic chest x-ray finding of a patient in heart failure?
A 76-year-old man is first seen in the office with new-onset severe hypertension that began rather suddenly 3 weeks ago. It has been refractive to treatment with HCTZ and lisinopril. He is asymptomatic. His physical examination discloses a blood pressure of 240/114 and an abdominal bruit. Which of the following is the most likely diagnosis?
A 65-year-old woman with a history of type 2 diabetes mellitus and past heart failure arrives at the office with a blood pressure of 160/84 over the past two visits. Which of the following is the most appropriate management?
A 44-year-old man arrives at the emergency department reporting three episodes of substernal chest pain that awoke him at night and lasted 10 minutes. The chest pain improved with one nitroglycerin tablet given by the paramedics. An ECG done on the scene disclosed ST segment elevation, which normalized on the second ECG in the emergency department 10 minutes later. Serial cardiac enzymes were all normal. He was admitted to the hospital and underwent cardiac catheterization, which disclosed normal coronary arteries with no significant stenosis. Which of the following is the most likely diagnosis?
A 45-year-old man with hyperlipidemia comes to the office complaining of two episodes of chest pressure on exertion lasting 3 minutes and relieved by rest over the past month. His physical examination and ECG are currently normal. Which of the following is the most appropriate management of this patient at this time?
A 53-year-old woman is brought to the emergency department with crushing substernal chest pain, ST segment elevation on ECG, and elevated CK-MB. Within 30 minutes, she becomes severely short of breath. Physical examination discloses new bibasilar rales and a new systolic murmur heard best at the base with radiation to the axilla. Which of the following is the most likely diagnosis?
Thrombolytic therapy in myocardial infarction (MI) should be used within how many hours of the onset of chest pain?
A 46-year-old patient experienced a myocardial infarction two weeks previously, and now presents with fever. Echocardiogram reveals pericarditis. Chest X-ray reveals pleural effusions. Based on the patient’s presentation, physical exam, and test results, which of the following is the most accurate diagnosis?
Which of the following cardiac arrhythmias is most effectively treated with intravenous administration of a 6 mg dose of adenosine?
A 58-year-old female presents with exertional dyspnea, non-productive cough, and fatigue. Auscultation of the chest reveals basilar rales and gallops. Patient’s chest X-ray reveals cardiomegaly, bilateral pleural effusions, and perivascular edema. Based on the patient’s presentation, physical exam, and test results, which of the following is the most accurate diagnosis?