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A 75-year-old man who has type 2 diabetes mellitus and chronic hypertension has new-onset atrial fibrillation. Blood pressure 130/82 mm Hg; pulse is 112/min. Lung examination is normal. The heart size is normal. No murmur or gallop is heard. Which of the following is the most appropriate management?
A 62-year-old man sustains blunt trauma to his chest and abdomen in a vehicular accident. Focal Assessment with Sonography for Trauma (FAST) is most valuable in the diagnosis of which of the following conditions?
An 84-year-old woman has an acute ST segment elevation (STEMI) anterior wall myocardial infarction. She is in normal sinus rhythm. Blood pressure 110/70 mm Hg, pulse 98/min/reg. Auscultation of the lungs is normal. Cardiac examination is normal except for the presence of an S4 gallop. Chest radiography shows no evidence of heart failure. In addition to aspirin, nitrates, and a beta adrenergic blocker, which of the following classes of medicines should be given?
A 62-year-old female presents to your office with a sudden episode of left-sided sharp chest pain and mild shortness of breath two days after a month long vacation in Australia. She states she had the flu at the start of the vacation but she was feeling better in about 2 weeks. B/P is 120/70 mmHg, HR is 112 bpm and Respirations are 22. Her V/Q scan is positive. Which of the following is the most likely EKG finding for this patient?
An 82-year-old woman takes verapamil in treatment of angina pectoris. Blood pressure is 116/74 mm Hg, pulse 66/min/regular. Which of the following is the most likely adverse effect of this medication?
A 67-year-old man who has chronic bronchitis now has chronic atrial fibrillation. Which of the following is the preferred medication to control the ventricular rate during his therapeutic walking program?
A 24-year-old asthmatic patient has the acute onset of paroxysmal supraventricular tachycardia. The patient is warm, dry, and alert. Blood pressure 110/74 mm Hg, pulse 200/min, respirations 16/min. Which of the following is the preferred initial management?
Intravenous adenosine is administered to a 23-year-old healthy man who has the acute onset of paroxysmal supraventricular tachycardia. Which of the following is the most likely transient adverse effect?
Intravenous adenosine is administered to a 30-year-old healthy woman who has the acute onset of paroxysmal supraventricular tachycardia. Which of the following is most likely to interfere with the action of the medication?
Lisinopril therapy is initiated in a 70-year-old woman in treatment of hypertension. Which of the following laboratory values should be obtained after 1 week of therapy?
Which of the following clinical signs or symptoms differentiate(s) between arterial and venous disease?
What percentage of people over the age of 65 years is living in nursing homes in the United States?
Which of the following is considered an instrumental activity of daily living (IADL)?
A 72-year-old male is in the emergency room with an anterior wall ST segment elevation myocardial infarction, he has had symptoms for approximately 8 hours. He has a history of an ischemic stroke 2 months ago. Cardiac catheterization is not available at this hospital. Which of the following is the most appropriate intervention for this patient?
Which β-blocker is used in the treatment of congestive heart failure (CHF)?
Cardiotoxicity is an adverse reaction of which cancer chemotherapeutic agent?
A 70-year-old previously healthy woman presents to the office with severe hypertension (diastolic: 120 mm Hg) that has been refractory to treatment. The physical examination discloses elevated blood pressure, normal funduscopic examination, and an abdominal bruit. What is the most likely diagnosis?
Congestive heart failure is the most common etiology for which of the following?
A 78-year-old woman presents with exertional chest pressure and one episode of syncope. The physical examination discloses a systolic murmur best heard at the second intercostal space, right sternal border with radiation into the carotids. What other finding would you expect to see in this patient?
Which of the following medications has the greatest proven efficacy for improving symptoms and reducing mortality in congestive heart failure?
Which of the following manifestations of acute rheumatic fever is NOT relieved by salicylate or steroid therapy?
The parents of a 2-month-old boy are concerned about his risk of coronary artery disease because of the recent death of his 40-year-old maternal uncle from a myocardial infarction. In managing this situation, you would do which of the following?
During a regular checkup on an 8-year-old child, you note a loud first heart sound with a fixed and widely split second heart sound at the upper left sternal border that does not change with respirations. The patient is otherwise active and healthy. The mostly likely heart lesion to explain these findings is:
A newborn infant has mild cyanosis, diaphoresis, poor peripheral pulses, hepatomegaly, and cardiomegaly. Respiratory rate is 60 breaths per min, and heart rate is 250 beats per min. The child most likely has congestive heart failure caused by:
A 2-year-old child with minimal cyanosis has an S3 and S4 (a quadruple rhythm), a systolic murmur in the pulmonic area, and a mid-diastolic murmur along the lower left sternal border. An electrocardiogram shows right atrial hypertrophy and a ventricular block pattern in the right chest leads. What is the most likely diagnosis?
A 4-year-old girl is brought to the nursing clinic. Her father reports that she suddenly became pale and stopped running while he had been playfully chasing her. After 30 min, she was no longer pale and wanted to resume the game. She has never had a previous episode or ever been cyanotic. Her physical examination was normal, as were her chest X-ray and echocardiogram. An electrocardiogram showed the pattern seen here, which indicates:
A cyanotic newborn is suspected of having congenital heart disease. The EKG shows left axis deviation and left ventricular hypertrophy (LVH). What is the most likely diagnosis?
A 3-day-old infant with a single second heart sound has had progressively deepening cyanosis since birth but no respiratory distress. Chest radiography demonstrates no cardiomegaly and normal pulmonary vasculature. An electrocardiogram shows an axis of 120° and right ventricular prominence. Which congenital cardiac malformation is most likely responsible for the cyanosis?
During a physical examination for participation in a sport, a 16-year-old girl is noted to have a late apical systolic murmur, which is preceded by a click. The rest of the cardiac examination is normal. She states that her mother also has some type of heart “murmur” but knows nothing else about it. What is the most likely diagnosis?
Blood pressure is gauged as the pressure exerted by blood as it moves through the brachial artery of the upper arm. The difference between the systolic and the diastolic pressure is known as the: