Cardiology 1 The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27

Welcome to episode 27of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint. This week we will be covering 10 topic specific Cardiology board review questions. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full cardiology review includes over 147 cardiology specific questions andis available to all members of the PANCE and PANRE Academy. You can download and listen to past FREE episodes here,oniTunesor StitcherRadio. You can listen to the latest episode, take an interactive quizand download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Cardiology Questions 1-10 The Audio PANCE and PANRE Cardiology 1 Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Start Congratulations - you have completed The Audio PANCE and PANRE Cardiology 1 . You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% %%FORM%% Have Your Exam Results Emailed to You Enter your name and email address below to have your results as well as the test questions, your answers and the correct answers delivered to your inbox. Name First Last Email mTouch Quiz Populated FieldsmTouch Quiz will automatically populate the fields below. Feel Free to add additional fields for the Quiz Taker to complete using the "Add Fields" options to the right.Quiz NameThe name of the quizResults SummaryScoreThe number of correct answers. 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Question 1Which of the following conditions would cause a positive Kussmaul's sign on physical examination?ALeft ventricular failureHint: Left ventricular failure results in the back-up of blood into the left atrium and then the pulmonary system so it would not be associated with Kussmaul's sign.BPulmonary edemaHint: Pulmonary edema primarily results in increased pulmonary pressures rather than having effects on the venous inflow into the heart.CCoarctation of the aortaHint: Coarctation of the aorta primarily affects outflow from the heart due to the stenosis resulting in delayed and decreased femoral pulses; it has no effect on causing Kussmaul's sign.DConstrictive pericarditisQuestion 1 Explanation: Kussmaul's sign is an increase rather than the normal decrease in the CVP during inspiration. It is most often caused by severe right-sided heart failure; it is a frequent finding in patients with constrictive pericarditis or right ventricular infarction.Question 2A 60 year-old male com plains of progressive fatigue and dyspnea. On examination his lungs are clear to auscultation bilaterally, heart exam reveals regular rate and rhythm without S3, S4 or murmur, and extremities show 1+ edema bilaterally. Chest x-ray reveals cardiomegaly. The electrocardiogram shows low voltage, and echocardiogram shows an ejection fraction of 55% with a small, thickened left ventricle that has rapid early filling with diastolic dysfunction. Which of the following is the most likely underlying etiology of this patient's cardiomyopathy?AAlcoholismHint: Chronic alcohol use is commonly associated with a dilated left ventricle with left ventricular dysfunction.BMyocarditisHint: Myocarditis is associated with a dilated, not small, left ventricle. CAmyloidosisDChronic hypertensionHint: Chronic hypertension is associated with a hypertrophic, hypercontractile left ventricle.Question 2 Explanation: Amyloidosis is the most common cause of restrictive cardiomyopathy and is associated with a small thickened left ventricle that has rapid early filling with diastolic dysfunction.Question 3A 45 year-old male presents to the Emergency Department complaining of sudden onset of tearing chest pain radiating to his back. On examination the patient is hypertensive and his peripheral pulses are diminished. Electrocardiogram shows no acute ST-T wave changes. Which of the following is the diagnostic study of choice in this patient?AComputed tomography (CT) scanBTransthoracic echocardiogramHint: CT scan is better than transthoracic echocardiogram for the diagnosis of acute aortic dissection. Transesophageal echocardiogram (TEE) is a good diagnostic modality, however it is not always available in the acute setting.CMagnetic resonance imagingHint: MRI is good in the diagnosis of a chronic aortic dissection, but the longer imaging time and the difficulty in monitoring the patient during the test makes it not the first choice in the setting of an acute dissection.DCardiac catheterizationHint : Cardiac catheterization is not indicated in the diagnosis of an acute aortic dissection.Question 3 Explanation: This patient has signs and symptoms of acute aortic dissection for which CT scan is the diagnostic study of choice.Question 4A 26 year-old patient is brought to the emergency department after a head on collision. The patient complains of chest pain, dyspnea and cough. Examination reveals the patient to be tachypneic and tachycardic with a narrow pulse pressure. Jugular venous distension is noted. Electrocardiogram reveals nonspecific t wave changes and electrical alternans. Which of the following is the most appropriate management plan for this patient?Aserial echocardiogramHint: Serial echocardiograms would be indicated if a patient had a small pericardial effusion and no intervention was immediately needed. This patient has signs and symptoms of cardiac tamponade and needs immediate intervention.BpericardiocentesisCcardiac cahterizationHint: There is no indication for cardiac catheterization in the management of cardiac tamponade.DpericardiectomyHint: A partial pericardiectomy may be needed in patients with recurrent pericardial effusions that occur secondary to neoplastic disease and uremia, but there is no indication for partial pericardiectomy in the acute management of cardiac tamponade.Question 4 Explanation: Urgent pericardiocentesis is the initial treatment of choice in a patient with cardiac tamponade. Question 5A 10 year-old female experiences fever and polyarthralgia. On examination you note a new early diastolic murmur. Laboratory results are positive for antistreptolysin O. The patient has no known drug allergies. Which of the following is the recommended prophylaxis for this condition?ADoxycyclineHint: Doxycycline and Bactrim are not indicated for the prophylaxis of recurrent rheumatic fever.BErythromycinHint: Erythromycin is considered second line for prophylaxis of recurrent rheumatic fever in a patient with a penicillin allergy.C Benzathine penicillin GDTrimethoprim/sulfamethoxazoleHint: See A for explanationQuestion 5 Explanation: Recurrences of rheumatic fever are most common in patients who have had carditis during their initial episode and in children. The preferred method of prophylaxis and secondary prevention of recurrence is penicillin G benzathine as a monthly IM injection, but oral daily penicillin or erythromycin is acceptable in areas of low prevalence. Duration is based on clinical presentation and degree of cardiac involvement: ARF without cardiac involvement: 5 years or until age 18 years, whichever is longer ARF with mild or resolved carditis: 10 years or until age 25 years, whichever is longer ARF with severe carditis or cardiac surgery: lifelongQuestion 6A 59 year-old male with history of hypertension and dyslipidemia presents with complaint of substernal chest pain for two hours. The pain woke him from sleep, does not radiate, and is associated with nausea and diaphoresis. Electrocardiogram reveals ST segment elevation in leads II, III, and AVF. Which of the following walls of the ventricle is most likely at risk?AAnteriorHint: See answer for explanationBInferiorCLateralHint: See answer for explanationDPosteriorHint: See answer for explanationQuestion 6 Explanation: Inferior wall myocardial infarction is characterized by ST segment elevation in leads II, III and AVF.Question 7An 80 year-old female presents with syncope and recent fatigue and lightheadedness over the past month. She denies chest pain or dyspnea. Physical examination reveals BP 130/70 mmHg, HR 40 bpm, regular, and RR 16. Electrocardiogram reveals two p waves before each QRS complex. Which of the following is the treatment of choice for this patient?ACardio defibrillator insertionHint: Cardio defibrillators treat ventricular tachycardia and are not indicated in the management of second degree AV block.BAtropine as neededHint: Atropine can be used in the acute management of second degree AV block Mobitz type II, but it should not be used as long-term therapy.CPermanent dual chamber pacemaker insertionDRitalin therapy dailyHint: Ritalin therapy is not indicated in the management of second degree heart block.Question 7 Explanation: This patient has findings consistent with symptomatic second degree AV block Mobitz type II for which permanent pacing is the treatment of choice.Question 8A 78 year-old male with history of coronary artery disease s/p coronary artery bypass grafting, hypertension, and dyslipidemia presents for routine physical examination. He feels well except for occasional brief episodes of substernal chest pain with exertion that are relieved with rest. He denies associate d dyspnea, nausea or diaphoresis. Physical examination reveals a BP of 110/70 mmHg, HR 56 bpm, regular, RR 14, unlabored. Lungs are clear to auscultation, heart is bradycardic, but regular with no S3, S4 or murmur. Electrocardiogram done in the office shows no acute ST-T wave changes. Which therapy is indicated for the acute management of this patient's symptoms?ASublingual nitroglycerineBMetoprololHint: Beta-blockers are preventative and not the first choice for the acute management of chronic stable angina. Beta-blockers may worsen this patient's bradycardia. CVerapamilHint: Calcium channel blockers are the third-line antiischemic agent and may also reduce the patient's heart rate. DLisinoprilHint: ACE inhibitors will not provide acute relief of anginal symptoms.Question 8 Explanation: Sublingual nitroglycerine is the drug of choice for the acute management of chronic stable angina. Question 9A 20 year-old male presents with complaint of brief episodes of rapid heart beat with a s udden onset and offset that have increased in frequency. He admits to associated shortness of breath and lightheadedness. He denies syncope. Electrocardiogram reveals a delta wave prominent in lead II. Which of the following is the most appropriate long-term management in this patient?AImplantable cardio defibrillatorHint: Implantable cardio defibrillators are indicated in the treatment of ventricular arrhythmias, not Wolf-Parkinson- White (WPW) syndrome.BRadiofrequency ablationCVerapamil (Calan)Hint: Calcium channel blockers and beta-blockers are not the best options for the long-term management of WPW. They may decrease the refractoriness of the accessory pathway or increase the refractoriness of the AV node in patients with atrial fibrillation or atrial flutter who have an antegrade conducting bypass tract. This may lead to faster ventricular rates.DMetoprolol (Lopressor)Hint: See C for explanationQuestion 9 Explanation: Radiofrequency ablation is the procedure of choice for long -term management in patients with accessory pathways (WPW) and recurrent symptoms.Question 10Which of the following is the optimal therapy for a 76 year-old patient with no allergies who has chronic atrial fibrillation?AAspirinHint: Aspirin's role to prevent thromboembolism in atrial fibrillation is limited to patients with no risk factors who are under age 65.BClopidorgrelHint: Clopidogrel is not the optimal therapy for patients with atrial fibrillation.CWarfarinDLow molecular weight heparinHint: Due to the increased costs and need for parenteral therapy, daily subcutaneous heparin is not first line therapy unless warfarin therapy is contraindicated.Question 10 Explanation: Patients older than age 75 who have chronic atrial fibrillation should be anticoagulated with warfarin to maintain an INR between 2.5 and 3.0 for optimum therapy Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 10 questions to complete. List Return Shaded items are complete. 12345678910End Return You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All doneNeed more practice!Keep trying!Not bad!Good work!Perfect! Looking for all the podcast episodes? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joiningThe PANCE and PANRE Exam Academy. I will bereleasing new episodes every few weeks. The Academy is currently discounted, so sign up now. Resources and Show Notes: My list of recommended PANCE and PANRE review books This Podcast is also available on iTunes and Stitcher Radio for Android iTunes:The Audio PANCE AND PANRE Podcast iTunes Stitcher Radio:The Audio PANCE and PANRE Podcast Stitcher document.createElement('audio'); http://traffic.libsyn.com/pasquini/Cardiology_1_The_Audio_PANCE_and_PANRE_Board_Review_Podcast.mp3Podcast: Download () | EmbedSubscribe: Apple Podcasts | Android | Email | Google Podcasts | Stitcher | RSS | PANCE and PANRE Podcast PlayerView all posts in this seriesThe Audio PANCE and PANRE Board Review Podcast Episode 1The Audio PANCE and PANRE Board Review Podcast Episode 3The Audio PANCE and PANRE Board Review Podcast Episode 5The Audio PANCE and PANRE Board Review Podcast Episode 7The Audio PANCE and PANRE Board Review Podcast Episode 9The Audio PANCE and PANRE Board Review Podcast Episode 11The Audio PANCE and PANRE Board Review Podcast Episode 13The Audio PANCE and PANRE Board Review Podcast Episode 15The Audio PANCE and PANRE Board Review Podcast Episode 17The Audio PANCE and PANRE Board Review Podcast Episode 19The Audio PANCE and PANRE Board Review Podcast Episode 21The Audio PANCE and PANRE Board Review Podcast Episode 23The Audio PANCE and PANRE Board Review Podcast Episod e 25Cardiology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31EENT 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 33Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Musculoskeletal 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37Reproductive System 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 39Episode 41: The Audio PANCE and PANRE Board Review PodcastEpisode 43: The Audio PANCE and PANRE Board Review PodcastMurmur Madness: The Audio PANCE and PANRE Episode 45Episode 47: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 49: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 51: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 53: General Surgery End of Rotation Exam The Audio PANCE and PANRE PodcastEpisode 55: The Audio PANCE and PANRE Board Review PodcastEpisode 57: The Audio PANCE and PANRE Board Review PodcastEpisode 59: Emergency Medicine EOR The Audio PANCE and PANRE Board Review PodcastEpisode 61: The Audio PANCE and PANRE Board Review PodcastEpisode 63: The Audio PANCE and PANRE PA Board Review PodcastPodcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-CPodcast Episode 67: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 69: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 71: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 73: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 77: The Audio PANCE and PANRE Board Review Podcast You may also like -The Audio PANCE and PANRE Board Review Podcast Episode 25Welcome to episode 25of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. 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