Cardiology Board Review

Ramdas G. Pai, Padmini Varadarajan, Sudha M. Pai

• Publisher: Wiley
• Year: 2017
• ISBN:
  9781118699010
• Edition: 1
• Topic: Medicine
• Subtopic: Cardiology

This compact but comprehensive board review includes everything you need to successfully prepare for the ABIM Cardiology Board Review examination.

• Features over 1200 questions with answers and clear explanations
• Includes over 400 accompanying images
• Covers all key areas of cardiology practice, from history/physicial examination through all major diseases/disorders, along with special topics, e.g. consultative cardiology, covered on the exam
• Complements standard textbook reading
• Written by an internationally-recognized, well-respected and well-published senior cardiologist, expert in valvular heart disease and cardiovascular imaging

1
History and Physical Examination

1. A 25-year-old woman has a 2/6 ejection systolic murmur best heard in the second left intercostal space with normal S1. The S2 is split during inspiration, and P2 intensity is normal. No apical or parasternal heave. The murmur diminishes during expiration and standing up. What is the murmur likely due to?

   1. Physiological or normal
   2. Atrial septal defect (ASD)
   3. Bicuspid aortic valve
   4. Hypertrophic obstructive cardiomyopathy (HOCM)
2. A 29-year-old pregnant woman was found to a have a systolic murmur best heard in the second left intercostal space. It is rough and there was a palpable thrill in the same area and in the suprasternal notch. Patient is asymptomatic and has normal exercise tolerance. What is the likely explanation of the murmur?

   1. Pulmonary stenosis (PS)
   2. Normal flow murmur due to increased cardiac output
   3. Posterior mitral leaflet prolapse causing an interiorly directed jet
   4. Mammary soufflé
3. A 22-year-old patient has a hypoplastic radial side of the forearm and fingerized thumb. What this may be associated with?

   1. ASD
   2. Tetralogy of Fallot
   3. Coarctation of aorta
   4. Ebstein's anomaly
4. A 28-year-old man presented with a history of shortness of breath on exertion. On examination, the pulse rate was 76 bpm and blood pressure (BP) 126/80 mmHg. The left ventricular apex was prominent and forceful. The S1 and S2 were normal, but there was a 2/6 ejection systolic murmur best heard in the third right intercostal space. There was no appreciable variation with respiration, but there was an increase in intensity with the Valsalva maneuver and standing up. It seemed to be less prominent on squatting. There was no audible click. What is the murmur likely due to?

   1. Valvular aortic stenosis
   2. HOCM
   3. Mitral valve prolapse (MVP)
   4. Innocent murmur
5. A 36-year-old asymptomatic woman was found to have a systolic murmur best heard in the apex, but also in the aortic area. It was mid to late systolic and was associated with a sharp systolic sound. What is the likely cause of the murmur?

   1. Posterior mitral leaflet prolapse
   2. Anterior mitral leaflet prolapse
   3. Valvular aortic stenosis
   4. Aortic subvalvular membrane
6. A 78-year-old man with hypertension and diabetes mellitus presented with exertional shortness of breath of 6 months’ duration. Examination revealed a 4/6 crescendo–decrescendo murmur best heard in the second right intercostal space. The first component of the second sound was soft. The murmur was also heard along the right carotid artery. What is this patient likely to have?

   1. Mild aortic stenosis
   2. Moderate or severe aortic stenosis
   3. Pulmonary stenosis
   4. MR
7. A thrill and a continuous machinery murmur in the left infraclavicular area is indicative of what?

   1. Patent ductus arteriosus (PDA)
   2. Increased flow due to left arm arteriovenous (AV) fistula for dialysis
   3. Venous hum
   4. Pulmonary AV fistula
8. Which of the following is not a feature of aortic coarctation?

   1. A continuous murmur on the back
   2. Lower blood pressure in legs compared with arm
   3. Radiofemoral delay
   4. Pistol shot sounds on femoral arteries
9. A 22-year-old newly immigrant woman was referred to high-risk pregnancy clinic because of clubbing and cyanosis. Examination in addition revealed a parasternal heave, 4/6 ejection systolic murmur in the third left intercostal space, normal jugular venous pressure (JVP), and oxygen saturation of 75%. What will you recommend after confirmation of the diagnosis?

   1. Continue pregnancy with sodium restriction
   2. Continue pregnancy, but deliver at 28 weeks
   3. Advise termination of pregnancy
   4. Perform percutaneous ASD closure and continue pregnancy
10. What is the murmur of ASD?

    1. Continuous due to flow across the defect
    2. Ejection systolic due to increased flow across the pulmonary valve
    3. Mid-diastolic due to increased flow across the tricuspid valve
    4. Continuous over lung fields due to increased flow in lungs
11. What is a systolic click that disappears on inspiration likely due to?

    1. Pulmonary valvular stenosis
    2. Bicuspid aortic valve
    3. MVP
    4. Pulmonary hypertension
12. A 36-year-old woman presented with an 8-month history of progressive exertional dyspnea. Physical examination revealed heart rate of 74 bpm, regular, BP 126/78 mmHg, no pedal edema. JVP and carotid upstroke were normal. Cardiac auscultation revealed normal S1, an accentuated P2 with narrow splitting of S2, an ejection click, and a 2/6 ejection systolic murmur. What is the likely diagnosis?

    1. Pulmonary hypertension
    2. PS
    3. Aortic stenosis
    4. ASD
13. Causes of prominent “a” wave in jugular venous pulsations include all of the following except which option?

    1. PS
    2. Pulmonary hypertension
    3. Tricuspid stenosis
    4. Aortic stenosis
    5. ASD
14. What is a 6-year-old Amish boy in Pennsylvania with short stature, polydactyly, short limbs, absent upper incisor teeth with dysplasia of other teeth, and a systolic m...

Table of contents

• Cover
• Title Page
• Copyright
• Preface
• 1 History and Physical Examination
• 2 Electrocardiography
• 3 Chest X-Ray in Cardiology
• 4 Stress Testing and Risk Stratification of Asymptomatic Subjects
• 5 Echocardiography
• 6 Cardiac Magnetic Resonance Imaging
• 7 Cardiac Computed Tomography
• 8 Cardiac Catheterization
• 9 Acute Coronary Syndromes
• 10 Chronic Coronary Artery Disease
• 11 Heart Failure, Transplant, Left Ventricular Assist Devices, Pulmonary Hypertension
• 12 Cardiomyopathies
• 13 Hypertension
• 14 Diabetes Mellitus
• 15 Lipids
• 16 Valvular Heart Disease
• 17 Adult Congenital Heart Disease
• 18 Pericardial Diseases
• 19 Aortic Diseases
• 20 Carotid and Vertebral Artery Disease
• 21 Peripheral Vascular Disease
• 22 Cardiac Arrhythmias
• 23 Pacemakers and Defibrillators
• 24 Cardiac Masses
• 25 Systemic Disorders Affecting the Heart
• 26 Interdisciplinary Consultative Cardiology
• 27 Heart Disease and Pregnancy
• 28 Racial and Gender Disparities
• 29 Pharmacological Principles of Cardiac Drugs
• 30 Anticoagulation
• 31 Aspirin and Antiplatelet Therapy
• 32 Statistical Concepts
• 33 Genetics
• 34 Cardiac Emergencies and Resuscitation
• Index
• EULA