DHA Dubai · Medical Sciences & Healthcare

Cardiovascular and Respiratory Medicine

44 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 44 questions

  1. A 64-year-old female presents with orthopnea, paroxysmal nocturnal dyspnea, and bilateral lower extremity pitting edema. Echocardiography reveals a left ventricular ejection fraction (LVEF) of 32%. Wh…
  2. A 42-year-old male with a history of deep vein thrombosis presents with sudden-onset pleuritic chest pain and dyspnea. Vital signs show HR 118 bpm, BP 110/72 mmHg, RR 26/min, and SpO2 88% on room air.…
  3. A 70-year-old male presents with exertional syncope, angina, and dyspnea. Physical examination reveals a late-peaking harsh crescendo-decrescendo systolic murmur at the right upper sternal border that…
  4. A 60-year-old female with long-standing poorly controlled hypertension presents for routine review. Her ECG reveals regular narrow-complex tachycardia at a rate of 160 bpm with no visible P waves. Car…
  5. A 55-year-old male with a 30 pack-year smoking history presents with chronic productive cough and progressive exertional breathlessness. Post-bronchodilator spirometry demonstrates an FEV1/FVC ratio o…
  6. A 28-year-old male is brought to the emergency department following an acute severe asthma attack. Arterial blood gas (ABG) analysis on room air reveals: pH 7.34, PaCO2 44 mmHg, PaO2 58 mmHg, and HCO3…
  7. A 68-year-old male is admitted with acute anterior wall STEMI. On day 3 post-infarction, he suddenly develops severe dyspnea, hypotension, and a new harsh holosystolic murmur heard best at the lower l…
  8. A 72-year-old female presents with persistent atrial fibrillation. Her past medical history includes hypertension, diabetes mellitus, ischemic stroke 2 years ago, and congestive heart failure. What is…
  9. A 35-year-old female presents to the clinic with persistent fever, weight loss, and painless erythematous lesions on the palms and soles (Janeway lesions). Blood cultures grow Streptococcus viridans.…
  10. A 50-year-old male with long-standing hypertension presents with sudden tearing substernal chest pain radiating to the interscapular region of the back. Blood pressure is 184/104 mmHg in the right arm…
  11. A 65-year-old male with a history of anterior myocardial infarction presents with resting dyspnea. Vital signs reveal blood pressure 82/50 mmHg, heart rate 115 bpm, cold clammy extremities, and pulmon…
  12. A 62-year-old heavy smoker presents with left-sided ptosis, miosis, and facial anhidrosis, accompanied by localized pain radiating down the medial aspect of the left arm. Chest CT reveals an apical pu…
  13. A 45-year-old female presents with persistent dry cough, progressive exertional breathlessness, and tender erythematous subcutaneous nodules over her bilateral shins (erythema nodosum). Chest radiogra…
  14. A 24-year-old tall, slender male with no previous respiratory history develops acute sharp right-sided pleuritic chest pain and dyspnea while resting at home. Physical examination reveals hyperresonan…
  15. A 67-year-old male with severe emphysema presents with acute respiratory acidosis. Arterial blood gas shows pH 7.22, PaCO2 72 mmHg, PaO2 50 mmHg, and HCO3 30 mEq/L despite maximal medical therapy with…
  16. An 8-year-old child presents with high fever, sore throat, drooling, and inspiratory stridor, assuming a forward-leaning 'tripod' position with neck extended. Lateral soft-tissue cervical radiography…
  17. A 52-year-old female presents with persistent daytime somnolence, morning headaches, and loud nocturnal snoring witnessed by her partner with brief choking episodes. Polysomnography reveals an Apnea-H…
  18. A 30-year-old male presents with recurrent episodes of hemoptysis and glomerulonephritis with progressive renal failure. Urinalysis demonstrates dysmorphic RBCs and RBC casts. Serum serology reveals h…
  19. A 73-year-old male with a history of anterior STEMI undergoes routine 2D-echocardiography 6 months later. The study reveals a localized thinned, dyskinetic apical left ventricular outpouching with a b…
  20. A 48-year-old female presents with progressive exertional dyspnea and syncope. Right-heart catheterization confirms a mean pulmonary arterial pressure (mPAP) of 38 mmHg at rest with a normal pulmonary…
  21. A 60-year-old female with long-standing systemic sclerosis presents with Raynaud phenomenon, sclerodactyly, and severe dyspnea. Echocardiography suggests elevated pulmonary pressures. What autoantibod…
  22. A 56-year-old male with severe peripheral artery disease presents with painful, non-healing ulcers on the tips of his toes and lateral malleolus. The foot is cool, pale on elevation, and displays rubo…
  23. A 29-year-old female presents with sudden sharp chest pain that is relieved by sitting upright and leaning forward, and worsened by lying supine or coughing. ECG shows diffuse, concave ST-segment elev…
  24. A 64-year-old male with a history of heavy tobacco use presents with cough, hoarseness, and painless visible hematuria. Chest radiography reveals a solitary pulmonary nodule measuring 3.5 cm in the ri…
  25. A 62-year-old male presents with persistent substernal chest pressure for 2 hours. The ECG demonstrates 3 mm ST elevation in leads V1 through V4. What is the occluded coronary artery?
  26. A 54-year-old female with reduced ejection fraction heart failure remains symptomatic despite optimal doses of enalapril and metoprolol succinate. Which drug class improves survival when added next?
  27. According to the modified Duke criteria, which clinical finding constitutes a major criterion for infective endocarditis?
  28. A 68-year-old male with persistent non-valvular atrial fibrillation has hypertension and type 2 diabetes. What is his CHA2DS2-VASc score and indicated management?
  29. A 55-year-old male presents with tearing chest pain radiating to his back. CT angiography reveals an intimal flap in the ascending aorta. What is the immediate treatment of choice?
  30. A 28-year-old male presents with sharp retrosternal chest pain relieved by leaning forward. ECG reveals diffuse concave ST elevation with PR depression. What is the first-line therapy?
  31. Which triad of clinical signs classic for acute cardiac tamponade comprises hypotension, jugular venous distension, and muffled heart sounds?
  32. A 21-year-old athlete has a harsh systolic crescendo-decrescendo murmur at the left sternal border that intensifies with the Valsalva maneuver. What is the first-line pharmacologic therapy?
  33. An 80-year-old male presents with exertional syncope and angina. Auscultation reveals a late-peaking systolic murmur radiating to the carotids with pulsus parvus et tardus. What is the diagnosis?
  34. A 66-year-old male presents with acute dizziness and a pulse of 36 beats per minute. Blood pressure is 74/46 mmHg. What is the initial drug of choice for this unstable bradycardia?
  35. A 64-year-old smoker with COPD presents with increased sputum volume, purulence, and breathlessness. Along with bronchodilators and systemic steroids, what antibiotic strategy is recommended?
  36. A 24-year-old female with persistent asthma uses low-dose inhaled budesonide daily but reports daytime symptoms four days a week and nighttime awakenings. What is the preferred next step in therapy?
  37. A 45-year-old female presents with acute pleuritic pain, dyspnea, tachycardia, and a high Wells score. What is the definitive initial diagnostic imaging modality of choice?
  38. Under the Berlin definition, which PaO2/FiO2 ratio on positive end-expiratory pressure of at least 5 cm H2O defines severe Acute Respiratory Distress Syndrome (ARDS)?
  39. A 34-year-old female presents with dry cough, erythema nodosum, and bilateral hilar lymphadenopathy on chest imaging. Biopsy reveals noncaseating granulomas. What is the diagnosis?
  40. According to Light's criteria, which laboratory value classifies a pleural effusion as an exudate?
  41. A 68-year-old male with chronic progressive dyspnea exhibits bilateral subpleural reticulation, traction bronchiectasis, and honeycombing on high-resolution chest CT. What is the diagnosis?
  42. In overnight polysomnography evaluation for suspected obstructive sleep apnea, what minimum Apnea-Hypopnea Index in an adult patient with daytime somnolence confirms the diagnosis?
  43. A 22-year-old trauma patient develops severe respiratory distress, hypotension, tracheal deviation to the right, and absent left breath sounds. What is the immediate life-saving intervention?
  44. In the CURB-65 pneumonia severity score, which feature is assigned 1 point to determine outpatient versus hospital admission?

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