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High-Yield NEET SS Medicine Cardiovascular Questions

Feb 16, 2024

High-Yield NEET SS Medicine Cardiovascular Questions

Preparing for the NEET SS exam can feel like navigating a maze, but fear not! We have got the perfect strategy to help you gauge your readiness by giving you a sneak peek into the exam format.

Dive into the NEET SS Medicine Cardiovascular Questions to gain insight into what to expect. Get started by practicing the questions below, boost your confidence and fine tune your NEET SS Medicine preparation.

1. A 50-year-old male patient presents to your clinic with a 150/92 mm Hg blood pressure. He is overweight with a BMI of 31 and has a sedentary lifestyle. He reports occasionally drinking 2-3 glasses of red wine daily with dinner. He has no history of clinical ASCVD or CHF; his 10-year ASCVD risk is estimated to be less than 10%. He reports a family history of hypertension and diabetes. He is otherwise healthy with no other significant medical history or medication use. What’s the most appropriate management for this patient?

  1. Prescribe a DASH diet and exercise program
  2. Encourage the patient to lose weight and limit alcohol intake
  3. Start antihypertensive medication
  4. Recheck blood pressure in 3 months

2. Physiologists study the pressure changes in the heart chambers and their effect on the opening and closing of the heart valves during the cardiac cycle. They developed a graph that shows pressure changes within the atria and the ventricles in relation to the cardiac cycle events. The graph is shown below. At which point of the graph the mitral valve will close?

mitral valve
  1. 1
  2. 2
  3. 3
  4. 4

3. A 61-year-old man presents at the emergency department with a one-week history of increased breathing difficulty. The symptoms occur when he climbs the stairs to his apartment on the third floor and when he goes to bed. He gained 2.3 kg (5 lbs) of weight in the last 5 days. His medical history is significant for hypertension, hyperlipidemia, alcoholic steatosis, and osteoarthritis. He is in respiratory distress with a respiratory rate of 27/min and oxygen saturation of 90% at room air. On examination, his lower limbs have 2+ pitting oedema with raised jugular venous pressure, and bilateral lung crackles were present on chest auscultation. What is the best first-line therapy for this patient?

  1. High Flow Oxygen
  2. Metoprolol
  3. Ivabradine
  4. Lisinopril

4. A 66-year-old male with a history of diabetes mellitus and hypertension presents to the emergency department complaining of sudden-onset substernal chest pain that began while he was mowing his lawn 50 minutes ago. The patient has difficulty breathing and is diaphoretic. His vital signs are stable. Physical examination shows no acute findings. An ECG reveals the results shown below. Which vessel is most likely occluded in this patient?

First diagonal branch of LAD
  1. Left coronary artery
  2. First diagonal branch of LAD
  3. Right coronary artery
  4. Posterior descending artery

5. A 30-year-old man arrives at the emergency department reporting palpitations, chest discomfort, and lightheadedness. An electrocardiogram (ECG) reveals regular tachycardia with normal QRS complexes. Based on these findings, what is the most probable diagnosis for this patient?

Atrioventricular nodal re-entrant tachycardia
  1. Ventricular tachycardia
  2. Atrial fibrillation
  3. Atrioventricular nodal re-entrant tachycardia
  4. Atrial flutter

6. A 56-year-old female is admitted to the hospital due to palpitations and dyspnea. The patient had 2 episodes of loss of consciousness in the past month and complains of occasional episodes of her heart ‘skipping a beat’. Past medical history is significant for treatment-resistant depression, hypertension and type II diabetes mellitus. ECG tracing is shown below. Which of the following medications is the most likely cause of this patient’s condition?

  1. Metformin
  2. Lisinopril
  3. Amitriptyline
  4. Verapamil

7. A 35-year-old male presents to the ER with cough and wheezing for the past two days. He has a history of mild intermittent asthma and uses his albuterol MDI only occasionally. He does not smoke. He denies chest pain. His vitals are BP 120/75, HR 98, RR 20, Temp 99.1, Sat 97% on nebulizer. Following albuterol nebulization and a dose of prednisone, he feels better about an hour later. However, the nurse as per protocol performed an ECG, which is below. The patient feels well and wants to go home. What should you do now for this patient?

electrophysiology consult
  1. Reassure him everything is fine and discharge him on a course of prednisone
  2. Call the cath team in immediately
  3. Draw a set of cardiac enzymes and give a dose of aspirin
  4. Ask him if he has ever had any syncopal events and call for an electrophysiology consult

8. A 35-year-old female comes to the clinic due to episodic palpitations and lightheadedness. Her medical history is significant for asthma which is controlled with inhaled albuterol, rheumatoid arthritis, and a diagnosis of acute rheumatic fever during childhood. Physical examination reveals an irregular pulse and an obese habitus with a BMI of 35 kg/m2. An echocardiogram shows a dilated left atrium. An ECG is shown below.

History of rheumatic fever

Which of the following is the most likely cause of this patient’s condition?

  1. Asthma
  2. History of rheumatic fever
  3. Obesity
  4. Rheumatoid arthritis

9. A 49-year-old female presents to the emergency department. She complains of a strange sensation in her chest as if her "heart is beating irregularly". On examination, her heart rate is 101/minute and irregularly irregular, her blood pressure is 108/81 mmHg, and her oxygen saturation is 97% on room air. She is a smoker and has not been getting enough rest for the last few weeks. An electrocardiogram is done. What is the most likely diagnosis?

Ventricular tachycardia
  1. Premature ventricular contraction
  2. Ventricular tachycardia
  3. Ventricular fibrillation
  4. Third-degree heart block

10. A 23-year-old male comes to the clinic due to episodic palpitations and lightheadedness for the past couple of months. He also reports chest discomfort and difficulty in breathing associated with these episodes. He says that holding his breath helps in controlling the symptoms. His medical history is significant for panic disorder for which he is undergoing cognitive behavioral therapy. Physical examination reveals regular tachycardia. An ECG is shown below.

Paroxysmal supraventricular tachycardia

Which of the following is the most likely diagnosis?

  1. Atrial fibrillation
  2. Panic attack
  3. Paroxysmal supraventricular tachycardia
  4. Ventricular fibrillation

11. A 62-year-old male patient presents to the emergency department with worsening shortness of breath, fatigue, and lower extremity edema. He has a history of chronic heart failure with reduced ejection fraction and is currently being treated with lisinopril, carvedilol, and furosemide. On examination, he has an elevated jugular venous pressure, bibasilar crackles on lung auscultation, and peripheral oedema. Electrocardiogram shows sinus tachycardia with left ventricular hypertrophy. Which medication is contraindicated in this patient's current clinical condition?

  1. Digoxin
  2. Hydralazine
  3. Amlodipine
  4. Spironolactone

12. A 14-year-old boy is in the middle of a basketball game when he suddenly becomes dizzy and collapses. An ambulance is called. He has no prior medical problems and was thought to have a benign murmur on his previous physical examination. When paramedics arrive, the patient is awake but uncomfortable, and complaining of a rapid heart rate. While the ECG (shown below) is obtained, he loses consciousness and becomes pulseless. With initiation of CPR and the application of a defibrillator, he regains a normal rhythm. During his ensuing workup, which test will likely diagnose the cause of this episode?

An echocardiogram
  1. An exercise stress test
  2. An echocardiogram
  3. A nuclear myocardial perfusion scan
  4. A Holter monitor

13. A 60-year-old man presented with loss of consciousness, severe anterior chest tearing pain, and shortness of breath. MR angiography demonstrated an ascending aorta intimal flap confirming the type B aortic dissection diagnosis. Which of the following represents the next step in this patient's management?

  1. Medical management
  2. Surgery
  3. Surveillance by USG
  4. No treatment

14. A 70-year-old woman presents after an episode of syncope. She reports chest pain and dyspnea for the last day. Auscultation reveals a late peaking systolic murmur that is best heard over the second right intercostal space. She continues to feel light-headed and is reporting persistent chest pain. Which of the following is correct regarding the management of the most likely diagnosis?

  1. Emergent CT angiography of the chest is indicated
  2. Intra-aortic balloon pump therapy is contraindicated if refractory cardiogenic shock occurs
  3. Nitrates and diuretics should be utilized to decrease preload
  4. Small fluid boluses should be provided

15. A 55-year-old man with a history of IV drug use presents to the emergency department with complaints of fever, chills, and fatigue for the past week. He also reports a new onset of shortness of breath and chest pain. On examination, he has a fever of 101.5°F, tachycardia, and a heart murmur. Blood cultures are positive for Staphylococcus aureus. A transthoracic echocardiogram reveals vegetation on the mitral valve with associated regurgitation. The patient is diagnosed with infective endocarditis. What is the pathophysiology of infective endocarditis?

  1. Bacteria directly invade the endocardium.
  2. The formation of immune complexes causing inflammation and damage to the endocardium.
  3. Endothelial layer disruption leading to sterile vegetation formation.
  4. Clot formation leads to embolization and subsequent infection of the endocardium.

16. A 20-year-old man presents in the medical emergency room with shortness of breath and bilateral pedal swellings from the last 2 days. He has a previous history of malignant melanoma for the last 2 years, for which he didn't take any treatment. On examination, his blood pressure is 80/60mmHg, heart rate is 110/min, and respiratory rate is 26/min. His JVP is raised with a paradoxical rise during inspiration. Heart sounds are muffled, and pulsus paradoxus is present. Considering the underlying diagnosis, which of the following echocardiographic findings is highly sensitive for this condition?

  1. Left atrial inversion sign
  2. Right atrial inversion sign
  3. McConnell's sign
  4. 60/60 sign

17. A 53-year-old male with HTN presents to the ER with a 2-hour history of progressive intermittent chest tightness with radiation to the right arm. The pain occurs more with exertion and is accompanied by shortness of breath and nausea. His ECG in triage shows sinus rhythm at 72 bpm with ST elevations of 2mm in II, III, and AvF. There are reciprocal ST depressions in the anterior leads. His blood pressure is 175/100. Your hospital has emergent PCI available. While waiting for the cardiologist and the CATH team to arrive, which off the following treatments are most appropriate for him?

  1. Nitroglycerine sublingual and aspirin PO, and unfractionated heparin and diltiazem intravenously
  2. Aspirin PO, and metroprolol and unfractionated heparin intravenously
  3. Aspirin PO and heparin intravenously
  4. Hydralizine and aspirin and propranolol PO

18. A 60-year-old man with a smoking history presents to the emergency department complaining of chest pain that started 2 hours ago while mowing the lawn. The pain is described as squeezing, pressure-like, and radiating to his left arm. He also reports shortness of breath and sweating. On examination, he appears pale, diaphoretic, and anxious. His cardiac enzymes are elevated, indicating myocardial injury. Electrocardiogram (ECG) shows ST-segment depression in leads V1 to V4. He is immediately started on aspirin, clopidogrel, nitroglycerin, and heparin to stabilize his condition. Coronary angiography is performed, which reveals a significant blockage in his left anterior descending artery (LAD). Which of the following post-management strategies would be appropriate?

  1. Initiate thrombolytic therapy
  2. Discharge home with no further treatment
  3. Initiate dual antiplatelet therapy and statin medication
  4. Start beta-blocker medication to control blood pressure

19. A 40-year-old male presents with sharp pain in his epigastrium and left lower chest that started about 20 minutes ago. He says he had just finished exercising when suddenly the pain started. He had some mild SOB with it but that was all. No radiation. He has no medical history and his father only has a history of HTN. He does not smoke. The ambulance gave him ASA prior to arrival and his pain is now about 5/10. His vitals are BP 130/90 mm Hg, HR 60 bpm, RR 20/ min, Temp 99.0°F , sPO2- 97% on RA. His ECG is attached. What is your next course of action with this patient?

early STEMI
  1. The EKG is nonspecific so he needs a set of cardiac enzymes but his story sounds more like PE so he needs D-DImer and if positive, needs a CT with contrast of the chest
  2. This is suspicious for an early STEMI. He needs clopidogrel, SL NTG, heparin, labs, a chest X-ray, and an ECG with leads V7-V9.
  3. This is suspicious for myocardial ischemia. He needs to be started on fractionated heparin subcutaneously, and a set of enzymes needs to be sent. He should be admitted for a three-enzyme rule-out
  4. His EKG is pretty much normal. It is likely he is deconditioned and needs reassurance and can be sent home

20. A 65-year-old male presents to the clinic with occasional chest pain and shortness of breath brought on by exertion. On examination, his vital signs are within normal ranges except his blood pressure which is 150/95mmHg. ECG shows ST depressions in V1 and V2 leads. Laboratory investigations, including cardiac biomarkers, suggest non-ST elevation myocardial infarction (NSTEMI). What of the following gives the correct location of the ischaemic changes in this patient?

  1. The lateral wall of the heart
  2. The inferior wall of the heart
  3. The anterior wall of the heart
  4. The posterior wall of the heart

21. A 62-year-old male patient with a smoking history and hyperlipidemia underwent coronary artery bypass grafting (CABG) surgery for triple-vessel coronary artery disease. The patient is now postoperative day 4 and has developed a fever. Labs reveal an elevated white blood cell count. On examination, the patient's sternum is tender to palpation with a purulent discharge from the surgical incision site. What is the most likely complication of CABG in this patient?

  1. Myocardial infarction
  2. Stroke
  3. Bleeding
  4. Deep sternal wound infection

22. A 4-month-old boy is brought to the paediatric outpatient department by his parents due to growth failure. The mother’s pregnancy was uneventful, and the boy was delivered by vaginal delivery at 37 weeks of gestation. Physical examination reveals a wide pulse pressure and a continuous machinery murmur in the left second intercostal space. What is the most likely diagnosis?

  1. Patent ductus arteriosus
  2. Ventricular septal defect
  3. Atrial septal defect
  4. Tricuspid atresia

23. A 52-year-old man presents to the emergency department with a history of deep vein thrombosis (DVT). He was started on heparin therapy 3 days ago. On examination, his blood pressure is 110/70 mmHg, and his heart rate is 90 beats per minute. He complains of difficulty breathing and chest pain. Laboratory investigations reveal a decrease in platelet count. What is the most likely complication of heparin therapy in this patient?

  1. Bleeding
  2. Thrombocytopenia
  3. Hyperkalemia
  4. Hypertension

24. A 28-year-old male patient comes to the clinic for a checkup. He has no active complaints. His average blood pressure is 158/92 mmHg on three separate readings. He has no family history of elevated blood pressure. Despite therapy, his blood pressure fails to reduce. He later on informs the physician that he has been taking anabolic steroids for many years to increase his muscle mass. Among the following choices, what is the most likely diagnosis?

  1. Elevated Blood Pressure
  2. Stage 1 of primary hypertension
  3. Stage 2 of primary hypertension
  4. Secondary hypertension

25. A 35-year-old woman presents to the medical outpatient clinic due to headaches, dizziness, and occasional chest pain for the past few weeks. She has a history of hypertension and takes medications for the same. On examination, her blood pressure is elevated at 150/90 mmHg. Laboratory investigations reveal elevated creatinine levels of 1.5 mg/dL. Imaging studies show bilateral renal artery stenosis with a "string of beads" appearance. What is the most appropriate management option for this patient's condition?

  1. Medical management with antihypertensive medications
  2. Percutaneous transluminal angioplasty
  3. Surgical revascularization
  4. Referral to a nutritionist for dietary management.

Hope you found this blog helpful for your NEET SS Cardiovascular preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs. 

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