A 24-year-old man is evaluated in hospital. He occasionally uses cocaine and consumes alcohol. He is 6’5″. BMI is 22.

Which of the following is most likely to be seen in this patient?

A) Aortic dissection
B) Bicuspid aortic valve
C) Myxomatous degeneration
D) Pulsus paradoxus
E) Wide pulse pressure

A 39-year-old woman comes to the physician for a 3-month history of intermittent intense sweating, diarrhea, and palpitations. Urinary 5-hydroxyindoleacetic acid is increased.

Which of the following is most likely to be seen in this patient?

A) 2/6 Early-diastolic murmur
B) 2/6 Holosystolic murmur that increases with inspiration
C) 2/6 Mid-systolic murmur
D) 3/6 Opening snap + diastolic murmur
E) 4/6 To-and-fro murmur

A 45-year-old man is evaluated in hospital. His cardiac auscultation is shown.

Which of the following is the most likely explanation for this patient’s findings?

A) Bicuspid aortic valve
B) Carcinoid syndrome
C) Dissection
D) History of rheumatic heart disease
E) Myxomatous degeneration

A 28 year-old-woman at 36 weeks’ gestation presents to the obstetrician for an antenatal appointment. Her pregnancy has been uncomplicated. Physical examination shows mild bilateral edema at the ankles. There is a 2/6 systolic murmur at the upper left sternal border. The lungs are clear to auscultation. Which of the following is the most likely explanation for this patient’s findings?

A) Antibodies against myocardium
B) Bicuspid aortic valve
C) Myxomatous degeneration
D) Functional murmur
E) Stenosis of the mitral valve

A 50-year-old woman is evaluated in hospital.

Which of the following is the most likely location of the patient’s pathology?

A) Atrium
B) AV node
C) His-Purkinje system
D) SA node
E) Ventricle

A 61-year-old woman comes to the physician for a follow-up appointment. She has no past medical history but inquires about how she can improve her overall health. She says she has heard saturated fats are bad for her blood vessels and heart. Which of the following is the most predominant mechanism behind the effect of saturated fat on cardiovascular health?

A) Decreased LDL receptor expression on adipocytes
B) Decreased LDL receptor expression on hepatocytes
C) Direct inhibition of sterol-regulatory element binding protein-2 (SREBP-2) transcription
D) Increased hepatic production of LDL
E) Increased plasma clearance of HDL

A 39-year-old man is brought in by ambulance following a motor vehicle accident. His blood pressure is 70/20. There is marked jugular venous distention. Heart sounds are distant. Which of the following is most likely to be seen in this patient?

A) Bounding pulsus
B) Delayed carotid upstroke
C) Paradoxical pulse
D) S3
E) S4

A 56-year-old man is evaluated in hospital. Cardiac  auscultation is performed.

Which of the following is the most likely explanation for this patient’s findings?

A) Aortic dissection
B) Calcified bicuspid aortic valve
C) Immune hypersensitivity
D) Intravenous drug use
E) Myxomatous degeneration

A 36-year-old man is evaluated in hospital. Cardiopulmonary auscultation is performed.

Which of the following is most likely to be seen in this patient?

A) Cocaine use
B) History of 20-30 episodes of left-sided “fleeting” chest pain
C) Murmur that increases with inspiration
D) Myocardial ischemia
E) Myxomatous degeneration

A 71-year-old man is brought in by ambulance after an episode of crushing chest pain. He has a history of hypertension and diabetes. Which of the following vessels is most likely occluded in this patient?

A) Left anterior descending artery
B) Left circumflex artery
C) Left main coronary artery
D) Obtuse marginal artery
E) Posterior descending artery