Try our Free PANE Practice questions 30 questions
1. A 65-year-old man presents with chest pain on exertion that is relieved by rest. What is the most likely diagnosis?
Answer: B. Stable angina
Explanation: Chest pain on exertion that is relieved by rest is characteristic of stable angina.
2. A 70-year-old woman presents with sudden onset of shortness of breath, palpitations, and dizziness. Her ECG shows an irregularly irregular rhythm with no distinct P waves. What is the most likely diagnosis?
Answer: C. Atrial fibrillation
Explanation: An irregularly irregular rhythm with no distinct P waves on ECG is indicative of atrial fibrillation.
3. A 58-year-old woman presents with chest pain at rest that radiates to her jaw. Her ECG shows ST-segment depression and T-wave inversion. What is the most likely diagnosis?
Answer: B. Unstable angina
Explanation: Chest pain at rest with ECG changes such as ST-segment depression and T-wave inversion is indicative of unstable angina.
4. A 45-year-old man presents with a tearing chest pain radiating to the back. His blood pressure is 180/110 mmHg, and there is a difference in blood pressure between his arms. What is the most likely diagnosis?
Answer: B. Aortic dissection
Explanation: A tearing chest pain radiating to the back with a difference in blood pressure between arms is characteristic of an aortic dissection.
5. A 55-year-old woman presents with fatigue and exertional dyspnoea. On examination, a crescendo-decrescendo systolic murmur is heard at the right second intercostal space. What is the most likely diagnosis?
Answer: B. Aortic stenosis
Explanation: A crescendo-decrescendo systolic murmur at the right second intercostal space is indicative of aortic stenosis.
6. A 60-year-old man with a history of hypertension presents with sudden onset of severe headache and visual disturbances. His blood pressure is 210/120 mmHg. What is the most likely diagnosis?
Answer: A. Hypertensive emergency
Explanation: Severe hypertension with end-organ damage such as headache and visual disturbances is indicative of a hypertensive emergency.
7. A 50-year-old man presents with palpitations and dizziness. His ECG shows a regular narrow complex tachycardia with a rate of 160 beats per minute. What is the most likely diagnosis?
Answer: C. Supraventricular tachycardia
Explanation: A regular narrow complex tachycardia with a rapid heart rate is indicative of supraventricular tachycardia.
8. A 75-year-old man presents with shortness of breath, leg swelling, and distended neck veins. On examination, he has a displaced apex beat and a third heart sound. What is the most likely diagnosis?
Answer: C. Congestive heart failure
Explanation: Shortness of breath, leg swelling, distended neck veins, a displaced apex beat, and a third heart sound are characteristic of congestive heart failure.
9. A 65-year-old woman presents with episodic chest pain, palpitations, and a "fluttering" feeling in her chest. Her ECG shows sawtooth-like flutter waves. What is the most likely diagnosis?
Answer: B. Atrial flutter
Explanation: Sawtooth-like flutter waves on ECG are indicative of atrial flutter.
10. A 55-year-old man presents with severe crushing chest pain radiating to his left arm. His ECG shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis?
Answer: C. Inferior myocardial infarction
Explanation: ST elevation in leads II, III, and aVF is indicative of an inferior myocardial infarction.
11. A 40-year-old woman presents with palpitations, sweating, and weight loss. On examination, she has a fine tremor and a regular rapid pulse. What is the most likely diagnosis?
Answer: A. Hyperthyroidism
Explanation: Palpitations, sweating, weight loss, fine tremor, and a regular rapid pulse are characteristic of hyperthyroidism.
12. A 75-year-old woman presents with fatigue, shortness of breath, and bilateral leg swelling. On examination, she has a raised jugular venous pressure and a third heart sound. What is the most likely diagnosis?
Answer: B. Congestive heart failure
Explanation: Fatigue, shortness of breath, bilateral leg swelling, raised jugular venous pressure, and a third heart sound are indicative of congestive heart failure.
13. A 60-year-old man presents with central crushing chest pain radiating to his jaw and left arm. His ECG shows ST elevation in leads V1-V4. What is the most likely diagnosis?
Answer: A. Anterior myocardial infarction
Explanation: ST elevation in leads V1-V4 is indicative of an anterior myocardial infarction.
14. A 50-year-old woman presents with sudden onset of severe tearing chest pain radiating to her back. She has a history of hypertension. What is the most likely diagnosis?
Answer: B. Aortic dissection
Explanation: Severe tearing chest pain radiating to the back in a patient with hypertension is characteristic of an aortic dissection.
15. A 45-year-old man presents with exertional dyspnoea and a heart murmur. On examination, he has a mid-systolic click followed by a late systolic murmur. What is the most likely diagnosis?
Answer: A. Mitral valve prolapse
Explanation: A mid-systolic click followed by a late systolic murmur is characteristic of mitral valve prolapse.
16. A 70-year-old man presents with sudden onset of shortness of breath and pleuritic chest pain. His D-dimer is elevated, and his ECG shows right heart strain. What is the most likely diagnosis?
Answer: B. Pulmonary embolism
Explanation: Sudden onset of shortness of breath, pleuritic chest pain, elevated D-dimer, and ECG showing right heart strain are indicative of a pulmonary embolism.
17. A 55-year-old woman presents with palpitations, shortness of breath, and dizziness. Her ECG shows a regular rhythm with a rate of 150 beats per minute and a sawtooth pattern. What is the most likely diagnosis?
Answer: B. Atrial flutter
Explanation: A regular rhythm with a rate of 150 beats per minute and a sawtooth pattern on ECG is indicative of atrial flutter.
18. A 65-year-old man presents with fatigue, palpitations, and shortness of breath. On examination, he has an irregularly irregular pulse and a displaced apex beat. What is the most likely diagnosis?
Answer: A. Atrial fibrillation
Explanation: Fatigue, palpitations, shortness of breath, an irregularly irregular pulse, and a displaced apex beat are indicative of atrial fibrillation.
19. A 50-year-old man presents with sudden onset of severe headache, visual disturbances, and weakness. His blood pressure is 220/130 mmHg. What is the most likely diagnosis?
Answer: B. Hypertensive emergency
Explanation: Severe hypertension with end-organ damage such as headache, visual disturbances, and weakness is indicative of a hypertensive emergency.
20. A 60-year-old woman presents with chest pain and shortness of breath. Her ECG shows ST elevation in leads I, aVL, V5, and V6. What is the most likely diagnosis?
Answer: B. Lateral myocardial infarction
Explanation: ST elevation in leads I, aVL, V5, and V6 is indicative of a lateral myocardial infarction.
21. A 72-year-old man presents with fatigue, dizziness, and syncope. His ECG shows a prolonged PR interval and dropped beats. What is the most likely diagnosis?
Answer: C. Second-degree heart block (Mobitz II)
Explanation: A prolonged PR interval with dropped beats is characteristic of second-degree heart block (Mobitz II).
22. A 55-year-old woman presents with fatigue, weight gain, and cold intolerance. On examination, she has bradycardia and a slow-relaxing reflex. What is the most likely diagnosis?
Answer: A. Hypothyroidism
Explanation: Fatigue, weight gain, cold intolerance, bradycardia, and slow-relaxing reflex are characteristic of hypothyroidism.
23. A 60-year-old man presents with sudden onset of severe chest pain and collapse. On examination, he has a widened mediastinum on chest X-ray. What is the most likely diagnosis?
Answer: C. Aortic dissection
Explanation: Severe chest pain, collapse, and a widened mediastinum on chest X-ray are indicative of an aortic dissection.
24. A 75-year-old woman presents with progressive dyspnoea and fatigue. On examination, she has a loud first heart sound and a diastolic rumble at the apex. What is the most likely diagnosis?
Answer: B. Mitral stenosis
Explanation: A loud first heart sound and a diastolic rumble at the apex are characteristic of mitral stenosis.
25. A 65-year-old man presents with exertional chest pain and syncope. On examination, he has a harsh systolic murmur at the right second intercostal space that radiates to the carotids. What is the most likely diagnosis?
Answer: A. Aortic stenosis
Explanation: Exertional chest pain, syncope, and a harsh systolic murmur at the right second intercostal space that radiates to the carotids are characteristic of aortic stenosis.
26. A 45-year-old woman presents with palpitations, sweating, and a feeling of impending doom. Her ECG shows a regular narrow complex tachycardia. What is the most likely diagnosis?
Answer: C. Supraventricular tachycardia
Explanation: Palpitations, sweating, a feeling of impending doom, and a regular narrow complex tachycardia on ECG are indicative of supraventricular tachycardia.
27. A 60-year-old man presents with sudden onset of severe back pain and hypotension. On examination, he has a pulsatile abdominal mass. What is the most likely diagnosis?
Answer: C. Aortic aneurysm rupture
Explanation: Severe back pain, hypotension, and a pulsatile abdominal mass are indicative of an aortic aneurysm rupture.
28. A 70-year-old woman presents with progressive exertional dyspnoea and orthopnoea. On examination, she has a displaced apex beat and a third heart sound. What is the most likely diagnosis?
Answer: B. Congestive heart failure
Explanation: Progressive exertional dyspnoea, orthopnoea, a displaced apex beat, and a third heart sound are indicative of congestive heart failure.
29. A 50-year-old man presents with palpitations, dizziness, and syncope. His ECG shows a prolonged QT interval. What is the most likely diagnosis?
Answer: C. Long QT syndrome
Explanation: Palpitations, dizziness, syncope, and a prolonged QT interval on ECG are indicative of long QT syndrome.
30. A 55-year-old woman presents with fatigue, weight gain, and cold intolerance. On examination, she has bradycardia and a slow-relaxing reflex. What is the most likely diagnosis?
Answer: A. Hypothyroidism
Explanation: Fatigue, weight gain, cold intolerance, bradycardia, and slow-relaxing reflex are characteristic of hypothyroidism.
Total Score: 0/30
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