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FCPS Part 1 Cardiovascular MCQs
Cardiovascular physiology questions test the cardiac cycle, pressure and volume changes, cardiac output and its determinants, heart sounds and murmurs, the ECG and the control of blood pressure.
Below are 5 free single-best-answer questions drawn from the most frequently examined cardiovascular concepts, each with the answer and a rationale for every option. The full bank has 177 cardiovascular concepts, each asked several different ways.
Free cardiovascular questions
Question 1
Which valve lesion produces a bounding, rapidly collapsing radial pulse?
- A. Mitral regurgitation
- B. Mitral stenosis
- C. Pulmonary stenosis
- D. Aortic stenosis
- E. Aortic regurgitation
Show answer
Answer: E. Aortic regurgitation
Backflow from the aorta in diastole lowers diastolic pressure and raises stroke volume, producing a wide pulse pressure. The left ventricle dilates with eccentric hypertrophy from volume overload.
Why not the others: Aortic stenosis: narrow pulse pressure, systolic murmur. Mitral stenosis: mid-diastolic rumble, loud S1. Mitral regurgitation: pansystolic apical murmur. Pulmonary stenosis: right ventricular ejection murmur.
High-yield: Wide pulse pressure + early diastolic murmur = aortic regurgitation.
Question 2
Pansystolic apical murmur radiating to axilla, with atrial fibrillation:
- A. Aortic regurgitation
- B. Pulmonary regurgitation
- C. Tricuspid stenosis
- D. Aortic stenosis
- E. Mitral regurgitation
Show answer
Answer: E. Mitral regurgitation
Regurgitant flow into the left atrium throughout systole causes a pansystolic murmur. Chronic volume overload dilates the atrium (AF) and ventricle, producing an S3.
Why not the others: Aortic stenosis: ejection systolic murmur. Pulmonary regurgitation: early diastolic murmur. Tricuspid stenosis: diastolic, right-sided. Aortic regurgitation: early diastolic.
High-yield: Pansystolic apex-to-axilla murmur = MR.
Question 3
Oedema in nephrotic syndrome results mainly from which change in the capillary?
- A. Increased capillary permeability
- B. Increased hydrostatic pressure
- C. Salt retention alone
- D. Decreased oncotic pressure
- E. Increased oncotic pressure
Show answer
Answer: D. Decreased oncotic pressure
Albumin supplies about 80% of plasma oncotic pressure. Urinary loss in nephrotic syndrome or failed synthesis in cirrhosis lowers it, so filtration exceeds reabsorption.
Why not the others: Raised hydrostatic pressure: heart failure and venous stasis. Raised oncotic pressure: opposes oedema. Permeability change: inflammation. Lymphatic block: lymphoedema.
High-yield: Low albumin states (nephrotic, cirrhosis) → oedema via low oncotic pressure.
Question 4
Loud S1, then a snap after S2 and an apical low-pitched diastolic rumble, point to:
- A. Tricuspid stenosis
- B. Aortic regurgitation
- C. Aortic stenosis
- D. Mitral regurgitation
- E. Mitral stenosis
Show answer
Answer: E. Mitral stenosis
Rheumatic fusion of the mitral leaflets raises left atrial pressure, causing pulmonary venous congestion, left atrial dilatation and later pulmonary hypertension. The LV is usually spared.
Why not the others: Aortic regurgitation: early diastolic murmur and wide pulse pressure. Mitral regurgitation: pansystolic apical murmur. Tricuspid stenosis: diastolic murmur at the left sternal edge, rare. Aortic stenosis: ejection systolic murmur.
High-yield: Shorter S2 to opening snap interval means more severe stenosis.
Question 5
Inferior rib notching on the chest film of a young adult hypertensive points to:
- A. Patent ductus arteriosus
- B. Postductal coarctation of aorta
- C. Ascending aortic aneurysm
- D. Preductal coarctation of aorta
- E. Aortic arch aneurysm
Show answer
Answer: B. Postductal coarctation of aorta
Narrowing distal to the ductus lets lower-body blood flow via subclavian, internal thoracic and intercostal collaterals. Years of dilated intercostal arteries erode the lower rib borders.
Why not the others: Preductal: infantile, ductus-dependent, no time for collaterals. Aortic arch aneurysm: dilatation, not hypertension with delay. Ascending aneurysm: no leg gradient. PDA: continuous murmur. VSD: pansystolic murmur.
High-yield: Rib notching needs years of collateral flow: adult postductal coarctation.
Keep going with cardiovascular
Anaesgen brings every concept back on a spaced-repetition schedule timed to your exam date, as a different question each time, with full mock papers for Paper 1 and 2.
Get full access Try the 5 sample questionsHigh-yield cardiovascular one-liners
The most-tested cardiovascular concepts, as a clue and the answer it points to:
- Collapsing pulse, wide pulse pressure, early diastolic murmur, de Musset → aortic regurgitation.
- Citrate in transfused blood, parathyroid injury, Trousseau, Chvostek → hypocalcaemia.
- Even blood in all tubes or xanthochromia → SAH.
- Pansystolic apical murmur, axillary radiation, S3, AF → mitral regurgitation.
- Nephrotic or liver disease → low albumin → low oncotic pressure.
- Opening snap, mid-diastolic rumble, loud S1, rheumatic fever → mitral stenosis.
- Rib notching, intercostal collaterals, adult radiofemoral delay → postductal coarctation.
- Left-hand astereognosis, left hemineglect → right parietal cortex.
- Controlled asthma plus past MI, limiting disease → ASA 3.
- Child, pansystolic murmur, left sternal edge, thrill → VSD.
- Hyperkalaemia with ECG changes, membrane stabilisation → calcium gluconate.
- MI death within 24 h, sudden, pre-hospital → cardiac arrhythmia (VF).
- Strong arms, weak legs, radiofemoral delay, bicuspid valve → coarctation of aorta.
- Blowing, high-pitched, left sternal edge → early diastolic murmur.
- RPF down, GFR up, filtration fraction up, angiotensin II → efferent constriction.
- Lower heart rate, same cardiac output → stroke volume rises.
- Postpartum haemorrhage, no lactation, amenorrhoea → panhypopituitarism (Sheehan).
- Old transmural infarct, scar, permanent → pathological Q waves.
- Arm exercise, vertigo, inter-arm BP gap, reversed vertebral flow → subclavian steal.
- STEMI with no PCI, early ischaemic stroke → thrombolysis.
Other FCPS Part 1 subjects
AnatomyPharmacologyPathologyBiochemistry & GeneticsNeurophysiologyMicrobiologyHaematologyGeneral PhysiologyImmunologyEndocrineRespiratoryEmbryologyObstetrics & GynaeRenal & Acid-BaseHistologyGI & LiverPhysicsBiostatistics
New to the exam? Read the FCPS Part 1 exam guide: dates, format and a 12-week study plan.