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USMLE (United States Medical Licensing Examination) Practice Exam 04

Practice exam for USMLE (United States Medical Licensing Examination).

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Question 1 of 1000%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

MEDIUM

A 58-year-old man with long-standing hypertension presents with progressive exertional dyspnea and lower-extremity edema. Physical examination shows elevated jugular venous pressure, a laterally displaced apical impulse, and bibasilar crackles. Echocardiography shows left ventricular ejection fraction of 30% and eccentric hypertrophy. Which of the following cellular adaptations most likely contributed to the ventricular remodeling in this patient?

Chronic pressure/volume stress causes cardiomyocyte hypertrophy via increased protein synthesis and sarcomere addition (remodeling). Adult cardiomyocytes have minimal proliferative capacity, so hyperplasia is not the primary response.

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