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Cardiology Flashcards

7 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Cardiology flashcards as text

  1. A 31-year-old woman at 34 weeks' gestation has new HFrEF (EF 30%). Which afterload-reducing regimen is most appropriate before delivery?

    Answer: Hydralazine plus isosorbide dinitrate

    ACE inhibitors, ARBs/ARNIs, and mineralocorticoid antagonists are avoided in pregnancy because of fetal toxicity, so hydralazine-nitrate is used.

  2. A patient with an LVEF of 30% has an aortic valve area of 0.8 cm² and a mean gradient of 25 mmHg. Which test best distinguishes true severe aortic stenosis from pseudo-severe stenosis?

    Answer: Low-dose dobutamine stress echocardiography

    With dobutamine, true severe AS keeps a small valve area as the gradient rises, while in pseudo-severe AS the valve area increases.

  3. A 46-year-old man has blood pressure of 168/100 mmHg on three agents including a diuretic, plus spontaneous hypokalemia. What is the best initial screening test?

    Answer: Plasma aldosterone-to-renin ratio

    Resistant hypertension with hypokalemia strongly suggests primary aldosteronism, which is screened with the aldosterone-renin ratio.

  4. Which patient should receive antibiotic prophylaxis before a dental extraction?

    Answer: A patient with prior infective endocarditis

    Prophylaxis is limited to the highest-risk groups (prosthetic valves, prior IE, certain congenital heart disease, and cardiac transplant valvulopathy).

  5. A 60-year-old woman with moderate rheumatic mitral stenosis develops atrial fibrillation. Which anticoagulant is preferred?

    Answer: Warfarin

    Patients with AF and moderate-to-severe rheumatic mitral stenosis were excluded from DOAC trials, so warfarin is recommended.

  6. A 58-year-old nondiabetic man with HFrEF (EF 30%) is on sacubitril-valsartan, carvedilol, and spironolactone, with an eGFR of 45. What should be added next?

    Answer: Dapagliflozin

    SGLT2 inhibitors are a pillar of guideline-directed therapy and reduce HF hospitalization and death whether or not the patient has diabetes.

  7. A 40-year-old man has a first episode of acute idiopathic pericarditis with pleuritic chest pain and diffuse ST elevation. Which regimen best reduces the risk of recurrence?

    Answer: High-dose NSAID plus colchicine for 3 months

    Adding colchicine for about 3 months to NSAID/aspirin therapy roughly halves recurrence rates, while early corticosteroids increase recurrence.

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