AMC MCQ Cardiovascular Medicine 2

Question 1

A 65-year-old man presents with crushing central chest pain radiating to the left arm for 40 minutes. ECG shows ST elevation in leads II, III and aVF. Which coronary artery is most likely occluded?

Accepted Answer

Right coronary artery

Answer

Inferior STEMI (leads II, III, aVF) most commonly results from right coronary artery occlusion.

Question 2

Which medication should be avoided in a patient with an inferior STEMI complicated by right ventricular infarction and hypotension?

Accepted Answer

Glyceryl trinitrate

Answer

Nitrates reduce preload and can cause severe hypotension in preload-dependent right ventricular infarction.

Question 3

A patient with acute coronary syndrome receives fibrinolysis. Which finding best indicates successful reperfusion?

Accepted Answer

Resolution of ST elevation by more than 50%

Answer

Greater than 50% resolution of ST elevation within 60-90 minutes indicates successful reperfusion.

Question 4

What is the recommended door-to-balloon time target for primary percutaneous coronary intervention in STEMI?

Accepted Answer

Within 90 minutes

Answer

Primary PCI should be performed within 90 minutes of first medical contact for best outcomes.

Question 5

A 58-year-old diabetic woman presents with epigastric discomfort, nausea and fatigue but no chest pain. ECG shows new ST depression. What is the most likely diagnosis?

Accepted Answer

Atypical acute coronary syndrome

Answer

Women and diabetics often present with atypical ACS symptoms such as epigastric pain and fatigue.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Cardiovascular Medicine 2