Patient Care & Risk Management Flashcards
7 cards from real CCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Care & Risk Management flashcards as text
A patient with HFpEF (LVEF 58%) presents with volume overload. Which class of medications has the most robust evidence for symptom relief and reducing hospitalizations in HFpEF?
Answer: SGLT-2 inhibitors
SGLT-2 inhibitors (empagliflozin, dapagliflozin) are the only drug class with robust trial evidence reducing HF hospitalizations and cardiovascular death in HFpEF.
A 45-year-old patient with familial hypercholesterolemia has LDL-C of 210 mg/dL despite maximally tolerated statin plus ezetimibe. What is the NEXT recommended therapeutic addition?
Answer: PCSK9 inhibitor
PCSK9 inhibitors (alirocumab, evolocumab) are recommended when maximally tolerated statin plus ezetimibe fails to achieve adequate LDL-C reduction, particularly in FH.
A patient is referred for cardiac evaluation prior to a high-risk non-cardiac surgery. The patient can climb two flights of stairs without symptoms. What does this functional capacity represent, and does it require further cardiac testing?
Answer: ≥4 METs; additional cardiac stress testing is generally not required
Climbing two flights of stairs represents ≥4 METs of functional capacity; ACC/AHA guidelines suggest surgery can proceed without further cardiac testing if this threshold is met.
Which component of the GRACE risk score is used specifically for risk stratification of ACS patients?
Answer: Serum creatinine level
Serum creatinine (reflecting renal function) is one of the eight variables in the GRACE score used to predict in-hospital and 6-month mortality in ACS.
A patient on long-term amiodarone therapy for persistent atrial fibrillation is found to have elevated TSH and low free T4. What is the most likely cause?
Answer: Amiodarone-induced hypothyroidism
Amiodarone contains high iodine content and can cause hypothyroidism by blocking thyroid hormone synthesis (Wolff-Chaikoff effect), presenting with elevated TSH and low T4.
A post-MI patient is enrolled in cardiac rehabilitation but reports severe depression and social isolation. Which intervention BEST addresses psychosocial risk in cardiovascular secondary prevention?
Answer: Integrate cognitive behavioral therapy or referral to mental health professional alongside cardiac rehab
Depression is an independent cardiovascular risk factor; integrating psychosocial interventions such as CBT alongside cardiac rehab improves both mental health and cardiac outcomes.
A 58-year-old woman with no prior cardiovascular disease has an intermediate ASCVD risk of 12%. Her coronary artery calcium score returns at 150 Agatston units. How should this result change her management?
Answer: CAC >100 reclassifies her to higher risk, favoring initiation of statin therapy
A CAC score >100 in an intermediate-risk patient reclassifies them to higher risk and supports initiating statin therapy per ACC/AHA 2019 guidelines.