Treatment Planning & 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 Treatment Planning & Management flashcards as text
A patient with type 2 diabetes and established atherosclerotic cardiovascular disease is already on metformin. Which add-on agent provides the most cardiovascular mortality benefit?
Answer: Empagliflozin (SGLT2 inhibitor)
SGLT2 inhibitors like empagliflozin demonstrated significant reduction in CV death and HF hospitalizations in high-CV-risk diabetic patients in the EMPA-REG OUTCOME trial.
A 55-year-old on high-intensity statin therapy still has LDL-C of 105 mg/dL after a recent MI. What is the next recommended pharmacologic step?
Answer: Add ezetimibe
Ezetimibe is the first add-on to maximally tolerated statin therapy when LDL-C remains above goal after ACS, as proven in the IMPROVE-IT trial.
A patient with New York Heart Association Class III HFrEF has LBBB with QRS duration of 158 ms and EF of 25% despite optimal medical therapy. What additional therapy is indicated?
Answer: Cardiac resynchronization therapy (CRT)
CRT is indicated for LBBB with QRS ≥150 ms in NYHA Class II–III HFrEF patients on optimal medical therapy; it improves EF, symptoms, and survival.
Which antiplatelet regimen is recommended after bare-metal stent (BMS) implantation for stable CAD?
Answer: Dual antiplatelet therapy (DAPT) for at least 1 month, then aspirin
After BMS in stable CAD, DAPT with aspirin plus a P2Y12 inhibitor for at least 1 month is recommended to prevent stent thrombosis, then aspirin alone.
A patient with acute aortic dissection (Type A) presents with hemodynamic instability. What is the immediate management priority?
Answer: Emergent surgical repair
Type A aortic dissection is a surgical emergency; immediate operative repair is indicated regardless of hemodynamic status due to risk of cardiac tamponade and aortic rupture.
A 68-year-old with peripheral artery disease and claudication has an ABI of 0.55. Which medication most directly reduces limb and CV events in this population?
Answer: Rivaroxaban 2.5 mg BID plus aspirin 100 mg
The COMPASS trial demonstrated that rivaroxaban 2.5 mg BID plus aspirin significantly reduced MACE and limb events compared to aspirin alone in PAD patients.
After successful cardioversion of atrial fibrillation, anticoagulation with therapeutic levels should be maintained for at least how long to prevent thromboembolic events?
Answer: 4 weeks
Atrial mechanical stunning after cardioversion persists for up to 4 weeks, so therapeutic anticoagulation must be maintained for at least 4 weeks post-cardioversion to prevent thromboembolism.