CMC Certification Cardio Vascular 3

Question 1

A patient develops wide complex tachycardia at 180 bpm with AV dissociation on 12-lead ECG. What is the most likely diagnosis?

Accepted Answer

Ventricular tachycardia

Answer

AV dissociation during wide complex tachycardia is a definitive criterion for ventricular tachycardia and distinguishes it from supraventricular causes.

Question 2

What is the most common cause of sudden cardiac death in athletes under 35 years of age in the United States?

Accepted Answer

Hypertrophic cardiomyopathy

Answer

Hypertrophic cardiomyopathy is the leading cause of sudden cardiac death in young US athletes, often due to ventricular fibrillation triggered by exertion.

Question 3

Which echocardiographic parameter best estimates left ventricular filling pressure non-invasively?

Accepted Answer

E/e' ratio

Answer

The E/e' ratio (ratio of mitral inflow E velocity to tissue Doppler e' velocity) correlates best with invasive left ventricular end-diastolic pressure.

Question 4

A patient with known HFrEF presents with worsening dyspnea. BNP is 900 pg/mL. Which intervention most directly reduces BNP release?

Accepted Answer

Initiating sacubitril/valsartan (ARNI)

Answer

Sacubitril inhibits neprilysin, which degrades BNP; however, ARNI therapy reduces wall stress (the stimulus for BNP release) more than it elevates BNP by degradation inhibition, resulting in net clinical improvement and symptom reduction.

Question 5

Which ECG pattern is characteristic of Wellens syndrome and indicates critical LAD stenosis?

Accepted Answer

Biphasic or deeply inverted T waves in V2-V3 during pain-free state

Answer

Wellens syndrome presents with characteristic biphasic or deeply inverted T waves in V2-V3 during a pain-free period, signifying critical proximal LAD stenosis and impending anterior MI.

CMC - Cardiac Medicine Certification Practice Test

CMC - Cardiac Medicine Certification Practice Test

CMC Certification Cardio Vascular 3