CMC Risk Assessment & Management 3

Question 1

A 55-year-old woman with type 2 diabetes has an LDL of 105 mg/dL and no prior cardiovascular events. Per 2018 ACC/AHA guidelines, what is her statin therapy indication?

Accepted Answer

Moderate- to high-intensity statin given diabetes as a risk-enhancing condition

Answer

Adults aged 40–75 with diabetes are candidates for moderate- to high-intensity statin; high-intensity is preferred when multiple risk factors or 10-year ASCVD risk ≥ 20% is present.

Question 2

Which hemodynamic parameter measured during right heart catheterization most directly quantifies pulmonary vascular resistance (PVR)?

Accepted Answer

(Mean PAP − PCWP) / cardiac output

Answer

PVR = (mean PAP − PCWP) / cardiac output, expressed in Wood units, and differentiates pre-capillary from post-capillary pulmonary hypertension.

Question 3

In a patient with stable ischemic heart disease, which non-invasive test result best identifies high-risk findings that mandate prompt coronary angiography?

Accepted Answer

Nuclear stress test with ≥ 10% ischemic myocardium at low workload

Answer

Ischemic myocardium ≥ 10% on nuclear perfusion imaging at low workload is a high-risk feature that warrants referral for coronary angiography.

Question 4

Which scoring system is used to estimate the operative mortality risk of patients undergoing cardiac surgery, and is commonly used in pre-operative cardiac risk stratification?

Accepted Answer

STS Risk Score

Answer

The Society of Thoracic Surgeons (STS) Risk Score estimates operative mortality and morbidity for cardiac surgical procedures and guides surgical candidacy decisions.

Question 5

In a patient with peripheral artery disease (PAD) and an ankle-brachial index (ABI) of 0.65, what is the most appropriate first-line cardiovascular risk-reduction therapy?

Accepted Answer

High-intensity statin therapy plus antiplatelet therapy

Answer

Patients with PAD (ABI < 0.9) have high ASCVD risk; high-intensity statin plus antiplatelet therapy (aspirin or clopidogrel) is the guideline-recommended medical management.

CMC - Cardiac Medicine Certification Practice Test

CMC - Cardiac Medicine Certification Practice Test

CMC Risk Assessment & Management 3