Family Practice Exam Family Practice Exam Cardiovascular Medicine 2

Question 1

A patient presents with sudden palpitations, HR 158 bpm, and an irregularly irregular rhythm on exam. What is the most likely diagnosis?

Accepted Answer

Atrial fibrillation

Answer

An irregularly irregular rhythm at a rapid rate is the hallmark clinical finding of atrial fibrillation.

Question 2

Which physical exam finding is most specific for heart failure with reduced ejection fraction?

Accepted Answer

S3 gallop

Answer

An S3 gallop (third heart sound) is highly specific for ventricular volume overload and reduced ejection fraction in heart failure.

Question 3

What is the LDL goal for a patient with established atherosclerotic cardiovascular disease (ASCVD)?

Accepted Answer

Less than 70 mg/dL

Answer

ACC/AHA guidelines recommend an LDL target of <70 mg/dL for patients with established ASCVD due to their very high cardiovascular risk.

Question 4

A patient with HFrEF on lisinopril develops a persistent dry cough. What is the best medication change?

Accepted Answer

Switch to an ARB

Answer

ARBs provide equivalent cardiovascular benefits to ACE inhibitors without causing bradykinin-mediated cough.

Question 5

Which valve lesion produces a harsh systolic ejection murmur best heard at the right upper sternal border radiating to the carotids?

Accepted Answer

Aortic stenosis

Answer

Aortic stenosis classically produces a harsh crescendo-decrescendo systolic murmur at the right second intercostal space that radiates to the carotid arteries.

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Family Practice Exam Family Practice Exam Cardiovascular Medicine 2