FMCLA Cardiovascular and Pulmonary Medicine 2

Question 1

Which finding distinguishes cardiac asthma from primary asthma in a patient with wheezing and dyspnea?

Accepted Answer

Elevated BNP and orthopnea

Answer

Elevated BNP and orthopnea indicate a cardiac cause of wheezing (pulmonary edema), distinguishing it from primary asthma.

Question 2

A patient on ACE inhibitor therapy develops a dry, persistent cough. What is the most appropriate management?

Accepted Answer

Switch to an ARB

Answer

ACE inhibitor-induced cough is a class effect due to bradykinin accumulation; switching to an ARB eliminates the cough while maintaining cardiovascular benefit.

Question 3

Which auscultatory finding is most characteristic of aortic stenosis?

Accepted Answer

Crescendo-decrescendo systolic murmur at the right upper sternal border

Answer

Aortic stenosis produces a harsh crescendo-decrescendo systolic ejection murmur best heard at the right upper sternal border with radiation to the carotids.

Question 4

A patient with asthma requires step-up therapy. They are currently on a low-dose ICS alone. What is the preferred next step per GINA guidelines?

Accepted Answer

Add a LABA to the ICS

Answer

GINA guidelines recommend adding a long-acting beta-agonist (LABA) to inhaled corticosteroids (ICS) as the preferred step-up approach.

Question 5

Which electrocardiogram finding is most consistent with right heart strain seen in massive pulmonary embolism?

Accepted Answer

S1Q3T3 pattern

Answer

The S1Q3T3 pattern (deep S in I, Q wave and T inversion in III) is a classic but non-specific ECG finding associated with acute right heart strain in PE.

FMCLA - Family Medicine Certification Longitudinal Assessment Practice Test

FMCLA - Family Medicine Certification Longitudinal Assessment Practice Test

FMCLA Cardiovascular and Pulmonary Medicine 2