FMCLA Cardiovascular and Pulmonary Medicine 3

Question 1

A patient presents with exertional dyspnea, orthopnea, and bilateral leg edema. BNP is 850 pg/mL. The most likely diagnosis is:

Accepted Answer

Decompensated heart failure

Answer

Elevated BNP with dyspnea, orthopnea, and edema strongly indicates decompensated heart failure with volume overload.

Question 2

Which antiarrhythmic drug is the most commonly used for long-term maintenance of sinus rhythm in atrial fibrillation?

Accepted Answer

Amiodarone

Answer

Amiodarone is the most effective antiarrhythmic for maintaining sinus rhythm in AF and is widely used despite its side effect profile.

Question 3

What is the pathophysiology underlying hypoxemia in pulmonary embolism?

Accepted Answer

Ventilation-perfusion (V/Q) mismatch

Answer

PE causes dead space ventilation (ventilated but unperfused alveoli), resulting in V/Q mismatch and subsequent hypoxemia.

Question 4

A patient with COPD has an FEV1 of 45% predicted. According to GOLD staging, this falls into which category?

Accepted Answer

GOLD 3 (Severe)

Answer

GOLD Grade 3 (Severe) is defined as FEV1 between 30% and 49% predicted, indicating significant airflow limitation.

Question 5

Which intervention has the greatest evidence-based mortality benefit in COPD patients with significant hypoxemia?

Accepted Answer

Long-term oxygen therapy

Answer

Long-term oxygen therapy (>15 hours/day) in COPD patients with resting PaO2 ≤55 mmHg is the only intervention proven to reduce mortality.

FMCLA - Family Medicine Certification Longitudinal Assessment Practice Test