FMCLA Cardiovascular and Pulmonary Medicine 1

Question 1

Which finding on spirometry is most consistent with obstructive lung disease?

Accepted Answer

FEV1/FVC ratio less than 0.70

Answer

An FEV1/FVC ratio below 0.70 post-bronchodilator is the diagnostic criterion for obstructive lung disease per GOLD guidelines.

Question 2

A 60-year-old male smoker presents with progressive dyspnea and chronic cough. Spirometry shows FEV1/FVC of 0.58. What is the diagnosis?

Accepted Answer

COPD

Answer

COPD is confirmed by post-bronchodilator FEV1/FVC <0.70 in a patient with relevant exposure history and symptoms.

Question 3

Which medication is first-line for rate control in a patient with atrial fibrillation with rapid ventricular response?

Accepted Answer

Metoprolol

Answer

Beta-blockers such as metoprolol or calcium channel blockers (diltiazem) are first-line for ventricular rate control in atrial fibrillation.

Question 4

What is the CHA2DS2-VASc score used to determine in patients with atrial fibrillation?

Accepted Answer

Risk of stroke and need for anticoagulation

Answer

The CHA2DS2-VASc score estimates thromboembolic stroke risk in AF patients and guides the decision to initiate anticoagulation.

Question 5

Which drug class is considered first-line for reducing cardiovascular mortality in patients with reduced ejection fraction heart failure?

Accepted Answer

Beta-blockers

Answer

Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) have demonstrated robust mortality reduction in HFrEF in multiple large trials.

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