Cardiovascular and Pulmonary Medicine Flashcards

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

Answer: Elevated BNP and orthopnea

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

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

Answer: Switch to an ARB

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

Which auscultatory finding is most characteristic of aortic stenosis?

Answer: Crescendo-decrescendo systolic murmur at the right upper sternal border

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

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?

Answer: Add a LABA to the ICS

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

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

Answer: S1Q3T3 pattern

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.

In a patient with stable ischemic heart disease, which medication has demonstrated mortality benefit beyond symptom control?

Answer: Aspirin and statin therapy

Antiplatelet therapy (aspirin) and high-intensity statin therapy are proven to reduce mortality and cardiovascular events in stable ischemic heart disease.