Cardiovascular and Pulmonary Medicine Flashcards

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

Answer: FEV1/FVC ratio less than 0.70

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

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

Answer: COPD

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

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

Answer: Metoprolol

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

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

Answer: Risk of stroke and need for anticoagulation

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

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

Answer: Beta-blockers

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

A patient with an ejection fraction of 35% and NYHA Class II symptoms is started on an ARNI. Which medication is this?

Answer: Sacubitril/valsartan

Sacubitril/valsartan (Entresto) is an ARNI (angiotensin receptor-neprilysin inhibitor) shown to reduce cardiovascular death in HFrEF compared to enalapril.