FREE Internal Medicine Cardiovascular Disease Management Questions and Answers

Question 1

A 62-year-old male with a history of hypertension, dyslipidemia, and previous myocardial infarction presents to the clinic for routine follow-up.
He is currently asymptomatic.
His current medication regimen includes atorvastatin 80 mg daily, aspirin 81 mg daily, metoprolol succinate 100 mg daily, and lisinopril 20 mg daily.
His LDL-C is 68 mg/dL.
Which of the following is the most appropriate next step in his cardiovascular disease management?

Accepted Answer

Continue current medications and lifestyle modifications.

Answer

Increase the dose of atorvastatin to 120 mg daily.

Answer

Add ezetimibe to his current medication regimen.

Answer

Switch metoprolol succinate to carvedilol.

Question 2

Which of the following is a primary indication for initiating sacubitril/valsartan in a patient with heart failure with reduced ejection fraction (HFrEF)?

Accepted Answer

NYHA Class II-IV symptoms with an LVEF of 35% and already on an ACE inhibitor or ARB.

Answer

As a first-line agent in all newly diagnosed HFrEF patients, regardless of symptoms.

Answer

In patients with preserved ejection fraction (HFpEF) who remain symptomatic on diuretics.

Answer

Only in patients who are intolerant to both ACE inhibitors and ARBs.

Question 3

A 55-year-old female presents with recurrent chest pain. Her ECG shows T-wave inversions in leads V3-V5. Troponin levels are elevated. She is diagnosed with NSTEMI. After initial stabilization, which medication class is crucial for long-term secondary prevention and reduction of cardiovascular events in this patient, assuming no contraindications?

Accepted Answer

HMG-CoA reductase inhibitors (statins).

Answer

Calcium channel blockers.

Answer

Alpha-1 blockers.

Answer

Peripheral vasodilators.

Question 4

Regarding the management of severe symptomatic aortic stenosis, which of the following statements is most accurate?

Accepted Answer

Surgical Aortic Valve Replacement (SAVR) is generally recommended for younger, lower-surgical-risk patients with severe symptomatic AS.

Answer

Medical therapy with diuretics and ACE inhibitors is the cornerstone of management to slow disease progression.

Answer

Transcatheter Aortic Valve Replacement (TAVR) is preferred over surgical aortic valve replacement (SAVR) in all patients with severe symptomatic AS.

Answer

Aggressive lipid-lowering therapy with high-dose statins has been shown to reverse the calcification process.

Question 5

A 70-year-old male with chronic stable angina is well-controlled on aspirin, metoprolol, and a statin. He experiences occasional anginal symptoms during strenuous activity. His blood pressure is 130/80 mmHg and heart rate is 60 bpm. Which medication would be the most appropriate addition to improve his anginal symptoms?

Accepted Answer

Initiate ranolazine.

Answer

Increase the dose of metoprolol.

Answer

Add isosorbide mononitrate.

Answer

Switch aspirin to clopidogrel.

Question 6

Which of the following interventions has the strongest evidence for improving overall survival in patients with peripheral artery disease (PAD)?

Accepted Answer

Smoking cessation.

Answer

Regular exercise program (supervised exercise therapy).

Answer

Cilostazol for symptomatic claudication.

Answer

Angioplasty with stenting of severe stenoses.