Cardiovascular Disease Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiovascular Disease flashcards as text
A 52-year-old man with diabetes presents 90 minutes after onset of crushing chest pain. ECG shows 3 mm ST elevation in V1-V4. Which reperfusion strategy is preferred?
Answer: Primary percutaneous coronary intervention (PCI)
Primary PCI is the preferred reperfusion strategy for STEMI when it can be performed within 90 minutes of first medical contact (door-to-balloon time), as it is superior to fibrinolysis.
A 44-year-old woman presents with sudden onset of pulmonary edema. Echo reveals severe mitral regurgitation with a flail posterior leaflet. Her blood pressure is 85/60 mmHg. What is the most appropriate immediate intervention?
Answer: Intra-aortic balloon pump followed by urgent surgery
Acute severe MR causing cardiogenic shock requires hemodynamic stabilization with an intra-aortic balloon pump (reduces afterload, increases coronary perfusion) as a bridge to urgent surgical repair.
Which clinical scenario best describes Dressler syndrome?
Answer: Fever, pleuritic chest pain, and pericarditis occurring weeks after MI or cardiac surgery
Dressler syndrome is an autoimmune pericarditis that occurs weeks to months after MI or cardiac surgery, presenting with fever, pleurisy, and pericardial inflammation.
A 66-year-old man with known HFrEF (EF 30%) develops worsening renal function after ACE inhibitor dose uptitration. Creatinine rose from 1.2 to 1.8 mg/dL. What is the most appropriate action?
Answer: Continue ACE inhibitor if creatinine rise is ≤30% above baseline
A creatinine rise of up to 30-50% above baseline is acceptable when starting or uptitrating ACE inhibitors in HFrEF, as these agents provide mortality benefit that outweighs the modest GFR reduction.
A 58-year-old woman with poorly controlled hypertension develops a new murmur. Echo shows aortic regurgitation with LV end-systolic diameter of 52 mm and EF of 48%. She is mildly symptomatic. What is the best management?
Answer: Aortic valve replacement
Symptomatic severe AR with EF 50 mm is a class I indication for aortic valve replacement, as these thresholds predict irreversible LV dysfunction if surgery is further delayed.
A 30-year-old woman in her 28th week of pregnancy develops dyspnea, orthopnea, and an EF of 35% on echo. She has no prior cardiac history. What is the most likely diagnosis?
Answer: Peripartum cardiomyopathy
Peripartum cardiomyopathy presents with new-onset heart failure with reduced EF in the last month of pregnancy or within 5 months postpartum without another identifiable cause.
A 55-year-old man with diabetes and hypertension has a 10-year ASCVD risk of 18% and LDL of 142 mg/dL. He is already on moderate-intensity statin therapy. What is the most appropriate next step?
Answer: Uptitrate to high-intensity statin therapy
Patients with ASCVD risk ≥7.5% should receive high-intensity statin therapy aiming for ≥50% LDL reduction; if on moderate-intensity and goal not met, uptitrating is the recommended next step.