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Cardiovascular Disease Management Flashcards

7 cards from real MCCQE 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 Management flashcards as text

  1. A 72-year-old woman with AF on warfarin (INR 2.5) undergoes elective knee replacement. What is the recommended perioperative anticoagulation strategy for low-to-moderate thromboembolic risk?

    Answer: Stop warfarin 5 days pre-op without bridging

    For AF patients with low-to-moderate thromboembolic risk (CHA₂DS₂-VASc <4), warfarin is held 5 days pre-op without bridging anticoagulation to reduce bleeding.

  2. A patient on amiodarone develops thyroid dysfunction. Which pattern is more consistent with amiodarone-induced thyrotoxicosis type II?

    Answer: Destructive thyroiditis with no uptake on scan

    Amiodarone-induced thyrotoxicosis type II is a destructive thyroiditis with low/absent radioiodine uptake, distinct from type I which involves iodine-induced excess hormone synthesis.

  3. A 50-year-old man with hypertension and no diabetes has a 10-year ASCVD risk of 12%. His LDL is 3.5 mmol/L. What is the best management?

    Answer: Moderate-intensity statin

    For intermediate ASCVD risk (7.5–20%) with LDL ≥2.6 mmol/L, moderate-intensity statin therapy is recommended after risk discussion.

  4. Which physical examination finding best differentiates hypertrophic obstructive cardiomyopathy (HOCM) from aortic stenosis?

    Answer: Valsalva maneuver increases HOCM murmur and decreases AS murmur

    Valsalva (reduces preload) increases HOCM obstruction and murmur intensity while decreasing AS murmur, a key clinical differentiator.

  5. A 68-year-old man 6 weeks after MI develops fever, pleuritic chest pain, and pericardial friction rub. ECG shows diffuse ST elevation. What is the most likely diagnosis?

    Answer: Dressler syndrome

    Dressler syndrome (post-cardiac injury syndrome) presents 2–10 weeks after MI with fever, pericarditis, and pleuritis due to autoimmune reaction to myocardial antigens.

  6. A 40-year-old woman with mitral stenosis (MVA 1.0 cm²) develops AF with rapid ventricular response at 140 bpm. She is hemodynamically stable. What is the priority intervention?

    Answer: Rate control with beta-blocker or diltiazem

    In mitral stenosis with AF and rapid rate, rate control is prioritized to allow adequate diastolic filling time across the stenotic valve before definitive intervention.

  7. A patient presents with sudden onset tearing chest pain radiating to the back. BP is 190/100 mmHg in the right arm and 150/80 mmHg in the left arm. CXR shows widened mediastinum. What is the immediate management?

    Answer: IV labetalol first, then nitroprusside for BP target <120/80

    In type A aortic dissection, heart rate control with IV beta-blocker (labetalol) precedes vasodilator therapy to prevent reflex tachycardia while targeting SBP <120 mmHg.