Practice Test Geeks(MCCQE) Medical Council of Canada Qualifying Examination Practice Test
← All MCCQE Flashcard Decks

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 55-year-old man with stable ischemic heart disease has undergone coronary angiography showing 70% mid-LAD stenosis. FFR is 0.85. What is the recommended management?

    Answer: Optimal medical therapy without revascularization

    FFR >0.80 indicates hemodynamically non-significant stenosis; PCI of non-flow-limiting lesions does not improve outcomes compared to optimal medical therapy (FAME trials).

  2. Which medication is most appropriate for long-term secondary prevention in a patient with peripheral artery disease (PAD) and no history of AF or MI?

    Answer: Aspirin 81 mg plus rivaroxaban 2.5 mg BID

    The COMPASS trial showed aspirin 100 mg plus low-dose rivaroxaban 2.5 mg BID significantly reduces MACE and MALE in PAD patients.

  3. A 63-year-old woman with hypertension presents with hypertensive emergency (BP 210/120, acute pulmonary edema). Which agent is most appropriate for immediate blood pressure reduction?

    Answer: IV sodium nitroprusside or nicardipine

    Hypertensive emergency with end-organ damage requires IV antihypertensives (nitroprusside, nicardipine, clevidipine) for controlled BP reduction by 25% in the first hour.

  4. A 77-year-old man with severe symptomatic aortic stenosis is deemed high-risk for surgery (STS score 8%). What intervention should be recommended?

    Answer: Transcatheter aortic valve implantation (TAVI)

    TAVI is recommended for symptomatic severe AS patients at high or prohibitive surgical risk, with equivalent or superior outcomes to SAVR in multiple trials (PARTNER).

  5. A 48-year-old marathon runner collapses during a race. He is found to be in ventricular fibrillation. After successful defibrillation, echocardiography shows asymmetric septal hypertrophy of 18 mm. What condition is most likely?

    Answer: Hypertrophic cardiomyopathy

    Hypertrophic cardiomyopathy with septal hypertrophy >15 mm and VF arrest is the most common cause of sudden cardiac death in young athletes.

  6. A patient with New York Heart Association Class III HFrEF (EF 28%) continues to have symptoms despite ACE inhibitor, beta-blocker, MRA, and SGLT2 inhibitor. What additional therapy should be considered?

    Answer: Refer for left ventricular assist device (LVAD) evaluation

    Refractory advanced HF on quadruple therapy with persistent Class III–IV symptoms warrants evaluation for advanced therapies including LVAD or cardiac transplantation.

  7. A 52-year-old man with a recent NSTEMI has LDL of 3.2 mmol/L despite maximum-dose rosuvastatin and ezetimibe. What is the next best lipid-lowering option?

    Answer: Add a PCSK9 inhibitor (evolocumab or alirocumab)

    PCSK9 inhibitors added to maximally tolerated statin plus ezetimibe further reduce LDL by 50–60% and reduce CV events in high-risk patients (FOURIER, ODYSSEY OUTCOMES).