MCCQE Cardiovascular Disease Management 2

Question 1

A 65-year-old man with STEMI undergoes primary PCI. Which antiplatelet regimen is recommended post-procedure?

Accepted Answer

Aspirin plus ticagrelor for 12 months

Answer

Aspirin alone for 12 months

Answer

Aspirin plus clopidogrel for 12 months

Answer

Clopidogrel alone for 6 months

Question 2

A patient with HFrEF (EF 30%) remains symptomatic on maximally tolerated ACE inhibitor and beta-blocker. What is the next best step?

Accepted Answer

Add sacubitril/valsartan replacing ACE inhibitor

Answer

Add digoxin

Answer

Add aldosterone antagonist

Answer

Refer for cardiac transplant evaluation

Question 3

Which ECG finding is most specific for right ventricular strain in acute pulmonary embolism?

Accepted Answer

S1Q3T3 pattern

Answer

Sinus tachycardia

Answer

New right bundle branch block

Answer

ST elevation in V1

Question 4

A 58-year-old woman with hypertension has a blood pressure of 170/100 mmHg. She has bilateral renal artery stenosis. Which antihypertensive is contraindicated?

Accepted Answer

ACE inhibitor

Answer

Amlodipine

Answer

Beta-blocker

Answer

Thiazide diuretic

Question 5

A patient presents with wide-complex tachycardia at 180 bpm. He is hemodynamically stable. Which drug is appropriate for acute management if VT is suspected?

Accepted Answer

Amiodarone IV

Answer

Adenosine IV

Answer

Verapamil IV

Answer

Digoxin IV

Question 6

In a patient with non-valvular atrial fibrillation and CHA₂DS₂-VASc score of 3, what is the most appropriate anticoagulation strategy?

Accepted Answer

A direct oral anticoagulant (DOAC)

Answer

Aspirin 81 mg daily

Answer

Warfarin with INR target 2.0–3.0

Answer

No anticoagulation needed

Question 7

A 70-year-old man has aortic stenosis with valve area 0.8 cm², mean gradient 55 mmHg, and EF 60%. He is asymptomatic. What is the recommended management?

Accepted Answer

Watchful waiting with annual echocardiography

Answer

Immediate aortic valve replacement

Answer

Start ACE inhibitor to reduce afterload

Answer

Balloon aortic valvuloplasty