PANRE Cardiology 2

Question 1

A 58-year-old man with hypertension presents with exertional chest pain relieved by rest. EKG at rest is normal. Which is the most appropriate next step?

Accepted Answer

Order exercise stress test

Answer

Start isosorbide mononitrate

Answer

Perform coronary angiography

Answer

Prescribe sublingual nitroglycerin and discharge

Question 2

Which finding on echocardiogram is most consistent with cardiac tamponade?

Accepted Answer

Right ventricular diastolic collapse

Answer

Left ventricular hypertrophy

Answer

Mitral valve prolapse

Answer

Aortic valve stenosis with reduced leaflet excursion

Question 3

A patient on warfarin for atrial fibrillation has an INR of 8.5 with no active bleeding. What is the most appropriate management?

Accepted Answer

Hold warfarin and administer oral vitamin K 2.5 mg

Answer

Administer IV vitamin K 10 mg

Answer

Administer fresh frozen plasma

Answer

Continue warfarin and recheck INR in 24 hours

Question 4

A 70-year-old woman develops hypotension, bradycardia, and cool extremities after an inferior MI. Which territory is most likely involved?

Accepted Answer

Right coronary artery

Answer

Left anterior descending artery

Answer

Left circumflex artery

Answer

Left main coronary artery

Question 5

Which medication is CONTRAINDICATED in a patient with hypertrophic obstructive cardiomyopathy (HOCM) who presents with symptoms?

Accepted Answer

Nitroglycerin

Answer

Metoprolol

Answer

Verapamil

Answer

Disopyramide

Question 6

A 65-year-old man has an EKG showing delta waves, short PR interval, and wide QRS. He develops rapid atrial fibrillation. Which drug should be AVOIDED?

Accepted Answer

Digoxin

Answer

Procainamide

Answer

Ibutilide

Answer

Amiodarone (IV initial use is controversial but not first-line contraindicated)

Question 7

Which class of antihypertensive is preferred as first-line therapy in a Black patient without diabetes or heart failure?

Accepted Answer

Thiazide diuretics or calcium channel blockers

Answer

ACE inhibitors

Answer

Beta-blockers

Answer

ARBs alone