PANRE Cardiology 5

Question 1

A 48-year-old woman with lupus develops worsening dyspnea and JVD. Echo shows a large pericardial effusion. Pulsus paradoxus is 18 mmHg. What is the definitive treatment?

Accepted Answer

Pericardiocentesis

Answer

High-dose IV corticosteroids

Answer

NSAIDs and colchicine

Answer

Urgent surgical pericardiectomy

Question 2

Which finding differentiates restrictive cardiomyopathy from constrictive pericarditis on echocardiography?

Accepted Answer

Increased tissue Doppler E' velocity

Answer

Reduced LVEF

Answer

Septal bounce on M-mode

Answer

Respiratory variation in mitral inflow <25%

Question 3

A 55-year-old man post-CABG develops new-onset fever, pleuritic chest pain, and pericardial rub on day 10. What is the most likely diagnosis?

Accepted Answer

Post-cardiac injury syndrome (Dressler syndrome)

Answer

Sternal wound infection

Answer

Pulmonary embolism

Answer

Recurrent MI

Question 4

In a patient with chronic kidney disease and new-onset atrial fibrillation, which anticoagulant requires dose adjustment and should be used with caution as GFR declines below 30?

Accepted Answer

Dabigatran

Answer

Warfarin

Answer

Apixaban

Answer

Rivaroxaban

Question 5

A 30-year-old athlete collapses during a basketball game and is found to be in ventricular fibrillation. After resuscitation, which condition is most likely?

Accepted Answer

Hypertrophic cardiomyopathy

Answer

Dilated cardiomyopathy

Answer

Long QT syndrome type 1

Answer

Wolff-Parkinson-White syndrome

Question 6

Which hemodynamic profile is characteristic of cardiogenic shock?

Accepted Answer

High PCWP, low CO, high SVR

Answer

Low CVP, low PCWP, high CO, low SVR

Answer

Low PCWP, high CO, low SVR

Answer

High CVP, high CO, low SVR

Question 7

A patient with stable angina is intolerant of beta-blockers and nitrates. Which agent is an appropriate alternative for angina prophylaxis?

Accepted Answer

Either B or C

Answer

Aspirin 325 mg daily

Answer

Ranolazine

Answer

Ivabradine (if sinus rhythm and HR >70)