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

Pericardiocentesis is the definitive treatment for cardiac tamponade causing hemodynamic compromise.

Question 2

Which finding differentiates restrictive cardiomyopathy from constrictive pericarditis on echocardiography?

Accepted Answer

Increased tissue Doppler E' velocity

Answer

Increased tissue Doppler E' velocity is seen in constrictive pericarditis (extrinsic constraint, normal myocardium); restrictive cardiomyopathy shows reduced E' due to abnormal myocardium.

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

Dressler syndrome is an autoimmune pericarditis occurring weeks after cardiac surgery or MI, presenting with fever, pleuritic pain, and friction rub.

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

Dabigatran is renally cleared (80%) and is contraindicated with GFR <15-30; other DOACs have less renal dependence but still require dose adjustments.

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

Hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in young athletes in the United States.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Cardiology 5