Physician Assistant Cardiovascular System Disorders 2

Question 1

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

Accepted Answer

Exercise stress test

Answer

Exercise stress testing is the standard initial evaluation for stable angina when the resting ECG is normal.

Question 2

Which finding on echocardiography is most consistent with cardiac tamponade?

Accepted Answer

Diastolic collapse of the right ventricle

Answer

Diastolic right ventricular collapse is the classic echocardiographic sign of cardiac tamponade due to elevated pericardial pressure.

Question 3

A patient with hypertension develops a blood pressure of 210/120 mmHg with headache and papilledema. How should this be managed?

Accepted Answer

IV nitroprusside with continuous BP monitoring

Answer

Hypertensive emergency with end-organ damage requires IV antihypertensives with controlled, gradual BP reduction.

Question 4

What is the primary mechanism of action of digoxin in atrial fibrillation?

Accepted Answer

Enhances vagal tone to slow AV node conduction

Answer

Digoxin slows ventricular rate in AF primarily by increasing vagal tone and decreasing AV nodal conduction.

Question 5

A 70-year-old woman with dyspnea has an S3 gallop, bilateral crackles, and JVD. Which BNP level best supports acute decompensated heart failure?

Accepted Answer

BNP 850 pg/mL

Answer

BNP >100 pg/mL strongly supports heart failure; levels above 400-500 pg/mL are highly specific for decompensated HF.

Physician Assistant Practice Test