Physician Assistant Cardiovascular System Disorders 3

Question 1

A 45-year-old man presents with sudden severe tearing chest pain radiating to the back. BP is 180/100 in the right arm and 140/80 in the left arm. What is the most likely diagnosis?

Accepted Answer

Aortic dissection

Answer

Asymmetric blood pressures combined with tearing back pain are classic for aortic dissection.

Question 2

Which medication is contraindicated in a patient with decompensated heart failure and an ejection fraction of 20%?

Accepted Answer

Carvedilol initiated at low dose

Answer

Beta-blockers should not be started during decompensated HF; they should only be initiated once the patient is stabilized.

Question 3

A patient with known HFrEF reports dizziness after starting a new medication. Potassium is 5.9 mEq/L and creatinine has risen. Which drug is most likely responsible?

Accepted Answer

Spironolactone

Answer

Spironolactone, a potassium-sparing aldosterone antagonist, commonly causes hyperkalemia and can worsen renal function.

Question 4

Wolff-Parkinson-White syndrome involves which anatomical abnormality?

Accepted Answer

Accessory conduction pathway (Bundle of Kent) bypassing the AV node

Answer

WPW is caused by an accessory pathway (Bundle of Kent) that bypasses the AV node, allowing pre-excitation of the ventricles.

Question 5

Which of the following ECG changes is MOST specific for hyperkalemia?

Accepted Answer

Peaked T waves

Answer

Peaked, narrow, symmetrical T waves are the earliest and most characteristic ECG finding in hyperkalemia.

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Physician Assistant Cardiovascular System Disorders 3