Physician Assistant Cardiovascular System Disorders 5

Question 1

A patient with new-onset heart failure has an ejection fraction of 35%. Which combination of medications has been shown to reduce mortality?

Accepted Answer

ACE inhibitor + beta-blocker + aldosterone antagonist

Answer

The combination of ACE inhibitor (or ARB/ARNI), beta-blocker, and aldosterone antagonist forms the evidence-based cornerstone of HFrEF therapy.

Question 2

Which type of shock is characterized by low PCWP, low SVR, and high cardiac output?

Accepted Answer

Distributive (septic) shock

Answer

Distributive shock (e.g., sepsis) features vasodilation causing low SVR and compensatory high CO with low filling pressures.

Question 3

A 62-year-old man with a history of MI presents with palpitations. ECG shows a wide complex tachycardia at 160 bpm. What is the most important initial step?

Accepted Answer

Assume VT and treat accordingly until proven otherwise

Answer

Wide complex tachycardia in a patient with structural heart disease should be presumed ventricular tachycardia until proven otherwise.

Question 4

Which physical exam maneuver increases the intensity of the murmur of hypertrophic obstructive cardiomyopathy?

Accepted Answer

Valsalva maneuver

Answer

Valsalva decreases preload and venous return, reducing LV size and worsening outflow obstruction in HOCM, increasing the murmur.

Question 5

A patient on warfarin for AF has an INR of 8.5 with active major bleeding. What is the most appropriate immediate treatment?

Accepted Answer

4-factor prothrombin complex concentrate (4F-PCC) plus IV vitamin K

Answer

Life-threatening warfarin-related bleeding requires rapid reversal with 4F-PCC for immediate effect plus IV vitamin K for sustained reversal.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Cardiovascular System Disorders 5