FREE Internal Medicine Cardiovascular Disease Management Questions and Answers

Question 1

A 62-year-old male with a history of hypertension and dyslipidemia presents to the emergency department with severe, substernal chest pain that started 2 hours ago.
An ECG shows ST-segment elevation in the anterior leads.
He undergoes successful percutaneous coronary intervention (PCI) with the placement of a drug-eluting stent in his left anterior descending artery.
According to the most recent ACC/AHA guidelines, what is the recommended minimum duration of dual antiplatelet therapy (DAPT) for this patient?

Accepted Answer

12 months

Answer

3 months

Answer

6 months

Answer

24 months

Question 2

A 58-year-old female without known cardiovascular disease presents for a routine physical exam. She has a history of hypertension, is a former smoker (quit 10 years ago), and her father had a myocardial infarction at age 55. Her blood pressure is 135/85 mmHg, total cholesterol is 210 mg/dL, and HDL is 45 mg/dL. Her calculated 10-year ASCVD risk is 8.5%. According to 2019 ACC/AHA guidelines on primary prevention, what is the most appropriate next step in management?

Accepted Answer

Initiate moderate-intensity statin therapy after a clinician-patient risk discussion.

Answer

Initiate high-intensity statin therapy immediately.

Answer

Recommend lifestyle modifications only.

Answer

Order a coronary artery calcium (CAC) score before deciding on statin therapy.

Question 3

A 74-year-old woman with a history of hypertension and type 2 diabetes is diagnosed with heart failure with preserved ejection fraction (HFpEF), with an LVEF of 55%. She experiences dyspnea on exertion. Her current medications include lisinopril and metformin. Which of the following medication classes has been shown in major clinical trials to reduce the composite endpoint of cardiovascular death and heart failure hospitalizations in patients with HFpEF?

Accepted Answer

Sodium-glucose cotransporter-2 (SGLT2) inhibitors

Answer

Beta-blockers

Answer

Angiotensin receptor-neprilysin inhibitors (ARNIs)

Answer

Loop diuretics

Question 4

A 67-year-old male presents with a 3-month history of predictable, substernal chest discomfort that occurs when he walks uphill and resolves within 5 minutes of rest. He has a normal resting ECG and no history of myocardial infarction. Which of the following is the most appropriate initial non-invasive test to evaluate for coronary artery disease?

Accepted Answer

Exercise stress echocardiography

Answer

Coronary MRA (Magnetic Resonance Angiography)

Answer

Resting 2D echocardiogram

Answer

Coronary angiography

Question 5

A 55-year-old African American male is diagnosed with Stage 1 Hypertension with an average blood pressure of 138/88 mmHg on multiple readings. He has no other comorbidities. His 10-year ASCVD risk score is calculated to be 12%. According to the 2025 ACC/AHA guidelines, what is the most appropriate initial monotherapy?

Accepted Answer

Amlodipine

Answer

Lisinopril

Answer

Metoprolol

Answer

Spironolactone

Question 6

A 70-year-old female with a history of heart failure and hypertension presents to the emergency department with acute-onset severe dyspnea, orthopnea, and a cough producing pink, frothy sputum. On examination, her blood pressure is 180/100 mmHg, heart rate is 110 bpm, and respiratory rate is 30/min. Auscultation reveals diffuse crackles throughout both lung fields. Oxygen saturation is 88% on room air. After applying oxygen, what is the most critical next step in management?

Accepted Answer

Administer intravenous nitroglycerin

Answer

Administer intravenous dobutamine

Answer

Administer a high-dose intravenous loop diuretic

Answer

Obtain a B-type natriuretic peptide (BNP) level