Cardiovascular Disease Management Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiovascular Disease Management flashcards as text
A 45-year-old man presents with acute pericarditis. He is hemodynamically stable with no fever. What is the first-line treatment?
Answer: Aspirin plus colchicine
Current guidelines recommend aspirin (or NSAIDs) combined with colchicine as first-line therapy for acute pericarditis to reduce recurrence risk.
A 70-year-old man with known aortic stenosis presents with syncope on exertion. His echocardiogram shows a mean gradient of 48 mmHg and AVA of 0.7 cm². What is the next step?
Answer: Aortic valve replacement (surgical or TAVR)
Symptomatic severe aortic stenosis (syncope, angina, or HF) is a Class I indication for aortic valve replacement; exercise stress testing is contraindicated in symptomatic severe AS.
Which electrocardiographic pattern is characteristic of Wolff-Parkinson-White (WPW) syndrome during sinus rhythm?
Answer: Short PR interval with delta wave and wide QRS
WPW syndrome manifests during sinus rhythm as a short PR interval (<120 ms), slurred upstroke (delta wave), and widened QRS due to ventricular pre-excitation via an accessory pathway.
A 55-year-old woman with HFpEF (EF 60%) presents with dyspnea and leg edema. Which intervention has the strongest evidence for improving outcomes in HFpEF?
Answer: SGLT2 inhibitor (empagliflozin or dapagliflozin)
SGLT2 inhibitors have demonstrated significant reduction in heart failure hospitalizations and cardiovascular death in HFpEF in landmark trials (EMPEROR-Preserved, DELIVER).
A 62-year-old man develops new bundle branch block and cardiogenic shock 6 hours after anterior STEMI. Echocardiography shows a ventricular septal defect. What is the definitive treatment?
Answer: Emergency surgical repair or percutaneous closure with hemodynamic support
Post-MI ventricular septal rupture causing cardiogenic shock requires urgent mechanical repair (surgical or percutaneous) along with hemodynamic support; medical therapy alone has very high mortality.
A 48-year-old man is found to have a 4.2 cm ascending aortic aneurysm incidentally. He is asymptomatic with no connective tissue disorder. What is the recommended management?
Answer: Surveillance imaging every 6–12 months and aggressive blood pressure control
Asymptomatic ascending aortic aneurysms <5.0–5.5 cm (without high-risk features) are managed with surveillance imaging and risk factor modification including BP control.
A 66-year-old woman is started on amiodarone for atrial fibrillation. Which baseline workup is most important before initiating therapy?
Answer: Thyroid function tests, liver function tests, pulmonary function tests, and ophthalmologic exam
Amiodarone affects thyroid, liver, lung, cornea, and skin; baseline TFTs, LFTs, PFTs, chest X-ray, and eye exam are essential to detect organ toxicity.