Cardiovascular Disease Flashcards
7 cards from real ITE 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 flashcards as text
A 45-year-old woman with no cardiac history presents with sharp pleuritic chest pain and a pericardial friction rub 2 weeks after a viral URI. ECG shows diffuse ST elevation with PR depression. What is the first-line treatment?
Answer: NSAIDs plus colchicine
Acute viral pericarditis is treated with NSAIDs plus colchicine, which reduces recurrence; steroids are reserved for refractory cases.
Which drug interaction is most clinically significant in a patient taking warfarin who is newly prescribed amiodarone?
Answer: Amiodarone inhibits CYP2C9, increasing warfarin effect
Amiodarone inhibits CYP2C9 (and CYP3A4), significantly reducing warfarin metabolism and increasing anticoagulant effect, requiring close INR monitoring and dose reduction.
A 55-year-old man with STEMI is treated with primary PCI. Two days later he develops new hypotension, elevated JVP, and a new holosystolic murmur at the left lower sternal border. What is the most likely diagnosis?
Answer: Ventricular septal defect (VSD)
Post-MI VSD typically occurs 2–5 days after infarction, presenting with a new harsh holosystolic murmur, right heart failure signs, and hemodynamic compromise.
A 68-year-old man with stable angina has a 70% stenosis of the left anterior descending artery on coronary angiography. His symptoms are well-controlled on medical therapy. What is the preferred management?
Answer: Continue optimal medical therapy
In stable ischemic heart disease, PCI does not reduce MI or mortality compared to optimal medical therapy (COURAGE trial), making medical management preferred for stable symptoms.
Which physical examination finding is most specific for cardiac tamponade?
Answer: Pulsus paradoxus >10 mmHg
Pulsus paradoxus (>10 mmHg drop in systolic BP during inspiration) is the most specific physical finding for cardiac tamponade.
A 72-year-old woman has a resting heart rate of 38 bpm and ECG showing P waves with no relationship to QRS complexes, which are narrow at 60 bpm. She is asymptomatic. What is the most appropriate treatment?
Answer: Permanent pacemaker implantation
Complete (third-degree) AV block with an escape rhythm, even if asymptomatic, carries risk of syncope and sudden death and is a Class I indication for permanent pacemaker.
A patient with hypertrophic obstructive cardiomyopathy (HOCM) develops worsening symptoms. Which intervention is contraindicated?
Answer: Nitrates for angina relief
Nitrates reduce preload and systemic vascular resistance, worsening the dynamic outflow tract obstruction in HOCM and are contraindicated.