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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.

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  1. A 62-year-old man presents with exertional chest pain. Stress test shows 2 mm ST depression in leads V4–V6 at 85% of maximum heart rate. He has diabetes and hypertension. What is the most appropriate next step?

    Answer: Coronary angiography

    A strongly positive stress test (≥2 mm ST depression at submaximal heart rate) in a high-risk patient warrants coronary angiography to define anatomy and guide revascularization.

  2. Which lipoprotein pattern is most associated with premature atherosclerotic cardiovascular disease?

    Answer: Elevated LDL-C with small dense LDL particles

    Small dense LDL particles are more atherogenic because they penetrate the endothelium more easily and are more susceptible to oxidation, driving plaque formation.

  3. A 50-year-old woman with systemic lupus erythematosus presents with dyspnea, elevated JVP, and an echocardiogram showing a thickened pericardium with respiratory variation in mitral inflow >25%. What is the diagnosis?

    Answer: Constrictive pericarditis

    Constrictive pericarditis presents with elevated JVP, Kussmaul's sign, and exaggerated respiratory variation in Doppler inflow velocities, and is a known complication of SLE.

  4. A 48-year-old male smoker with hyperlipidemia and hypertension has a resting ECG showing Q waves in leads II, III, and aVF. He has no chest pain history. What is the most likely explanation?

    Answer: Prior inferior myocardial infarction

    Pathological Q waves in the inferior leads (II, III, aVF) in the setting of multiple cardiovascular risk factors most likely represent a prior silent inferior MI.

  5. A 66-year-old woman with atrial fibrillation and a CHA₂DS₂-VASc score of 4 is started on apixaban. She asks about dietary restrictions. What is the most accurate counseling?

    Answer: No significant dietary restrictions required

    Unlike warfarin, apixaban (a direct oral anticoagulant) does not require dietary vitamin K restriction or routine INR monitoring.

  6. A 35-year-old competitive athlete collapses during a basketball game. Resuscitation is successful. ECG shows deep T-wave inversions in V1–V4 and left axis deviation. His father died suddenly at age 40. What is the most likely diagnosis?

    Answer: Arrhythmogenic right ventricular cardiomyopathy (ARVC)

    ARVC characteristically presents with T-wave inversions in right precordial leads, ventricular arrhythmias triggered by exercise, and a family history of sudden death.

  7. A 74-year-old man with EF of 25% is on optimal HFrEF therapy. He has NYHA class III symptoms. His ICD was implanted 2 years ago. QRS is 110 ms. What additional therapy should be considered to reduce hospitalization?

    Answer: SGLT2 inhibitor (dapagliflozin or empagliflozin)

    SGLT2 inhibitors (dapagliflozin, empagliflozin) reduce HF hospitalization and cardiovascular death in HFrEF independent of diabetes status.