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Cardiovascular Medicine 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 Medicine flashcards as text

  1. A 60-year-old man with known CAD is prescribed ranolazine for refractory angina. Which mechanism of action explains its antianginal effect?

    Answer: Inhibition of late sodium current reducing myocardial oxygen demand

    Ranolazine inhibits the late inward sodium current (I_Na late), which reduces intracellular calcium overload and myocardial oxygen demand without significantly affecting heart rate or blood pressure.

  2. An 80-year-old woman with severe symptomatic aortic stenosis is deemed high surgical risk. Which factor most strongly favors TAVR over surgical AVR?

    Answer: Predicted operative mortality >8% using STS score

    High surgical risk (STS mortality score ≥8%) is the primary indication favoring TAVR, which has demonstrated non-inferior or superior outcomes in this population.

  3. A 44-year-old woman has recurrent syncopal episodes during emotional stress. ECG shows a prolonged QTc of 520ms. She is started on nadolol. Which additional measure is most important for preventing sudden death?

    Answer: Avoidance of all QT-prolonging medications

    Avoidance of QT-prolonging drugs (antiarrhythmics, antibiotics, antiemetics, antipsychotics) is critical in congenital long QT syndrome to prevent torsades de pointes.

  4. A 67-year-old man undergoes coronary angiography and is found to have a 50% left main stenosis. FFR measurement yields 0.79. What is the most appropriate management?

    Answer: PCI of the left main lesion

    An FFR of 0.79 (≤0.80) indicates hemodynamically significant ischemia; left main disease with positive FFR warrants revascularization, with CABG preferred over PCI for left main.

  5. A 38-year-old man presents with fever, new murmur, and positive blood cultures for Streptococcus viridans. Echocardiography shows a 12mm vegetation on the mitral valve. Which finding would prompt urgent surgical consultation?

    Answer: Heart failure due to severe mitral regurgitation

    Heart failure secondary to valve dysfunction from endocarditis is the most common indication for urgent surgery, as it significantly increases mortality without intervention.

  6. A 72-year-old man with peripheral artery disease and claudication at 1 block has an ABI of 0.55. He already walks regularly. What is the next best step in management?

    Answer: Cilostazol 100mg twice daily

    Cilostazol, a phosphodiesterase-3 inhibitor, improves claudication symptoms and walking distance and is indicated for symptomatic PAD when exercise alone is insufficient.

  7. Which of the following best describes the mechanism of torsades de pointes in patients taking class IA antiarrhythmics?

    Answer: Early afterdepolarizations due to prolonged repolarization triggering ventricular arrhythmia

    Class IA drugs block K+ channels, prolonging repolarization (QT interval), which can trigger early afterdepolarizations (EADs) that initiate torsades de pointes.