Cardiovascular Questions 6-10

Answer 10

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:37:00 +0000

10. Choice B is the correct answer. Elevated bradykinnin levels are responsible for the dry cough in patients that take ACE inhibitors. It should be thought of as a class effect. Switching the patient to an Angiotensin Receptor Blocker would help this. There is no elevated bradykinnin levels with that class. Prostaglandin levels are increased with ACE inhibitors and ARB’s but do not cause the dry cough. Elevated cyclooxygenase levels and catecholamine levels have nothing to do with the dry cough or ACE inhibitors.

Question 10

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:36:00 +0000

10. Your patient is a 53 year old male that presents with a dry cough and has been recently started on lisinopril for hypertension. Which of the following is the best explanation for the patients symptoms?

A. Elevated Prostaglandin levels
B. Elevated Bradykinnin levels
C. Elevated cyclooxygenase levels
D. Elevated catecholamines

Answer 9

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:35:00 +0000

9. Choice B is the correct answer. Alcohol ingestion is not identified as a modifiable risk factor. In fact mild alcohol intake may be beneficial in helping heart disease. Diabetes, smoking, hypertension are modifiable risk factors.

Question 9

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:34:00 +0000

9. Which of the following is not recognized as a modifiable risk factor in the prevention of coronary disease?

A. Diabetes
B. Alcohol intake
C. Smoking
D. Hypertension

Answer 8

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:33:00 +0000

8. Choice C is the correct answer. Prinzmetal’s angina or Variant angina is caused by spasm of the coronary arteries. It tends to occur at rest. Verapamil best targets it because it helps dilate arteries. Nitroglycerin has little activity on arteries. Metoprolol is useful in regular angina because it helps decrease myocardial demand by blocking the effect of catecholamines. Lisinopril helps with after load reduction.

Question 8

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:32:00 +0000

8. Which of the following is the medication of choice for treating Prinzmetal’s Angina?

A. Metoprolol

B. Lisinopril

C. Verapamil

D. Nitroglycerin

Answer 7

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:30:00 +0000

7. Choice C is the correct answer. This patient with his presenting symptoms and impaired renal function needs a TEE. CT with IV contrast is contraindicated when the creatinine is greater than 2.0. The above two are the only two options for screening for a dissection. A normal ECHO is not going to be able give you any information rather the patient is dissecting or not. Taking the patient to surgery without a definitive diagnosis is dangerous and should not be done.

Question 7

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:29:00 +0000

7. Your patient is a 75 year old male that presents with sharp chest pain radiating through to his back. His vitals signs are BP 85/53, HR 110, RR 12, Temp 96.5. His Chem 7 is as follows Na 130, K 4.1, Cl-112, HCO3 22, BUN-36, Creatinine-2.5, Glucose 96. Which of the following is the best management option?

A. Order a Stat CTA of Chest with IV contrast to look for a dissection
B Order a Stat Bedside ECHO
C. Order a Transesophageal ECHO (TEE)
D. Call the cardiothoracic surgeon and take the patient to the operating room immediately.

Answer 6

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:28:00 +0000

6. Choice A is the correct answer. Aortic Stenosis presents with systolic murmur. Presenting symptoms are usually dizziness and sometimes chest pain. They also can present with CHF. Mitral Stenosis and Aortic Regurgitation are both diastolic murmurs so are incorrect. Carotid artery stenosis is not likely because the patient does not have any carotid bruits.

Question 6

noreply@blogger.com (Anonymous) — Sat, 30 Nov 2013 18:27:00 +0000

6. Your patient is a 84 year old female that presents with a new onset of systolic murmur bets heard at the sternal border. She has been having near syncope getting progressively worse. She has no carotid bruits. Which of the following is the most likely diagnosis?

A. Aortic Stenosis
B. Aortic Regurgitation
C. Carotid Artery Stenosis
D. Mitral Stenosis