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WSC 2026: Are we there yet? SS10 Nationalism FRE L4
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The pathophysiology that underlies the Inflammation
formation of atherosclerotic plaque in
coronary arteries is primarily associated with
which the following mechanisms?
An 80 year old woman is evaluated in your Discontinue atorvastatin until the myopathy has resolved, then
clinic for muscle aches. Her daughter, who is consider restarting atorvastatin at a low dose, such as 10 mg
a nurse, states that her symptoms worsened once daily or an alternative statin.
after recently starting atorvastatin 80 mg
daily. This medication and dose was
selected based on the patient wanting to
reduce her chance of a heart attack or
stroke. She has a known history of stable
coronary artery disease, without prior
coronary revascularization. She takes low
dose aspirin and her blood pressure is well
controlled on lisinopril 20 mg once daily.
You recognize that myalgia and myopathic
symptoms are dose related and more
common in older adults prescribed statins.
Which of the following recommendations
would be appropriate at this time?
A 75 year old man with stable ischemic His antianginal regimen should be improved to include the
heart disease and moderate angina returns addition of a beta blocker and/or a long acting nitrate.
for follow up. Prior stress testing has
documented myocardial ischemia. A
coronary angiogram performed 6 months
ago showed that he has few options for
revascularization and should be managed
medically, although high0risk percutaneous
coronary intervention can be performed for
lifestyle limiting symptoms. Reviewing his
medications, it appears that has been taking
amlodipine 10mg daily, in addition to statin,
aspiring, and as needed sublingual
nitroglycerin. What would be the most
appropriate next step in his management?
, A 88 year old femal patient with Parkinson Convert warfarin to a direct oral anticoagulant
disease presents to clinic for hospital follow
up for atrial Fib with rapid RVR. Home heart
rate monitoring shows good rate control of
her AF ventricular rates. She has a history of
falls and labile international normalized
ration with irregular adherence with blood
draws. Her current medications include
carbidopa-levodopa, metoprolol, and
warfarin and she has a robust drug plan that
allowed for a variety of medications choices.
What changes would you recommend to
her medications regimen?
In patient with heart failure, the most useful Transthoracic echocardiogram
initial imaging modality is
Compared with angiotensin-converting Angioedema
enzyme (ACE) inhibitors angiotensin
receptor blocker are less likely to be
associated with
Which class of drug has not been shown to Diuretics
provide a mortality benefit in heart failure
patients with reduced ejection fraction
Which of the following would be consistent Dyspnea, worsening ability to self care, anorexia, confusion
with the new onset of heart failure in an (all of the above)
older patient
A 65 year old male is evaluated in a follow Add a long acting inhaled bronchodialator
up examination for worsening dyspnea and
chronic cough productive of mucoid
sputum for the past 6 months. He is
otherwise healthy but was diagnosed with
COPD 3 years ago and needed inhaled
albuterol as needed. The patient has a 40
pack year history but quit 8 months ago. ON
PE VS are normal and the patient is not in
any respiratory distress. Breath sounds are
decreased but there is no edema or jugular
venous distention. Spirometry shows a
forced expiratory volume in the first second
FEV1 of 58% of predicted with no
reversibility of FEV1/forced vital capacity
(FVC) ration of 65%. His COPD symptoms
seem poorly controlled and he has one
exacerbation in the past year. A chest
radiograph is obtained and showed mild
hyperinflation. Which of the following is the
most appropriate therapy for this patient?