Rosh Cardiology Set 2
Study online at https://quizlet.com/_8zxq15
1. Furosemide A 58-year-old man ran out of his congestive heart failure medications. He presents
with significant dyspnea and altered mental status. Examination reveals bibasilar
crackles and jugular venous distension. An electrocardiogram shows sinus rhythm
with low voltage complexes. Which of the following is most appropriate at this
time?
A. Amiodarone
B. Disopyramide
C. Furosemide
D. Ventricular assist device
2. Gemfibrozil A diabetic patient with secondary dyslipidemia has a triglyceride level not at
goal. Which of the following medications offers the highest reduction in serum
triglyceride levels?
A. Atorvastatin
B. Gemfibrozil
C. Lovastatin
D. Sitagliptin
3. III A 65-year-old man presents to the ED with a known history of heart failure. He
complains of progressive shortness of breath over the preceding month to the
point that he now has to rest even when he walks from his bed to the bathroom.
These symptoms resolve at rest. What is this patient's New York Heart Association
classification?
A. I
B. II
C. III
D. IV
4. Right-sided elec- A 52-year-old man presents to the Emergency Department via ambulance with
trocardiogram substernal chest pain. He received aspirin and nitroglycerin from emergency
personnel in route. Vital signs include BP 95/55 mm Hg, HR 60 beats/minute,
RR 20 breaths/minute, and T 97.6F. His electrocardiogram is shown above. Which
, Rosh Cardiology Set 2
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of the following is the most appropriate next diagnostic study?
A. Chest radiograph
B. Computed tomographic angiogram of the chest
C. Posterior electrocardiogram
D. Right-sided electrocardiogram
5. Outpatient fol- A previously healthy 35-year-old woman presents to the emergency department
low-up and oral with pleuritic chest pain and malaise. She has been feeling unwell for the past
naproxen few days with intermittent fever. Her pulse is 87 beats/minute, respiratory rate
is 19 breaths/minute, blood pressure is 122/82 mm Hg, and temperature is
37.0°C. On exam, a pericardial friction rub is appreciated. Echocardiography is
negative for pericardial effusion. Which of the following is the most appropriate
management?
A. Admission and intravenous acyclovir
B. Admission and intravenous gentamicin
C. Outpatient follow-up and oral naproxen
D. Outpatient follow-up and oral prednisone
6. Pericarditis A 15-year-old young man presents with sharp substernal chest pain that is
relieved by sitting up and leaning forward. Cardiac auscultation is normal. What
is his chest pain most likely due to?
A. Coronary ischemia
B. Costochondritis
C. Esophageal spasm
D. Pericarditis
7. Diastolic blood A 68-year-old woman presents to the ED with chest pain. It occurs at rest, and has
pressure been getting worse over the past 2 hours. Her past medical history includes COPD,
GERD, diabetes, urinary incontinence and Factor V Leiden. Her past surgical histo-
, Rosh Cardiology Set 2
Study online at https://quizlet.com/_8zxq15
ry is significant for carpal tunnel release four years ago and total hip arthroplasty
18 months ago. Blood pressure is 168/118 mm Hg, heart rate is 100 BPM and
oxygen saturation is 95% on room air. An electrocardiogram reveals ST-elevation.
An initial cardiac panel shows a positive troponin level. In this scenario, which of
the following in this patient is a relative contraindication to fibrinolytic therapy?
A. Diastolic blood pressure
B. Factor V Leiden
C. Gastroesophageal reflux disease
D. Total hip arthroplasty
8. Pericarditis A 55-year-old man is being evaluated for sudden onset of chest pain. He describes
the pain as sharp that is improved by sitting up and leaning forward. The chest
pain is made worse by inspiration or coughing. An ECG shows new widespread ST
segment elevation. Auscultation over the left sternal border reveals a superficial
scratchy sound. Which of the following is the most likely diagnosis?
A. Aortic stenosis
B. Mitral stenosis
C. Patent ductus arteriosus
D. Pericarditis
9. Atropine A 50-year-old woman presents to the Emergency Department following a synco-
pal episode. On physical exam she is diaphoretic, but alert and orientated. Her
blood pressure is 100/50 mm Hg, heart rate 46 beats per minute, and respirations
12 per minute. Her rhythm strip is shown above. What is the most appropriate
treatment for this patient's condition?
A. Adenosine
B. Amiodarone
C. Amlodipine
D. Atropine
10. Tricuspid A 40-year-old woman, who actively uses intravenous drugs, presents to the ED
with fever and fatigue for the past 3 days. In the ED, her vital signs are BP 126/82,
, Rosh Cardiology Set 2
Study online at https://quizlet.com/_8zxq15
HR 90, RR 16, oxygen saturation 99% on room air, and temperature 101.6°F.
On exam, a murmur is noted. A transesophageal echocardiography is ordered
for suspected endocarditis. Which of the following valves is most likely to be
affected?
A. Aortic
B. Mitral
C. Pulmonic
D. Tricuspid
11. Administer clopi- A 65-year-old man presents to the ED for chest pain. You are concerned for acute
dogrel coronary syndrome and want to administer aspirin, but the patient states that he
develops angioedema to aspirin. Which of the following is the most appropriate
next step in management?
A. Administer clopidogrel
B. Administer dipyridamole
C. Administer the lower dose, 81 mg of aspirin and observe closely for angioede-
ma
D. Pretreat with corticosteroids and antihistamines and administer full-dose as-
pirin
12. Bisoprolol A 60-year-old man presents with nighttime dyspnea. His medical history is sig-
nificant for chronic hypertension. A recent echocardiogram showed an increase
in left ventricular chamber volume but normal ventricular wall thickness. Based
on this finding alone, which of the following medications is the most appropriate
treatment for this patient's dyspnea?
A. Bisoprolol
B. Propranolol
C. Salmeterol
D. Timolol
13. ST segment ele- A 34-year-old man presents to the emergency department with complaints of
vation with recip- worsening chest pain, fever, and malaise. The pain is pleuritic, worsens when he
Study online at https://quizlet.com/_8zxq15
1. Furosemide A 58-year-old man ran out of his congestive heart failure medications. He presents
with significant dyspnea and altered mental status. Examination reveals bibasilar
crackles and jugular venous distension. An electrocardiogram shows sinus rhythm
with low voltage complexes. Which of the following is most appropriate at this
time?
A. Amiodarone
B. Disopyramide
C. Furosemide
D. Ventricular assist device
2. Gemfibrozil A diabetic patient with secondary dyslipidemia has a triglyceride level not at
goal. Which of the following medications offers the highest reduction in serum
triglyceride levels?
A. Atorvastatin
B. Gemfibrozil
C. Lovastatin
D. Sitagliptin
3. III A 65-year-old man presents to the ED with a known history of heart failure. He
complains of progressive shortness of breath over the preceding month to the
point that he now has to rest even when he walks from his bed to the bathroom.
These symptoms resolve at rest. What is this patient's New York Heart Association
classification?
A. I
B. II
C. III
D. IV
4. Right-sided elec- A 52-year-old man presents to the Emergency Department via ambulance with
trocardiogram substernal chest pain. He received aspirin and nitroglycerin from emergency
personnel in route. Vital signs include BP 95/55 mm Hg, HR 60 beats/minute,
RR 20 breaths/minute, and T 97.6F. His electrocardiogram is shown above. Which
, Rosh Cardiology Set 2
Study online at https://quizlet.com/_8zxq15
of the following is the most appropriate next diagnostic study?
A. Chest radiograph
B. Computed tomographic angiogram of the chest
C. Posterior electrocardiogram
D. Right-sided electrocardiogram
5. Outpatient fol- A previously healthy 35-year-old woman presents to the emergency department
low-up and oral with pleuritic chest pain and malaise. She has been feeling unwell for the past
naproxen few days with intermittent fever. Her pulse is 87 beats/minute, respiratory rate
is 19 breaths/minute, blood pressure is 122/82 mm Hg, and temperature is
37.0°C. On exam, a pericardial friction rub is appreciated. Echocardiography is
negative for pericardial effusion. Which of the following is the most appropriate
management?
A. Admission and intravenous acyclovir
B. Admission and intravenous gentamicin
C. Outpatient follow-up and oral naproxen
D. Outpatient follow-up and oral prednisone
6. Pericarditis A 15-year-old young man presents with sharp substernal chest pain that is
relieved by sitting up and leaning forward. Cardiac auscultation is normal. What
is his chest pain most likely due to?
A. Coronary ischemia
B. Costochondritis
C. Esophageal spasm
D. Pericarditis
7. Diastolic blood A 68-year-old woman presents to the ED with chest pain. It occurs at rest, and has
pressure been getting worse over the past 2 hours. Her past medical history includes COPD,
GERD, diabetes, urinary incontinence and Factor V Leiden. Her past surgical histo-
, Rosh Cardiology Set 2
Study online at https://quizlet.com/_8zxq15
ry is significant for carpal tunnel release four years ago and total hip arthroplasty
18 months ago. Blood pressure is 168/118 mm Hg, heart rate is 100 BPM and
oxygen saturation is 95% on room air. An electrocardiogram reveals ST-elevation.
An initial cardiac panel shows a positive troponin level. In this scenario, which of
the following in this patient is a relative contraindication to fibrinolytic therapy?
A. Diastolic blood pressure
B. Factor V Leiden
C. Gastroesophageal reflux disease
D. Total hip arthroplasty
8. Pericarditis A 55-year-old man is being evaluated for sudden onset of chest pain. He describes
the pain as sharp that is improved by sitting up and leaning forward. The chest
pain is made worse by inspiration or coughing. An ECG shows new widespread ST
segment elevation. Auscultation over the left sternal border reveals a superficial
scratchy sound. Which of the following is the most likely diagnosis?
A. Aortic stenosis
B. Mitral stenosis
C. Patent ductus arteriosus
D. Pericarditis
9. Atropine A 50-year-old woman presents to the Emergency Department following a synco-
pal episode. On physical exam she is diaphoretic, but alert and orientated. Her
blood pressure is 100/50 mm Hg, heart rate 46 beats per minute, and respirations
12 per minute. Her rhythm strip is shown above. What is the most appropriate
treatment for this patient's condition?
A. Adenosine
B. Amiodarone
C. Amlodipine
D. Atropine
10. Tricuspid A 40-year-old woman, who actively uses intravenous drugs, presents to the ED
with fever and fatigue for the past 3 days. In the ED, her vital signs are BP 126/82,
, Rosh Cardiology Set 2
Study online at https://quizlet.com/_8zxq15
HR 90, RR 16, oxygen saturation 99% on room air, and temperature 101.6°F.
On exam, a murmur is noted. A transesophageal echocardiography is ordered
for suspected endocarditis. Which of the following valves is most likely to be
affected?
A. Aortic
B. Mitral
C. Pulmonic
D. Tricuspid
11. Administer clopi- A 65-year-old man presents to the ED for chest pain. You are concerned for acute
dogrel coronary syndrome and want to administer aspirin, but the patient states that he
develops angioedema to aspirin. Which of the following is the most appropriate
next step in management?
A. Administer clopidogrel
B. Administer dipyridamole
C. Administer the lower dose, 81 mg of aspirin and observe closely for angioede-
ma
D. Pretreat with corticosteroids and antihistamines and administer full-dose as-
pirin
12. Bisoprolol A 60-year-old man presents with nighttime dyspnea. His medical history is sig-
nificant for chronic hypertension. A recent echocardiogram showed an increase
in left ventricular chamber volume but normal ventricular wall thickness. Based
on this finding alone, which of the following medications is the most appropriate
treatment for this patient's dyspnea?
A. Bisoprolol
B. Propranolol
C. Salmeterol
D. Timolol
13. ST segment ele- A 34-year-old man presents to the emergency department with complaints of
vation with recip- worsening chest pain, fever, and malaise. The pain is pleuritic, worsens when he
