ABFM + KSA
HEART DISEASE
Certification Exam
Actual Questions and Answers
100% Guarantee Pass.
This Exam contains:
100% Guarantee Pass.
Actual Questions and Answers
Multiple choice (single best answer)
Case Studies/Scenario-Based Questions
Verified Rationales
,**A 69-year-old female presents to the emergency department with a 1-hour
episode of severe substernal chest pain that has now resolved. Her past medical
history is notable for current tobacco abuse, hypertension, and depression. Her
current medica ons include lisinopril/hydrochlorothiazide (Zestore c), 10/12.5
mg daily; citalopram (Celexa), 20 mg daily; and aspirin, 81 mg daily. On
examina on she has a blood pressure of 150/92 mm Hg and a pulse rate of 92
beats/min. An EKG reveals a sinus rhythm with deep and symmetrical T-wave
inversions in the inferior leads. You decide to admit the pa ent to the hospital.
Which one of the following should be administered on admission?**
A. Alteplase (Ac vase) intravenously
B. Aspirin, 81 mg, and nitroglycerin via intravenous drip
C. Enoxaparin (Lovenox), 1 mg/kg subcutaneously, and nitroglycerin, 0.4 mg
sublingually
D. Ticagrelor (Brilinta), 60 mg orally, and enoxaparin, 1 mg/kg subcutaneously
E. Ticagrelor, 180 mg, and aspirin, 325 mg
**Answer:** E
**Ra onale:**
The management of unstable angina or non-ST-eleva on myocardial infarc on
(NSTEMI) is similar to the management of ST-eleva on myocardial infarc on
except that fibrinoly c therapy has no role in unstable angina or NSTEMI (SOR A).
Studies indicate that fibrinoly c therapy in these pa ents has no benefit in terms
of mortality or myocardial infarc on (MI), and may even increase the risk for
intracranial hemorrhage and both fatal and nonfatal MI. Unless there is a
contraindica on, all pa ents with acute coronary syndrome should begin dual
an platelet therapy with aspirin, star ng with a loading dose of 325 mg followed
,by a maintenance dosage of 81 mg daily, and a P2Y12 inhibitor (either clopidogrel,
prasugrel, or cagrelor), as well as an coagula on therapy with either low
molecular weight heparin (SOR A), fondaparinux in combina on with a factor IIa
inhibitor (SOR B), unfrac onated heparin (SOR B), or bivalirudin in pa ents
managed with an early invasive strategy (SOR B). β-Blockers have been shown to
reduce myocardial ischemia, reinfarc on, and the frequency of complex
ventricular dysrhythmias, and they increase long-term survival. Provided there are
no contraindica ons, American Heart Associa on guidelines recommend that oral
β-blocker therapy be ini ated within the first 24 hours in pa ents with acute
coronary syndrome (SOR A).
**A 65-year-old female who has heart failure with an ejec on frac on of 35% is
found to have a TSH level of 13.8 µU/mL (N 0.3-4.82). Her T3 and T4 levels are
normal, and her thyroid gland is normal to palpa on. You check her levels again
in 2 months and they are unchanged. You advise her that**
A. hypothyroidism decreases her metabolic rate, which reduces the stress on her
heart
B. hypothyroidism is detrimental to her heart only if she develops hypothyroid
symptoms
C. subclinical hypothyroidism has nega ve effects on heart failure and treatment
should be considered
D. treatment of subclinical hypothyroidism would raise her LDL-cholesterol level
**Answer:** C
**Ra onale:**
, Clinical hypothyroidism has long been associated with cardiac dysfunc on. It has
also been shown that subclinical hypothyroidism (TSH >4 µU/mL with normal or
borderline low thyroid hormone levels) can cause le@ ventricular systolic and
diastolic dysfunc on, which improves with thyroid replacement therapy. Pa ents
with overt or subclinical hypothyroidism should be treated with levothyroxine to
improve their cardiovascular func on and decrease the poten al risk of heart
failure. Thyroxine in excess can exacerbate coronary artery disease, and should be
started at low doses and increased slowly in pa ents with possible underlying
coronary artery disease. Results of meta-analyses indicate that therapy will lower,
not raise, serum LDL-cholesterol levels.
---
**A 58-year-old male is hospitalized with severe decompensated heart failure
refractory to intravenous inotropic therapy and guideline-directed medical
therapy. You are considering referral to a ter ary care hospital for mechanical
circulatory support to bridge to transplanta on. Which one of the following is
true regarding mechanical circulatory support bridge therapy?**
A. It should be limited to pa ents who meet the criteria for heart transplanta on
B. It should only be used in pa ents with biventricular heart failure
C. It generally improves quality of life while wai ng for transplanta on
D. It greatly reduces quality of life while wai ng for transplanta on
**Answer:** C
**Ra onale:**
HEART DISEASE
Certification Exam
Actual Questions and Answers
100% Guarantee Pass.
This Exam contains:
100% Guarantee Pass.
Actual Questions and Answers
Multiple choice (single best answer)
Case Studies/Scenario-Based Questions
Verified Rationales
,**A 69-year-old female presents to the emergency department with a 1-hour
episode of severe substernal chest pain that has now resolved. Her past medical
history is notable for current tobacco abuse, hypertension, and depression. Her
current medica ons include lisinopril/hydrochlorothiazide (Zestore c), 10/12.5
mg daily; citalopram (Celexa), 20 mg daily; and aspirin, 81 mg daily. On
examina on she has a blood pressure of 150/92 mm Hg and a pulse rate of 92
beats/min. An EKG reveals a sinus rhythm with deep and symmetrical T-wave
inversions in the inferior leads. You decide to admit the pa ent to the hospital.
Which one of the following should be administered on admission?**
A. Alteplase (Ac vase) intravenously
B. Aspirin, 81 mg, and nitroglycerin via intravenous drip
C. Enoxaparin (Lovenox), 1 mg/kg subcutaneously, and nitroglycerin, 0.4 mg
sublingually
D. Ticagrelor (Brilinta), 60 mg orally, and enoxaparin, 1 mg/kg subcutaneously
E. Ticagrelor, 180 mg, and aspirin, 325 mg
**Answer:** E
**Ra onale:**
The management of unstable angina or non-ST-eleva on myocardial infarc on
(NSTEMI) is similar to the management of ST-eleva on myocardial infarc on
except that fibrinoly c therapy has no role in unstable angina or NSTEMI (SOR A).
Studies indicate that fibrinoly c therapy in these pa ents has no benefit in terms
of mortality or myocardial infarc on (MI), and may even increase the risk for
intracranial hemorrhage and both fatal and nonfatal MI. Unless there is a
contraindica on, all pa ents with acute coronary syndrome should begin dual
an platelet therapy with aspirin, star ng with a loading dose of 325 mg followed
,by a maintenance dosage of 81 mg daily, and a P2Y12 inhibitor (either clopidogrel,
prasugrel, or cagrelor), as well as an coagula on therapy with either low
molecular weight heparin (SOR A), fondaparinux in combina on with a factor IIa
inhibitor (SOR B), unfrac onated heparin (SOR B), or bivalirudin in pa ents
managed with an early invasive strategy (SOR B). β-Blockers have been shown to
reduce myocardial ischemia, reinfarc on, and the frequency of complex
ventricular dysrhythmias, and they increase long-term survival. Provided there are
no contraindica ons, American Heart Associa on guidelines recommend that oral
β-blocker therapy be ini ated within the first 24 hours in pa ents with acute
coronary syndrome (SOR A).
**A 65-year-old female who has heart failure with an ejec on frac on of 35% is
found to have a TSH level of 13.8 µU/mL (N 0.3-4.82). Her T3 and T4 levels are
normal, and her thyroid gland is normal to palpa on. You check her levels again
in 2 months and they are unchanged. You advise her that**
A. hypothyroidism decreases her metabolic rate, which reduces the stress on her
heart
B. hypothyroidism is detrimental to her heart only if she develops hypothyroid
symptoms
C. subclinical hypothyroidism has nega ve effects on heart failure and treatment
should be considered
D. treatment of subclinical hypothyroidism would raise her LDL-cholesterol level
**Answer:** C
**Ra onale:**
, Clinical hypothyroidism has long been associated with cardiac dysfunc on. It has
also been shown that subclinical hypothyroidism (TSH >4 µU/mL with normal or
borderline low thyroid hormone levels) can cause le@ ventricular systolic and
diastolic dysfunc on, which improves with thyroid replacement therapy. Pa ents
with overt or subclinical hypothyroidism should be treated with levothyroxine to
improve their cardiovascular func on and decrease the poten al risk of heart
failure. Thyroxine in excess can exacerbate coronary artery disease, and should be
started at low doses and increased slowly in pa ents with possible underlying
coronary artery disease. Results of meta-analyses indicate that therapy will lower,
not raise, serum LDL-cholesterol levels.
---
**A 58-year-old male is hospitalized with severe decompensated heart failure
refractory to intravenous inotropic therapy and guideline-directed medical
therapy. You are considering referral to a ter ary care hospital for mechanical
circulatory support to bridge to transplanta on. Which one of the following is
true regarding mechanical circulatory support bridge therapy?**
A. It should be limited to pa ents who meet the criteria for heart transplanta on
B. It should only be used in pa ents with biventricular heart failure
C. It generally improves quality of life while wai ng for transplanta on
D. It greatly reduces quality of life while wai ng for transplanta on
**Answer:** C
**Ra onale:**
