Please select the best answer
1. Main and most common pathophysiologic process in unstable angina:
A. Dynamic obstruction (coronary spasm)
B. Plaque rupture and nonocclusive thrombosis
C. Advancing coronary atherosclerosis
D. Increased myocardial oxygen demand
2. The following are risk factors based on the TIMI Risk Score system used for stratifying UA
patients as “high risk” for death, MI or urgent revascularization, except:
A.Elevated cardiac marker
B. Age < 65 years
C. ST deviation ≥ 0.5 mm
D. ≥ 2 anginal events ≤ 24 hrs
3. Contraindication to the use of nitrates in UA:
A. Obstructive airway disease
B. Advanced A-V block
C. Use of Sildenafil within 24 hours prior
D. Congestive heart failure
4. Antithrombotic therapy in unstable angina/NSTEMI may include the following, except:
A. Clopidogrel
B. Low molecular weight heparin
C. Glycoprotein IIb/IIIa inhibitors
D. Tissue plasminogen activator (tPA)
5. What is the initial step in platelet-initiated thrombosis?
A. Platelet activation
B. Platelet aggregation
C. Platelet adhesion
D. Platelet reconfiguration
6. Which of the following best describes Prinzmetal’s variant angina?
A. Asymptomatic or silent ischemia in diabetics
B. Myocardial ischemia due to focal spasm of epicardial coronary artery
C. Angina presenting as heart failure
D. Chronic stable angina
7. True statements regarding the pathophysiology of ST elevation MI (STEMI), except:
A. Slowly developing, high grade coronary stenoses do not typically precipitate STEMI
B. Coronary plaques prone to rupture have large lipid cores and thin fibrous caps
C. Platelet activation generates release of thromboxane A2, a potent local
vasodilator(vasoconstrictor)
D. There occurs a conformational change in the GPIIb-IIIa receptor
8. True statements regarding cardiac enzymes or biomarkers, except:
A. Cardioversion causes false elevation of CK-MB
B. Measurement of both troponin and CK-MB is not cost-effective
C. CK-MB remains elevated 7-10 days after STEMI (it’s troponin that remains (+) for 7-10
days; CK + for only 48-72 hrs)
D.The peak concentration of biomarkers correlates weakly with infarct size
9. Which of the following is NOT appropriate in the acute ER management of STEMI?
A. Calcium channel blockers
B. IV beta blockers
C. Chewed ASA 160-325 mg
D. IV Nitrogycerin
10. If the initial ECG shows ST elevation of at least 2 mm in 2 contiguous precordial leads and
1mm in 2 adjacent limb leads, the patient should be considered for:
A. Immediate CABG
B. Immediate cardioversion
C. IV unfractionated heparin
D. Reperfusion therapy (PCI or fibrinolysis)
11. ACE inhibitors decrease mortality rates after STEMI through this mechanism:
A. Reduction in ventricular remodeling after infarction
B. Inhibition of aldosterone synthesis and release
C. Decreased tendency for early myocardial fibrosis
D. Beneficial effect on blood pressure
12. In STEMI patients with EF <40%, regardless of whether CHF is present or not, which of the
following agents would offer maximum benefit?
A. Nitrates
B. Beta blockers
C. ACE inhibitors or ARBs
D. Aldosterone antagonists
13. Infarction of how much left ventricular mass usually results in cardiogenic shock?
A. ≥ 40%
B. ≥ 30%
C. ≥ 20%
D. at least 60%
14. Therapeutic agents considered highly beneficial for CHF complicating STEMI, except:
A. Nitrates
B. ACE inhibitors
C. Digitalis
D. Diuretics
15. Aside from peripheral vascular resistance, what is the other determinant of arterial blood
pressure?
A. Cardiac output
B. Heart rate
C. Stroke volume
D. Vascular compartment size
16. This nonselective α-adrenergic blocker binds to pre- and postsynaptic receptors and is
primarily used in the treatment of pheochromocytoma:
A. Prazosin
B. Guanfacine
C. Phenoxybenzamine
D. Doxazosin
17. Compelling indication for the use of alpha-blockers in hypertension:
A. Congestive heart failure
B. Sick sinus syndrome
C. Impotence
D. Prostatic hyperplasia
18. The following side effects are commonly associated with ACE inhibitors, except:
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. AV conduction abnormalities
19. Basic laboratory tests recommended in the evaluation of hypertension, except:
A. Serum creatinine
B. Total cholesterol and triglycerides
C. Blood uric acid
D. Serum potassium
20. This beta adrenergic blocker also has peripheral α-adrenergic receptor blocking properties,
making it useful in CHF:
A. Pindolol
B. Atenolol
C. Carvedilol
D. Oxprenolo
Match the right answers
1.
A. Atrial fibrillation
B. Atrial Flutter
C. Sinus rhythm
D. Sinus tachycardia
2.
A. Sinus rhythm
B. Atrial Fibrillation
C. Sinus arrhythmia
D. 2nd degree Av Block
3.
A. 1st degree AV Block
B. 2nd degree AV Block
C. 3rd degree AV Block
D. High Degree AV Block
4.
A. 1st degree AV Blcok
B. 2nd degree AV block Mobitz type 1
C. 2nd degree AV block Mobitz type II
D. Complete heart block
5.
A. 1st degree AV Blcok
B. 2nd degree AV block Mobitz type 1
C. 2nd degree AV block Mobitz type II
D. Complete heart block
