1. BP-170/120 mmof hg with no end organ damage, what it called as?

2. Identify the stage of hypertension.BP-152/80 mm of hg?

3. ST elevation in lead II, III, AVF suggest? (MI= Myocardial Infarction)

4. Young man who came to office immediately after 10 minutes of brisk walk with no previous history of hypertension. His blood pressure is 150/90mmof he? What is the next step?

5. First symptoms in patient with Left heart failure is?

6. The typical ECG changes associated with the first hour of acute pericarditis?

7. Hyperkelemia is characterised by all of the following except?

8. which of the following drug is cause of secondary hypertension?

9. Hypertensive patient with sudden, severe chest and back pain has likely diagnosis of?

10. Mild Hypertension with pregnancy first ling drug of choice ?

11. Cardiac catheterization is performed to find out if you have disease of?

12. in CABG (Coronary Artery Bypass Grafting) which artery is typically used as a pedicled graft to the left anterior descending coronary artery?

13. Resistant hypertension when goal is not achieved.

14. A 76 year old man presents with atrial fibrillation(AF) which is permanent. He is lucid and has specifically made an appointment with you to discuss the best way of stopping him “dying ” as a result of the AF.
Past medical historyHypertension (treated), Mild COPD.
Drug historyVerapamil (as treatment for AF),Amlodipine,Simvastatin,PRN inhalers
Social HistoryLives alone.Independent. Can carry out all ADL’s (activities of daily living)
What is the anticoagulation schedule you would recommend to prevent stroke?

15. A 50-year-old man with diabetes and hypertension complains of central chest pain while walking this morning. The pain lasted 10 minutes, was relieved by rest and had not occurred before. Examination and resting ECG are normal. Which is the SINGLE MOST appropriate next investigation?

16. Radiofrequency ablation is done for?

17. Most specific and sensitive test for myocardial damage is?

18. The best test for establishing the diagnosis and the degree of myocardial dysfunction is

19. Cardiac transplantation should not be performed in which of the following condition?

20. Intraaortic Ballon Counter pulsation (IABP) is contraindicated in which of the following condition?

21. Corrigan’s pulse, Quicke’spulse, water hammer pulse, traube’ssign, and Durozias’s sign are seen in??

22. Charachteristic ECG changes in hypothermia is?

23. 35 year’s woman presented with exertionaldyspnoea, precordial exam revealed loud S1 and rumbling mid condition murmur at apex. Possible complications of this condition can be all except?

24. which of the following is a distinctive feature of left ventricular failure?

25. the three stages of a one heart beat includes all of the following except?

26. An 18-mo-old boy is brought to the paediatrician because of progressively worsening episodes of cyanosis. The child has moments where he turns blue and becomes dyspneic. During these episodes the child becomes irritable and remains in a squatting position. Physical examination reveals a small and thin child with clubbing of the fingers and toes. Lungs are normal. Heart auscultation reveals an RV lift and a grade III/VI harsh systolic ejection murmur at the upper left sternal border. Which of the following is the most likely diagnosis?

27. Which of the following tests can assess risk or indicate prognosis for heart?

28. Pulmonary Hypertension is Most Severe in which Untreated Valvular Disease?

29. A 71 year old man had trans femoral catheterization for coronary angiography which revealed the presence of severe atherosclerotic narrowing of all major coronary arteries. Within hours of the procedure, he developed severe left lower quadrant abdominal pain, which was later associated with rebound tenderness, lividoreticularis (erythematous skin rash) of the abdominal skin, increasing hypertension, cold blue toes and progressively worsening renal failure. Laparotomy revealed necrosis of the descending colon. This was resected. Microscopic examination showed amorphous eosinophilic material containing slit-like spaces occluding arteries in the submucosa.
Which one of the following is the most likely explanation?

30. Which features are seen with the Tetrology of Fallot?

31. Which of the following is most commonly associated with an increased risk for the development of torsades de pointes?

32. A 65 y/o female is very weak with acute cholecystitis not responding to medical treatment. She has a history of myocardial infarction (MI) suffered about 5 months ago and currently has an irregular pulse and JVD. Her BP is normal. What’s the most appropriate next step?

33. A 42yearold man with acute renal failure is confused. His serum potassium is 8.1 mEq/L . The most likely abnormal ECG finding is:

34. A 45-year-old patient on hemodialysis for one week has noted that his blood pressure is more difficult to control. He reports good compliance with his medications, which include erythropoietin, ferrous sulfate, vancomycin, and vitamin D. His blood pressure is 180/99 mm Hg. Which of the following is the most likely cause for the worsening control of his blood pressure?

35. Cardiovascular syncope what is true?

36. Patient with hypertrophic subaortic stenosis referred from dentist before doing dental procedure what is true

37. Patient presents to the emergency department with sudden onset of weakness in lower part of body with urinary incontinence since 4 hrs. CT scan shows ischemic stroke.Patient is already on aspirin. What would you do:

38. 15 years old male patient complaining of joint pain & fever for 1 week , difficulty swallowing, liver 1 cm below costal and pancystolic murmur

39. The best way of treating patient with BP= 130-139/80-85:

40. A 70 y/o tall man fell off the curb while walking and is brought to the ER for severe chest pain. He is short of breath, pale, and perspiring heavily. P/E results: BP = 80/60 mmHg; HR = 120/min; JVD is (+); heart sounds are weak; bilateral breath sounds seem normal. He has a history of hypertension for the past 10 years. What’s the most likely Diagnosis?

41. Male patient who is a known case of hypercholesterolemia, BMI: 31, his investigations show high total cholesterol, high LDL & high TG, of these investigations what is the most important risk factor for developing coronary artery disease?

42. Adult with pulseless QRS different shapes:

43. Patient was brought by his son. He was pulseless and ECG showed ventricular tachycardia, BP -70 systolic,Diastolic not measurable and patient is unconcious.what is your action?

44. A 50-year-old woman is hospitalized for an acute inferior myocardial infarction for which she has undergone angioplasty to the right coronary artery. On day 4, she develops acute shortness of breath and hypotension. She does not have any chest pain. On examination, she is tachycardic with a 3/6 holosystolic murmur at the apex and bibasilar crackles. An electrocardiogram shows sinus tachycardia, and a chest x-ray shows pulmonary edema.
Which of the following is the most appropriate management for this patient’s problem?

45. One of the following is a characteristic of syncope (vasovagal attack):

46. Patient who is a known case of posterior MI presented with syncope. Examination showed canon (a) wave with tachycardia, unreadable BP & wide QRS complexes on ECG. The diagnosis is:

47. Which of the following indicate inferior wall Myocardial Infarciton in ECG?

48. ECG shows ST elevation in the following leads V1, 2, 3, 4 & reciprocal changes in leads aVF & 2, what is the diagnosis?(MI=Myocardial infarction)
MI=Myocardial Infarction.

49. Arriving first to the scene, you find an unresponsive person with no pulse that has thrown up. You feel CPR is not something you are comfortable giving them. What would be the next best thing for you to do?

50. Warfarin is given to all the following except:

51. What will increase heart blood flow when increase load on heart?

52. Most common cause of chronic hypertension:

53. All are true about the best position in hearing the murmurs, EXCEPT:

54. What is the most risk of antihypertensive drugs on elderly patient?

55. Idiosyncratic hypotensive reaction to nitrates is reversed promptly by ?

56. 60 year’s old male presented with history of 2 hours chest pain, ECG showed ST elevation on V1-V4 with multiple PVC (Premature Ventricular Contraction) & ventricular tachycardia. The management is:

57. About ventricular fibrillation:

58. Diastolic blowing murmur best heard in the left sternal border increased with squatting

59. A 35 years old woman presented with exertional dyspnea. Precordial examination revealed loud S1 and rumbling mid diastolic murmur at apex. Possible complications of this condition can be all the following EXCEPT:

60. A patient with sudden cardiac arrest, the ECG showed no electrical activities with oscillation of QRS with different shapes. The underlying process is

61. Which of the following is the least likely to cause infective endocarditis:

62. Sinus tachycardia and atrial flutter, how to differentiate?

63. A patient has persistent >2mm ST elevation in V2-6 two hours following a myocardial infarction, with hypertension of 205/115 mmHg. He has already been given morphine and aspirin. What is the next management of choice?

64. S3 occur in all of the following EXCEPT:

65. Patient present with carotid artery obstruction by 80%, treatment of choice is?

66. A patient is a known case of coronary artery disease, presents with its symptoms, to diagnose if that patient has MI or not, by first ECG & cardiac enzyme

67. Treatment of chronic atrial fibrillation all, EXCEPT:

68. Treatment of unstable angina include all EXCEPT:

69. A patient is 5 weeks post-Myocardial Infarction, complaining of chest pain,fever and arthralagia:

70. Old male come with CHF (Congestive Heart Failure) and pulmonary edema, what is the best initial therapy?

71. Young patient came to ER with dyspnea and productive tinged blood frothy sputum, he is a known case of rheumatic heart disease, Atrial fibrillation and his cheeks have dusky rash, what is the diagnosis?

72. Nitroglycerine causes all of the following, EXCEPT:

73. Calcium channel blockers as nifedipine, verapamil and diltiazem are extremely useful in all of the following applications except?

74. In atrial fibrillation and stroke, all are true , EXCEPT:

75. Old man who had stable angina, all of the followings are correct except:

76. Coarctation of the aorta is commonly associated with which of the following syndromes:

77. 70 years old male was brought to the ER with sudden onset of pain in his left lower limb. The pain was severe with numbness. He had acute myocardial infarction 2 weeks ago and was discharged 24 hours prior to his presentation. The left leg was cold and pale, right leg was normal. The most likely diagnosis is:

78. The antibiotic prophylaxis for endocarditis is:

79. Patient with hypercholesterolemia, he should avoid:

80. Difference between unstable and stable angina :

81. Patient presented to ER with substernal chest pain. 3 months ago, the patient had complete physicalexamination, and was normal, ECG normal, only high LDL in which he started low fat diet and medication for it. What is the factor the doctor will take into considerations as a risk factor?

82. A drug that is contraindicated in hypertrophic obstructive cardiomyopathy (HOCM):

83. Fick method in determining cardiac output

84. A man who has had MI you will follow the next enzyme

85. Regarding murmur of mitral stenosis:

86. What is the correct about unstable angina :

87. Patient with history of AF + MI, what the best prevention for stroke is?

88. Which is the most common condition associated with endocarditis?

89. Drug used in treatment of CHF which decrease the mortality

90. A patient is a known case of stable angina for 2 years, came c/o palpitation , Holtis monitor showed 1.2mm ST depression for 1 to 2 minutes in 5-10 minutes wt your Dx

91. Furmingham risk score predict?

92. What explains coronary artery disease the best?

93. Which of the following is the most dangerous to a patient in terms of risk for CAD?

94. A postmenopausal woman develops chest pain immediately on hearing the news of her son’s death in a war. Shedevelops acute chest pain, dyspnea, and ST segment elevation in leads V2 to V4 on electrocardiogram. Elevated levels of troponin confirm an acute myocardial infarction. Coronary angiography is normal including an absence of vasospasm on provocative testing. Echocardiography reveals apical left ventricular “ballooning.”
What is the presumed mechanism of this disorder?

95. Correcting which of the following risk factors for CAD(Coronary Artery Disease) will result in the most immediate benefit for the patient?

96. A man with atypical chest pain is found to have normal nuclear isotope uptake in his myocardium at rest. On exercise, there is decreased uptake in the inferior wall. Two hours after exercise, the uptake of nuclear isotope returns to normal. What is the right thing to do?

97. A 48-year-old woman comes to the office with chest pain that has been occurring over the last several weeks. The pain is not reliably related to exertion. She is comfortable now. The location of the pain is retrosternal. She has no hypertension, and the EKG is normal.
What is the most appropriate next step in management?

98. A 64-year-old man is placed on lisinopril as part of managing CAD in association with an ejection fraction of 24% and symptoms of breathlessness. Although he sometimes has rales on lung examination, the patient is asymptomatic today. Physical examination reveals minimal edema of the lower extremities. Blood tests reveal an elevated level of potassium that is present on a repeat measurement. EKG is unchanged.
How would you best manage the patient?

99. Which of the following is the most common adverse effect of statin medications?

100. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour. The pain radiates to her left arm and is associated with anxiety, diaphoresis, and nausea. She describes the pain as “sore”and “dull” and clenches her fist in front of her chest. She has a history of hypertension.
Which of the following is most likely to be found in this patient?

101. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour.
Which of the following EKG findings would be associated with the worst prognosis?

102. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour. An
EKG shows ST segment elevation in V2 to V4.
What is the most appropriate next step in the management of this patient?

103. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour. An EKG shows ST segment elevation in V2 to V4. Aspirin has been given to the patient to chew.
What is the most appropriate next step in the management of this patient?

104. Which of the following is most important in decreasing the risk of restenosis of the coronary artery after PCI?

105. A patient comes to a small rural hospital without a catheterization laboratory. The patient has chest pain and ST segment elevation. What is the most appropriate next step in the management of the patient?

106. A man comes to the emergency department with chest pain for the last hour that is crushing in quality and does not change with respiration or the position of his body. An EKG shows ST segment depression in leads V2 to V4. Aspirin has been given.
What is the most appropriate next step in the management of this patient?

107. Which of the following is the most common cause of death from CHF?

108. A 74-year-old African American man with a history of dilated cardiomyopathy secondary to MI in the past is seen in the office for routine evaluation. He is asymptomatic and is maintained on lisinopril, furosemide, metoprolol, aspirin, and digoxin. Lab tests reveal a persistently elevated potassium level. The EKG is
unchanged. What is the best management?

109. A 74-year-old woman comes to the emergency department with the acute onset of shortness of breath, respiratory rate of 38 per minute, rales to her apices, S3 gallop, and jugulovenous distension. What is the best initial step in the management of this patient?

110. A 78-year-old man with a history of lung cancer comes to the emergency department with several days of increasing
shortness of breath. He became somewhat lightheaded today, and that is what has brought him to the hospital. On physical
examination, he has a blood pressure of 106/70 mm Hg; pulse of 112 bpm; jugulovenous distention; and the lungs are clear to
auscultation. The blood pressure drops to 92/58 mm Hg on inhalation.Which of the following is the most appropriate to confirm the
diagnosis?

111. A 67-year-old man comes to the emergency department with the
sudden onset of chest pain. He also has pain between his
scapulae. He has a history of hypertension and tobacco
smoking. His blood pressure is 169/108 mm Hg.
What is the best initial test?

112. A 67-year-old man comes to the emergency department with the
sudden onset of chest pain. He also has pain between his
scapulae. He has a history of hypertension and tobacco
smoking. His blood pressure is 169/108 mm Hg.
What is the most accurate test?

113. Which of the following is the most appropriate screening for
aortic aneurysm?

114. Which of the following is the most dangerous to a pregnant woman?

1. BP-170/120 mmof hg with no end organ damage, what it called as?

2. Identify the stage of hypertension.BP-152/80 mm of hg?

3. ST elevation in lead II, III, AVF suggest? (MI= Myocardial Infarction)

4. Young man who came to office immediately after 10 minutes of brisk walk with no previous history of hypertension. His blood pressure is 150/90mmof he? What is the next step?

5. First symptoms in patient with Left heart failure is?

6. The typical ECG changes associated with the first hour of acute pericarditis?

7. Hyperkelemia is characterised by all of the following except?

8. which of the following drug is cause of secondary hypertension?

9. Hypertensive patient with sudden, severe chest and back pain has likely diagnosis of?

10. Mild Hypertension with pregnancy first ling drug of choice ?

11. Cardiac catheterization is performed to find out if you have disease of?

12. in CABG (Coronary Artery Bypass Grafting) which artery is typically used as a pedicled graft to the left anterior descending coronary artery?

13. Resistant hypertension when goal is not achieved.

14. A 76 year old man presents with atrial fibrillation(AF) which is permanent. He is lucid and has specifically made an appointment with you to discuss the best way of stopping him “dying ” as a result of the AF.
Past medical historyHypertension (treated), Mild COPD.
Drug historyVerapamil (as treatment for AF),Amlodipine,Simvastatin,PRN inhalers
Social HistoryLives alone.Independent. Can carry out all ADL’s (activities of daily living)
What is the anticoagulation schedule you would recommend to prevent stroke?

15. A 50-year-old man with diabetes and hypertension complains of central chest pain while walking this morning. The pain lasted 10 minutes, was relieved by rest and had not occurred before. Examination and resting ECG are normal. Which is the SINGLE MOST appropriate next investigation?

16. Radiofrequency ablation is done for?

17. Most specific and sensitive test for myocardial damage is?

18. The best test for establishing the diagnosis and the degree of myocardial dysfunction is

19. Cardiac transplantation should not be performed in which of the following condition?

20. Intraaortic Ballon Counter pulsation (IABP) is contraindicated in which of the following condition?

21. Corrigan’s pulse, Quicke’spulse, water hammer pulse, traube’ssign, and Durozias’s sign are seen in??

22. Charachteristic ECG changes in hypothermia is?

23. 35 year’s woman presented with exertionaldyspnoea, precordial exam revealed loud S1 and rumbling mid condition murmur at apex. Possible complications of this condition can be all except?

24. which of the following is a distinctive feature of left ventricular failure?

25. the three stages of a one heart beat includes all of the following except?

26. An 18-mo-old boy is brought to the paediatrician because of progressively worsening episodes of cyanosis. The child has moments where he turns blue and becomes dyspneic. During these episodes the child becomes irritable and remains in a squatting position. Physical examination reveals a small and thin child with clubbing of the fingers and toes. Lungs are normal. Heart auscultation reveals an RV lift and a grade III/VI harsh systolic ejection murmur at the upper left sternal border. Which of the following is the most likely diagnosis?

27. Which of the following tests can assess risk or indicate prognosis for heart?

28. Pulmonary Hypertension is Most Severe in which Untreated Valvular Disease?

29. A 71 year old man had trans femoral catheterization for coronary angiography which revealed the presence of severe atherosclerotic narrowing of all major coronary arteries. Within hours of the procedure, he developed severe left lower quadrant abdominal pain, which was later associated with rebound tenderness, lividoreticularis (erythematous skin rash) of the abdominal skin, increasing hypertension, cold blue toes and progressively worsening renal failure. Laparotomy revealed necrosis of the descending colon. This was resected. Microscopic examination showed amorphous eosinophilic material containing slit-like spaces occluding arteries in the submucosa.
Which one of the following is the most likely explanation?

30. Which features are seen with the Tetrology of Fallot?

31. Which of the following is most commonly associated with an increased risk for the development of torsades de pointes?

32. A 65 y/o female is very weak with acute cholecystitis not responding to medical treatment. She has a history of myocardial infarction (MI) suffered about 5 months ago and currently has an irregular pulse and JVD. Her BP is normal. What’s the most appropriate next step?

33. A 42yearold man with acute renal failure is confused. His serum potassium is 8.1 mEq/L . The most likely abnormal ECG finding is:

34. A 45-year-old patient on hemodialysis for one week has noted that his blood pressure is more difficult to control. He reports good compliance with his medications, which include erythropoietin, ferrous sulfate, vancomycin, and vitamin D. His blood pressure is 180/99 mm Hg. Which of the following is the most likely cause for the worsening control of his blood pressure?

35. Cardiovascular syncope what is true?

36. Patient with hypertrophic subaortic stenosis referred from dentist before doing dental procedure what is true

37. Patient presents to the emergency department with sudden onset of weakness in lower part of body with urinary incontinence since 4 hrs. CT scan shows ischemic stroke.Patient is already on aspirin. What would you do:

38. 15 years old male patient complaining of joint pain & fever for 1 week , difficulty swallowing, liver 1 cm below costal and pancystolic murmur

39. The best way of treating patient with BP= 130-139/80-85:

40. A 70 y/o tall man fell off the curb while walking and is brought to the ER for severe chest pain. He is short of breath, pale, and perspiring heavily. P/E results: BP = 80/60 mmHg; HR = 120/min; JVD is (+); heart sounds are weak; bilateral breath sounds seem normal. He has a history of hypertension for the past 10 years. What’s the most likely Diagnosis?

41. Male patient who is a known case of hypercholesterolemia, BMI: 31, his investigations show high total cholesterol, high LDL & high TG, of these investigations what is the most important risk factor for developing coronary artery disease?

42. Adult with pulseless QRS different shapes:

43. Patient was brought by his son. He was pulseless and ECG showed ventricular tachycardia, BP -70 systolic,Diastolic not measurable and patient is unconcious.what is your action?

44. A 50-year-old woman is hospitalized for an acute inferior myocardial infarction for which she has undergone angioplasty to the right coronary artery. On day 4, she develops acute shortness of breath and hypotension. She does not have any chest pain. On examination, she is tachycardic with a 3/6 holosystolic murmur at the apex and bibasilar crackles. An electrocardiogram shows sinus tachycardia, and a chest x-ray shows pulmonary edema.
Which of the following is the most appropriate management for this patient’s problem?

45. One of the following is a characteristic of syncope (vasovagal attack):

46. Patient who is a known case of posterior MI presented with syncope. Examination showed canon (a) wave with tachycardia, unreadable BP & wide QRS complexes on ECG. The diagnosis is:

47. Which of the following indicate inferior wall Myocardial Infarciton in ECG?

48. ECG shows ST elevation in the following leads V1, 2, 3, 4 & reciprocal changes in leads aVF & 2, what is the diagnosis?(MI=Myocardial infarction)
MI=Myocardial Infarction.

49. Arriving first to the scene, you find an unresponsive person with no pulse that has thrown up. You feel CPR is not something you are comfortable giving them. What would be the next best thing for you to do?

50. Warfarin is given to all the following except:

51. What will increase heart blood flow when increase load on heart?

52. Most common cause of chronic hypertension:

53. All are true about the best position in hearing the murmurs, EXCEPT:

54. What is the most risk of antihypertensive drugs on elderly patient?

55. Idiosyncratic hypotensive reaction to nitrates is reversed promptly by ?

56. 60 year’s old male presented with history of 2 hours chest pain, ECG showed ST elevation on V1-V4 with multiple PVC (Premature Ventricular Contraction) & ventricular tachycardia. The management is:

57. About ventricular fibrillation:

58. Diastolic blowing murmur best heard in the left sternal border increased with squatting

59. A 35 years old woman presented with exertional dyspnea. Precordial examination revealed loud S1 and rumbling mid diastolic murmur at apex. Possible complications of this condition can be all the following EXCEPT:

60. A patient with sudden cardiac arrest, the ECG showed no electrical activities with oscillation of QRS with different shapes. The underlying process is

61. Which of the following is the least likely to cause infective endocarditis:

62. Sinus tachycardia and atrial flutter, how to differentiate?

63. A patient has persistent >2mm ST elevation in V2-6 two hours following a myocardial infarction, with hypertension of 205/115 mmHg. He has already been given morphine and aspirin. What is the next management of choice?

64. S3 occur in all of the following EXCEPT:

65. Patient present with carotid artery obstruction by 80%, treatment of choice is?

66. A patient is a known case of coronary artery disease, presents with its symptoms, to diagnose if that patient has MI or not, by first ECG & cardiac enzyme

67. Treatment of chronic atrial fibrillation all, EXCEPT:

68. Treatment of unstable angina include all EXCEPT:

69. A patient is 5 weeks post-Myocardial Infarction, complaining of chest pain,fever and arthralagia:

70. Old male come with CHF (Congestive Heart Failure) and pulmonary edema, what is the best initial therapy?

71. Young patient came to ER with dyspnea and productive tinged blood frothy sputum, he is a known case of rheumatic heart disease, Atrial fibrillation and his cheeks have dusky rash, what is the diagnosis?

72. Nitroglycerine causes all of the following, EXCEPT:

73. Calcium channel blockers as nifedipine, verapamil and diltiazem are extremely useful in all of the following applications except?

74. In atrial fibrillation and stroke, all are true , EXCEPT:

75. Old man who had stable angina, all of the followings are correct except:

76. Coarctation of the aorta is commonly associated with which of the following syndromes:

77. 70 years old male was brought to the ER with sudden onset of pain in his left lower limb. The pain was severe with numbness. He had acute myocardial infarction 2 weeks ago and was discharged 24 hours prior to his presentation. The left leg was cold and pale, right leg was normal. The most likely diagnosis is:

78. The antibiotic prophylaxis for endocarditis is:

79. Patient with hypercholesterolemia, he should avoid:

80. Difference between unstable and stable angina :

81. Patient presented to ER with substernal chest pain. 3 months ago, the patient had complete physicalexamination, and was normal, ECG normal, only high LDL in which he started low fat diet and medication for it. What is the factor the doctor will take into considerations as a risk factor?

82. A drug that is contraindicated in hypertrophic obstructive cardiomyopathy (HOCM):

83. Fick method in determining cardiac output

84. A man who has had MI you will follow the next enzyme

85. Regarding murmur of mitral stenosis:

86. What is the correct about unstable angina :

87. Patient with history of AF + MI, what the best prevention for stroke is?

88. Which is the most common condition associated with endocarditis?

89. Drug used in treatment of CHF which decrease the mortality

90. A patient is a known case of stable angina for 2 years, came c/o palpitation , Holtis monitor showed 1.2mm ST depression for 1 to 2 minutes in 5-10 minutes wt your Dx

91. Furmingham risk score predict?

92. What explains coronary artery disease the best?

93. Which of the following is the most dangerous to a patient in terms of risk for CAD?

94. A postmenopausal woman develops chest pain immediately on hearing the news of her son’s death in a war. Shedevelops acute chest pain, dyspnea, and ST segment elevation in leads V2 to V4 on electrocardiogram. Elevated levels of troponin confirm an acute myocardial infarction. Coronary angiography is normal including an absence of vasospasm on provocative testing. Echocardiography reveals apical left ventricular “ballooning.”
What is the presumed mechanism of this disorder?

95. Correcting which of the following risk factors for CAD(Coronary Artery Disease) will result in the most immediate benefit for the patient?

96. A man with atypical chest pain is found to have normal nuclear isotope uptake in his myocardium at rest. On exercise, there is decreased uptake in the inferior wall. Two hours after exercise, the uptake of nuclear isotope returns to normal. What is the right thing to do?

97. A 48-year-old woman comes to the office with chest pain that has been occurring over the last several weeks. The pain is not reliably related to exertion. She is comfortable now. The location of the pain is retrosternal. She has no hypertension, and the EKG is normal.
What is the most appropriate next step in management?

98. A 64-year-old man is placed on lisinopril as part of managing CAD in association with an ejection fraction of 24% and symptoms of breathlessness. Although he sometimes has rales on lung examination, the patient is asymptomatic today. Physical examination reveals minimal edema of the lower extremities. Blood tests reveal an elevated level of potassium that is present on a repeat measurement. EKG is unchanged.
How would you best manage the patient?

99. Which of the following is the most common adverse effect of statin medications?

100. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour. The pain radiates to her left arm and is associated with anxiety, diaphoresis, and nausea. She describes the pain as “sore”and “dull” and clenches her fist in front of her chest. She has a history of hypertension.
Which of the following is most likely to be found in this patient?

101. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour.
Which of the following EKG findings would be associated with the worst prognosis?

102. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour. An
EKG shows ST segment elevation in V2 to V4.
What is the most appropriate next step in the management of this patient?

103. A 70-year-old woman comes to the emergency department with crushing substernal chest pain for the last hour. An EKG shows ST segment elevation in V2 to V4. Aspirin has been given to the patient to chew.
What is the most appropriate next step in the management of this patient?

104. Which of the following is most important in decreasing the risk of restenosis of the coronary artery after PCI?

105. A patient comes to a small rural hospital without a catheterization laboratory. The patient has chest pain and ST segment elevation. What is the most appropriate next step in the management of the patient?

106. A man comes to the emergency department with chest pain for the last hour that is crushing in quality and does not change with respiration or the position of his body. An EKG shows ST segment depression in leads V2 to V4. Aspirin has been given.
What is the most appropriate next step in the management of this patient?

107. Which of the following is the most common cause of death from CHF?

108. A 74-year-old African American man with a history of dilated cardiomyopathy secondary to MI in the past is seen in the office for routine evaluation. He is asymptomatic and is maintained on lisinopril, furosemide, metoprolol, aspirin, and digoxin. Lab tests reveal a persistently elevated potassium level. The EKG is
unchanged. What is the best management?

109. A 74-year-old woman comes to the emergency department with the acute onset of shortness of breath, respiratory rate of 38 per minute, rales to her apices, S3 gallop, and jugulovenous distension. What is the best initial step in the management of this patient?

110. A 78-year-old man with a history of lung cancer comes to the emergency department with several days of increasing
shortness of breath. He became somewhat lightheaded today, and that is what has brought him to the hospital. On physical
examination, he has a blood pressure of 106/70 mm Hg; pulse of 112 bpm; jugulovenous distention; and the lungs are clear to
auscultation. The blood pressure drops to 92/58 mm Hg on inhalation.Which of the following is the most appropriate to confirm the
diagnosis?

111. A 67-year-old man comes to the emergency department with the
sudden onset of chest pain. He also has pain between his
scapulae. He has a history of hypertension and tobacco
smoking. His blood pressure is 169/108 mm Hg.
What is the best initial test?

112. A 67-year-old man comes to the emergency department with the
sudden onset of chest pain. He also has pain between his
scapulae. He has a history of hypertension and tobacco
smoking. His blood pressure is 169/108 mm Hg.
What is the most accurate test?

113. Which of the following is the most appropriate screening for
aortic aneurysm?

114. Which of the following is the most dangerous to a pregnant woman?