Dr. Usman's Cardiology Notes

A patient with diabetes mellitus has been found to have high blood pressure. Which of the following antihypertensives can worsen diabetes? A. Furosemide B. Hydrochlorothiazide C. Lisinopril D. Spironolactone Click the button below to view answer: Show Answer

A 65-year-old woman presents to the outpatient department with complaints of fatigue and shortness of breath for the past four and a half months. The patient has a past medical history of breast cancer, diabetes mellitus, and gastroesophageal reflux disease. Her breast cancer was treated with a combination of radiation and chemotherapy and is now in remission. Her other medications include ranitidine and metformin. She has never traveled outside the United States. Her blood pressure is 130/70 mmHg, the pulse is 79/min and the temperature is 98.6 F (37 C). General physical examination shows conjunctival pallor, pedal edema and a rise in jugular venous pressure following inspiration. What is the definitive management of the patient’s condition? A. Cardiac transplant B. Myomectomy C. Pericardiotomy D. Pericardiectomy Click the button below to view answer: Show Answer

A 16-year-old girl presents with a history of slowly progressive abnormal movement of her limbs. She had a sore throat one month prior to this event. The patient was conscious, well oriented to time, place and person. She demonstrated the choreoathetotic movement of her upper and lower limbs. The rest of her systemic examination was normal. ECHO study revealed mild mitral valve regurgitation with tethering of the posterior leaflet. What is the most likely etiology of the condition in the patient? A. Infective endocarditis B. Rheumatic fever C. Wilson disease D. Polycythaemia Click the button below to view answer: Show Answer

A 52-year-old female with a past medical history of systemic scleroderma presents to a clinic with a recent 3-month history of shortness of breath, lightheadedness, and fatigue. On auscultation, a loud P2 sound is noted. An echocardiogram is performed, which reveals the increased thickness of the right ventricular wall, and a Swan-Ganz heart catheter shows right atrial pressure of 10 mmHg with an elevated mean pulmonary arterial pressure =25 mmHg. What is the mechanism of the first-line treatment for this condition? A. Inhibition of dehydroepiandrosterone synthesis B. Prostaglandin induced vasodilation of the pulmonary arteries C. Stimulation of beta 2 receptors to decrease bronchospasm D. Blockage of histamine synthesis Click the button below to view answer: Show Answer

A 61-year-old male with a history of chronic smoking, diabetes, hypertension, and chronic atrial fibrillation presents with acute onset of vertigo, dysarthria, dysphagia, sensory abnormalities on the face, and on the opposite trunk and extremities. Neurological exam reveals loss of pain and temperature on the same side of the face with decreased pain and temperature sensation and on the opposite side of trunk and extremities. MRI showed an occlusion of his right posterior inferior cerebellar artery. The patient improved well during hospitalization. What is the most important treatment for secondary prevention in this patient that has the greatest impact on his subsequent risk of stroke? A. Smoking cessation B. Good control of his hemoglobin A1C C. Oral coumadin D. Combined aspirin and clopidogrel Click the button below to view answer: Show Answer

A patient presents with anterior chest pain and has a cardiac friction rub without murmurs. Two weeks ago the patient had a sore throat with a fever to 100 degrees F and a skin rash. What test should be performed? A. Throat culture B. Rheumatoid factor C. Viral serology D. Blood cultures x 2 Click the button below to view answer: Show Answer

How long should air travel be postponed after a patient experiences an uncomplicated myocardial infarction? A. 1 week B. 2 weeks C. 1 month D. 6 months Click the button below to view answer: Show Answer

Which of the following medications is most appropriate for the treatment of fibrillation caused by thyrotoxicosis? A.  Digitalis B. Verapamil C. Propranolol D. Quinidine Click the button below to view answer: Show Answer

Select the best treatment for pericarditis secondary to acute myocardial infarction. A. Ibuprofen B. Aspirin C. Colchicine D. Corticosteroids Click the button below to view answer: Show Answer

A 62-year-old patient with a past medical history of essential hypertension, asthma, and congestive heart failure presents to the emergency department for progressively worsening shortness of breath and lower extremity swelling for the past five days. After admission and stabilization, the patient is transferred to a rehabilitation hospital. The patient is evaluated, and a rehabilitation program is designed. Which of the following is not a result of cardiac rehabilitation? A. Decrease depression B. Increase maximal oxygen uptake C. Reduce smoking D. Decrease mortality before 12 months Click the button below to view answer: Show Answer

Which is true regarding coronary artery vasospasm or Prinzmetal angina? A. Diagnosis cannot be made by cardiac catheterization B. It happens in the morning when the patient is resting C. Calcium channel blockers are contraindicated D. Does not continue to myocardial infarction Click the button below to view answer: Show Answer

1. A 65-year old male comes to the office due to shortness of breath with prolonged walking for the last few months. He has no symptoms at rest or at night. He had a myocardial infarction one year ago and was treated with bypass grafting nine months ago. The patient was smoking a pack of cigarettes per day but stopped after heart surgery. He is compliant with medications and currently taking metoprolol succinate, valsartan, rosuvastatin, aspirin, furosemide, and spironolactone. His blood pressure is 125/80 mmHg, heart rate is 70 beats/min, and respiratory rate is 20/min. Chest auscultation revealed S3 gallop and bilateral basilar rales. Pitting edema is noted in bilateral lower extremities. Echocardiography showed a dilated left ventricle with an ejection fraction of 25%. What would be the next step in the management of this patient? A. Implantable cardioverter-defibrillator placement B. Coronary angiography C. The left ventricle assist device D. Refer for a heart transplant Click the...