Cardiology

🔹 Question: A 73-year-old man presents with severe shortness of breath at night, ankle swelling, and chest pain on exertion. Examination reveals bilateral lung crackles, hepatomegaly, and ankle edema.

Which of the following is most appropriate for immediate management?

🔹 Question: A 66-year-old man with a history of hypertension presents with worsening shortness of breath on exertion. He can walk only 200-300 meters and struggles to climb stairs. His medications include amlodipine 5 mg OD and indapamide 2.5 mg OD. On examination, he has bilateral basal crackles and mild pitting ankle edema. Labs show:

Which of the following is the most appropriate next therapy?

🔹 Question: A 60-year-old man with diabetes mellitus and ischemic heart disease is admitted to the Critical Care Unit in shock. The following parameters are obtained from pulmonary artery catheterization:

What is the most likely diagnosis?

🔹 Question: A 67-year-old male patient presented with shortness of breath (SOB), orthopnea, and paroxysmal nocturnal dyspnea (PND) for one month. On examination, he has an early diastolic murmur. Echocardiogram showed severe aortic regurgitation and ejection fraction (EF) of 40%.

Which of the following is the best management for this patient?

🔹 Question: A 68-year-old patient, a known case of DM and HTN, presents to the hospital with chest pain for 2 hours. The pain is retrosternal, associated with nausea and sweating.
BP: 112/77, HR: 78.
ECG shows ST segment elevation in leads II, III, and aVF.

What is the most appropriate next step in evaluating this patient?

🔹 Question:
A 70-year-old man with stage 3 chronic kidney disease and hypertension was hospitalized 6 days ago for acute leg ischemia, treated with angioplasty and stenting. He is now asymptomatic. Current medications include aspirin, clopidogrel, diltiazem, and captopril.

Lab Results:

• Creatinine: 140 µmol/L (44-115 µmol/L)
• Total cholesterol: 5.9 mmol/L (<5.1 mmol/L)
• LDL cholesterol: 4.9 mmol/L (<4.0 mmol/L)

What is the most appropriate therapy for secondary prevention of cardiovascular disease?

🔹 Question: A 70-year-old patient presents with sudden severe pain and numbness in the left lower limb.

• The leg is cold and pale, while the right leg appears normal.
• The patient had an acute myocardial infarction (MI) 2 weeks ago and was discharged 24 hours prior.

What is the most likely diagnosis?

🔹 Question: A 60-year-old male with a history of diabetes and hypertension presents with neck pain and sweating for 1 hour. He has a history of recurrent chest pain that resolves with rest.

• ECG shows non-specific ST and T wave changes.
• Initial troponin is normal.

What is your next step?

🔹 Question: A 52-year-old man is diagnosed with acute inferior wall myocardial infarction (MI) in the Emergency Department. He is treated with intravenous morphine bolus and IV nitroglycerin infusion for severe chest discomfort.

Twenty minutes later, while being prepared for primary percutaneous coronary intervention (PCI), his condition worsens. Examination reveals:

• Elevated JVP
• Clear lungs

Initial vitals:

• Blood pressure: 120/70 mmHg
• Heart rate: 90/min (regular)
• Respiratory rate: 22/min
• Oxygen saturation: 96% (room air)

Thirty minutes later:

• Blood pressure: 75/40 mmHg
• Heart rate: 105/min (regular)

What is the most likely cause of the hypotension?

🔹 Question: A 65-year-old woman presents with rapid-onset shortness of breath and left shoulder and arm ache. Her vital signs are as follows:

• Blood pressure: 100/50 mmHg
• Heart rate: 90/min
• Respiratory rate: 25/min
• Temperature: 36.9°C

What is the most appropriate treatment after initial Emergency Department management?

🔹 Question: An elderly patient with a history of hypertension and type 2 diabetes, on metformin, atorvastatin, lisinopril, and furosemide, presents with severe right leg pain and swelling diagnosed as deep vein thrombosis (DVT). He is started on heparin. The lab results are as follows:

• Creatinine: 120 (Normal: 115)
• Potassium: 6 (Normal: 5.1)
• PT and APTT: Prolonged

Which of the following drugs should be stopped?

🔹 Question: A patient with diabetes mellitus (DM) and hypertension (HTN) presents for an elective cholecystectomy. He had a myocardial infarction (MI) 2 weeks ago. What is the most appropriate action?

🔹 Question: A 64-year-old man presented to the Emergency Room with dyspnea, palpitations, and irregular pulse. He has a history of diabetes, hypertension, hyperlipidemia, smoking, and stroke. Examination reveals:

• High JVP
• Bilateral crackles
• Atrial fibrillation on ECG

Vital signs:

• Blood Pressure: 150/90 mmHg
• Heart Rate: 144 bpm
• Oxygen Saturation: 89%

What is the CHADS2 score of this patient?

🔹 Question: A 45-year-old man presents to the hospital with shortness of breath, fever, and fatigue for a few days. On examination, he has:

• High jugular venous pressure (JVP)
• Pulsus paradoxus
• Distended heart sounds
  Auscultation reveals clear lungs. Laboratory results show:
• Blood Pressure: 90/55 mmHg
• Heart Rate: 120 bpm
• Respiratory Rate: 20/min
• Temperature: 36.6°C
  ECG shows low voltage QRS complexes. Chest X-ray reveals an increased cardiac silhouette.

Which area of the heart is primarily involved?

🔹 Question: A 38-year-old man has episodic chest pain. He describes the pain as tightness, located behind his sternum, lasting less than 3 minutes, and relieved with rest. He takes no medications, has no family history of coronary disease, and has never smoked. His ECG in the office is normal.

What is the most appropriate test to exclude cardiac ischemia?