Rosh Review Cardiovascular UPDATED ACTUAL Questions and CORRECT
Answers
1. An elderly woman presents with intermittent leg pain. C
She states it is a burning heaviness that is not neces-
sarily associated with activity. Inspection reveals sev-
eral dilated and tortuous veins about the lower legs.
The skin is edematous and speckled with dark brown
areas of capillary dilation but no specific pallor. Distal
motor and sensory examinations are intact. Which of
the following is the most appropriate initial tests in the
evaluation of these symptoms?
A Angiography
B Coagulation panel
C Duplex ultrasonography
D Electrodiagnostics
2. An elderly woman presents to the clinic 2 weeks after Enoxaparin
a lengthy hospital stay. She had repair of a hip fracture
which required prolonged bed rest. Her main com-
plaint today is an area of "painful redness" on her leg.
Examination reveals a nodular, rope-like, tender super-
ficial vein on the anteromedial proximal thigh. You or-
der a duplex ultrasound which reveals superficial vein
thrombus with extension into the deep veins of the
thigh. Which of the following is the most appropriate
when considering anticoagulation in this patient?
Aspirin
Enoxaparin
Ibuprofen
Unfractionated heparin
3.
, A 58-year-old man is undergoing a pre-operative eval- Antiplatelet or anticoagu-
uation before an elective surgery. An ECG shows atrial lation
fibrillation with rapid ventricular response. The patient
has no symptoms and is completely unaware of his
dysrhythmia. He has a past medical history significant
for obesity and hypertension that is treated with lisino-
pril. His vital signs are BP 120/80, HR 150, RR 16 and
oxygen saturation is 100% on room air. What is the
appropriate management with regards to anticoagu-
lation?
Antiplatelet or anticoagulation
Diltiazem
No therapy
Warfarin and aspirin
4. A 69-year-old man with atherosclerosis presents with Atrophic, shiny skin - PVD
calf pain during ambulation. He notices a blanching of
the leg skin when the pain is at its worst. If he stops
walking, the pain ceases within 5 minutes. He has a
120 pack-year history of tobacco use. Examination of
the toes reveals prolonged capillary refill but normal
sensation. A recent work-up revealed normal cardiac
function. Which of the following abnormalities would
most likely be found during examination of this pa-
tient's lower extremities?
Atrophic, shiny skin
Intrinsic foot muscle weakness
Pitting edema
Varicose veins
, 5. When considering the diagnosis of a patient with leg compression ultrasonog-
pain and swelling, you determine that the pretest raphy
probability of deep vein thrombosis is high. Which of
the following is the most appropriate test in confirm-
ing this diagnosis?
Compression ultrasonography
D-dimer assay
Factor V level
Venography
6. A young women with Raynaud's phenomenon pre- Normal exercise stress test
sents with a 3 month history of cyclical short episodes
of chest pain. Her social history is positive for inter-
mittent cocaine use. The pain occurs most commonly
after she wakes in the morning, lasts for 20 minutes,
then resolves. This pain occurs at rest and is not worse
with exercise or increased activity. Which of the follow-
ing would you most expect to find during an evaluation
of these symptoms?
Coronary artery stenosis
Normal exercise stress test
Pain relief during ergonivine administration
ST-segment depression
7. A 70-year-old woman with a history of hypertension Smoking history
presents to the Emergency Department with a com-
plaint of abdominal pain. On physical examination,
there is a pulsatile mass in the midline of her ab-
domen. Which of the following is the most common
risk factor for the development of this condition?
Answers
1. An elderly woman presents with intermittent leg pain. C
She states it is a burning heaviness that is not neces-
sarily associated with activity. Inspection reveals sev-
eral dilated and tortuous veins about the lower legs.
The skin is edematous and speckled with dark brown
areas of capillary dilation but no specific pallor. Distal
motor and sensory examinations are intact. Which of
the following is the most appropriate initial tests in the
evaluation of these symptoms?
A Angiography
B Coagulation panel
C Duplex ultrasonography
D Electrodiagnostics
2. An elderly woman presents to the clinic 2 weeks after Enoxaparin
a lengthy hospital stay. She had repair of a hip fracture
which required prolonged bed rest. Her main com-
plaint today is an area of "painful redness" on her leg.
Examination reveals a nodular, rope-like, tender super-
ficial vein on the anteromedial proximal thigh. You or-
der a duplex ultrasound which reveals superficial vein
thrombus with extension into the deep veins of the
thigh. Which of the following is the most appropriate
when considering anticoagulation in this patient?
Aspirin
Enoxaparin
Ibuprofen
Unfractionated heparin
3.
, A 58-year-old man is undergoing a pre-operative eval- Antiplatelet or anticoagu-
uation before an elective surgery. An ECG shows atrial lation
fibrillation with rapid ventricular response. The patient
has no symptoms and is completely unaware of his
dysrhythmia. He has a past medical history significant
for obesity and hypertension that is treated with lisino-
pril. His vital signs are BP 120/80, HR 150, RR 16 and
oxygen saturation is 100% on room air. What is the
appropriate management with regards to anticoagu-
lation?
Antiplatelet or anticoagulation
Diltiazem
No therapy
Warfarin and aspirin
4. A 69-year-old man with atherosclerosis presents with Atrophic, shiny skin - PVD
calf pain during ambulation. He notices a blanching of
the leg skin when the pain is at its worst. If he stops
walking, the pain ceases within 5 minutes. He has a
120 pack-year history of tobacco use. Examination of
the toes reveals prolonged capillary refill but normal
sensation. A recent work-up revealed normal cardiac
function. Which of the following abnormalities would
most likely be found during examination of this pa-
tient's lower extremities?
Atrophic, shiny skin
Intrinsic foot muscle weakness
Pitting edema
Varicose veins
, 5. When considering the diagnosis of a patient with leg compression ultrasonog-
pain and swelling, you determine that the pretest raphy
probability of deep vein thrombosis is high. Which of
the following is the most appropriate test in confirm-
ing this diagnosis?
Compression ultrasonography
D-dimer assay
Factor V level
Venography
6. A young women with Raynaud's phenomenon pre- Normal exercise stress test
sents with a 3 month history of cyclical short episodes
of chest pain. Her social history is positive for inter-
mittent cocaine use. The pain occurs most commonly
after she wakes in the morning, lasts for 20 minutes,
then resolves. This pain occurs at rest and is not worse
with exercise or increased activity. Which of the follow-
ing would you most expect to find during an evaluation
of these symptoms?
Coronary artery stenosis
Normal exercise stress test
Pain relief during ergonivine administration
ST-segment depression
7. A 70-year-old woman with a history of hypertension Smoking history
presents to the Emergency Department with a com-
plaint of abdominal pain. On physical examination,
there is a pulsatile mass in the midline of her ab-
domen. Which of the following is the most common
risk factor for the development of this condition?
