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Which of the following is least consistent with a 55-year-old man with hypertension
and dyslipidemia who is presenting with acute coronary syndrome?
Diaphoresis and nausea
Ill-defined pain that often radiates
Retrosternal pain for 30 minutes
Localized chest pain that persists for up to 15 minutes - ANSWER Localized
chest pain that persists for up to 15 minutes
Major risk factors for heart failure include all of the following except:
Coronary artery disease.
Mitral valve prolapse.
Long-standing poorly-controlled hypertension.
Sleep apnea. - ANSWER Mitral valve prolapse.
You see a 62-year-old male with COPD who is scheduled for a follow-up on recent
hospitalization for COPD exacerbation. As he ambulates into the exam room, he
begins to stagger, perspires profusely, and complains of generalized pain and a
tightening feeling in his chest. The most appropriate action is to:
Have him lie down with feet elevated for 10 minutes before resuming the test.
Obtain an ECG to detect heart rhythm abnormalities.
Immediately initiate oxygen therapy.
1
,Administer nitroglycerin and call 911 to activate emergency medical services. -
ANSWER Administer nitroglycerin and call 911 to activate emergency medical
services.
Which of the following patients is the use of a direct oral anticoagulant (DOAC) most
appropriate?
A 78-year-old man with a prosthetic heart valve and recent history of transient
ischemic attack
A 62-year-old woman with a history of venous thrombotic event and an upcoming
surgery
A 62-year-old man with atrial fibrillation
A 64-year-old male with pulmonary embolism and peptic ulcer - ANSWER A 62-
year-old man with atrial fibrillation
What is the goal INR for a 56-year-old male patient with atrial fibrillation taking
warfarin?
1.0-2.0
2.0-3.0
3.0-3.5
3.5-4.0 - ANSWER 2.0-3.0
recommended for patients with atrial fibrillation to prevent the formation of blood
clots in the heart chambers that can lead to a stroke. - ANSWER Lifelong
anticoagulant therapy
INR prolongation is seen in about _____________ hours after the first warfarin dose -
ANSWER 48 to 72
2
, Jim is a 47-year-old male who presents with complaints of chest pain, shortness of
breath and nausea that has lasted over one hour. He states that he thinks he is
having a heart attack. Which of the following is an expected finding observed on an
electrocardiogram (ECG) of a person experiencing a myocardial infarction?
Absence of pathological Q waves
ST-segment elevation
QTc prolongation
QR-segment depression - ANSWER ST-segment elevation
cardiac enzymes (such as CK-MB and troponin) are typically detected in the serum
_____________ after onset of an MI, the ECG is an important diagnostic tool within
the first few hours after the MI to confirm the diagnosis. - ANSWER 5-7 hours
an important diagnostic tool within the first few hours after the MI to confirm the
diagnosis. - ANSWER ECG
Jim is a 68-year-old man who has a 60 pack-year smoking history, 20-year history of
hypertension with intermittent use of anti-hypertension medications, and a 15-year
history of dyslipidemia. At today's visit he states, "Heart damage showed up in my
blood work" during a recent hospitalization for ACS. What would you expect to find
on review of his labs that would be consistent with myocardial infarction?
Elevated troponin level that can persist up to 7 days after symptom onset
Elevated serotonin level that can persist up to 5 days after symptom onset
Elevated AST and decreased ALT for up to 3 days after symptom onset
Elevated TSH level for up to 14 days after symptom onset - ANSWER Elevated
troponin level that can persist up to 7 days after symptom onset
Mrs. Jones is a 58-year-old female recently diagnosed with acute bacterial
endocarditis following a surgical procedure. She was managed with intravenous
3
Which of the following is least consistent with a 55-year-old man with hypertension
and dyslipidemia who is presenting with acute coronary syndrome?
Diaphoresis and nausea
Ill-defined pain that often radiates
Retrosternal pain for 30 minutes
Localized chest pain that persists for up to 15 minutes - ANSWER Localized
chest pain that persists for up to 15 minutes
Major risk factors for heart failure include all of the following except:
Coronary artery disease.
Mitral valve prolapse.
Long-standing poorly-controlled hypertension.
Sleep apnea. - ANSWER Mitral valve prolapse.
You see a 62-year-old male with COPD who is scheduled for a follow-up on recent
hospitalization for COPD exacerbation. As he ambulates into the exam room, he
begins to stagger, perspires profusely, and complains of generalized pain and a
tightening feeling in his chest. The most appropriate action is to:
Have him lie down with feet elevated for 10 minutes before resuming the test.
Obtain an ECG to detect heart rhythm abnormalities.
Immediately initiate oxygen therapy.
1
,Administer nitroglycerin and call 911 to activate emergency medical services. -
ANSWER Administer nitroglycerin and call 911 to activate emergency medical
services.
Which of the following patients is the use of a direct oral anticoagulant (DOAC) most
appropriate?
A 78-year-old man with a prosthetic heart valve and recent history of transient
ischemic attack
A 62-year-old woman with a history of venous thrombotic event and an upcoming
surgery
A 62-year-old man with atrial fibrillation
A 64-year-old male with pulmonary embolism and peptic ulcer - ANSWER A 62-
year-old man with atrial fibrillation
What is the goal INR for a 56-year-old male patient with atrial fibrillation taking
warfarin?
1.0-2.0
2.0-3.0
3.0-3.5
3.5-4.0 - ANSWER 2.0-3.0
recommended for patients with atrial fibrillation to prevent the formation of blood
clots in the heart chambers that can lead to a stroke. - ANSWER Lifelong
anticoagulant therapy
INR prolongation is seen in about _____________ hours after the first warfarin dose -
ANSWER 48 to 72
2
, Jim is a 47-year-old male who presents with complaints of chest pain, shortness of
breath and nausea that has lasted over one hour. He states that he thinks he is
having a heart attack. Which of the following is an expected finding observed on an
electrocardiogram (ECG) of a person experiencing a myocardial infarction?
Absence of pathological Q waves
ST-segment elevation
QTc prolongation
QR-segment depression - ANSWER ST-segment elevation
cardiac enzymes (such as CK-MB and troponin) are typically detected in the serum
_____________ after onset of an MI, the ECG is an important diagnostic tool within
the first few hours after the MI to confirm the diagnosis. - ANSWER 5-7 hours
an important diagnostic tool within the first few hours after the MI to confirm the
diagnosis. - ANSWER ECG
Jim is a 68-year-old man who has a 60 pack-year smoking history, 20-year history of
hypertension with intermittent use of anti-hypertension medications, and a 15-year
history of dyslipidemia. At today's visit he states, "Heart damage showed up in my
blood work" during a recent hospitalization for ACS. What would you expect to find
on review of his labs that would be consistent with myocardial infarction?
Elevated troponin level that can persist up to 7 days after symptom onset
Elevated serotonin level that can persist up to 5 days after symptom onset
Elevated AST and decreased ALT for up to 3 days after symptom onset
Elevated TSH level for up to 14 days after symptom onset - ANSWER Elevated
troponin level that can persist up to 7 days after symptom onset
Mrs. Jones is a 58-year-old female recently diagnosed with acute bacterial
endocarditis following a surgical procedure. She was managed with intravenous
3
