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Cardiovascular

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Exam of 20 pages for the course Evaluation of Dyspnea in a 60-Year-Old Female Pa at Evaluation of Dyspnea in a 60-Year-Old Female Pa (Cardiovascular)

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Cardiovascular
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1.A 58-year- bu

old male presents for evaluation after an episode of chest pain noted la
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st night after an argument with his wife. The pain lasted about 20 minut
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es and was described as a tightness and burning sensation in his chest
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behind the sternum and radiated to the left shoulder and upper arm. He s
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tates the pain improved after he rested. The patient states this is the thi
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rd such episode during stressful situations this month. Which of the foll
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owing is the most likely diagnosis for this patient?: Angina pectoris
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2.A 60-year- bu

old male complains of progressive fatigue and dyspnea. On ex-
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buamination his lungs are clear to auscultation bilaterally, heart exam re
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veals regular rate and rhythm without S3, S4 or murmur, and extremitie
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s show 1+ edema bilaterally. CXR reveals cardiomegaly.
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Electrocardiogram shows low voltage, and echocardiogram shows an eject bu bu bu bu bu bu bu bu

ion fraction of 55% with a small, thickened LV that has rapid early filling
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with dias- bu

butolic dysfunction. Which of the following is the most likely underlying eti
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ology of this patient's cardiomyopathy?: Restrictive cardiomyopathy fro
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m Amyloidosis
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3.A 42-year- bu

old male patient with viral myocarditis has developed fatigue, pro-
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bugressively worsening shortness of breath, and lower extremity over the
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upast three days. CXR reveals cardiomegaly and pulmonary vascular con
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gestion. Which of the following is the most likely diagnosis?: Congestiv
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e heart failure
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4.A 66 y/ bu bu

o female with a history of CAD presents with a new onset of dizziness an
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d fatigue for two weeks. She recalls nearly passing out on one occasion.
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PE is unremarkable except for bradycardia. EKG reveals a HR of 50 with
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a normal PR interval followed by a normal QRS. There are several non-
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conducting P waves and no lengthening of the PR interval. Which of the
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ufollowing interven- bu

butions is the therapy of choice?: Permanent pacemaker
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5.A 52 year old male with a history of hypertension, dyslipidemia, and
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con-
bugestive heart failure presents to the emergency department with acute
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buon-
buset swelling of the lips, eyes, and tongue causing airway obstruction
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and respiratory distress. He also has an urticarial rash. Which of the f
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, Cardiovascular
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ollowing bumedicationsbuisbuthebulikelybuculpritbuofbuhisbucurrentbusymptoms?:buca
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ptopril
6.A 72-year-
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old male comes to the office with intermittent symptoms of dys-
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pnea on exertion, palpitations, and cough occasionally productive of bl
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ood. On cardiac auscultation, a low-
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pitched diastolic rumbling murmur is faintly heard toward the apex. The
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origin of the patient's problem probably relates to: Rheumatic fever as
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a youth
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7.Which of the following valvular heart abnormalities will most likely be
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seen on echocardiography as a complication of acute myocardial infarctio
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n?: Mitral regurgitation
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2bu/
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, Cardiovascular
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8.A grade IV/VI harsh cresendo-
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decresendo systolic murmur heard best in the 2nd right intercostals spac
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e which radiates into the neck and is also heard in the second left inter
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space is indicative of:: Aortic Stenosis
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9.A 62-year- bu

old male with a severely depressed EF has worsening shortness of breat
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h, orthopnea, PND, & a 20 lb weight gain in the past week. BP is 110/72,
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HR 100, RR 22, Temp 98.6F. He has elevated JVP to the angle of the man
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dible, S 3 heart sound, bibasilar rales, and 3+ LE pitting edema.
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After ruling out the patient for an MI, which of the following medications
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should be administered now to this patient with acute decompensated
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heart failure?: IV Furosemide
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10.A 36-year-old male presents for follow-
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up of his hypertension. The patient is currently on three anti-
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hypertensive medications without improvement of his blood pressure. O
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n examination his BP is 170/86 mmHg, and his HR is
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60 bpm and regular. His heart examination reveals a regular rate and rh
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ythm without S3, S4 or murmur and his lungs are clear to auscultation
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bilaterally. Abdominal examination reveals a bruit over his left upper abd
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omen. Which of the following is the most likely underlying etiology for th
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is patient's hyperten- sion?: Renal artery stenosis
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11.A 16 year old boy is 6' 4" tall, has hyperextensible fingers and pectu
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s car- bu

inatum. Which of the following is the most common complication?: Diss
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ection of aorta bu bu


12.A 69-year- bu

old man below present to a rural emergency room with 2 hours of subst
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ernal chest pain, acute ST-segment elevations in leads V2-
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V4 on ECG, and elevated serum troponin. Cardiac catheterization is not
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available. All bu

the following patients should receive intravenous thrombolytics EXCEPT:
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A 62-year-
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old male who had a hemorrhagic cerebrovascular accident (CVA) 6 w
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eeks ago. He did not receive thrombolytics at that time.
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13.A 53-year- bu

old man presents to the emergency room after the acute onset of chest
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upain. The episode occurred 8 h prior to his arrival and lasted for a tota
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l of 20 to 30 min. The chest pain is now resolved. The patient has a lo
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ng history of DM and hypercholesteremia and has smoked approximatel
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3bu/
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July 12, 2025
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