Internal Medicine Pt. 1 – Cardiology Exam Questions and Answers | Coronary
Artery Disease (CAD), Stable Angina, Unstable Angina, Acute Coronary
Syndrome (ACS), Myocardial Infarction, Stress Testing & Coronary Angiography |
Detailed Rationales | Latest Board Exam Prep Guide
A 56-Year-Old Male Presents With Chest Pain That Occurs With Exertion And Is Relieved By Rest.
The Pain Is Described As A Pressure-Like Sensation In The Middle Of His Chest And Lasts For
About 5-10 Minutes. His Medical History Includes Hypertension And Hyperlipidemia. Which Of
The Following Is The Most Likely Diagnosis?
A. Stable Angina Pectoris
B. Unstable Angina
C. Myocardial Infarction
D. Aortic Dissection
ANSWER: A. Stable Angina Pectoris
Stable Angina Is Characterized By Chest Pain Or Discomfort That Typically Occurs With Exertion
Or Stress And Is Relieved By Rest Or Nitroglycerin. The Pain Is Usually Predictable And Follows A
Pattern. In This Case, The Patient's Symptoms Of Exertional Chest Pain Relieved By Rest Are
Classic For Stable Angina.
A 62-Year-Old Female With A History Of Coronary Artery Disease Presents With Worsening
Chest Pain That Now Occurs At Rest. She Reports That The Pain Has Been Increasing In
Frequency And Duration Over The Past Few Days. Her ECG Shows ST-Segment Depressions In
The Inferior Leads. What Is The Most Appropriate Next Step In Management?
A. Continue With Current Outpatient Management
B. Admit To The Hospital For Further Evaluation
C. Prescribe A Higher Dose Of Sublingual Nitroglycerin
, D. Start A Low-Dose Aspirin Regimen
ANSWER: B. Admit To The Hospital For Further Evaluation
The Patient's Presentation Is Concerning For Unstable Angina, Characterized By Chest Pain At
Rest, Increasing In Frequency, Duration, Or Severity. This Condition Requires Prompt Evaluation
And Management, Including Hospitalization For Monitoring, Further Diagnostic Testing, And
Treatment To Prevent Myocardial Infarction.
A 70-Year-Old Man With A History Of Stable Angina Presents To The Clinic For A Follow-Up. He
Has Been Compliant With His Medications, Which Include Aspirin, Beta-Blockers, And Statins.
Despite This, He Reports Occasional Episodes Of Chest Pain With Minimal Exertion. What Is The
Best Next Step In His Management?
A. Increase The Dose Of His Beta-Blocker
B. Refer For Coronary Angiography
C. Add A Calcium Channel Blocker
D. Start On A Long-Acting Nitrate
ANSWER: B. Refer For Coronary Angiography
The Patient's Stable Angina Is Worsening Despite Optimal Medical Therapy, Which May Indicate
Significant Coronary Artery Disease. Coronary Angiography Is Recommended To Assess The
Severity Of The Disease And Determine If Revascularization (E.G., Percutaneous Coronary
Intervention Or Coronary Artery Bypass Grafting) Is Needed.
A 58-Year-Old Female Presents With Chest Pain That She Describes As Sharp And Stabbing,
Radiating To Her Left Arm. The Pain Began Suddenly While She Was Resting And Is Not Relieved
By Nitroglycerin. Her ECG Shows No Significant Changes, And Her Troponin Levels Are Normal.
What Is The Most Likely Diagnosis?
Artery Disease (CAD), Stable Angina, Unstable Angina, Acute Coronary
Syndrome (ACS), Myocardial Infarction, Stress Testing & Coronary Angiography |
Detailed Rationales | Latest Board Exam Prep Guide
A 56-Year-Old Male Presents With Chest Pain That Occurs With Exertion And Is Relieved By Rest.
The Pain Is Described As A Pressure-Like Sensation In The Middle Of His Chest And Lasts For
About 5-10 Minutes. His Medical History Includes Hypertension And Hyperlipidemia. Which Of
The Following Is The Most Likely Diagnosis?
A. Stable Angina Pectoris
B. Unstable Angina
C. Myocardial Infarction
D. Aortic Dissection
ANSWER: A. Stable Angina Pectoris
Stable Angina Is Characterized By Chest Pain Or Discomfort That Typically Occurs With Exertion
Or Stress And Is Relieved By Rest Or Nitroglycerin. The Pain Is Usually Predictable And Follows A
Pattern. In This Case, The Patient's Symptoms Of Exertional Chest Pain Relieved By Rest Are
Classic For Stable Angina.
A 62-Year-Old Female With A History Of Coronary Artery Disease Presents With Worsening
Chest Pain That Now Occurs At Rest. She Reports That The Pain Has Been Increasing In
Frequency And Duration Over The Past Few Days. Her ECG Shows ST-Segment Depressions In
The Inferior Leads. What Is The Most Appropriate Next Step In Management?
A. Continue With Current Outpatient Management
B. Admit To The Hospital For Further Evaluation
C. Prescribe A Higher Dose Of Sublingual Nitroglycerin
, D. Start A Low-Dose Aspirin Regimen
ANSWER: B. Admit To The Hospital For Further Evaluation
The Patient's Presentation Is Concerning For Unstable Angina, Characterized By Chest Pain At
Rest, Increasing In Frequency, Duration, Or Severity. This Condition Requires Prompt Evaluation
And Management, Including Hospitalization For Monitoring, Further Diagnostic Testing, And
Treatment To Prevent Myocardial Infarction.
A 70-Year-Old Man With A History Of Stable Angina Presents To The Clinic For A Follow-Up. He
Has Been Compliant With His Medications, Which Include Aspirin, Beta-Blockers, And Statins.
Despite This, He Reports Occasional Episodes Of Chest Pain With Minimal Exertion. What Is The
Best Next Step In His Management?
A. Increase The Dose Of His Beta-Blocker
B. Refer For Coronary Angiography
C. Add A Calcium Channel Blocker
D. Start On A Long-Acting Nitrate
ANSWER: B. Refer For Coronary Angiography
The Patient's Stable Angina Is Worsening Despite Optimal Medical Therapy, Which May Indicate
Significant Coronary Artery Disease. Coronary Angiography Is Recommended To Assess The
Severity Of The Disease And Determine If Revascularization (E.G., Percutaneous Coronary
Intervention Or Coronary Artery Bypass Grafting) Is Needed.
A 58-Year-Old Female Presents With Chest Pain That She Describes As Sharp And Stabbing,
Radiating To Her Left Arm. The Pain Began Suddenly While She Was Resting And Is Not Relieved
By Nitroglycerin. Her ECG Shows No Significant Changes, And Her Troponin Levels Are Normal.
What Is The Most Likely Diagnosis?
