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Cardiac Medicine Certification (CMC)
Exam | 1000 Questions and Answers |
Complete Study Guide & Exam
Preparation
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Define acute coronary syndrome (ACS) and ACS refers to a spectrum of myocardial ischemia caused by reduced
identify its three major clinical presentations. coronary blood flow due to plaque rupture and thrombosis. The three
major presentations are unstable angina (UA), non-ST elevation
myocardial infarction (NSTEMI), and ST-elevation myocardial infarction
(STEMI). STEMI involves complete coronary occlusion with ST
elevation, NSTEMI causes myocardial necrosis without ST elevation,
and UA causes ischemia without detectable myocardial injury
biomarkers.
A patient presents with crushing chest pain NSTEMI. Elevated troponin confirms myocardial injury, while absence
radiating to the left arm and diaphoresis. Troponin of ST elevation differentiates NSTEMI from STEMI. Immediate treatment
is elevated but no ST elevation is present. What is includes antiplatelet therapy, anticoagulation, nitrates, beta blockers,
the most likely diagnosis? and risk stratification for possible catheterization.
What is the pathophysiology of stable angina? Stable angina occurs when fixed atherosclerotic coronary artery
narrowing limits oxygen supply during exertion or stress. Myocardial
oxygen demand exceeds supply, causing transient ischemia and chest
discomfort relieved by rest or nitroglycerin.
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The most sensitive and specific biomarker for Cardiac troponin (Troponin I or Troponin T).
myocardial injury is __________.
Differentiate between right-sided and left-sided Left-sided heart failure primarily causes pulmonary congestion with
heart failure. dyspnea, crackles, orthopnea, and pulmonary edema. Right-sided
heart failure leads to systemic venous congestion causing peripheral
edema, jugular venous distention (JVD), hepatomegaly, ascites, and
weight gain.
What ECG changes are typically seen in Peaked T waves, widened QRS complexes, prolonged PR interval,
hyperkalemia? flattened P waves, sine-wave appearance, and potentially ventricular
arrhythmias or cardiac arrest in severe cases.
Troponin elevation always indicates acute False. Troponin elevation indicates myocardial injury but not always
myocardial infarction. Explain. acute MI. Causes include myocarditis, pulmonary embolism, renal
failure, sepsis, heart failure, tachyarrhythmias, and cardiac trauma.
Clinical correlation and ECG findings are essential.
What is the hallmark auscultatory finding in aortic A harsh crescendo-decrescendo systolic murmur best heard at the
stenosis? right second intercostal space radiating to the carotids. Severe cases
may also present with pulsus parvus et tardus.
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A patient develops sudden severe chest pain Aortic dissection. Immediate blood pressure control and emergent
radiating to the back with unequal blood imaging such as CT angiography are required because rupture risk is
pressures in both arms. What condition should be life-threatening.
suspected?
What are the classic symptoms of infective Fever, new or changing heart murmur, fatigue, petechiae, splinter
endocarditis? hemorrhages, Osler nodes, Janeway lesions, and embolic phenomena.
Blood cultures and echocardiography are essential for diagnosis.
Define cardiogenic shock. Cardiogenic shock is a state of inadequate tissue perfusion due to
severe cardiac dysfunction, usually from extensive myocardial
infarction. Findings include hypotension, cool clammy skin, oliguria,
altered mental status, and elevated filling pressures.
Which medication class reduces mortality in ACE inhibitors, beta blockers, aldosterone antagonists, SGLT2
systolic heart failure? inhibitors, and ARNI therapy significantly reduce mortality in heart
failure with reduced ejection fraction (HFrEF).
https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
https://www.stuvia.com/user/educatorjake
Cardiac Medicine Certification (CMC)
Exam | 1000 Questions and Answers |
Complete Study Guide & Exam
Preparation
https://www.stuvia.com/user/educatorjake
https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
,https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
Define acute coronary syndrome (ACS) and ACS refers to a spectrum of myocardial ischemia caused by reduced
identify its three major clinical presentations. coronary blood flow due to plaque rupture and thrombosis. The three
major presentations are unstable angina (UA), non-ST elevation
myocardial infarction (NSTEMI), and ST-elevation myocardial infarction
(STEMI). STEMI involves complete coronary occlusion with ST
elevation, NSTEMI causes myocardial necrosis without ST elevation,
and UA causes ischemia without detectable myocardial injury
biomarkers.
A patient presents with crushing chest pain NSTEMI. Elevated troponin confirms myocardial injury, while absence
radiating to the left arm and diaphoresis. Troponin of ST elevation differentiates NSTEMI from STEMI. Immediate treatment
is elevated but no ST elevation is present. What is includes antiplatelet therapy, anticoagulation, nitrates, beta blockers,
the most likely diagnosis? and risk stratification for possible catheterization.
What is the pathophysiology of stable angina? Stable angina occurs when fixed atherosclerotic coronary artery
narrowing limits oxygen supply during exertion or stress. Myocardial
oxygen demand exceeds supply, causing transient ischemia and chest
discomfort relieved by rest or nitroglycerin.
https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
,https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
The most sensitive and specific biomarker for Cardiac troponin (Troponin I or Troponin T).
myocardial injury is __________.
Differentiate between right-sided and left-sided Left-sided heart failure primarily causes pulmonary congestion with
heart failure. dyspnea, crackles, orthopnea, and pulmonary edema. Right-sided
heart failure leads to systemic venous congestion causing peripheral
edema, jugular venous distention (JVD), hepatomegaly, ascites, and
weight gain.
What ECG changes are typically seen in Peaked T waves, widened QRS complexes, prolonged PR interval,
hyperkalemia? flattened P waves, sine-wave appearance, and potentially ventricular
arrhythmias or cardiac arrest in severe cases.
Troponin elevation always indicates acute False. Troponin elevation indicates myocardial injury but not always
myocardial infarction. Explain. acute MI. Causes include myocarditis, pulmonary embolism, renal
failure, sepsis, heart failure, tachyarrhythmias, and cardiac trauma.
Clinical correlation and ECG findings are essential.
What is the hallmark auscultatory finding in aortic A harsh crescendo-decrescendo systolic murmur best heard at the
stenosis? right second intercostal space radiating to the carotids. Severe cases
may also present with pulsus parvus et tardus.
https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
, https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
A patient develops sudden severe chest pain Aortic dissection. Immediate blood pressure control and emergent
radiating to the back with unequal blood imaging such as CT angiography are required because rupture risk is
pressures in both arms. What condition should be life-threatening.
suspected?
What are the classic symptoms of infective Fever, new or changing heart murmur, fatigue, petechiae, splinter
endocarditis? hemorrhages, Osler nodes, Janeway lesions, and embolic phenomena.
Blood cultures and echocardiography are essential for diagnosis.
Define cardiogenic shock. Cardiogenic shock is a state of inadequate tissue perfusion due to
severe cardiac dysfunction, usually from extensive myocardial
infarction. Findings include hypotension, cool clammy skin, oliguria,
altered mental status, and elevated filling pressures.
Which medication class reduces mortality in ACE inhibitors, beta blockers, aldosterone antagonists, SGLT2
systolic heart failure? inhibitors, and ARNI therapy significantly reduce mortality in heart
failure with reduced ejection fraction (HFrEF).
https://www.stuvia.com/user/educatorjake https://www.stuvia.com/user/educatorjake
