MKSAP Cardio Qs

Question 1

What is the best way to prevent heart failure readmission?

Answer 1

Phone call 2-3 days after the fact

Question 2

What sign is associated with monomorphic VT?

Answer 2

cannon a waves

Question 3

Young female with PVCs that are driving her crazy, not a secondary cause, what is the next best step for her?

Answer 3

Propranolol

Question 4

A claudication patient has ABIs 0.92 and 0.94 bilaterally, still complaining of pain. What is the next best test for evaluation?

Answer 4

Exercise Ankle-Brachial Index testing

Question 5

What is Ecolocumab?

Answer 5

A PCSK9 inhibitor, can use if patient is struggling to get LDL under 70

Question 6

Severe Aortic Stenosis has what?
Valve area?
High Peak Velocity?
Mean Gradient?

Answer 6

Valve area less than 1.0
Velocity greater than 4 m/s
High Mean Gradient > 40 mmHg

Question 7

If I had an ASD closed 1 year ago, do I require dental cleaning antibiotics?

Answer 7

NO

Question 8

62 Year old female with chest pain, equivocal EKG, D-dimer, and S4, what is the next best step?

Answer 8

Coronary CT angiography

Question 9

Adenosine Myocardial Perfusion imaging cannot be done in patients with a history of what?

Answer 9

eating beforehand?

Question 10

A mechanical valve patient on warfarin, has bruising, INR 3.4 (Goal is 2.5-3.5), stable hemoglobin, what should be done?

Answer 10

Nothing, stay the course, stable hemoglobin, do not change anything

Question 11

Cilostazol is contraindicated in what disease?

Answer 11

Heart Failure

Question 12

Neck cancer patients can incidentally have what cardiac disease despite no risk factors?

Answer 12

Coronary Artery Disease

Question 13

Ascending aorta or aortic root greater than 4.5 cm requires what?

Answer 13

Surgery

Question 14

Marfan’s Syndrome plus an aorta greater than 4mm, what should a woman have done if she is going to become pregnant?

Answer 14

Have Aortic Root Surgery

Question 15

If the aorta grows more than how many mm a year, then surgery should happen?

Answer 15

5 mm a year

Question 16

Cardiac MRI is the gold standard to address patients with what type of disease?

Answer 16

Infiltrative Cardiomyopathy, amyloidosis

Question 17

Warfarin is ok in pregnancy, 1st trimester, under what dose?

Answer 17

5mg is ok, 2nd and 3rd warfarin is prefered

Question 18

Bicuspid Aortic Valve, patient could not have aorta visualized well with echo, what is the next best test?

Answer 18

CT chest angio of thoracic

Question 19

Bad valves and the severity is moderate what is the next best test?

Answer 19

Stress echo or Stress Dobutamine, if story sounds like moderate symptoms, do this first before intervention

Question 20

68 year old man with a known PAD history, bilateral carotid and femoral bruits, starts graded exercise program. What is the best drug to start him on?

Answer 20

Rivaroxaban

Question 21

What is the first line atrial flutter treatment?

Answer 21

Catheter Ablation

Question 22

New onset post pregnancy chest pain, elevated troponins, and elevated ST elevations, what could this be?

Answer 22

Spontaneous Coronary Artery Dissection

Question 23

Peripartum Cardiomyopathy after pregnancy will demonstrate what on the echo?

Answer 23

Global Systolic Function reduction

Question 24

New onset, post pregnancy heart failure, what are the first two drugs to order?

Answer 24

Lasixs and an ACE inhibitor

Question 25

If a pacemaker pocket becomes infected, what is the next best step?

Answer 25

Pacemaker extraction, do not aspirate anything

Question 26

If a STEMI comes in with a culprit LAD lesion, and a 70% RCA lesion. Assuming the LAD lesion is dealt with easily, what else should be done before the patient leaves the hospital?

Answer 26

RCA lesions should be worked on

Question 27

Long term cardiomyopathy and A-fib, what is the best long term solution?

Answer 27

Cardiac Transplant

Question 28

Patient comes in on clopidogrel, rivaroxaban, and aspirin with bruising, what drug(s) should be stopped?

Answer 28

Aspirin

Question 29

Systolic Ejection murmur that decreases with squatting, what is this?

Answer 29

HOCM

Question 30

1 year post DES stent placement, patient is on aspirin and plavix. Should medications be continued, stopped, or changed? The patient has no horrible reasons to discontinue medication?

Answer 30

Continue Plavix and Aspirin

Question 31

Glaring AO dissection, blood pressure is low, what is the next best step?

Answer 31

Open Aortic Surgery

Question 32

Left Atrial Myxoma, what is the next best step?

Answer 32

Surgery, especially if weight loss, fever, and night sweats

Question 33

Symptomatic PAD, on statin, makes everything worse, what is the next best step?

Answer 33

Keep on the statin

Question 34

2 week history of palpitations, not associated with any activity, what is the next best test?

Answer 34

12 lead EKG

Question 35

Post RCA MI, rounds of heart block, bradycardia, what is the next best step?

Answer 35

Temporary pacing, do not jump for pacemaker right away

Question 36

Acute limb ischemia, what is the next step?

Answer 36

unfractionated heparin

Question 37

Stroke with a PFO, what is next best step, close the hole or give aspirin?

Answer 37

Close the hole

Question 38

NSTEMI patients, what is the best drug to give with troponins wnl, no ST elevations, and no chest pain, but had chest pain 2x throughout the day?

Answer 38

Give Clopidogrel

Question 39

HF with reduced ejection fraction, gynecomastia with spironolactone, what is the next best step?

Answer 39

Start Eplerenone

Question 40

Any ischemic heart disease, what medication should be discontinued?

Answer 40

Flecanide

Question 41

Mitral valve regurgitation has an EF less than 60% and a left ventricle end-systolic dimension (End Systolic Volume) of 60 mm means what? (name of the intervention)

Answer 41

Surgical Repair

Question 42

Pulsus Paradoxus, weight loss, distant heart sounds, what is the next best thing?

Answer 42

Echo

Question 43

CABG, LBBB, chest pain in exercise routine, what is the best test?

Answer 43

vasodilator single-photon emission CT

Question 44

Type 2 DM and atherosclerotic heart disease/stroke, what is the next best drug? (high sugars)

Answer 44

Empagliflozin

Question 45

High risk bleeding patient, on plavix, post stent after 6 months, now has ecchymosis on limbs, what is the next step?

Answer 45

Stop Plavix