Cardiovascular Knowledge Quiz

1. A 40-year old African-American female brings you her lipid panel results from a work health fair and asks if she should start taking medication to lower her cholesterol. The results include a total cholesterol of 295 mg/dL, an LDL-cholesterol of 170 mg/dL, an HDL-cholesterol level of 42 mg/dL, and a triglyceride level of 200 mg/dL. The patient does not smoke and except for a BMI of 30.4 kg/m2 she is otherwise healthy. Her blood pressure is 132/76 mm Hg and she takes no medications. Which one of the following would be consistent with current guidelines?

2. In a critically ill adult, which one of the following options for deep vein thrombosis prophylaxis is associated with greatest reduction in mortality risk?

3. One of your patients is admitted to the hospital with an acute myocardial infarction and requires a drug-eluting stent in his left circumflex artery. Which one of the following antiplatelet regimens would be most appropriate for at least the next 6-12 months?

4. In older patients with aortic stenosis and a systolic murmur, which one of the following would be most concerning?

5. At a routine visit, a 40-year-old female asks about beginning an exercise regimen. She has a family history of heart disease and hypertension. She currently has no medical problems, but she is sedentary. Which one of the following would be the most appropriate recommendation for this patient?

6. Which one of the following is the most common cause of sudden cardiac death in young athletes?

7. A healthy 18-year-old male plans to play soccer and basketball and presents for a preparticipation sports evaluation. The American Academy of Family Physicians recommends AGAINST which one of the following measures to screen for cardiac disease for this patient?

8. A 42-year-old female presents to the ED with a 2-hour history of palpitations. Her physical examination is normal except for what seems to be a regular rhythm tachycardia and blood pressure of 84/54 mm Hg. An EKG reveals a regular narrow-complex tachycardia at a rate of 180 beats/min without clear atrial activity. The optimal treatment for this patient is:

9. An asymptomatic 46-year-old male with autosomal dominant polycystic kidney disease sees you for a routine visit. His vital signs in the office include a blood pressure of 152/93 mm Hg, a heart rate of 82 beats/min, a respiratory rate of 17/min, a temperature of 37.0 C (98.6 F) and an oxygen saturation of 99% on room air. His glomerular filtration rate is 49 mL/min/1.73 m2. Which one of the following is the preferred initial therapy for controlling this patient’s blood pressure?

10. An 84-year-old female sees you for a follow-up visit for cardiovascular issues, including a previous myocardial infarction. Her current medication regimen consists of Lisinopril (Prinivil, Zestril) and carvedilol (Coreg). While she is not dyspneic at rest, she now becomes short of breath after walking half a block. On examination her blood pressure is 122/74 mm Hg, pulse rate 72 beats/min, respirations 18/min, and oxygen saturation 97% on room air. She has no jugular venous distention and her lungs are clear. No edema is noted. A recent echocardiogram showed a left ventricular ejection fraction of 30%. Adding which one of the following would help to decrease both mortality and the risk of hospitalization?

11. A 60-year-old male sees your for a routine health maintenance visit. One of the patient’s friends recently underwent screening for an abdominal aortic aneurysm (AAA), and he asks if he should be screened. He is asymptomatic, has never smoked, and has no other risk factors. Which one of the following does the U.S. Preventive Services Task Force advise with regard to AAA screening for this patient?

12. You see a 90-year-old patient with elevated blood pressure. Which one of the following is expected physiologic change in elderly patients?

13. A 30-year-old male is diagnosed with Lyme disease and is concerned because he read that this can lead to heart disease. Which one of the following is the most common cardiac problem associated with this disease?

14. Patients being treated with amiodarone (Cordarone) should be monitored periodically with serum levels of:

15. A 75-year-old male is noted to have palpitations. He has COPD from smoking for many years and uses an albuterol (Proventil, Ventolin) inhaler and inhaled corticosteroids. On examination his blood pressure is 130/70 mm Hg, his pulse rate is 110 beats/min, and his rhythm is irregularly irregular. Auscultation of the lungs reveals a few scattered wheezes and rhonchi. An EKG shows irregular R-R intervals with narrow QRS complexes and no P waves. Which one of the following would be the best choice to control this patient’s heart rate?