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Category: Cardiology--->Ischaemic heart disease
Page: 23

Question 111#Print Question

A 74-year-old man was hospitalized for a subacute MI. He presented 1 week prior to admission one episode of chest pain lasting 3 hours but he did not seek medical attention. The ECG at admission revealed deep Q waves and persisting ST-segment elevation in the anterior leads. The angiography showed a total occlusion of the proximal left anterior ascending coronary artery.

Which statement about the benefit of revascularization in this particular patient does apply?

A. PCI reduces the occurrence of death
B. PCI reduces the occurrence of reinfarction
C. PCI reduces the occurrence of heart failure
D. CABG should be preferred to PCI
E. PCI does not reduce the occurrence of death, reinfarction, or heart failure


Question 112#Print Question

A 60-year-old man with a history of PCI 3 years previously asks for your advice with respect to his pharmacologic treatment. He is asymptomatic and his CV risk factors include smoking, hypertension, hypercholesterolemia, and impaired glucose tolerance. His medications include aspirin, atorvastatin, metoprolol, metformin, and lisinopril. His friend told him that clopidogrel should be added to his regimen.

What is the correct statement about that suggestion in this particular patient?

A. There is no significant benefit associated with clopidogrel plus aspirin as compared with placebo plus aspirin in reducing the incidence of the primary endpoint of MI, stroke, or death from CV causes
B. There is a significant benefit associated with clopidogrel plus aspirin as compared with placebo plus aspirin in reducing the incidence of the primary endpoint of MI, stroke, or death from CV causes
C. The rate of severe or moderate bleeding is not significantly greater with clopidogrel and aspirin compared with aspirin alone
D. The rate of severe or moderate bleeding is significantly greater with clopidogrel and aspirin compared with aspirin alone
E. Answers a and d are correct


Question 113#Print Question

A 60-year-old woman was discharged after an MI. Pharmacologic secondary prevention with antiplatelet agents, statins, β-blockers, and angiotensinconverting enzyme inhibitors is associated with:

A. Significant reduction in recurrent angina but no mortality benefit
B. Significant survival advantage
C. No significant clinical benefit
D. Significant reduction in recurrent hospitalization but no mortality benefit
E. Significant survival advantage only in patients treated with PCI


Question 114#Print Question

A 55-year-old man presents since 3 months typical chest pain at moderate exertion. The angiography revealed single-vessel disease. An optimal therapy has been started; what is the benefit of a treatment with PCI of the culprit lesion?

A. PCI would reduce the risk of death, MI, or other major CV events when added to optimal medical therapy (OMT)
B. PCI may reduce the episodes of angina in the presence of moderate-tosevere ischemia at stress single-photon emission computed tomography (SPECT) but not the risk of death, MI, or other major CV events when added to OMT
C. PCI would not reduce the risk of death, MI, angina episodes, or other CV events when added to OMT
D. The benefit of revascularization in patients with stable angina and ischemia detected on SPECT is independent of the extent of ischemia
E. Selective ischemia-driven PCI approach should be avoided, as thus not improved clinical outcomes


Question 115#Print Question

A 67-year-old man known for hypertension and hypercholesterolemia presented significant ST elevation in inferoposterior leads during the treadmill test. The angiogram shows (Fig. below)

A. Severe LCX stenosis
B. Severe left main trunk stenosis
C. Severe LAD stenosis
D. Severe RCA stenosis
E. No significant coronary artery stenosis




Category: Cardiology--->Ischaemic heart disease
Page: 23 of 26