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Multiple Choice Questions (MCQ)


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Category: Medicine--->Cardiology
Page: 8

Question 36# Print Question

You are seeing for the first time a 45-year-old female patient of your partner. A review of the patient’s medical record shows that her systolic blood pressure was greater than 140 mm Hg at both of her last clinic appointments. Her medical history is significant only for diabetes mellitus. Her blood pressure today is 164/92. What is the best next step in her blood pressure management? 

A. Ask the patient to keep a written record of her blood pressure and bring with her to a return appointment
B. Advise the patient to begin a heart healthy, low-sodium diet and refer to a nutritionist
C. Prescribe an ACE inhibitor in addition to heart healthy diet
D. Prescribe a dihydropyridine calcium-channel blocker in addition to a heart healthy diet
E. Arrange for echocardiogram to assess for end-organ damage


Question 37# Print Question

A 67-year-old man presents to your clinic to establish primary care; he is asymptomatic. He has a history of hypertension for which he takes hydrochlorothiazide. His father had a myocardial infarction at age 62. The patient smoked until 5 years ago, but has been abstinent from tobacco since then. His blood pressure in the office today is 132/78. Aside from being overweight, the remainder of the physical examination is unremarkable. Which of the following preventive health interventions would be most appropriately offered to him today?

A. Carotid ultrasound to evaluate for carotid artery stenosis
B. Abdominal ultrasound to evaluate for aortic aneurysm
C. Lipoprotein(a) assay to evaluate coronary heart disease risk
D. Exercise (treadmill) stress testing to evaluate for coronary artery disease
E. Homocysteine level to evaluate coronary heart disease risk


Question 38# Print Question

A 68-year-old man complains of pain in his calves while walking. He notes bilateral foot pain, which awakens him at night. His blood pressure is 117/68. Physical examination reveals diminished bilateral lower extremity pulses. An ankle:brachial index measures 0.6. The patient’s current medications include aspirin and hydrochlorothiazide. Which of the following is the best initial management plan for this patient’s complaint?

A. Smoking cessation therapy, warfarin
B. Smoking cessation therapy, graduated exercise regimen, cilostazol
C. Smoking cessation therapy, schedule an arteriogram
D. Smoking cessation therapy, warfarin, peripherally acting calcium-channel blocker
E. Smoking cessation therapy, consultation with a vascular surgeon


Question 39# Print Question

 A 70-year-old man with a history of mild chronic kidney disease, diabetes mellitus, and CHF is admitted to your inpatient service with decreased urine output, weakness, and shortness of breath. He takes several medications but cannot remember their names. Labs tests are pending; his ECG is shown below.

Based on the information available, what is the best initial step in management?

A. Administration of intravenous insulin
B. Administration of intravenous sodium bicarbonate
C. Administration of intravenous 3% hypertonic saline
D. Administration of oral sodium polystyrene sulfonate
E. Administration of intravenous calcium gluconate


Question 40# Print Question

You are called by a surgical colleague to evaluate a 54-year-old woman with ECG abnormalities 1 day after a subtotal thyroidectomy for a toxic multinodular goiter. Her only medication is fentanyl for postoperative pain control. The patient denies any history of syncope and has no family history of sudden cardiac death. Physical examination is unremarkable except for a clean postoperative incision at the base of the neck. Her ECG is reproduced below.

What is the best next step in evaluation and management of this patient?

A. Administration of intravenous magnesium sulfate
B. Measurement of serum ionized calcium
C. Stat non-contrast CT scan of the brain
D. Formal auditory testing
E. Reassure the patient that her ECG is normal for a woman her age




Category: Medicine--->Cardiology
Page: 8 of 9