CVS

Question 1

Active cardiac conditions (4) that warrant delay of elective surgery for further evaluation or treatment

Answer 1

(1) Unstable coronary syndromes, (2) decompensated HF, (3) significant arrhythmia, (4) severe valvular disease

Question 2

Patients with an episode of pulmonary edema should delay elective surgery for this duration

Answer 2

1 week

Question 3

For patients who received angioplasty and stenting, elective surgery should be postponed for at least this duration after bare-metal stent placement

Answer 3

4-6 weeks

12 months if drug-eluting stent

Question 4

Chest pain is the presenting symptom of postoperative MI in only this percentage of patients

Answer 4

50%

Question 5

Peak incidence of postoperative MI is during this number of hours after surgery

Answer 5

24 to 48 hours

Question 6

Classic symptom of peripheral arterial disease

Answer 6

Intermittent claudication

Question 7

Ankle-brachial index in peripheral arterial disease

Answer 7

0.90 or less

Question 8

When the ABI is greater than 1.40, this test will provide a better assessment of lower extremity perfusion

Answer 8

Toe-brachial index

Question 9

Contraindications to cilostazol (2)

Answer 9

Low LVEF or history of HF

Question 10

Size of asymptomatic AAA that warrants surgical repair

Answer 10

5.5 cm or greater

or those growing 0.5 cm or more per year, or symptomatic

Question 11

Monitoring for unrepaired AAA measuring 4.0 to 5.4 cm

Answer 11

Ultrasound every 6 months

Every 2-3 years for smaller AAAs

Question 12

Patients should be counselled against pregnancy if the aortic root diameter exceeds this value

Answer 12

4 cm

Question 13

Class of drugs that reduce the rate of thoracic aortic dilation in thoracic aneurysms

Answer 13

Beta blockers

Question 14

Confirmatory test for coarctation of the aorta

Answer 14

Magnetic resonance angiography

Question 15

Chest x-ray findings in coarctation of the aorta (2)

Answer 15

“Figure 3” sign and notching on the undersides of the posterior ribs

Question 16

Balloon dilation is indicated in coarctation of the aorta if the pressure gradient exceeds this value

Answer 16

20 mmHg

Question 17

A golden or brightly refractile cholesterol body within a retinal artery; pathognomonic for atheroembolism

Answer 17

Hollenhorst plaque

Question 18

Most common cause of ventricular rates 30 to 50 per min

Answer 18

Third-degree block

Question 18

Pulmonary side effects of adenosine (2)

Answer 18

Cough and bronchospasm

Question 19

Duration of anticoagulation prior to elective cardioversion for patients with chronic AF

Answer 19

3 weeks

Question 19

Diagnostic procedure of choice for prosthetic valve dysfunction

Answer 19

TEE

Question 20

Addition of this drug to warfarin further decreases the risk of thromboembolism and is recommended in all patients with prosthetic heart valves

Answer 20

Aspirin

Question 21

Most common cause of significant MR

Answer 21

Mitral valve prolapse

Question 22

Prolonged use of these drugs (3) is associated with chronic MR

Answer 22

Ergotamine, pergolide, or cabergoline

* Goldman - also dexfenfluramine and fenfluramine

Question 23

Target MAP for patients with acute MR

Answer 23

Less than 60 mmHg

Question 24

Aortic stenosis and gastrointestinal bleeding due to acquired von Willebrand disease

Answer 24

Heyde syndrome

Question 25

Treatment for acute pericarditis that increases risk of recurrence

Answer 25

Corticosteroids

Question 26

Most common ECG abnormality associated with cardiac amyloidosis

Answer 26

Low voltage complexes

Question 27

Third-line agent for HCM (after beta blockere and CCBs)

Answer 27

Disopyramide

Question 28

Three major risk factors for sudden death in HCM

Answer 28

Prev cardiac arrest, spontaneous sustained VT, first-degree relative with sudden death

Question 29

Serum BNP level that effectively excludes HF as a cause of acute dyspnea

Answer 29

Less than 100 pg/mL

Question 30

ICD is indicated for patients with HF and this EF

Answer 30

35% or less

Question 31

Biventricular pacing is indicated for NYHA class III-IV HF with this EF and QRS duration

Answer 31

35% or less; more than 120 ms

Question 32

Biventricular pacing is indicated for NYHA class II HF with this EF and QRS duration

Answer 32

30% or less; more than 150 ms

Question 33

Indication for cardiac transplantation in HF

Answer 33

VO2max less than 14 mL/kg/min or less than 50% age-predicted maximum

Question 34

Appropriate stress test for patients with nonspecific baseline ECG changes or complete RBBB

Answer 34

Exercise ECG

Question 35

Appropriate stress test for patients with LBBB

Answer 35

Vasodilator MPI

Question 36

Appropriate stress test for patients with ventricular paced rhythm

Answer 36

Pharmacologic stress MPI

Question 37

Dose of ranolazine should be reduced when taken together with these anti-ischemic drugs (2)

Answer 37

Diltiazem or verapamil

Question 38

Preferred aldosterone antagonist in acute MI

Answer 38

Eplerenone

Question 39

ICD implantation after STEMI should be done after this number of days since MI

Answer 39

40 days

Question 40

All post-MI patients should be screened for this psychiatric condition as it is associated with increased hospitalization and death

Answer 40

Depression