Soal Dewasa Seri 1 dari 5

Question 1

Activation of the sympathetic nervous system and the renin-angiotensin system can result in myocyte loss

Answer 1

T

Question 2

Activation of the sympathetic nervous system and the renin-angiotensin system can result in myocyte loss

Answer 2

All of the above

Question 3

Digoxin therapy decreases mortality rates in patients with chronic heart failure

Answer 3

F

Question 4

Among patients with class II angina and one- or two-vessel disease, PCI is indicated for which of the following?

Answer 4

To improve symptomps

Question 5

Among patients with class II angina and one- or two-vessel disease, PCI is indicated for which of the following?

Answer 5

<100 mg/dL

Question 6

A 65-year-old man presents with unstable angina and an elevated troponin level. Comorbidities include adult-onset DM treated with metformin and essential hypertension treated with metoprolol. Angiography shows three-vessel CAD with three discrete proximal flow limiting lesions and normal LV function. Treatment of choice is:

Answer 6

CABG including a LIMA graft

Question 7

Measurement of LVEF in MI setting

Answer 7

Is a class I indication in patients treated with thrombolytic therapy

Question 8

A 59-year-old male with long standing essential hypertension on drug treatment had two episodes of chest heaviness in the last 24 hours and was admitted to the ER. ECG shows new 2-mm ST depression with T wave inversions in V5-V6. His initial troponin is 0.1 ng/ml, LDL cholesterol was 148 mg/dl. The most appropriate initial treatment will be:

Answer 8

ASA, heparin, IIb/IIIa inhibitor, beta blocker

Question 9

The patient described above stabilizes on medical therapy. Elective catheterization shows 70% stenosis of the second OM with TIMI III flow, 40% to 50% lesions in remaining vessels. The OM lesion is suitable for PCI with stent. EF 68%, no areas of ventricular hypokinesis
The next step will be:

Answer 9

Perform PCI with stent, IIb/IIIa inhibitor, dismiss on ASA, clopidogrel, beta blocker and statin

Question 10

Which of the following scenarios illustrates the most appropriate first-line selection of antihypertensive agent in the hypertensive patient described?

Answer 10

A 32- year-old with chronic migraines is prescribed metoprolol

Question 11

A 32- year-old with chronic migraines is prescribed metoprolol

Answer 11

F

Question 12

A 62-year-old man with chronic congestive heart failure (CHF) due to coronary artery disease has been on a stable medical regimen of lisinopril, aspirin, and furosemide for years. He has been extremely compliant with medications and office visits. He closely monitors his weight daily. In addition to his CHF, he has hypertension, diabetes, and gout. Last month, he suffered a gout flare-up that is being treated with indomethacin. Over the last three weeks he has noticed a gradual decline in exercise tolerance, a weight gain of 5 pounds, and worsening pedal edema. What is the most appropriate course of action?

Answer 12

Discontinue the indomethacin

Question 13

Hypouricemia

Answer 13

F

Question 14

Ticlopidine and clopidogrel reversibly affect platelet aggregation

Answer 14

F

Question 15

The administration of aspirin in AMI:

Answer 15

Is statistically as effective as streptokinase at reducing 30-day mortality but is added in benefit when used in conjunction with streptokinase or another thrombolytic agent.

Question 16

A 38-year-old who had an anterior STEMI followed by prompt revascularization of a proximal LAD lesion with a sirolimus-coated DES is recovering uneventfully in the coronary care unit. On hospital day 4, the nurse alerts you to a new rash that he has developed. It is on his knees, elbows, and scalp and is well-demarcated with red-raised skin and silvery scale. Which of his new medications is likely the cause?

Answer 16

Metoprolol

Question 17

Patients with isolated chronic mitral or aortic valve regurgitation often have normal filling pressures despite significant LV enlargement. The mechanism by which this may occur is known to include which one of the following?

Answer 17

A rightward shift in the LV pressure–volume relationship

Question 18

The intensity of the diastolic murmur is closely related to the severity of mitral stenosis

Answer 18

F

Question 19

Dilated cardiomyopathy

Answer 19

F

Question 20

Which of the following statements is false with respect to STEMI versus NSTEMI?

Answer 20

The thrombus in a STEMI is more platelet rich than is the thrombus of a NSTEMI

Question 21

Hypertension resolves in almost all patients after discontinuation of oral contraceptives

Answer 21

F

Question 22

Diuretic therapy, particularly the use of loop diuretics, is mainstay therapy for symptomatic heart failure. Which of the following is incorrect regarding loop diuretics in heart failure?

Answer 22

Does not require higher dosing in renal insufficiency or heart failure

Question 23

Which of the following would be most likely in a patient with chronic severe MR?

Answer 23

Third heart sound

Question 24

NYHA functional class I, EF 70%, LV end systolic diameter 35mm

Answer 24

F

Question 25

Which of the following is true about the treatment of IE?

Answer 25

When enterococci resistant to both penicillin G and vancomycin cause endocarditis, no medical therapy is reliably effective
b. Cefazolin may be used to treat enterococcal endocarditis