Soal Dewasa Seri 2 dari 2 Flashcards
A dilated, failing heart becomes less sensitive to preload and more sensitive to afterload
T
A 43 year old man complains of dyspnea on exertion and exertional chest pain. An echocardiographic demonstrates an aortic valve orifice area of less than 0.70 cm2, making it most appropriate to schedule the patient for which of the following?
Follow-up evaluation with echocardiography in 2 years
A 45 year old woman with history of mitral valve prolapse presents with the acute onset of shortness of breath and fever. Physical examination reveals an early systolic murmur at the apex and bilateral pulmonary rales. Chest x-ray demonstrates bilateral pulmonary edema but not cardiomegaly. In addition to blood cultures, the next test that should be performed is which of the following?
Echocardiography
Activation of the sympathetic nervous system and the RAAS can results in myocyte loss
T
Captopril has been shown to reduce systemic arterial pressures and lower ventricular filling pressure
T
The braking phenomenon, seen with long term loop diuretic administration, refers to an increase in tubular sodium resorption by the distal tubule
T
Which of the following is a feature of spironolactone?
It has been associated with reduced mortality in CHF, possibly by reducing arrhythmic death
Digoxin is of limited value for right sided heart failure
T
A combination of β adrenergic blocking agents and nitrates is more effective than treatment with β adrenergic blocking agents alone
T
It is not unusual for an MI to go unnoticed by the patient
T
If CKMB accounts for less than 5 percent of total CK, a skeletal muscle source should be considered for elevated plasma CKMB activity
T
For which of the following patients should primary PCI be considered over thrombolytic therapy?
A 58 yar old with blood pressure on presentation of 190/ 110 mmHg
In patients undergoing valve replacement for aortic regurgitation, a high risk group can be identified by which of the following?
Left ventricular end systolic dimension is greater than 55 mm
Vasodilators are useful in the management of patient with acute AR
T
Total coronary blood flow is increased in severe AR
T
Symptoms of heart failure present when ventricular remodelling occurs
T
Which of the following conditions is likely to precipitate symptomatic heart failure in patients with previously compensated left ventricular contractile dysfunction ?
Right ventricular apical pacing
Angiotensin II receptor blockers provide morbidity and mortality benefits comparable to ACE inhibitors in patients with heart failure
F
Among patients with class II angina and one- or two-vessel disease, PCI is indicated for which of the following?
To alleviate symptomatic ischemia
The LDL NCEP goal for treatment of lipids in patients with known CAD or CAD risk equivalent is:
<130 mg/dL
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:
GA ADA JAWABANNYA
Measurement of LVEF in MI setting:
Could accurately predict long-term mortality in the pre-thrombolytic era but not in patients treated with reperfusion therapy
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:
ASA, heparin, statin, ace-inhibitors
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:
Perform PCI with stent, dismiss on ASA, clopidogrel, Lovenox 7 days
