Soal Dewasa Seri 2.a dari 5 Flashcards
Penentuan kategori diagnostik untuk rekurensi Demam Rheuma yang disertai dengan penyakit jantung rheuma sesuai dengan kriteria WHO 2002-2003 adalah :
Ditandai dengan adanya 2 kriteria minor dan bukti adanya infeksi bakteri Streptokokus grup A.
A 72-year-old white female, previously well controlled on a once-daily combination pill containing atenolol 50 mg and hydrochlorothiazide 25 mg, presents with a rise in her blood pressure to 170/110. You add 5 mg of lisinopril, and her creatinine rises from 1.1 to 1.9. What do you suspect?
Atherosclerotic renal artery stenosis
Which of the following scenarios illustrates the most appropriate first-line selection of antihypertensive agent in the hypertensive patient described?
A 32- year-old with chronic migraines is prescribed metoprolol
- A 47-year-old male with diabetes presents as a new patient to your clinic. He does not recall any abnormal blood pressure readings. You find his blood pressure to be 138/86 on two readings during this visit. You should
Provide lifestyle counseling and recheck blood pressure within a few months
24-hour Holter monitor
F
A 65-year-old man presents with class III symptoms of heart failure and a known ischemic cardiomyopathy with prior myocardial infarctions. His EF is 18%. His ECG shows a QRS duration of 110 ms. Appropriate therapy for this man would include all of the following except
A biventricular pacing ICD
A biventricular pacing ICD
Discontinue the indomethacin
A 75-year-old man is diagnosed with aortic stenosis. What is the most likely etiology of his valvular disorder?
Degenerative calcific valve
A 75-year-old man is diagnosed with aortic stenosis. What is the most likely etiology of his valvular disorder?
Urgent echocardiogram and surgical consultation
Urgent echocardiogram and surgical consultation
The likely diagnosis is mitral stenosis, and she should respond to furosemide and β-blockers
Hypertension resolves in almost all patients after discontinuation of oral contraceptives
F
Thiazide diuretics can contribute to each of the following metabolic effects, except :
Hypouricemia
Reversible hepatotoxicity develops in 10 percents of patients
F
Lifestyle modifications significantly reduce the rate of diabetes development in at-risk individuals
T
Ticlopidine and clopidogrel reversibly affect platelet aggregation
F
Thrombolytic therapy increases the incidence of early post – MI pericarditis
F
The intensity of the diastolic murmur is closely related to the severity of mitral stenosis
F
A 53-year-old man with chronic mitral regurgitation underwent echocardiographic examination, which demonstrated a mildly enlarged LV diastolic chamber size, a normal end-systolic dimension (38 mm), and an LV ejection fraction of 60 percent. He is asymptomatic, and has not experienced unusual dyspnea on exertion, orthopnea, or lower-extremity edema. For this patient, each of the following statements is correct regarding the timing of mitral valve surgery, except
Chronic administration of an ACE inhibitor would delay the need for surgery
A 47-year-old male with diabetes presents as a new patient to your clinic. He does not recall any abnormal blood pressure readings. You find his blood pressure to be 138/86 on two readings during this visit. You should
Provide lifestyle counseling and recheck blood pressure within a few months
A 47-year-old male with type 2 diabetes returns for follow-up. You find his blood pressure to be 138/72 in the left arm and 142/74 in the right arm. One month ago, his blood pressures were 136/68 in the left arm and 140/72 in the right, and on the visit before that the readings were 138/70 in the left arm and 142/68 in the right arm. He has attempted to modify his diet and exercise. Urinalysis shows microalbuminuria. You recommend
Start lisinopril 5 mg po every day
The absence of pulmonary rales on examination excludes the presence of an elevated pulmonary capillary pressure
F
When anticoagulant therapy is required during pregnancy, warfarin is less desireable than heparin. Select the reason :
Warfarin crosses placental barrier and may cause fetal abnormality
Besides relieving the anxiety and pain of myocardial infarction, morphine has additional beneficial cardiovascular effect. Which of the following describe an important Cardiovascular effect of Morphine ?
Dilates vein, reducing venous return
A patient with hypertension (HTN) has CHF, with an EF of less than 30%. Her serum creatinine is stable at 2 mg per dL, and she is currently on digoxin and furosemide. Her BP is 152/90 mm Hg. Which antihypertensive agent is indicated?
Captopril
Increased ventricular pressure
F
Which of the following methods can improve patient adherence to antihypertensive therapy?
all of the above
Which of the following would have the least risk patients contemplating pregnancy
Severe MR fc I
Primary cause of of diastolic heart failure include all of the following, except
Hypertension
Indikasi potensial revaskularisasi, pada angina pektoris stabil, kecuali:
Pasien yang asma bronchiale, karena tidak bisa diberikan beta blocker
Beta blocker dibawah ini di eliminasi sebagian besar melalui ginjal maka tidak dianjurkan pada pasien dengan gagal ginjal, kecuali
Metoprolol
