Soal Dewasa Seri 2.a dari 5

Question 1

Penentuan kategori diagnostik untuk rekurensi Demam Rheuma yang disertai dengan penyakit jantung rheuma sesuai dengan kriteria WHO 2002-2003 adalah :

Answer 1

Ditandai dengan adanya 2 kriteria minor dan bukti adanya infeksi bakteri Streptokokus grup A.

Question 2

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?

Answer 2

Atherosclerotic renal artery stenosis

Question 3

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

Answer 3

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

Question 4

4. 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

Answer 4

Provide lifestyle counseling and recheck blood pressure within a few months

Question 5

24-hour Holter monitor

Answer 5

F

Question 6

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

Answer 6

A biventricular pacing ICD

Question 7

A biventricular pacing ICD

Answer 7

Discontinue the indomethacin

Question 8

A 75-year-old man is diagnosed with aortic stenosis. What is the most likely etiology of his valvular disorder?

Answer 8

Degenerative calcific valve

Question 9

A 75-year-old man is diagnosed with aortic stenosis. What is the most likely etiology of his valvular disorder?

Answer 9

Urgent echocardiogram and surgical consultation

Question 10

Urgent echocardiogram and surgical consultation

Answer 10

The likely diagnosis is mitral stenosis, and she should respond to furosemide and β-blockers

Question 11

Hypertension resolves in almost all patients after discontinuation of oral contraceptives

Answer 11

F

Question 12

Thiazide diuretics can contribute to each of the following metabolic effects, except :

Answer 12

Hypouricemia

Question 13

Reversible hepatotoxicity develops in 10 percents of patients

Answer 13

F

Question 14

Lifestyle modifications significantly reduce the rate of diabetes development in at-risk individuals

Answer 14

T

Question 15

Ticlopidine and clopidogrel reversibly affect platelet aggregation

Answer 15

F

Question 16

Thrombolytic therapy increases the incidence of early post – MI pericarditis

Answer 16

F

Question 17

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

Answer 17

F

Question 18

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

Answer 18

Chronic administration of an ACE inhibitor would delay the need for surgery

Question 19

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

Answer 19

Provide lifestyle counseling and recheck blood pressure within a few months

Question 20

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

Answer 20

Start lisinopril 5 mg po every day

Question 21

The absence of pulmonary rales on examination excludes the presence of an elevated pulmonary capillary pressure

Answer 21

F

Question 22

When anticoagulant therapy is required during pregnancy, warfarin is less desireable than heparin. Select the reason :

Answer 22

Warfarin crosses placental barrier and may cause fetal abnormality

Question 23

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 ?

Answer 23

Dilates vein, reducing venous return

Question 24

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?

Answer 24

Captopril

Question 25

Increased ventricular pressure

Answer 25

F

Question 26

Which of the following methods can improve patient adherence to antihypertensive therapy?

Answer 26

all of the above

Question 27

Which of the following would have the least risk patients contemplating pregnancy

Answer 27

Severe MR fc I

Question 28

Primary cause of of diastolic heart failure include all of the following, except

Answer 28

Hypertension

Question 29

Indikasi potensial revaskularisasi, pada angina pektoris stabil, kecuali:

Answer 29

Pasien yang asma bronchiale, karena tidak bisa diberikan beta blocker

Question 30

Beta blocker dibawah ini di eliminasi sebagian besar melalui ginjal maka tidak dianjurkan pada pasien dengan gagal ginjal, kecuali

Answer 30

Metoprolol