following treatments is likely to worsen his
prognosis?
a. Aspirin
b. Fondaparinux
e, Itravenous tisstte plasminogen actıvator
PA)
d. Metoprolol
e. Ticagrelor
16)An 84 year old man is evaluated during a
84
routine physical examination. His only
concern is a easy fatigue and low energy. He
has hypertension, & on lisinopri.I his BP is
125/78 mm Hg and PR $ 52 /min. Heart
rate is regular. Laboratory studies are within
normal limits, including TSH. ECG shows
sinus bradycardia Ambulatory 48-hour
ECG monitoring shows a maximum heart
rate of 72/ min during aerobic activity. An
echocardiogram and exercise stress test
performed I year ago for atypical chest pain
revealed normal left ventricular function and
no ischemia, with appropriate augmentation
of heart rate. Which of the following is-best
next step
a. Hospital admission
b. Pacemaker implantation
< Switch lisinoprit to amlodipines
d. Reassurance and clinical monitoring
14) 65 year old smoker with hypertension is
found to to have an abdominal aortic aneurysm
on population screening with ultrasound
Which intervention will most reduce his
future risk of aortic aneurysm rupture?
a. ACE inhibitor
b. B-blocker
○. Smoking cessation
Statin
e. Warfarin
15)A 30-year-old man is hospitalized for a3
17) A 40-year-old female with mitral
day history of progressive fatigue, fever, and
stenosis consults for advice regarding
shortness of breath. He underwent surgical
operative procedures. In which of the
aortic valve replacement 3 years ago. He
following circumstances would antibiotic
also has end-stage kidney disease. For
prophylaxis of infective endocarditis be
which he receives hemodialysis.
required?
Medications are lisinopril, sevelamer, and
a. Caesarian section
warfarin. BP is 145/34 and pulse rate is 120
6, Cardiac catheterizatton
min, Cardiac examination reveals bounding
Dental sealing
pulses and a loud decrescendo diastolic
A d. Removal of a lipoma
murmur at the left sternal border. Crackles
prolonged at first the lung degree basis. An atrioventricular ECG shows block.
e. Termination ofp pregnancy
are heard
Chest x-ray shows pulmonary edema. Echo
18)A 65-year-old man has an ejection
systolic murmur and narrow pulse pressure
reveals LV EF= 60, with normal LV
on clinical examination. There is no history
dimensions and a 1.S-cm vegetation on the
of chest pain, breathlessness or Syncope. An
aortic valve bioprosthesis associated with
ECHO confirms aortic stenosIs and shows
severe AR. Multiple blood cultures
are
obtained, & empiric intravenous antibiotic
valve gradient of 40mmHg good
an
aortic
therapy is initiated. Which of the following
LV function. Which of the following 1S the
most appropriate 2.
is the most appropriate management?
a. Anticoagulation
a. Cardiac catheterization
A0. EarlV suroiea noriic valve replacement
b Aortic valve plasty
O. Placement of temporary pacemaker
Follow -up$ETH
O Routine aortic valve replacement
d. No change 0 therapy
e. Aortic valve replacement
