Medicine
Cardiology
Which complication or major adverse outcome is particularly associated with Acute aortic dissection?
A. Intracranial hemorrhage
B. Heart failure
C. Aortic rupture with tamponade
D. Systemic embolization
Correct Answer: C
Proximal dissection can rupture into the pericardium, causing tamponade and sudden death.
Medicine
Cardiology
A patient is diagnosed with Acute aortic dissection. Which is the most appropriate management principle?
A. Control ventricular rate and assess anticoagulation need using validated stroke-risk assessment
B. Control heart rate and shear stress with intravenous beta-blockade and arrange urgent surgery for ascending aortic involvement
C. Use a titratable intravenous antihypertensive with controlled blood-pressure reduction
D. Refer for aortic valve replacement when severe symptomatic disease is confirmed
Correct Answer: B
Initial anti-impulse therapy limits propagation; Stanford type A dissections generally require emergency surgical management.
Medicine
Cardiology
In a patient with suspected Acute aortic dissection, which investigation or diagnostic approach is most appropriate at this stage?
A. Urgent CT angiography of the aorta in a hemodynamically stable patient
B. Transthoracic echocardiography
C. 12-lead electrocardiogram
D. Immediate assessment for acute target-organ injury
Correct Answer: A
CT angiography rapidly defines the dissection anatomy in stable patients; alternative imaging is used when CT is unsuitable or the patient is unstable.
Medicine
Cardiology
A patient develops abrupt severe tearing chest pain radiating to the back with an inter-arm blood-pressure difference. What is the most likely diagnosis?
A. Acute ST-elevation myocardial infarction (STEMI)
B. Heart failure with reduced ejection fraction (HFrEF)
C. Atrial fibrillation
D. Acute aortic dissection
Correct Answer: D
Abrupt maximal-at-onset tearing pain with pulse or blood-pressure asymmetry is classic for aortic dissection.
Medicine
Cardiology
Which ECG pattern is most typical of uncomplicated acute pericarditis?
A. ST elevation limited to one coronary territory
B. Deep Q waves only
C. Diffuse ST elevation with PR-segment depression
D. Short PR interval with delta waves
Correct Answer: C
Pericarditis classically causes diffuse rather than territorial ST elevation, often with PR depression.
Medicine
Cardiology
Which complication or major adverse outcome is particularly associated with Acute pericarditis?
A. Systemic embolization
B. Cardiac tamponade
C. Aortic rupture with tamponade
D. Ventricular tachyarrhythmia
Correct Answer: B
A significant pericardial effusion may impair ventricular filling and cause obstructive shock.
Medicine
Cardiology
A patient is diagnosed with Acute pericarditis. Which is the most appropriate management principle?
A. Use an NSAID plus colchicine when not contraindicated
B. Refer for aortic valve replacement when severe symptomatic disease is confirmed
C. Start targeted prolonged intravenous antimicrobial therapy after cultures and obtain specialist input
D. Control heart rate and shear stress with intravenous beta-blockade and arrange urgent surgery for ascending aortic involvement
Correct Answer: A
NSAIDs and colchicine are standard therapy for uncomplicated acute pericarditis and reduce recurrence.
Medicine
Cardiology
In a patient with suspected Acute pericarditis, which investigation or diagnostic approach is most appropriate at this stage?
A. Immediate assessment for acute target-organ injury
B. Transthoracic echocardiography with Doppler
C. Multiple blood cultures before antibiotics followed by echocardiography
D. Electrocardiogram with echocardiography when effusion or complication is a concern
Correct Answer: D
ECG supports the diagnosis, while echocardiography evaluates for pericardial effusion and tamponade.
Medicine
Cardiology
A patient has sharp pleuritic chest pain that improves on sitting forward and diffuse ST-segment elevation on ECG. What is the most likely diagnosis?
A. Atrial fibrillation
B. Hypertensive emergency
C. Acute pericarditis
D. Severe aortic stenosis
Correct Answer: C
Positional pleuritic chest pain with diffuse ST elevation is typical of acute pericarditis.
Medicine
Cardiology
Which organism is especially associated with acute infective endocarditis in people who inject drugs?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Mycoplasma pneumoniae
D. Clostridioides difficile
Correct Answer: B
S. aureus is a major cause of acute endocarditis and is strongly associated with injection-drug use.
Medicine
Cardiology
Which complication or major adverse outcome is particularly associated with Infective endocarditis?
A. Systemic embolization
B. Ventricular tachyarrhythmia
C. Acute pulmonary edema
D. Ischemic stroke
Correct Answer: A
Vegetations can embolize to the brain, spleen, kidneys and other organs.
Medicine
Cardiology
A patient is diagnosed with Infective endocarditis. Which is the most appropriate management principle?
A. Control heart rate and shear stress with intravenous beta-blockade and arrange urgent surgery for ascending aortic involvement
B. Give aspirin and activate an urgent reperfusion pathway, preferably primary PCI when promptly available
C. Start guideline-directed HFrEF therapy and use a loop diuretic when congestion is present
D. Start targeted prolonged intravenous antimicrobial therapy after cultures and obtain specialist input
Correct Answer: D
Treatment is organism-directed and prolonged; surgery may be required for heart failure, uncontrolled infection or selected embolic-risk situations.
Medicine
Cardiology
In a patient with suspected Infective endocarditis, which investigation or diagnostic approach is most appropriate at this stage?
A. Electrocardiogram with echocardiography when effusion or complication is a concern
B. Urgent CT angiography of the aorta in a hemodynamically stable patient
C. Multiple blood cultures before antibiotics followed by echocardiography
D. Immediate 12-lead electrocardiogram
Correct Answer: C
Blood cultures identify the organism and echocardiography evaluates vegetations and valve complications.
Medicine
Cardiology
A patient has persistent fever, a new murmur and multiple peripheral embolic or immunologic findings. What is the most likely diagnosis?
A. Severe aortic stenosis
B. Infective endocarditis
C. Acute pericarditis
D. Acute aortic dissection
Correct Answer: B
Fever with a new or changing murmur and embolic phenomena should raise strong suspicion for infective endocarditis.
Medicine
Cardiology
Where does the murmur of classic aortic stenosis most characteristically radiate?
A. Carotid arteries
B. Left axilla
C. Back between the scapulae
D. Epigastrium
Correct Answer: A
Aortic stenosis produces a crescendo-decrescendo systolic murmur that commonly radiates to the carotids.
Medicine
Cardiology
Which complication or major adverse outcome is particularly associated with Severe aortic stenosis?
A. Ischemic stroke
B. Intracranial hemorrhage
C. Systemic embolization
D. Heart failure
Correct Answer: D
Progressive outflow obstruction causes pressure overload, ventricular dysfunction and eventually heart failure.
Medicine
Cardiology
A patient is diagnosed with Severe aortic stenosis. Which is the most appropriate management principle?
A. Start guideline-directed HFrEF therapy and use a loop diuretic when congestion is present
B. Control ventricular rate and assess anticoagulation need using validated stroke-risk assessment
C. Refer for aortic valve replacement when severe symptomatic disease is confirmed
D. Use a titratable intravenous antihypertensive with controlled blood-pressure reduction
Correct Answer: C
Valve replacement is the definitive treatment for symptomatic severe aortic stenosis.
Medicine
Cardiology
In a patient with suspected Severe aortic stenosis, which investigation or diagnostic approach is most appropriate at this stage?
A. Immediate 12-lead electrocardiogram
B. Transthoracic echocardiography with Doppler
C. Transthoracic echocardiography
D. 12-lead electrocardiogram
Correct Answer: B
Doppler echocardiography quantifies valve gradients, valve area and ventricular function.
Medicine
Cardiology
A patient has exertional dyspnea, angina and syncope with a harsh systolic ejection murmur radiating to the carotids. What is the most likely diagnosis?
A. Severe aortic stenosis
B. Acute aortic dissection
C. Acute ST-elevation myocardial infarction (STEMI)
D. Heart failure with reduced ejection fraction (HFrEF)
Correct Answer: A
The classic symptom triad plus a carotid-radiating ejection murmur strongly suggests severe aortic stenosis.
Medicine
Cardiology
Which feature best distinguishes hypertensive emergency from severe asymptomatic hypertension?
A. A single systolic pressure above 160 mmHg
B. Headache alone
C. Long-standing history of hypertension
D. Acute target-organ injury
Correct Answer: D
The presence of acute organ injury, not a specific blood-pressure threshold alone, defines hypertensive emergency.