Question 1

A 58-year-old man presents with chest pain described as squeezing and suffocating, located substernally and radiating to his left arm. The pain is relieved by rest and nitroglycerin. Which condition does this clinical scenario most likely represent?

Accepted Answer

Stable ischemic heart disease (IHD)

Question 2

Which of the following is a major determinant of myocardial oxygen demand?

Accepted Answer

Contractility

Question 3

During which phase of the cardiac cycle does most coronary blood flow to the myocardium occur?

Accepted Answer

Diastole

Question 4

A patient with STEMI is found to have a transmural infarction. What does 'transmural' mean in this context?

Accepted Answer

Infarction involving the full thickness of the heart wall

Question 5

Which laboratory test is most specific for diagnosing acute myocardial infarction?

Accepted Answer

Troponin I and T

Question 6

A patient with a sedentary lifestyle and diabetes presents with atypical chest pain and minimal symptoms. Which factor may explain the atypical presentation?

Accepted Answer

Neuropathy affecting pain perception

Question 7

Which of the following is a mediator of coronary vasodilation?

Accepted Answer

Nitric oxide (NO)

Question 8

A patient with unstable angina has chest pain at rest that is not relieved by nitroglycerin. What is the underlying pathophysiology?

Accepted Answer

Intermittent blood flow interruptions due to thrombosis and lysis

Question 9

Which equation best represents the relationship between cardiac output, heart rate, and stroke volume?

Accepted Answer

$CO = HR 	imes SV$

Question 10

A patient with STEMI is treated with tissue plasminogen activator (tPA). What is the primary purpose of this therapy?

Accepted Answer

Lyse the coronary artery clot

Question 11

Which of the following interventions is most likely to increase myocardial oxygen supply?

Accepted Answer

Coronary artery stent placement

Question 12

A patient with NSTEMI is found to have subendocardial infarction. Which EKG finding is most consistent with this diagnosis?

Accepted Answer

ST segment depression

Question 13

Which of the following drugs is used to decrease myocardial oxygen demand by reducing heart rate and contractility?

Accepted Answer

Beta-blocker

Question 14

Which coronary artery is most commonly affected by atherosclerosis leading to myocardial infarction?

Accepted Answer

Left anterior descending artery

Question 15

A patient with STEMI develops thinning and dilation of the ventricular wall. What is this process called?

Accepted Answer

Ventricular remodeling

Question 16

Which of the following is a common sequelae of infarcted myocardial tissue?

Accepted Answer

Thinning and dilation of the ventricular wall

Question 17

Which of the following treatments is indicated to prevent clot extension in acute coronary syndromes?

Accepted Answer

Antiplatelet agents such as aspirin

Question 18

A patient with variant angina (Prinzmetal’s) is most likely to benefit from which class of medication?

Accepted Answer

Calcium channel blockers

Question 19

Which of the following best describes the effect of increased heart rate on coronary blood flow?

Accepted Answer

Decreases diastolic filling time and coronary perfusion

Question 20

A patient with acute coronary syndrome is found to have elevated troponin levels 8 hours after ER arrival. What does this indicate?

Accepted Answer

Recent myocardial infarction

Disorders of Cardiac Function: Ischemic Heart Disease and Acute Coronary Syndromes

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