Question 1

Which of the following is the primary determinant of myocardial oxygen supply during diastole?

Accepted Answer

Coronary blood flow via the aorta

Question 2

A patient presents with chest pain described as squeezing and suffocating, located substernally and radiating to the jaw and left arm. The pain is relieved by nitroglycerin within minutes. Which condition is most likely?

Accepted Answer

Stable ischemic heart disease (IHD)

Question 3

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

Accepted Answer

Troponin I and T

Question 4

Which of the following best describes the pathophysiology of a STEMI?

Accepted Answer

Plaque rupture with transmural (full thickness) infarction due to coronary artery thrombosis

Question 5

Which equation best represents cardiac output, a key determinant of myocardial oxygen supply?

Accepted Answer

$$CO = HR 	imes SV$$

Question 6

A patient with a sedentary lifestyle and diabetes presents with atypical chest pain and minimal discomfort. Which factor is most likely affecting their clinical presentation?

Accepted Answer

Neuropathy affecting pain perception

Question 7

Which of the following mediators is responsible for coronary vasodilation?

Accepted Answer

Nitric oxide (NO)

Question 8

A patient with STEMI is treated with tissue plasminogen activator (tPA). What is the primary therapeutic goal of this intervention?

Accepted Answer

Lyse the coronary artery clot

Question 9

Which of the following is a common sequelae of myocardial infarction involving ventricular remodeling?

Accepted Answer

Thinning and dilation of infarcted ventricular wall

Question 10

Which intervention is most effective for decreasing myocardial oxygen demand in a patient with acute coronary syndrome?

Accepted Answer

Using beta-blockers to reduce heart rate and contractility

Question 11

Which of the following is a distinguishing feature of unstable angina compared to stable angina?

Accepted Answer

Pain is new onset, more severe, and not relieved within 5-10 minutes

Question 12

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

Accepted Answer

Left anterior descending artery

Question 13

A patient with NSTEMI is found to have elevated troponin levels but no ST elevation on EKG. What is the most likely underlying mechanism?

Accepted Answer

Subendocardial infarction due to partial coronary occlusion

Question 14

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

Accepted Answer

Antiplatelet agents such as aspirin and clopidogrel

Question 15

Which physiological change would most likely decrease coronary blood flow?

Accepted Answer

Vasoconstriction mediated by endothelin

Question 16

Which of the following best describes the effect of ventricular remodeling after a myocardial infarction?

Accepted Answer

Non-infarcted tissue hypertrophies to preserve stroke volume

Question 17

Which of the following is NOT a determinant of myocardial oxygen demand?

Accepted Answer

Patent artery

Question 18

A patient with STEMI is at risk for sudden cardiac death within the first hour due to which of the following complications?

Accepted Answer

Ventricular arrhythmias

Question 19

Which of the following best explains why myocardial tissue extracts approximately 75% of oxygen from coronary blood flow?

Accepted Answer

High metabolic demand of cardiac muscle

Question 20

Which of the following interventions directly improves myocardial oxygen supply in a patient with acute coronary syndrome?

Accepted Answer

Red blood cell transfusion

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

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