Internal-Medicine

18 1: Cardiology
74. A 64-year-old woman with metastatic breast
cancer presents with fatigue and malaise. She
recently started noticing polyuria and polydypsia.
On examination, her JVP is below the
sternal angle, heart sounds are normal, and she
has tenderness over her thoracic spine. (SELECT
ONE)
75. A 78-year-old man develops recent-onset chest
pain and dyspnea on exertion. His blood pressure
is 150/90 mm Hg, pulse 90/min, and a
systolic ejection murmur at the right sternal
border that radiates to the carotids. His carotid
pulse is also diminished. (SELECT ONE)
Questions 76 through 79
(A)
(B)
(C)
(D)
true of metoprolol but not captopril
true of captopril but not metoprolol
true of both captopril and metoprolol
true of neither captopril nor metoprolol
For each of the following statements, select whether
it is applicable to metoprolol and/or captopril.
76. Useful in heart failure (SELECT ONE)
77. The effects on the heart result in a prominent
negative inotropic effect (SELECT ONE)
78. The treatment of chronic atrial fibrillation
(SELECT ONE)
79. Mechanism of action is calcium blockade
(SELECT ONE)
Questions 80 through 84
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
hydralazine
enalapril
spironolactone
metoprolol
nifedipine
digoxin
furosemide
metolazone
amlodipine
nitrates
For each of the following statements, select
whether it is applicable to any or all of the above
medications.
80. Direct action on vascular smooth muscle
(SELECT FOUR)
81. Inhibition of angiotensin converting enzyme I
(ACE I) (SELECT ONE)
82. Myocardial stimulant (SELECT ONE)
83. Used for primary pulmonary hypertension
(SELECT ONE)
84. May decrease mortality by direct myocardial
protective action against catecholamines
(SELECT ONE)
Questions 85 through 89
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
pulsus tardus
pulsus paradoxus
hyperkinetic pulse
bisferiens pulse
dicrotic pulse
pulsus alternans
delayed femoral pulse
pulsus bigeminus
For each of the following patients, select the characteristic
arterial pulse finding.
85. A 75-year-old woman with hypertension develops
fatigue and dyspnea on exertion. Her blood
pressure is 160/60 mm Hg and pulse 80/min.
The second heart sound is diminished and
there is an early diastolic murmur that radiates
from the right sternal border to the apex.
Your clinical diagnosis is aortic regurgitation.
(SELECT ONE)
86. A 64-year-old man with two previous MIs
develops SOB at rest and has difficulty lying
down. His blood pressure is 95/70 mm Hg,
pulse 100/min, and JVP is 8 cm. The cardiac
apex is dilated and displaced laterally, heart
sounds are normal, but there is a soft third