130 Questions
Which of the following is the most common cause of impaired coronary blood flow resulting in angina pectoris?
Hypercholesterolemia
Which of the following is the first manifestation of ischemic heart disease?
Myocardial infarction
What is the most important risk factor for ischemic heart disease?
Male gender
What is the definition of unstable angina?
All of the above
What is the equation for coronary perfusion pressure (CPP)?
CPP = Aortic diastolic pressure - LVEDP
What is the most dangerous anatomic lesion associated with an unfavorable prognosis in ischemic heart disease?
Left main coronary artery disease
What is the most common cause of myocardial ischemia?
Atherosclerotic plaque
Which of the following agents should NOT be administered as part of the next management steps for a patient with chest pain and ST depression on the electrocardiogram (ECG)?
Procainamide
What is the formula for cardiac output?
CO = HR x SV
What is the special consideration for a 32-year-old female with mitral stenosis undergoing a large abdominal surgery?
Avoid hypervolemia
Which reflex is usually seen in brain injury and is characterized by Cushing's triad (hypertension, bradycardia, and irregular breathing)?
Cushing reflex
What are the compatible vital signs for a patient with severe traumatic brain injury and epidural hematoma being taken to the operating room for decompressive craniotomy?
HR: 50, BP: 180/99, RR: 14 (on MV), Saturation: 100%
Which reflex is responsible for maintaining circulatory homeostasis by responding to changes in blood pressure and heart rate?
Baroreceptor reflex
What is the formula for stroke volume?
SV = ESK-EDV
Which of the following is the most common cause of acute myocardial infarction (MI)?
Rupture of a plaque that had produced less than 50% stenosis of a coronary artery
Which of the following is NOT a treatment option for chronic stable angina?
Revascularization by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)
Which of the following is a recommended lifestyle modification for reducing the risk of coronary artery disease?
All of the above
Which class of drugs is associated with a substantial decrease in the risk of death due to cardiac events?
Antiplatelet drugs
Which of the following is a contraindication for the use of nitrates?
All of the above
Which of the following is a common side effect of nitrate treatment?
Headache
Which class of drugs is associated with a decrease in heart rate and myocardial contractility?
Beta blockers
Which class of medications is recommended for the medical management of Angina Pectoris?
Calcium channel blockers
What is the mechanism of action of calcium channel blockers?
All of the above
What are the common side effects of calcium channel blockers?
All of the above
What are the contraindications to the use of calcium channel blockers?
Both A and B
Which class of medications is recommended for the medical management of Angina Pectoris in patients with coronary artery disease and hypertension?
ACE inhibitors
What are the contraindications to the use of ACE inhibitors?
All of the above
When is revascularization indicated for the treatment of Angina Pectoris?
All of the above
In patients with ST-segment elevation myocardial infarction (STEMI), when is percutaneous coronary intervention (PCI) preferred over thrombolytic therapy?
All of the above
What is the recommended timeframe for performing angioplasty in patients with STEMI?
Both A and B
Which of the following is a common symptom of ischemic heart disease?
Chest pain
Which of the following is a common treatment for valvular heart disease?
Valve replacement surgery
Which of the following is a risk factor for congenital heart disease?
Advanced maternal age
Which of the following agents should NOT be administered as part of the next management steps for a patient with chest pain and ST depression on the electrocardiogram (ECG)?
Procainamide
Which of the following reflexes is usually seen in brain injury and is characterized by Cushing's triad (hypertension, bradycardia, and irregular breathing)?
Cushing reflex
Which of the following reflexes is responsible for maintaining circulatory homeostasis by responding to changes in blood pressure and heart rate?
Baroreceptor reflex
Which class of drugs is associated with a decrease in heart rate and myocardial contractility?
Beta blockers
Which of the following is the most common cause of impaired coronary blood flow resulting in angina pectoris?
Hypercholesterolemia
Which of the following is the most dangerous anatomic lesion associated with an unfavorable prognosis in ischemic heart disease?
Left main coronary artery disease
Which of the following is the first manifestation of ischemic heart disease?
Myocardial infarction (MI)
Which of the following is the most important risk factor for ischemic heart disease?
Male gender
Which of the following is NOT a diagnostic modality for angina pectoris?
Adenosine SPECT
Which of the following is a characteristic feature of stable angina?
Chest pain that changes appreciably in frequency or severity over 2 months or longer
Which of the following is a symptom of unstable angina?
Angina at rest or of new onset
Which of the following is a lifestyle modification recommended for reducing the risk of coronary artery disease?
All of the above
Which of the following is the most common side effect of nitrate treatment?
Headache
Which class of drugs is associated with a decrease in heart rate and myocardial contractility?
Beta-blockers
Which of the following is a contraindication for the use of nitrates?
All of the above
Which of the following is the most common cause of impaired coronary blood flow resulting in angina pectoris?
Rupture of a plaque with less than 50% stenosis of a coronary artery
Which of the following is a class of drugs associated with a substantial decrease in the risk of death due to cardiac events?
Antiplatelet drugs
Which of the following is the most correct statement about the therapeutic value of organic nitrates?
The therapeutic value of organic nitrates is compromised by the development of tolerance
Which class of medications is contraindicated in patients with severe congestive heart failure or severe aortic stenosis?
Long acting calcium channel blockers
What are the common side effects of calcium channel blockers?
Hypotension, peripheral edema, and headache
Which class of medications is recommended for patients with coronary artery disease, especially those with hypertension, left ventricular dysfunction, or diabetes?
ACE inhibitors
What is the preferred treatment choice in patients with a contraindication to thrombolytic therapy and those with severe heart failure and/or pulmonary edema?
Percutaneus Coronary Intervention (PCI)
When is revascularization indicated for the treatment of Angina Pectoris?
All of the above
What is the recommended timeframe for performing angioplasty in patients with STEMI?
Within 90 minutes of arrival at the health care facility and within 12 hours of symptom onset
Which of the following is a contraindication for the use of nitrates?
Both A and B
What is the equation for coronary perfusion pressure (CPP)?
CPP = (2 * SBP) + DBP
Which of the following is a recommended lifestyle modification for reducing the risk of coronary artery disease?
Smoking cessation
Which medication should be started at least one week before surgery?
Statins
What is the most effective method for monitoring myocardial ischemia during surgery?
Computerized ST-segment analysis
Which medication is an appropriate choice when myocardial ischemia is associated with a normal or modestly elevated blood pressure?
Nitroglycerin
What is the goal heart rate during surgery to control tachycardia?
Around 80 bpm
Which induction agent is preferred for cardiac transplantation due to its minimal effect on hemodynamics?
Etomidate
What is the preferred technique for maintenance of anesthesia during cardiac transplantation?
Total intravenous anesthesia
Which anesthetic drug should be avoided in patients undergoing cardiac transplantation due to the presence of significant pulmonary hypertension?
Nitrous oxide
Which mechanism is responsible for the increase in stroke volume in response to an increase in preload in patients with transplanted hearts?
Frank-Starling mechanism
Which of the following is a significant association with increased troponin levels in surgical patients?
Cardiac death
What is the recommended action if there is an increase in troponin level postoperatively, even in the absence of clear cardiovascular signs and symptoms?
Immediate referral to a cardiologist
Which of the following is a specialized preoperative testing for perioperative assessment in ischemic heart disease?
Thallium Scintigraphy scan
What is the purpose of evaluating clinical risk factors in the perioperative assessment of ischemic heart disease?
To evaluate severity, progression, and functional limitations
Which of the following is a major clinical predictor of increased perioperative cardiovascular risk?
Uncontrolled systemic hypertension
Which of the following is a moderate clinical risk factor for perioperative cardiac complications?
Abdominal aortic aneurysm
Which of the following is a minor clinical risk factor for coronary artery disease?
History of stroke
What is the fundamental reason for risk stratification in patients with ischemic heart disease?
To identify patients at increased risk for perioperative cardiac events
Which patients are traditionally thought to be contraindicated for β-blockers?
All of the above
What is the primary goal in the management of STEMI?
Reestablishment of blood flow in the obstructed coronary artery
What is the association between thrombolytic therapy and hemorrhagic stroke?
Hemorrhagic stroke occurs in 0.3% to 1% of patients receiving thrombolytic therapy
What is the recommended duration of delaying elective noncardiac surgery after PCI with drug-eluting stent placement?
12 months
Which of the following is the most common symptom of valvular heart disease?
Shortness of breath
Which of the following is NOT a diagnostic modality used in the perioperative evaluation of valvular heart disease?
Cardiac catheterization
Which of the following is the most appropriate management strategy for patients with valvular heart disease who require anticoagulation therapy?
Continue anticoagulation therapy during minor surgery
Which of the following is the most common complication associated with prosthetic heart valves?
Valve thrombosis
Which of the following is the most common cause of mitral stenosis?
Rheumatic heart disease
What is the normal mitral valve area?
4-6 cm2
Which of the following symptoms is commonly associated with mitral stenosis?
Dyspnea
What is the gold standard for diagnosing mitral stenosis?
Echocardiogram (ECHO)
Which of the following is the recommended treatment for mitral stenosis?
Percutaneous repair or replacement
What events should be prevented or treated during anesthesia for patients with mitral stenosis?
All of the above
Which chamber of the heart is best heard at the cardiac apex?
Left ventricle
Which heart sound is produced by the closure of the tricuspid and mitral valves?
S1
Which heart sound is produced by the closure of the pulmonic and aortic valves?
S2
Which valve lesion requires a slow heart rate to improve left ventricular filling and coronary blood flow?
Mitral stenosis
Which induction agent is preferred for cardiac transplantation because it has little effect on hemodynamics?
Etomidate
Which of the following is rarely used during cardiac transplantation due to the presence of significant pulmonary hypertension?
Nitrous oxide
Which mechanism is responsible for the increase in stroke volume in response to an increase in preload in patients with transplanted hearts?
Frank-Starling mechanism
Which of the following is a noninvasive imaging test used to assess myocardial perfusion in patients with suspected ischemic heart disease?
Radionuclide imaging
Which of the following is a significant association with increased troponin levels in surgical patients?
Increased risk of congestive heart failure
What is the recommended action when an increase in troponin level is detected postoperatively, even in the absence of cardiovascular signs and symptoms?
Immediate referral to a cardiologist
Which specialized preoperative testing is recommended for perioperative assessment in ischemic heart disease?
Exercise ECG
What is the purpose of perioperative assessment in ischemic heart disease?
Evaluate severity, progression, and functional limitations
Which of the following is a contraindication for the use of β-blockers?
All of the above
Which type of plaque is most prone to rupture?
Plaques with rich lipid cores and thin fibrous caps
What is the primary goal in the management of STEMI?
Reestablish blood flow in the obstructed coronary artery
What is the recommended duration of dual antiplatelet therapy after a PCI with drug-eluting stent placement?
12 months
Which of the following is a major clinical risk factor for perioperative cardiovascular risk?
Uncontrolled systemic hypertension
Which of the following is an intermediate clinical risk factor for perioperative cardiovascular risk?
Previous MI based on history or Q waves on ECG
Which of the following is a minor clinical risk factor for coronary artery disease?
Rhythm other than sinus arrhythmias
Which of the following is a goal in the preoperative management of patients with ischemic heart disease?
All of the above
Which medication should be used to treat myocardial ischemia associated with a normal or modestly elevated blood pressure?
Nitroglycerin
Which medication can be used to treat a persistent increase in heart rate in the setting of normal or high blood pressure?
Esmolol
What is the most effective method for monitoring myocardial ischemia during surgery?
Monitoring three leads (II, V4, and V5)
When should treatment of myocardial ischemia be instituted?
When there are 1-mm ST-segment changes on the ECG
Which of the following is the most common cause of mitral stenosis?
Rheumatic heart disease
What is the normal mitral valve area?
4-6 cm2
Which of the following symptoms is characteristic of mitral stenosis?
Progressive dyspnea
What is the gold standard for diagnosing mitral stenosis?
ECHO
What is the recommended treatment for mitral stenosis?
Percutaneous balloon valvuloplasty
Which of the following events can impact mitral stenosis during anesthesia?
Marked increase in central blood volume
Which of the following is the most common cause of mitral stenosis?
Rheumatic heart disease
What is the normal mitral valve area?
4-6 cm2
Which gender is most commonly affected by mitral stenosis?
Females
What is the most common symptom of mitral stenosis?
Dyspnea
What is the gold standard for diagnosing mitral stenosis?
Echocardiography (ECHO)
What is the treatment of choice for mitral stenosis?
Percutaneous repair or replacement
What is the most important factor to monitor during anesthesia for patients with mitral stenosis?
Pulmonary artery pressure
What is the risk associated with overtransfusion or head-down positioning in patients with mitral stenosis?
Pulmonary edema
What is the recommended technique for induction of anesthesia in patients with mitral stenosis?
Intravenous induction
What is the most common complication after mitral stenosis surgery?
Pulmonary edema
Test your knowledge on the most common cause of inferret Acute MI and the treatment options available. Learn about plaque stability and how to reduce risk factors for better heart health.
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