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Final Examination

This is your final examination. See how you do....

1) Which of the following IS NOT an absolute contraindication to cardiac exercise testing?

A) Unstable angina.

B) Recent pulmonary embolism.

C) Active pericarditis.

D) Left bundle branch block.

See question 2.2.2.

2) Which of the following is the preferred antiplatelet drug for treating chest pain in the emergency department?

A) Aspirin 81 mg PO.

B) Aspirin 325 mg PO.

C) Clopidogrel 75 mg PO.

D) Clopidogrel 300 mg PO.

E) 2B/IIIA glycoprotein inhibitor.

See question 2.1.4.

3) This ECG, shown in Figure 30-1, represents a(n):

 

Image not available.

FIGURE 30-1.

A) Inferior wall MI.

B) Anterior wall MI.

C) Inferolateral MI.

D) Normal ECG.

E) Pericarditis.

See question 2.17.3.

4) The most appropriate initial treatment of this rhythm in a stable patient, shown in Figure 30-2, is:

 

Image not available.

FIGURE 30-2.

 

A) Amiodarone.

B) Adenosine.

C) Diltiazem.

D) Lidocaine.

See question 2.3.5.

5) You admit a patient to the hospital after an episode of chest pain. The patient has a history of chronic kidney disease stage 4, type 2 diabetes mellitus, hypertension, hyperlipidemia, and obesity. At time of admission, troponin is elevated at 0.06 (normal <0.03). The medical student rotating with you on her family medicine clerkship asks the significance of the elevated troponin. You tell her which of the following?

A) An elevated troponin is always indicative of cardiac ischemia/infarct.

B) Troponin rises before creatine phosphokinase (CPK) and stays elevated for a longer period of time.

C) Pulmonary embolism and renal failure are two causes of an elevated troponin.

D) CPK is overall the most sensitive (but not specific) cardiac marker for cardiac ischemia.

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