Quiz on IHD

Which of the following is the primary mechanism of action of beta-blockers in the management of ischemic heart disease? *

A 55-year-old male presents with symptoms of acute coronary syndrome. Coronary angiography reveals severe triple-vessel disease with significant left ventricular dysfunction. He is not a candidate for percutaneous coronary intervention or coronary artery bypass grafting due to comorbidities. Which of the following is the most appropriate long-term management strategy to improve his symptoms and reduce his risk of future ischemic events? *

A 70-year-old male with a history of stable angina and hypertension is prescribed amlodipine 10 mg daily. He reports that his angina symptoms are not fully controlled. His physician is considering adding another anti-anginal medication. Which of the following medications, when added to amlodipine, would be most appropriate for further symptom management? *

A 60-year-old female presents with symptoms of unstable angina. She is initiated on intravenous heparin and aspirin. Her physician is considering adding a glycoprotein IIb/IIIa inhibitor. Which of the following is a common indication for the use of a glycoprotein IIb/IIIa inhibitor in this patient? *

A 55-year-old male with a history of coronary artery disease (CAD) and previous myocardial infarction (MI) is on aspirin 81 mg daily and atorvastatin 40 mg daily. He presents with recurrent exertional chest pain that is relieved by rest. His stress test reveals inducible ischemia. He is now being considered for further medical management. Which of the following medications would be most appropriate to add to his regimen to improve symptoms and reduce myocardial oxygen demand? *

A 72-year-old woman with a history of unstable angina is treated medically with aspirin, clopidogrel, and an intravenous heparin infusion. She develops new-onset atrial fibrillation with a rapid ventricular response. Her physician is concerned about the risk of stroke. Which of the following anticoagulants is generally NOT recommended in combination with dual antiplatelet therapy (DAPT) due to a significantly increased risk of bleeding? *

A 65-year-old male presents to the emergency department with sudden onset, crushing chest pain radiating to his left arm, accompanied by diaphoresis and nausea. His electrocardiogram (ECG) shows ST-segment elevation in leads II, III, and aVF. He has a history of hypertension and hyperlipidemia. He is hemodynamically stable. What is the most appropriate initial pharmacologic management for this patient? *

A 72-year-old woman with a history of stable angina and type 2 diabetes mellitus is admitted for a non-ST-elevation myocardial infarction (NSTEMI). She is currently on metformin and lisinopril. Her laboratory results show a troponin I level of 0.8 ng/mL. She is deemed to be at intermediate-high risk for recurrent ischemic events. Which of the following medications should be added to her regimen to reduce the risk of further thrombotic events? *

A 68-year-old man with known CAD experiences an acute anterior STEMI. He undergoes successful primary percutaneous coronary intervention (PCI) with stent placement. Post-procedure, he is started on aspirin 81 mg and ticagrelor 90 mg twice daily. He has a history of peptic ulcer disease. Which of the following is the most critical consideration regarding his antiplatelet therapy in the long term? *

A 58-year-old male with exertional angina is prescribed sublingual nitroglycerin for acute symptom relief. He experiences an episode of chest pain while gardening and uses a sublingual nitroglycerin tablet. Approximately how long does it typically take for sublingual nitroglycerin to provide relief from anginal pain? *

A 65-year-old male with a history of CAD and type 2 diabetes mellitus is diagnosed with chronic stable angina. He is already on aspirin 81 mg and metoprolol succinate 100 mg daily. His HbA1c is 7.8%. His physician wants to optimize his lipid management to reduce cardiovascular risk. What is the recommended intensity of statin therapy for this patient? *

A 75-year-old male with a history of myocardial infarction 3 years ago is admitted with new-onset heart failure symptoms. Echocardiogram shows significantly reduced ejection fraction. He is currently on aspirin, a beta-blocker, and an ACE inhibitor. Which of the following medications, when added to his regimen, has been shown to improve mortality and reduce hospitalizations in patients with heart failure with reduced ejection fraction (HFrEF) and ischemic etiology? *