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  • 1. (Chapters 80-94) CARDIOVASCULAR DISEASE IN SPECIAL POPULATIONS; CARDIOVASCULAR DISEASE AND DISORDERS OF OTHER ORGANSDIRECTIONS: For each question below, select the ONE A. Patients with CKD are at increased risk of bleeding butBEST response. decreased risk of thrombotic events when compared with normal individuals B. The outcomes of patients with CKD who present withQUESTION 630 acute coronary syndromes are similar to those of patients with normal renal functionA 24-year-old man who is training for the Olympic decath- C. Renal dysfunction is the most significant independentlon team experiences a presyncopal event and is referred predictor of mortality of patients in coronary carefor evaluation. He has been training aggressively for the unitspast 2 years and aside from occasional single palpita- D. Patients with CKD who present to the hospital withtions has not noticed any prior lightheadedness, other chest pain comprise a relatively low-risk group ofcardiac symptoms, or physical limitations. He has no acute coronary syndromes, with a cardiac event ratehistory of hypertension and his family history is free of of 45 mL/kg/min on car- infiltrate diopulmonary exercise testing is more consistent with B. Aortic aneurysm formation is more common than hypertrophic cardiomyopathy than Athletes Heart arterial stenosesE. The most common cause of sudden cardiac death C. This condition is 10 times more common in women in athletes is anomalous origin of the left coronary than men artery D. Claudication occurs more commonly in the lower extremities than the upper extremities E. Coronary vasculitis is not typical in this syndromeQUESTION 631A 66-year-old man with chronic kidney disease (CKD) is QUESTION 633referred for office evaluation after a recent admission foran acute coronary syndrome. Which of the following A 58-year-old woman complains of a new-onset severestatements is TRUE concerning chronic kidney disease headache, jaw pain with chewing, and temporal(CKD) and cardiovascular disease? artery tenderness. Laboratory examination shows an 285
  • 2. 286 erythrocyte sedimentation rate (ESR) of 80 mm/hr. B. Clinical and hemodynamic findings in PPCM are Which of the following is TRUE regarding treatment indistinguishable from those of other forms of dilated of this condition? cardiomyopathy A. Corticosteroids should not be administered until C. The incidence of PPCM is greatest in first pregnan- biopsy evidence confirms the diagnosis cies B. Clinical improvement with appropriate treatment D. Approximately 50% of PPCM patients show recoveryCARDIOVASCULAR DISEASE IN SPECIAL POPULATIONS; CARDIOVASCULAR DISEASE AND DISORDERS OF OTHER ORGANS generally occurs over several weeks within the first 6 months after delivery C. Anti-TNF therapies have been shown to be beneficial E. Subsequent pregnancies in women with PPCM carry in this condition a 30% risk of relapse D. In the absence of contraindications, low-dose aspirin should be prescribed for all patients with this condition QUESTION 637 E. Normalization of the ESR is a reliable indicator of treatment response A 67-year-old man with multivessel coronary disease is scheduled for coronary artery bypass graft surgery (CABG). Which of the following statements regarding QUESTION 634 CABG and perioperative complications is TRUE? A. Perioperative myocardial infarction occurs, on average, A 35-year-old woman with hypertension is considering in 5% to 10% of elective procedures pregnancy. She is currently taking lisinopril 10 mg daily. B. Early postoperative cognitive decline occurs in 75% D. Cardiovascular disease is twice as common in women D. Radial artery grafts are less likely to develop vaso- with diabetes compared with nondiabetics spasm than internal mammary grafts E. Hormone replacement therapy with estrogen does E. Patients who receive internal mammary artery grafts not reduce the risk of cardiac events in postmeno- suffer fewer late deaths and myocardial infarctions pausal women than those who receive only saphenous vein grafts QUESTION 636 QUESTION 639 A 36-year-old woman with no prior history of cardiac A previously healthy 17-year-old high school athlete col- disease develops exertional dyspnea and orthopnea 1 lapses during a basketball game. He is noted to have brief month after delivering a healthy full-term infant. Echo- seizure-like activity and has no initial pulse but is cardiography demonstrates a dilated left ventricle with immediately resuscitated by a brisk precordial thump. globally reduced contractile function. Each of the fol- Assuming that this event represents sudden cardiac death lowing statements about peripartum cardiomyopathy (SCD), each of the following statements is true EXCEPT: (PPCM) is correct EXCEPT: A. Arrhy


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