Your-Doctor Multiple Choice Questions (MCQ)

Category: Cardiology--->Arrythmias
Page: 6

Question 26#Print Question

A 75-year-old man with a previous history of persistent AF, peptic ulceration, and renal failure (creatinine 220 μmol/L) undergoes elective PCI to his LAD with a bare metal stent (BMS). He was on warfarin for AF prior to his PCI.
What is the best combination of drugs immediately following the procedure?

a. Aspirin, clopidogrel, and warfarin
b. Aspirin and clopidogrel
c. Aspirin and warfarin
d. Clopidogrel and warfarin
e. Warfarin alone


Question 27#Print Question

A 35-year-old man with no past medical history of note and on no regular medication presents to clinic with palpitations.
Holter monitoring reveals short-lasting episodes of atrial fibrillation during which he has noted ‘a fluttering sensation’ in his patient diary.
What is the best initial management plan?

a. Warfarin and atenolol
b. Amiodarone and aspirin
c. Refer for pulmonary vein isolation
d. Flecainide and atenolol
e. Disopyramide and aspirin


Question 28#Print Question

An 80-year-old woman with permanent atrial fibrillation and palpitations attends clinic. She has been in AF for over 10 years and has a left atrial diameter of 5.5 cm. She has high ventricular rates despite being on digoxin 125 micrograms od and atenolol 50 mg od. She has dizzy episodes when she has high ventricular rates and had a pre-syncopal episode 1 month ago. She is keen to consider an AV node ablation.
What do you advise?

a. There is no evidence that this will improve her symptoms
b. The mortality of the procedure is about the same as for medical treatment of AF
c. The procedure is contraindicated in patients with heart failure
d. PVI ablation should be attempted first
e. A pacemaker is required but will be programmed to minimize right heart pacing


Question 29#Print Question

A 50-year-old man with a history of hypertension, diabetes, and persistent atrial fibrillation, for which he is warfarinized, is admitted with an NSTEMI. He undergoes PCI to his proximal LAD with a drug-eluting stent (DES).
What is the best combination of drugs following his intervention?

a. Aspirin, clopidogrel, and warfarin for  month; then warfarin alone thereafter
b. Aspirin, clopidogrel and warfarin for 1 month; then warfarin and clopidogrel for 12 months followed by warfarin alone
c. Aspirin, clopidogrel, and warfarin for 6 months; then warfarin and clopidogrel for 6 months followed by warfarin alone
d. Aspirin, clopidogrel and warfarin for 12 months; then warfarin alone
e. Aspirin and warfarin for 12 months; then clopidogrel alone


Question 30#Print Question

An 85-year-old woman is referred to your cardiology clinic because of an incidental finding of atrial fibrillation at a routine check-up. The patient is asymptomatic from a cardiovascular perspective, but a 24-hour tape organized by the GP shows atrial fibrillation throughout with rates varying between 60 and 110 bpm. The patient has a history of hypertension and stable angina. Coronary angiography performed several years ago showed minor atheroma in the LAD, circumflex, and RCA. Echocardiography shows good biventricular systolic function with a left atrial diameter of 5.2 cm. The patient is on aspirin 75 mg od, ramipril 10 mg od, simvastatin 20 mg od, and atenolol 50 mg od.
What thromboprophylactic treatment do you recommend?

a. Warfarinization with a target INR of 2.0–3.0
b. Warfarinization with a target INR of 1.8–2.5
c. Continue with aspirin 75 mg od
d. Aspirin and warfarin with a target INR of 2.0–3.0
e. Aspirin and warfarin with a target INR of 1.8–2.5




Category: Cardiology--->Arrythmias
Page: 6 of 7