1. A 55-year-old man presents to the emergency department with sudden onset of chest pain, shortness of breath, and diaphoresis. An ECG shows ST-segment elevation in the anterior leads. Which of the following is the most likely diagnosis?
A. Unstable angina
B. Non-ST-elevation myocardial infarction
C. ST-elevation myocardial infarction
D. Aortic dissection
E. Pulmonary embolism
2. Which of the following is the most common risk factor for the development of coronary heart disease?
A. Diabetes mellitus
B. Hypertension
C. Smoking
D. Hyperlipidemia
E. Obesity
3. A 62-year-old woman with a history of hypertension and hyperlipidemia presents with chest pain that is relieved by rest. An exercise stress test is performed, and the results show 2 mm of ST-segment depression in the inferior leads. What is the next best step in management?
A. Coronary angiography
B. Percutaneous coronary intervention
C. Coronary artery bypass grafting
D. Stress echocardiography
E. Initiate medical therapy
4. Which of the following is the most common cause of sudden cardiac death in adults?
A. Arrhythmia
B. Acute myocardial infarction
C. Aortic dissection
D. Pulmonary embolism
E. Hypertrophic cardiomyopathy
5. A 45-year-old man with a history of coronary artery disease presents with exertional chest pain that is relieved by rest. Which of the following is the most appropriate initial treatment?
A. Aspirin
B. Beta-blocker
C. Calcium channel blocker
D. Nitrate
E. Anticoagulant
6. A 60-year-old man with a history of myocardial infarction presents with worsening dyspnea and leg swelling. An echocardiogram shows reduced left ventricular ejection fraction. Which of the following medications is the most appropriate to initiate?
A. Angiotensin-converting enzyme (ACE) inhibitor
B. Angiotensin II receptor blocker (ARB)
C. Diuretic
D. Beta-blocker
E. Calcium channel blocker
7. A 72-year-old man with a history of coronary artery disease presents with chest pain at rest. An ECG shows ST-segment depression in the anterior leads. Which of the following is the most appropriate next step in management?
A. Coronary angiography
B. Percutaneous coronary intervention
C. Coronary artery bypass grafting
D. Stress echocardiography
E. Initiate medical therapy
8. Which of the following is the most common presentation of coronary artery disease in women?
A. Typical angina
B. Atypical angina
C. Asymptomatic
D. Myocardial infarction
E. Sudden cardiac death
9. A 55-year-old man with a history of hypertension and hyperlipidemia presents with chest pain that is relieved by rest. Coronary angiography shows a 90% stenosis of the proximal left anterior descending artery. Which of the following is the most appropriate next step in management?
A. Aspirin and statin therapy
B. Percutaneous coronary intervention with stenting
C. Coronary artery bypass grafting
D. Cardiac rehabilitation
E. Stress echocardiography
10. A 68-year-old woman with a history of coronary artery disease presents with exertional chest pain that is relieved by rest. Which of the following is the most appropriate initial treatment?
A. Aspirin
B. Beta-blocker
C. Calcium channel blocker
D. Nitrate
E. Anticoagulant
11. A 75-year-old man with a history of coronary artery disease presents with sudden onset of chest pain, shortness of breath, and diaphoresis. An ECG shows ST-segment elevation in the inferior leads. Which of the following is the most appropriate next step in management?
A. Coronary angiography
B. Percutaneous coronary intervention
C. Coronary artery bypass grafting
D. Thrombolytic therapy
E. Anticoagulant therapy
12. Which of the following is the most common cause of chest pain in patients with known coronary artery disease?
A. Unstable angina
B. Myocardial infarction
C. Aortic dissection
D. Pulmonary embolism
E. Gastroesophageal reflux disease
13. A 60-year-old man with a history of coronary artery disease presents with chest pain that is relieved by rest. An exercise stress test is performed, and the results show ST-segment elevation in the anterior leads. Which of the following is the most appropriate next step in management?
A. Coronary angiography
B. Percutaneous coronary intervention
C. Coronary artery bypass grafting
D. Stress echocardiography
E. Initiate medical therapy
14. Which of the following is the most common complication of myocardial infarction?
A. Arrhythmia
B. Heart failure
C. Cardiogenic shock
D. Stroke
E. Sudden cardiac death
15. A 72-year-old woman with a history of hypertension and diabetes presents with chest pain that is relieved by rest. Coronary angiography shows significant multi-vessel coronary artery disease. Which of the following is the most appropriate treatment?
A. Percutaneous coronary intervention
B. Coronary artery bypass grafting
C. Medical therapy with antiplatelet and statin
D. Cardiac rehabilitation
E. Stress echocardiography
16. Which of the following is the most important risk factor for the development of coronary artery disease in patients with diabetes?
A. Duration of diabetes
B. Glycemic control
C. Presence of hypertension
D. Presence of dyslipidemia
E. Obesity
17. A 55-year-old man with a history of myocardial infarction presents with chest pain, shortness of breath, and leg swelling. An echocardiogram shows a left ventricular ejection fraction of 30%. Which of the following medications is the most appropriate to initiate?
A. Aspirin
B. Beta-blocker
C. Angiotensin-converting enzyme (ACE) inhibitor
D. Diuretic
E. Calcium channel blocker
18. Which of the following is the most common symptom of stable angina?
A. Chest pain with exertion
B. Chest pain at rest
C. Shortness of breath
D. Diaphoresis
E. Nausea
19. A 65-year-old man with a history of coronary artery disease presents with sudden onset of chest pain, shortness of breath, and diaphoresis. An ECG shows ST-segment depression in the anterior leads. Which of the following is the most appropriate next step in management?
A. Coronary angiography
B. Percutaneous coronary intervention
C. Coronary artery bypass grafting
D. Thrombolytic therapy
E. Anticoagulant therapy
20. Which of the following is the most important modifiable risk factor for the development of coronary artery disease?
A. Age
B. Family history
C. Smoking
D. Hypertension
E. Diabetes