Under Pressure
Cholesterol is Evil
Call a Plummer
The Fibs
You Need a (Valve) Intervention
100
This is the goal BP for all adults according to the 2025 AHA/ACC guideline.
What is <120/80 mmHg?
100
A patient has a remote history of CAD with PCI over 10 years ago to the mid RCA for NSTEMI type I. What is the goal LDL-c?
What is < 55 mg/dL?
100
A patient with known chronic coronary disease presents to the office with stable angina. These medication classes are first-line therapy (yes, name both).
What are beta blockers and calcium channel blockers?
100
This is the first line drug class for patients to reduce stroke risk in atrial fibrillation, for most patients.
What are DOACs?
100
These three echocardiographic criteria are consistent with severe aortic stenosis.
What are 1) AVA < 1 cm2, B) mean gradient > 40 mmHg, and C) VMax > 4 m/s?
200
A patient has persistent hypertension despite maximal doses of rampiril, chlorthalidone, and amlodipine. What medication should you consider next?
What is spironolactone?
200
A patient with history of ASCVD gets blood work done, their LDL-c is 82 mg/dl. They are on 40 mg of rosuvastatin daily. What is the next medication to consider?
What is add ezetimibe or PCSK9-I?
Can accept PCSK9-I, but generally stepwise approach is maximal statin --> ezetimibe --> PCSK9-I.
200
A 52-year-old patient in the clinic presents after getting PCI to the mid LAD last week for stable angina. He notes bruising on his hands more easily and wants to know how long he needs to take these pesky blood thinning medications. He has no history of major bleeding. He should take DAPT for at least this long.
What is 6 months?
200
These two conditions warrant the use of warfarin over DOAC in atrial fibrillation.
What are: 1) rheumatic mitral disease and 2) moderate to severe mitral stenosis?
Mechanical valves should always be on warfarin so will not accept that answer.
200
In severe mitral regurgitation, what are the two echocardiographic indications to intervene upon the valve?
What are A) LVEF </= 60% or B) LVESD > 40 mm
300
What medication class has not only been shown to improve BP but also is associated independently with risk reduction in CV disease?
What are RAAS inhibitors (ACE-I or ARB)?
300
This is the new risk stratification tool recommended by the newest AHA/ACC guidelines for guiding therapy to reduce CV risk.
What is the PREVENT score?
300
A patient presents to the office with a history of stable angina which is controlled medically. He is not on antiplatelet therapy because he has anaphylaxis to asprin. What is the best medication to add to his regimen?
What is clopidogrel?
300
What is the first line treatment therapy for a person with paroxysmal atrial fibrillation and HFrEF?
What is catheter ablation?
300
This score can help guide the predicted success of balloon mitral valve commissurotomy in severe rheumatic mitral valve stenosis.
What is the Wilkins score?
400
This 2015 trial, which was stopped early due to benefit, found that in high risk non-diabetic patients older than 50 years old a stricter SBP </= 120 mmHg was superior to SBP </= 140 mmHg.
What is SPRINT?
400
This lipid parameter should be assessed at least once in every adult and is a risk-enhancing factor that favors more intense therapy, according to the 2026 guidelines.
What is liproprotein A (Lp(a))?
400
This anti-inflammatory was incorporatated into the 2023 chronic coronary disease guidelines as an adjunctive therapy to reduce CV risk.
What is low-dose colchicine (0.5 mg daily)
400
If a patient requires cardioversion, they must be on full dose anticougulation for this long (unless you do a TEE first to r/o thrombus).
What is 3 weeks?
400
In patients with severe secondary mitral regurgitation this should be the first course of treatment/therapy.
What is maximal GDMT?
Only intervene on the valve if severe despite maximally tolerated GDMT.
500
A patient presents with episodic hypertension, diaphoresis, and palpitations. You make the diagnosis. What is the medical treatment?
What is phenoxybenzamine?
(Will accept alpha blocker in general but that drug is preferred due to longer duration of action).
500
A 35 year-old healthy appearing male comes to the clinic to establish with a cardiologist. His father died from an MI at 52 years old. You note on exam soft yellow bumps on his elbows. What is A) the diagnosis and B) the inheritence pattern?
A) What is famililal hyperlipidemia?
B) What is autosomal dominant?
500
This trial, published in 2019, found that an initial invasive strategy in stable coronary disease with moderate to severe ischemia did not reduce a primary composite endpoint of factors inlcuding CV death, MI, or MACE.
What is ISCHEMIA?
500
This recently published trial found that the WATCHMAN FLX device was noninferior to anticoagulation in patients who WERE candidates for AC.
What is CHAMPION-AF
Published in NJEM in 2026.
500
This trial found that trancatheter edge-to-edge mitral valve repair in secondary MR on maximal GDMT reduced HF hospitalization and mortality.
What is COAPT?