Here are some scenario-based multiple choice questions related to hypertrophic obstructive cardiomyopathy (HOCM)
A 22-year-old male presents to the emergency department with chest pain and shortness of breath. He reports a family history of sudden cardiac death. On physical examination, a harsh systolic murmur is heard at the apex, which increases with the Valsalva maneuver. What is the most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Hypertrophic obstructive cardiomyopathy (HOCM)
D) Pericarditis
Answer: C) Hypertrophic obstructive cardiomyopathy (HOCM)
A 35-year-old female presents to the clinic for a routine check-up. She reports a history of palpitations and occasional chest pain. On physical examination, a double-apical impulse is noted. An electrocardiogram (ECG) shows left ventricular hypertrophy (LVH). What is the most appropriate initial diagnostic test?
A) Echocardiogram
B) Exercise stress test
C) Holter monitor
D) Cardiac MRI
Answer: A) Echocardiogram
A 50-year-old male with a history of HOCM presents to the clinic for a follow-up visit. He reports occasional chest pain and shortness of breath with exertion. An echocardiogram shows asymmetric septal hypertrophy and a dynamic left ventricular outflow tract (LVOT) obstruction. What is the most appropriate initial treatment?
A) Beta-blockers
B) Calcium channel blockers
C) Antiarrhythmic medications
D) Septal myectomy
Answer: A) Beta-blockers
A 40-year-old male with HOCM presents to the emergency department with syncope. An ECG shows ventricular tachycardia (VT). What is the most appropriate initial treatment?
A) Electrical cardioversion
B) Amiodarone
C) Lidocaine
D) Immediate defibrillation
Answer: D) Immediate defibrillation
A 60-year-old female with HOCM presents to the clinic with persistent symptoms despite medical management. An echocardiogram shows a large septal bulge and severe LVOT obstruction. What is the most appropriate next step in management?
A) Continued medical management
B) Septal myectomy
C) Alcohol septal ablation
D) Heart transplant evaluation
Answer: B) Septal myectomy
A 45-year-old man presents to the emergency department with chest pain and shortness of breath. An ECG shows ST-segment elevation in leads V1 to V4. A transthoracic echocardiogram shows severe hypertrophy of the interventricular septum with a peak gradient of 80 mmHg. What is the most likely diagnosis?
a) Acute myocardial infarction
b) Hypertrophic obstructive cardiomyopathy
c) Pericarditis
d) Aortic stenosis
Answer: b) Hypertrophic obstructive cardiomyopathy
A 30-year-old woman presents to her primary care physician with palpitations and fatigue. She has a family history of sudden cardiac death. An ECG shows sinus bradycardia with occasional premature ventricular contractions. A transthoracic echocardiogram shows asymmetrical septal hypertrophy with a peak gradient of 40 mmHg. What is the most appropriate next step in management?
a) Initiate beta-blocker therapy
b) Refer for implantable cardioverter-defibrillator (ICD) placement
c) Start calcium channel blocker therapy
d) Obtain cardiac magnetic resonance imaging (MRI)
Answer: a) Initiate beta-blocker therapy
A 60-year-old man with a history of hypertrophic obstructive cardiomyopathy presents to the emergency department with syncope. He has no history of implantable cardioverter-defibrillator (ICD) placement. An ECG shows sinus rhythm with a prolonged QT interval. A transthoracic echocardiogram shows severe hypertrophy of the interventricular septum with a peak gradient of 120 mmHg. What is the most appropriate next step in management?
a) Administer intravenous beta-blocker therapy
b) Perform an urgent septal myectomy
c) Administer intravenous epinephrine
d) Refer for implantable cardioverter-defibrillator (ICD) placement.
Answer: d) Refer for implantable cardioverter-defibrillator (ICD) placement
Comments
Post a Comment