Facharzt FMH Kardiologie Practice Questions - Facharzt FMH für Kardiologie Spécialiste FMH en cardiologie Exam - Facharzt FMH Kardiologie Practice Questions - Facharzt FMH für Kardiologie Spécialiste FMH en cardiologie Exam

Question 1

A 58-year-old man presents to a regional non-PCI hospital with severe retrosternal chest pain for 45 minutes. The 12-lead ECG demonstrates 3 mm ST-segment elevation in leads V1–V4 with reciprocal ST depression in leads II, III, and aVF. The anticipated transfer time to the nearest catheterization laboratory is 110 minutes, with an estimated first medical contact (FMC)-to-wire crossing time of 135 minutes. According to current ESC STEMI guidelines, what is the most appropriate reperfusion strategy?

Administer weight-adjusted intravenous tenecteplase immediately within 10 minutes, followed by urgent transfer to a PCI center for routine post-fibrinolysis coronary angiography within 2 to 24 hours. Transfer the patient immediately for primary percutaneous coronary intervention without fibrinolysis, accepting the 135-minute delay since mechanical reperfusion is superior. Initiate an unfractionated heparin infusion and dual antiplatelet therapy, deferring reperfusion decisions until high-sensitivity troponin T results confirm acute myocardial necrosis. Administer intravenous eptifibatide monotherapy and arrange elective coronary angiography during the index hospitalization within 48 to 72 hours.

Correct Answer:

Administer weight-adjusted intravenous tenecteplase immediately within 10 minutes, followed by urgent transfer to a PCI center for routine post-fibrinolysis coronary angiography within 2 to 24 hours.

Question 2

A 62-year-old woman receives full-dose intravenous tenecteplase for an acute anterior STEMI at a community clinic. Ninety minutes after lytic administration, she reports persistent crushing chest pain (8/10), and repeat ECG reveals less than 20% resolution of the maximal ST-segment elevation in lead V3. What is the mandatory next step in management?

Administer a second full dose of intravenous tenecteplase to achieve complete enzymatic thrombus dissolution. Switch to intravenous bivalirudin infusion and observe the patient in the coronary care unit for 6 hours. Initiate high-dose intravenous nitroglycerin and wait 24 hours for delayed endogenous fibrinolysis. Perform emergent coronary angiography and rescue percutaneous coronary intervention without delay.

Correct Answer:

Perform emergent coronary angiography and rescue percutaneous coronary intervention without delay.

Question 3

A 69-year-old male with hypertension and chronic kidney disease presents with 2 hours of rest angina. ECG reveals 1.5 mm horizontal ST-segment depression in leads V4–V6 and T-wave inversion in lead I and aVL. High-sensitivity cardiac troponin T is elevated at 980 ng/L (upper reference limit 14 ng/L). He is hemodynamically stable without signs of heart failure, and his calculated GRACE risk score is 152. According to ESC NSTE-ACS guidelines, what is the recommended timing for invasive coronary angiography?

Immediate invasive strategy within 2 hours of hospital arrival. Selective non-invasive functional ischemia testing prior to any angiography. Elective coronary angiography performed within 72 hours after completing 3 days of medical stabilization. Early invasive strategy with coronary angiography within 24 hours of hospital admission.

Correct Answer:

Early invasive strategy with coronary angiography within 24 hours of hospital admission.

Question 4

A 60-year-old man undergoes successful primary PCI with an everolimus-eluting stent to the proximal LAD for acute anterior STEMI. He has no prior history of stroke, transient ischemic attack, or bleeding diathesis, and his body weight is 82 kg. According to ESC ACS guidelines and head-to-head randomized trial evidence (ISAR-REACT 5), which oral antiplatelet regimen is preferred as default therapy for 12 months?

Aspirin 100 mg once daily plus clopidogrel 75 mg once daily. Aspirin 100 mg once daily plus cilostazol 100 mg twice daily. Ticagrelor 90 mg twice daily monotherapy without aspirin. Aspirin 100 mg once daily plus prasugrel 10 mg once daily.

Correct Answer:

Aspirin 100 mg once daily plus prasugrel 10 mg once daily.

Question 5

A 78-year-old female with a history of major peptic ulcer bleeding 4 months ago and baseline anemia (hemoglobin 98 g/L) undergoes uncomplicated drug-eluting stent implantation for NSTEMI. She meets the Academic Research Consortium criteria for High Bleeding Risk (ARC-HBR). According to ESC ACS guidelines and the MASTER-DAPT trial, what is the most appropriate antithrombotic strategy?

Dual antiplatelet therapy for 1 month, followed by single antiplatelet monotherapy (e.g., clopidogrel or ticagrelor). Dual antiplatelet therapy with aspirin and prasugrel for a mandatory minimum duration of 12 months. Triple antithrombotic therapy with aspirin, clopidogrel, and rivaroxaban for 6 months. Lifelong aspirin monotherapy starting on the day of PCI with complete avoidance of all P2Y12 inhibitors.

Correct Answer:

Dual antiplatelet therapy for 1 month, followed by single antiplatelet monotherapy (e.g., clopidogrel or ticagrelor).

Question 1

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Prepare with the Facharzt FMH Kardiologie Practice Questions - Facharzt FMH für Kardiologie Spécialiste FMH en cardiologie Exam practice quiz. This question bank includes 100 questions covering year-old, male, ventricular, heart, and presents. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Facharzt FMH Kardiologie Practice Questions - Facharzt FMH für Kardiologie Spécialiste FMH en cardiologie Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, male, ventricular, heart, and presents. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

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Facharzt FMH Kardiologie Practice Questions - Facharzt FMH für Kardiologie Spécialiste FMH en cardiologie Exam

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