FCP(SA) Part II Practice Questions - Fellowship of the College of Physicians of South Africa Part II Exam - FCP(SA) Part II Practice Questions - Fellowship of the College of Physicians of South Africa Part II Exam

Question 1

A 62-year-old male presents 5 days after an anterior ST-elevation myocardial infarction with sudden hemodynamic deterioration, dyspnea, and a new harsh holosystolic murmur heard loudest at the lower left sternal border with an associated parasternal thrill. Oxygen saturation drops from a right atrial sample of 65% to a right ventricular sample of 84% during bedside pulmonary artery catheterization. Which of the following is the most definitive immediate management strategy?

Urgent surgical repair or transcatheter closure with intra-aortic balloon pump stabilization Emergent bed-side pericardiocentesis and bolus fluid administration Urgent mitral valve replacement with coronary artery bypass grafting Immediate intravenous thrombolysis with tenecteplase and systemic heparinization

Correct Answer:

Urgent surgical repair or transcatheter closure with intra-aortic balloon pump stabilization

Question 2

A 74-year-old female presents with progressive exertional angina and presyncope. Echocardiography demonstrates a calcified aortic valve with an aortic valve area (AVA) of 0.7 cm², a mean transvalvular gradient of 28 mmHg, and a left ventricular ejection fraction (LVEF) of 32%. A low-dose dobutamine stress echocardiogram is performed. Which of the following findings confirms true severe low-flow, low-gradient aortic stenosis?

Increase in mean gradient to 30 mmHg and AVA increase to 1.3 cm² with increased stroke volume Increase in mean gradient to >= 40 mmHg with AVA remaining <= 1.0 cm² as stroke volume increases No change in stroke volume, mean gradient, or AVA despite maximum dobutamine infusion Decrease in mean gradient below 20 mmHg with an increase in LVEF to 55%

Correct Answer:

Increase in mean gradient to >= 40 mmHg with AVA remaining <= 1.0 cm² as stroke volume increases

Question 3

A 58-year-old male with long-standing ischemic heart disease and an LVEF of 28% remains symptomatic (NYHA Class III) on enalapril 10 mg twice daily and carvedilol 25 mg twice daily. Blood pressure is 124/76 mmHg, heart rate is 68 bpm, serum potassium is 4.3 mmol/L, and eGFR is 62 mL/min/1.73m². What is the most appropriate next step in optimizing guideline-directed medical therapy (GDMT)?

Add digoxin and increase carvedilol to 50 mg twice daily Discontinue carvedilol and initiate ivabradine 5 mg twice daily Switch enalapril to sacubitril/valsartan, and add spironolactone and dapagliflozin Add hydralazine and isosorbide dinitrate while maintaining current enalapril

Correct Answer:

Switch enalapril to sacubitril/valsartan, and add spironolactone and dapagliflozin

Question 4

A 45-year-old male with a mechanical aortic valve presents with fever, new heart failure symptoms, and blood cultures positive for Staphylococcus aureus. Transesophageal echocardiography reveals a 14 mm mobile vegetation on the prosthetic valve with a perivalvular abscess and a new second-degree AV block. Which of the following is the most urgent intervention?

Initiate intravenous vancomycin, gentamicin, and rifampicin and observe for 4 weeks Perform urgent temporary transvenous pacing followed by outpatient oral antibiotic therapy Increase intravenous antibiotic dosing and repeat echocardiography in 14 days Initiate targeted intravenous antibiotics and refer for emergency cardiac surgery

Correct Answer:

Initiate targeted intravenous antibiotics and refer for emergency cardiac surgery

Question 5

A 22-year-old competitive athlete is diagnosed with hypertrophic cardiomyopathy (HCM). Echocardiography shows asymmetric septal hypertrophy of 32 mm and a peak resting left ventricular outflow tract (LVOT) gradient of 45 mmHg. His father died suddenly at age 35. He reports no syncope. Which of the following is the primary indication for secondary or primary prevention implantable cardioverter-defibrillator (ICD) insertion in this patient?

Maximal wall thickness >= 30 mm and family history of sudden cardiac death Resting LVOT gradient of 45 mmHg alone Asymmetric septal ratio greater than 1.3 NYHA Functional Class I status

Correct Answer:

Maximal wall thickness >= 30 mm and family history of sudden cardiac death

Question 1

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Prepare with the FCP(SA) Part II Practice Questions - Fellowship of the College of Physicians of South Africa Part II Exam practice quiz. This question bank includes 100 questions covering year-old, presents, woman, mmhg, and mmol. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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FCP(SA) Part II Practice Questions - Fellowship of the College of Physicians of South Africa Part II Exam

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

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FCP(SA) Part II Practice Questions - Fellowship of the College of Physicians of South Africa Part II Exam

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