Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 104065

In scope icon M 6 E
QID 104065 (Type "104065" in App Search)
A 58-year-old African-American male is scheduled to undergo a cardiac treadmill stress test in 2 weeks. His family physician recommended the test, as the patient would like to begin a new exercise program in order to begin training to run a half-marathon later this year. His past medical history includes hypertension, which has been well-controlled with amlodipine, hyperlipidemia, for which he is taking simvastatin, and non-insulin dependent diabetes treated with metformin. His history is negative for prior myocardial infarction, heart failure, angina, or any form of coronary artery disease. Which of the following instructions should be given to the patient regarding his upcoming stress test?

Do not consume caffeine or caffeine-containing substances for 5 days prior to the stress test

24%

23/97

Stop taking aspirin 1 week prior to the stress test

6%

6/97

Stop taking amlodipine 2 days prior to the stress test

58%

56/97

Take double the normal dose of metformin and avoid eating the morning of the test

0%

0/97

Stop smoking 10 days before the stress test

11%

11/97

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

For patients without a history of coronary artery disease, medications including beta-blockers, calcium channel blockers (amlodipine), and nitrates should be stopped 48 hours before undergoing a cardiac stress test, as these agents affect the accuracy of stress testing.

Such medications may cause a false negative by masking ischemic changes on the electrocardiogram or stress test imaging. Additionally, they may cause a false positive result by creating artificial ischemic changes on the electrocardiogram. Stopping these agents 48 hours prior to the stress test allows for 4-5 half-lives to pass, thereby reversing the hemodynamic effects of these medications. In contrast to the above patient, if a patient has a known history of coronary artery disease, their antianginal medications (nitrates, beta-blockers, and calcium channel blockers) should be continued to evaluate the efficacy of the patient's treatment regimen with exertion. Indications for stress testing can include pre-operative assessment, identification of the extent/existence of coronary artery disease, evaluation of the efficacy of current cardiac treatment, and identification of appropriate and safe levels of exercise.

Incorrect Answers:
Answer 1: Caffeine interferes with stress testing, but it is only necessary to withhold consumption for 24 hours before the test.
Answer 2: Aspirin does not affect the quality of the results obtained from stress testing, and there is no need to hold this medication prior to the test.
Answer 4: Increasing metformin and skipping a meal may trigger a hypoglycemic episode, particularly with the exertion involved in an exercise stress test.
Answer 5: Although smoking cessation is always advised, for the purposes of the stress test, smoking should only be stopped on the day of the test to maintain accuracy.

Bullet Summary:
For patients without a history of coronary artery disease, medications like calcium channel blockers should be stopped 48 hours prior to a cardiac stress test to ensure accurate results.

Authors
Rating
Please Rate Question Quality

4.7

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(6)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options