INTERNAL MEDICINE EOR ACTUAL TEST
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉CARDIOLOGY: EKG should be obtained if CP appears cardiac in
nature. CXR is initial step to rule out pneumothorax, pulmonary
infiltrates, and rib fractures. ____should be done for patients w
worrisome histories for aortic dissection regardless of CXR or EKG
results. Answer: CT
◉_____is minimally invasive and rapid for detecting aortic dissection
at the bedside. Answer: TEE - transesophageal echocardiogram
◉A ____ is used for pleuritic pain w normal CXR when a PE is
suspected. Answer: V/Q scan - but not good for a small PE
◉A _____is sensitive for small PE and may detect other chest
abnormalities leading to pain. Answer: helical chest CT
◉____is used when CP is esophageal in origin. Answer: Esophageal
pH monitoring
,◉EKG: A ______suggests underlying heart disease (ischemic,
hypertensive). Answer: left bundle branch block
◉A _____may be indicative of right heart strain (as in pulmonary
embolus). Answer: right bundle branch block
◉____is a term used to describe decreased perfusion and oxygen
delivery to the body. This is best defined by BP = CO x SVR. What are
the three main types? Answer: Shock; hypovolemic, cardiogenic,
distributive
◉______shock can be from pump failure from infarction,
cardiomyopathy, or tamponade, arrhythmia, valve failure, obstructed
outflow from tension pneumothorax or massive PE. Answer:
Cardiogenic
◉______shock can be from hemorrhage, diarrhea, heat stroke, or
third spacing. Answer: Hypovolemic
◉______shock can be from sepsis, anaphylaxis, adrenal crisis, or
myxedema coma. Answer: Distributive
◉The formation of _______occurs via:
a. endothelial dysfunction & formation of fatty streak
,b. LDL enters fatty streak and attracts macrophages
c. proliferating smooth muscle cells, connective tissue, & lipids
become incorporated into plaque
d. "fibrous cap" forms Answer: atherosclerotic plaque
◉Name some risk factors for CHD. Answer: Diabetes Mellitus
Patient Age
Peripheral Vascular disease
Chronic Renal Failure
Elevated homocysteine level
elevated inflammatory markers like CRP
Low Activity Level
Low intake of fruits and vegetables
lack of moderate alcohol intake
◉_____is insufficiently specific for assessment of patients with low
(<10%) pretest probability of CHD. It is best reserved for patients
with intermediate pretest probability. Sensitivity and specificity can
be increased with imaging studies such as radionuclide imaging or
echocardiography. What is the gold standard to diagnose coronary
artery disease? Answer: Exercise stress testing; coronary
angiography
, ◉The AHA suggests the following mnemonic for the important
elements in treatment of stable angina: Answer: A: aspirin, ACEi,
antianginals - nitrates/CCB
B: B-blocker, bp
C: cholesterol & cigarettes
D: diet and diabetes
E: education and exercise
◉CCB: Short acting dihydropyridine CCBs ie ____ have been shown to
increase cardiac risk therefore nondihydropyridines are
recommended. They are ___or___. Second generation
dihydropyridines have fewer negative inotropic effects and can be
used in settings of reduced ejection fraction. (ie. ___or___) Answer:
Nifedipine
verapamil or diltiazem
amlodipine or nicardipine
◉Patients with stenosis of left anterior descending, left main
coronary disease, three vessel disease, or survivors of sudden
cardiac death or sustained VF/VT would benefit from _________.
Answer: coronary artery bypass grafting (CABG)
◉_______can be used to relieve symptoms in patients who fail medical
therapy but who do not have significant enough disease to require
CABG. Answer: PCI - percutaneous coronary intervention
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉CARDIOLOGY: EKG should be obtained if CP appears cardiac in
nature. CXR is initial step to rule out pneumothorax, pulmonary
infiltrates, and rib fractures. ____should be done for patients w
worrisome histories for aortic dissection regardless of CXR or EKG
results. Answer: CT
◉_____is minimally invasive and rapid for detecting aortic dissection
at the bedside. Answer: TEE - transesophageal echocardiogram
◉A ____ is used for pleuritic pain w normal CXR when a PE is
suspected. Answer: V/Q scan - but not good for a small PE
◉A _____is sensitive for small PE and may detect other chest
abnormalities leading to pain. Answer: helical chest CT
◉____is used when CP is esophageal in origin. Answer: Esophageal
pH monitoring
,◉EKG: A ______suggests underlying heart disease (ischemic,
hypertensive). Answer: left bundle branch block
◉A _____may be indicative of right heart strain (as in pulmonary
embolus). Answer: right bundle branch block
◉____is a term used to describe decreased perfusion and oxygen
delivery to the body. This is best defined by BP = CO x SVR. What are
the three main types? Answer: Shock; hypovolemic, cardiogenic,
distributive
◉______shock can be from pump failure from infarction,
cardiomyopathy, or tamponade, arrhythmia, valve failure, obstructed
outflow from tension pneumothorax or massive PE. Answer:
Cardiogenic
◉______shock can be from hemorrhage, diarrhea, heat stroke, or
third spacing. Answer: Hypovolemic
◉______shock can be from sepsis, anaphylaxis, adrenal crisis, or
myxedema coma. Answer: Distributive
◉The formation of _______occurs via:
a. endothelial dysfunction & formation of fatty streak
,b. LDL enters fatty streak and attracts macrophages
c. proliferating smooth muscle cells, connective tissue, & lipids
become incorporated into plaque
d. "fibrous cap" forms Answer: atherosclerotic plaque
◉Name some risk factors for CHD. Answer: Diabetes Mellitus
Patient Age
Peripheral Vascular disease
Chronic Renal Failure
Elevated homocysteine level
elevated inflammatory markers like CRP
Low Activity Level
Low intake of fruits and vegetables
lack of moderate alcohol intake
◉_____is insufficiently specific for assessment of patients with low
(<10%) pretest probability of CHD. It is best reserved for patients
with intermediate pretest probability. Sensitivity and specificity can
be increased with imaging studies such as radionuclide imaging or
echocardiography. What is the gold standard to diagnose coronary
artery disease? Answer: Exercise stress testing; coronary
angiography
, ◉The AHA suggests the following mnemonic for the important
elements in treatment of stable angina: Answer: A: aspirin, ACEi,
antianginals - nitrates/CCB
B: B-blocker, bp
C: cholesterol & cigarettes
D: diet and diabetes
E: education and exercise
◉CCB: Short acting dihydropyridine CCBs ie ____ have been shown to
increase cardiac risk therefore nondihydropyridines are
recommended. They are ___or___. Second generation
dihydropyridines have fewer negative inotropic effects and can be
used in settings of reduced ejection fraction. (ie. ___or___) Answer:
Nifedipine
verapamil or diltiazem
amlodipine or nicardipine
◉Patients with stenosis of left anterior descending, left main
coronary disease, three vessel disease, or survivors of sudden
cardiac death or sustained VF/VT would benefit from _________.
Answer: coronary artery bypass grafting (CABG)
◉_______can be used to relieve symptoms in patients who fail medical
therapy but who do not have significant enough disease to require
CABG. Answer: PCI - percutaneous coronary intervention
