SARAH MICHELLE CRASH COURSE Q&A 2026/2027 |
Rapid-Fire High-Yield Review | Pass Guaranteed - A+
Graded
SECTION 1: CARDIOVASCULAR & RESPIRATORY MUST-KNOWS (15
Questions)
Q1: A 62-year-old male with HTN presents with sudden-onset crushing chest pain
radiating to the jaw, diaphoresis, and N/V. BP 88/52, HR 110. EKG shows ST elevation in
V1-V4. Which is the HIGHEST priority intervention?
A. Administer aspirin 325 mg PO
B. Start nitroglycerin SL
C. Activate the cath lab for primary PCI [CORRECT]
D. Administer morphine 2 mg IV
Correct Answer: C
Rationale: STEMI with cardiogenic shock requires immediate reperfusion. Primary PCI is
the gold standard; door-to-balloon time <90 min. Nitroglycerin is contraindicated with
hypotension. Pearl: "STEMI = Cath lab, NSTEMI = Heparin + cath within 24-48h."
Q2: A 58-year-old female with AFib on warfarin has an INR of 5.2. She is asymptomatic
with no active bleeding. What is the BEST initial management?
,A. Administer vitamin K 10 mg IV
B. Hold next 1-2 warfarin doses and recheck INR in 2-3 days [CORRECT]
C. Give fresh frozen plasma (FFP)
D. Switch to rivaroxaban immediately
Correct Answer: B
Rationale: Asymptomatic INR 4.5-10: hold warfarin, monitor. Vitamin K is reserved for
INR >10 or active bleeding. FFP is for life-threatening hemorrhage. Pearl: "INR 5-9? Hold
and watch. INR >10? Vitamin K. Bleeding? FFP + Vitamin K."
Q3: A 45-year-old male with sudden dyspnea, pleuritic chest pain, and tachycardia. HR
118, BP 100/68. D-dimer is 1800 ng/mL. What is the MOST definitive test to confirm the
diagnosis?
A. CT pulmonary angiography (CTPA) [CORRECT]
B. Ventilation-perfusion (V/Q) scan
C. D-dimer
D. Chest X-ray
Correct Answer: A
Rationale: CTPA is the gold standard for diagnosing PE, especially with
intermediate/high pretest probability. V/Q is used when CTPA is contraindicated (renal
failure, contrast allergy). Pearl: "PE suspected + high D-dimer = CTPA. Pregnant? V/Q
first."
,Q4: A 70-year-old with COPD presents with increased dyspnea, purulent sputum, and
fever. SaO2 88% on room air. Which antibiotic is FIRST-LINE for outpatient
management?
A. Levofloxacin 750 mg daily
B. Amoxicillin-clavulanate 875/125 mg BID [CORRECT]
C. Azithromycin 500 mg daily
D. Piperacillin-tazobactam IV
Correct Answer: B
Rationale: Outpatient COPD exacerbation (no risk factors for Pseudomonas):
amoxicillin-clavulanate, doxycycline, or macrolide. Risk factors for Pseudomonas:
recent antibiotics, frequent exacerbations, severe disease. Pearl: "Simple COPD flare =
Augmentin or doxy. Pseudomonas risk = FQ or pip-tazo."
Q5: A 55-year-old with HFrEF (EF 30%) is on lisinopril and metoprolol. Which medication,
when added, has been shown to reduce mortality in HFrEF?
A. Digoxin
B. Hydralazine-isosorbide
C. Spironolactone [CORRECT]
D. Amlodipine
Correct Answer: C
Rationale: Spironolactone (MRA) reduces mortality in HFrEF (EF ≤35%) per RALES trial.
Digoxin improves symptoms but not mortality. Hydralazine-isosorbide is for African
, Americans with persistent symptoms. Pearl: "HFrEF mortality reducers:
ACE-I/ARB/ARNI + Beta-blocker + MRA = Triple therapy."
Q6: A 68-year-old with HTN has BP 168/102 on three medications (lisinopril, HCTZ,
amlodipine). What is the MOST appropriate next step?
A. Add clonidine
B. Evaluate for secondary causes of HTN [CORRECT]
C. Increase lisinopril to maximum dose
D. Add hydralazine
Correct Answer: B
Rationale: Resistant HTN = failure of 3 drugs (including diuretic) at max tolerated doses.
Evaluate for secondary causes: renal artery stenosis, primary aldosteronism, OSA,
Cushing's. Pearl: "Resistant HTN = think secondary. Screen for primary aldosteronism
with aldosterone:renin ratio."
Q7: A 50-year-old with asthma has persistent symptoms despite daily low-dose ICS.
What is the BEST next step in management?
A. Add a long-acting beta-agonist (LABA) [CORRECT]
B. Switch to high-dose ICS monotherapy
C. Add a leukotriene receptor antagonist
D. Start oral prednisone daily
Correct Answer: A
Rapid-Fire High-Yield Review | Pass Guaranteed - A+
Graded
SECTION 1: CARDIOVASCULAR & RESPIRATORY MUST-KNOWS (15
Questions)
Q1: A 62-year-old male with HTN presents with sudden-onset crushing chest pain
radiating to the jaw, diaphoresis, and N/V. BP 88/52, HR 110. EKG shows ST elevation in
V1-V4. Which is the HIGHEST priority intervention?
A. Administer aspirin 325 mg PO
B. Start nitroglycerin SL
C. Activate the cath lab for primary PCI [CORRECT]
D. Administer morphine 2 mg IV
Correct Answer: C
Rationale: STEMI with cardiogenic shock requires immediate reperfusion. Primary PCI is
the gold standard; door-to-balloon time <90 min. Nitroglycerin is contraindicated with
hypotension. Pearl: "STEMI = Cath lab, NSTEMI = Heparin + cath within 24-48h."
Q2: A 58-year-old female with AFib on warfarin has an INR of 5.2. She is asymptomatic
with no active bleeding. What is the BEST initial management?
,A. Administer vitamin K 10 mg IV
B. Hold next 1-2 warfarin doses and recheck INR in 2-3 days [CORRECT]
C. Give fresh frozen plasma (FFP)
D. Switch to rivaroxaban immediately
Correct Answer: B
Rationale: Asymptomatic INR 4.5-10: hold warfarin, monitor. Vitamin K is reserved for
INR >10 or active bleeding. FFP is for life-threatening hemorrhage. Pearl: "INR 5-9? Hold
and watch. INR >10? Vitamin K. Bleeding? FFP + Vitamin K."
Q3: A 45-year-old male with sudden dyspnea, pleuritic chest pain, and tachycardia. HR
118, BP 100/68. D-dimer is 1800 ng/mL. What is the MOST definitive test to confirm the
diagnosis?
A. CT pulmonary angiography (CTPA) [CORRECT]
B. Ventilation-perfusion (V/Q) scan
C. D-dimer
D. Chest X-ray
Correct Answer: A
Rationale: CTPA is the gold standard for diagnosing PE, especially with
intermediate/high pretest probability. V/Q is used when CTPA is contraindicated (renal
failure, contrast allergy). Pearl: "PE suspected + high D-dimer = CTPA. Pregnant? V/Q
first."
,Q4: A 70-year-old with COPD presents with increased dyspnea, purulent sputum, and
fever. SaO2 88% on room air. Which antibiotic is FIRST-LINE for outpatient
management?
A. Levofloxacin 750 mg daily
B. Amoxicillin-clavulanate 875/125 mg BID [CORRECT]
C. Azithromycin 500 mg daily
D. Piperacillin-tazobactam IV
Correct Answer: B
Rationale: Outpatient COPD exacerbation (no risk factors for Pseudomonas):
amoxicillin-clavulanate, doxycycline, or macrolide. Risk factors for Pseudomonas:
recent antibiotics, frequent exacerbations, severe disease. Pearl: "Simple COPD flare =
Augmentin or doxy. Pseudomonas risk = FQ or pip-tazo."
Q5: A 55-year-old with HFrEF (EF 30%) is on lisinopril and metoprolol. Which medication,
when added, has been shown to reduce mortality in HFrEF?
A. Digoxin
B. Hydralazine-isosorbide
C. Spironolactone [CORRECT]
D. Amlodipine
Correct Answer: C
Rationale: Spironolactone (MRA) reduces mortality in HFrEF (EF ≤35%) per RALES trial.
Digoxin improves symptoms but not mortality. Hydralazine-isosorbide is for African
, Americans with persistent symptoms. Pearl: "HFrEF mortality reducers:
ACE-I/ARB/ARNI + Beta-blocker + MRA = Triple therapy."
Q6: A 68-year-old with HTN has BP 168/102 on three medications (lisinopril, HCTZ,
amlodipine). What is the MOST appropriate next step?
A. Add clonidine
B. Evaluate for secondary causes of HTN [CORRECT]
C. Increase lisinopril to maximum dose
D. Add hydralazine
Correct Answer: B
Rationale: Resistant HTN = failure of 3 drugs (including diuretic) at max tolerated doses.
Evaluate for secondary causes: renal artery stenosis, primary aldosteronism, OSA,
Cushing's. Pearl: "Resistant HTN = think secondary. Screen for primary aldosteronism
with aldosterone:renin ratio."
Q7: A 50-year-old with asthma has persistent symptoms despite daily low-dose ICS.
What is the BEST next step in management?
A. Add a long-acting beta-agonist (LABA) [CORRECT]
B. Switch to high-dose ICS monotherapy
C. Add a leukotriene receptor antagonist
D. Start oral prednisone daily
Correct Answer: A
