CMN 552 – MODULE 2 EXAM
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES GRADED A+
UNIVERSITY OF SOUTH ALABAMA
1.
A 55-year-old patient presents with severe crushing chest pain radiating to the left
arm, diaphoresis, and nausea. ECG shows ST-segment elevation in leads V2–V5.
Which coronary artery is most likely occluded?
A) Right coronary artery
B) Left circumflex artery
C) Left anterior descending artery
D) Posterior descending artery
Answer: C) Left anterior descending artery
Rationale: ST elevation in precordial leads V2–V5 indicates an anterior
myocardial infarction, most commonly due to occlusion of the LAD.
2.
Which of the following is the first-line therapy for acute heart failure
exacerbation with pulmonary edema?
A) IV furosemide
B) Oral spironolactone
C) Oral ACE inhibitor
D) IV dopamine
Answer: A) IV furosemide
Rationale: Loop diuretics like furosemide reduce preload and pulmonary
congestion in acute decompensated heart failure.
,3.
A 42-year-old female presents with fatigue, cold intolerance, weight gain, and dry
skin. Labs show TSH 12 µIU/mL and T4 3 µg/dL. What is the most likely
diagnosis?
A) Hyperthyroidism
B) Primary hypothyroidism
C) Secondary hypothyroidism
D) Subclinical hypothyroidism
Answer: B) Primary hypothyroidism
Rationale: High TSH with low T4 indicates primary thyroid failure; secondary
hypothyroidism would show low TSH.
4.
Which of the following lab findings is characteristic of iron-deficiency anemia?
A) Microcytic anemia with low ferritin
B) Macrocytic anemia with high B12
C) Normocytic anemia with low reticulocyte count
D) Hemolytic anemia with high LDH
Answer: A) Microcytic anemia with low ferritin
Rationale: Iron-deficiency anemia presents with microcytosis, low ferritin, and
low serum iron.
5.
A patient presents with acute shortness of breath, pleuritic chest pain, and
hemoptysis after long-distance travel. Which is the most likely diagnosis?
A) Pneumonia
B) Pulmonary embolism
C) Asthma exacerbation
D) Heart failure
,Answer: B) Pulmonary embolism
Rationale: Sudden onset dyspnea, pleuritic chest pain, and hemoptysis in a patient
with immobilization risk suggests PE.
6.
Which of the following is first-line therapy for type 2 diabetes mellitus in
adults?
A) Insulin
B) Metformin
C) Sulfonylurea
D) GLP-1 receptor agonist
Answer: B) Metformin
Rationale: Metformin improves insulin sensitivity and reduces hepatic glucose
output, making it first-line therapy.
7.
A patient presents with right upper quadrant pain, fever, and jaundice. Labs
show elevated ALP and bilirubin. What is the most likely diagnosis?
A) Cholangitis
B) Hepatitis A
C) Cirrhosis
D) Acute pancreatitis
Answer: A) Cholangitis
Rationale: Charcot’s triad (fever, jaundice, RUQ pain) and cholestatic labs
suggest ascending cholangitis, often from biliary obstruction.
, 8.
Which of the following medications is safe for anticoagulation in pregnancy?
A) Warfarin
B) Heparin
C) Rivaroxaban
D) Apixaban
Answer: B) Heparin
Rationale: Heparin does not cross the placenta and is safe in pregnancy, unlike
warfarin or DOACs.
9.
Which of the following lab values is most indicative of acute myocardial
infarction?
A) Elevated CK-MB
B) Elevated troponin
C) Elevated BNP
D) Elevated ALT
Answer: B) Elevated troponin
Rationale: Troponin is highly specific for myocardial injury and remains elevated
for several days post-infarction.
10.
A 60-year-old patient presents with progressive dyspnea and dry cough. HRCT
shows honeycombing in the lungs. What is the most likely diagnosis?
A) Asthma
B) COPD
C) Idiopathic pulmonary fibrosis
D) Pneumonia
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES GRADED A+
UNIVERSITY OF SOUTH ALABAMA
1.
A 55-year-old patient presents with severe crushing chest pain radiating to the left
arm, diaphoresis, and nausea. ECG shows ST-segment elevation in leads V2–V5.
Which coronary artery is most likely occluded?
A) Right coronary artery
B) Left circumflex artery
C) Left anterior descending artery
D) Posterior descending artery
Answer: C) Left anterior descending artery
Rationale: ST elevation in precordial leads V2–V5 indicates an anterior
myocardial infarction, most commonly due to occlusion of the LAD.
2.
Which of the following is the first-line therapy for acute heart failure
exacerbation with pulmonary edema?
A) IV furosemide
B) Oral spironolactone
C) Oral ACE inhibitor
D) IV dopamine
Answer: A) IV furosemide
Rationale: Loop diuretics like furosemide reduce preload and pulmonary
congestion in acute decompensated heart failure.
,3.
A 42-year-old female presents with fatigue, cold intolerance, weight gain, and dry
skin. Labs show TSH 12 µIU/mL and T4 3 µg/dL. What is the most likely
diagnosis?
A) Hyperthyroidism
B) Primary hypothyroidism
C) Secondary hypothyroidism
D) Subclinical hypothyroidism
Answer: B) Primary hypothyroidism
Rationale: High TSH with low T4 indicates primary thyroid failure; secondary
hypothyroidism would show low TSH.
4.
Which of the following lab findings is characteristic of iron-deficiency anemia?
A) Microcytic anemia with low ferritin
B) Macrocytic anemia with high B12
C) Normocytic anemia with low reticulocyte count
D) Hemolytic anemia with high LDH
Answer: A) Microcytic anemia with low ferritin
Rationale: Iron-deficiency anemia presents with microcytosis, low ferritin, and
low serum iron.
5.
A patient presents with acute shortness of breath, pleuritic chest pain, and
hemoptysis after long-distance travel. Which is the most likely diagnosis?
A) Pneumonia
B) Pulmonary embolism
C) Asthma exacerbation
D) Heart failure
,Answer: B) Pulmonary embolism
Rationale: Sudden onset dyspnea, pleuritic chest pain, and hemoptysis in a patient
with immobilization risk suggests PE.
6.
Which of the following is first-line therapy for type 2 diabetes mellitus in
adults?
A) Insulin
B) Metformin
C) Sulfonylurea
D) GLP-1 receptor agonist
Answer: B) Metformin
Rationale: Metformin improves insulin sensitivity and reduces hepatic glucose
output, making it first-line therapy.
7.
A patient presents with right upper quadrant pain, fever, and jaundice. Labs
show elevated ALP and bilirubin. What is the most likely diagnosis?
A) Cholangitis
B) Hepatitis A
C) Cirrhosis
D) Acute pancreatitis
Answer: A) Cholangitis
Rationale: Charcot’s triad (fever, jaundice, RUQ pain) and cholestatic labs
suggest ascending cholangitis, often from biliary obstruction.
, 8.
Which of the following medications is safe for anticoagulation in pregnancy?
A) Warfarin
B) Heparin
C) Rivaroxaban
D) Apixaban
Answer: B) Heparin
Rationale: Heparin does not cross the placenta and is safe in pregnancy, unlike
warfarin or DOACs.
9.
Which of the following lab values is most indicative of acute myocardial
infarction?
A) Elevated CK-MB
B) Elevated troponin
C) Elevated BNP
D) Elevated ALT
Answer: B) Elevated troponin
Rationale: Troponin is highly specific for myocardial injury and remains elevated
for several days post-infarction.
10.
A 60-year-old patient presents with progressive dyspnea and dry cough. HRCT
shows honeycombing in the lungs. What is the most likely diagnosis?
A) Asthma
B) COPD
C) Idiopathic pulmonary fibrosis
D) Pneumonia
