SARAH MICHELLE LIVE REVIEW
COMPREHENSIVE EXAM QUESTIONS &
ANSWERS 100% GUARANTEE PASS
1. A 65-year-old patient presents with a harsh, mid-systolic crescendo-decrescendo murmur
heard best at the second right intercostal space that radiates to the carotid arteries. Which of
the following is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: B
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the right
upper sternal border that radiates to the carotids.
2. According to JNC 8 guidelines, what is the initial drug of choice for a 55-year-old African
American male with hypertension and no history of chronic kidney disease or diabetes?
A. Lisinopril
B. Losartan
C. Metoprolol
,D. Amlodipine
Answer: D
Conceptual Explanation: For African American patients, thiazide-type diuretics or
Calcium Channel Blockers (CCBs) like Amlodipine are preferred first-line treatments for
HTN.
3. A patient presents with a ‘pearl-like’ waxy skin lesion on the nose with telangiectasia. This
description is most characteristic of which condition?
A. Squamous Cell Carcinoma
B. Malignant Melanoma
C. Actinic Keratosis
D. Basal Cell Carcinoma
Answer: D
Conceptual Explanation: Basal Cell Carcinoma typically presents as a pearly, waxy papule
with telangiectasia and central ulceration (rodent ulcer).
4. A patient with asthma is using a SABA as needed and currently experiences symptoms 3
days per week and wakes up twice a month due to shortness of breath. Which step should be
added next according to GINA/NHLBI guidelines?
A. High-dose ICS
B. Oral Prednisone
, C. Low-dose ICS
D. LABA alone
Answer: C
Conceptual Explanation: The patient is in the mild persistent category (symptoms >2
days/week but not daily). The preferred treatment is Step 2: Low-dose Inhaled
Corticosteroids (ICS).
5. A 32-year-old female presents with fatigue and weight gain. Lab results show TSH of 12.5
mIU/L and Free T4 of 0.4 ng/dL. What is the most likely diagnosis?
A. Secondary Hypothyroidism
B. Primary Hypothyroidism
C. Subclinical Hypothyroidism
D. Graves’ Disease
Answer: B
Conceptual Explanation: Elevated TSH and low Free T4 indicate primary hypothyroidism,
most commonly Hashimoto’s thyroiditis.
6. Which cranial nerve is assessed when asking the patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN XI (Spinal Accessory)
COMPREHENSIVE EXAM QUESTIONS &
ANSWERS 100% GUARANTEE PASS
1. A 65-year-old patient presents with a harsh, mid-systolic crescendo-decrescendo murmur
heard best at the second right intercostal space that radiates to the carotid arteries. Which of
the following is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: B
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the right
upper sternal border that radiates to the carotids.
2. According to JNC 8 guidelines, what is the initial drug of choice for a 55-year-old African
American male with hypertension and no history of chronic kidney disease or diabetes?
A. Lisinopril
B. Losartan
C. Metoprolol
,D. Amlodipine
Answer: D
Conceptual Explanation: For African American patients, thiazide-type diuretics or
Calcium Channel Blockers (CCBs) like Amlodipine are preferred first-line treatments for
HTN.
3. A patient presents with a ‘pearl-like’ waxy skin lesion on the nose with telangiectasia. This
description is most characteristic of which condition?
A. Squamous Cell Carcinoma
B. Malignant Melanoma
C. Actinic Keratosis
D. Basal Cell Carcinoma
Answer: D
Conceptual Explanation: Basal Cell Carcinoma typically presents as a pearly, waxy papule
with telangiectasia and central ulceration (rodent ulcer).
4. A patient with asthma is using a SABA as needed and currently experiences symptoms 3
days per week and wakes up twice a month due to shortness of breath. Which step should be
added next according to GINA/NHLBI guidelines?
A. High-dose ICS
B. Oral Prednisone
, C. Low-dose ICS
D. LABA alone
Answer: C
Conceptual Explanation: The patient is in the mild persistent category (symptoms >2
days/week but not daily). The preferred treatment is Step 2: Low-dose Inhaled
Corticosteroids (ICS).
5. A 32-year-old female presents with fatigue and weight gain. Lab results show TSH of 12.5
mIU/L and Free T4 of 0.4 ng/dL. What is the most likely diagnosis?
A. Secondary Hypothyroidism
B. Primary Hypothyroidism
C. Subclinical Hypothyroidism
D. Graves’ Disease
Answer: B
Conceptual Explanation: Elevated TSH and low Free T4 indicate primary hypothyroidism,
most commonly Hashimoto’s thyroiditis.
6. Which cranial nerve is assessed when asking the patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN XI (Spinal Accessory)
