PAEA EOC & Summative Practice Questions
and Correct Answers
what exactly causes the occlusive vascular disease of
thromboangiitis obliterans? Ans: aka Buerger's disease
inflammatory thrombi affecting the medium and small vessels
(nonatherosclerosis)
polymorphonuclear leukocytes, microabscesses, and
multinucleated giant cells may be presen
Treatment options for thromboangiitis obliterans? Ans: smoking
cessation most important!
cilostazol (PDE 3 inhibitor) has vasodilator properties (alleviated
symptoms)
if raynauds also present, CCB (nifedipine)
what heart failure treatment provides a benefit of reduction in
morbidity and mortality? Ans: ACE inhibitors
beta blockers can also reduce M&M
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diuretics have no reduction in mortality
how would you manage a patient with a MI in the setting of
cocaine use? Ans: benzodiazepine early
no beta blockers
If PCI cannot be done for a STEMI patient within 120 minutes, what
should be done? Ans: fibrolytic therapy
then do PCI & coronary angiography when it can be done
ideally PCI is done within 90 minutes
fibrolytic therapy can be used up to 12 hours of symptoms
If you suspect an acute limb ischemia due to arterial embolism,
what imaging should you get? Ans: catheter-based arteriography
(digital subtraction arteriography) provides the most useful
information. can also help with treatment
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can help distinguish between thrombosis and embolus
where are arterial emboli often found? Ans: lower extremities
more common than upper extremities
The common femoral, common iliac, and popliteal artery
bifurcations are frequent locations
majority originate in the heart
fun fact: Compared with thromboemboli, atheroemboli are less
likely to produce symptoms of acute limb ischemia
how would you work up a patient with treatment resistant
hypertension that you suspect a secondary cause? Ans: 24-hour
ambulatory monitoring (to ensure not white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
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labs (electrolytes, glucose, creatinine, UA)
If pheo suspected: measure fractionated metanephrines and
catecholamines in a 24-hour urine collection
other than atherosclerosis leading to renal artery stenosis and
secondary HTN, what is another causes of a renal-associated
secondary HTN? Ans: fibromuscular dysplasia (usually in a young
pt)
most important modifable risk factor for AAA? Ans: smoking
cessation!
when is it okay to do screening survelliance for AAA rather than
repair and how often should you screen? Ans: if AAA is <5.5 cm
then annual screening with US is recommended. may need every 6
months if rapidly expanding or other concerns
how should you educate a patient with AAA on exercise? Ans:
Patients should be counseled that moderate physical activity such
as running, biking, swimming, hiking, or sexual activity and
activities such as gardening, golfing, and horseback riding do not
precipitate AAA rupture
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