Section 2: Endocrine & Metabolic Disorders (Diabetes, Thyroid, Obesity)
Section 3: Gastrointestinal & Renal/Urinary Disorders
Section 4: Musculoskeletal & Rheumatologic Disorders
Section 5: Neurologic & Special Senses Disorders
Section 6: Dermatologic & Infectious Diseases
Section 1: Cardiovascular & Respiratory Disorders
Q1: A 55-year-old African American male has a blood pressure of 152/96 mmHg. He has no
other comorbidities. According to the 2017 ACC/AHA guidelines, what is the appropriate
classification?
A. Elevated
B. Stage 1 Hypertension [CORRECT]
C. Stage 2 Hypertension
D. Hypertensive Crisis
Correct Answer: B
Rationale: Stage 1 Hypertension is defined as systolic 130-139 or diastolic 80-89. Wait, 152/96
is >140 and >90. This is Stage 2. Correction: 152/96 meets criteria for Stage 2.
Note: The user asked for a different set. In the previous set, Q1 was 148/92. This is similar. Let
me adjust to ensure variety.
Revised Q1: A 45-year-old female has BP of 128/82. Classification?
,A. Normal
B. Elevated [CORRECT]
C. Stage 1
D. Stage 2
Correct Answer: B
Rationale: Elevated BP is systolic 120-129 and diastolic <80. Stage 1 requires diastolic 80-89.
Normal is <120/<80.
Key Review Point: Elevated BP = 120-129 / <80.
Q2: A patient with HFrEF (EF 30%) is currently on Lisinopril and Metoprolol. What medication
should be added next to reduce mortality?
A. Furosemide
B. Spironolactone (MRA) [CORRECT]
C. Digoxin
D. Hydralazine
Correct Answer: B
Rationale: MRAs (Spironolactone/Eplerenone) reduce mortality in HFrEF and are part of the
"quadruple therapy" (along with Beta-blocker, ACEi/ARNI, SGLT2i). Furosemide is for
symptoms only.
Key Review Point: HFrEF Mortality Reduction = Add MRA (if eGFR/K+ allows).
Q3: A 70-year-old male presents with syncope. He describes a sensation of "fluttering" in his
chest before the event. ECG shows QRS complexes of varying morphology and irregular R-R
intervals. What is the diagnosis?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrial Flutter with variable block [CORRECT]
D. SVT
Correct Answer: C
.
,Rationale: Atrial Flutter typically produces "sawtooth" waves. If the block is variable, the
ventricular rate (R-R) is irregular, mimicking Afib but with distinct flutter waves.
Key Review Point: Atrial Flutter = Sawtooth waves (variable block = irregular pulse).
Q4: A patient with stable angina is unable to tolerate beta-blockers due to severe asthma. What is
the alternative medication for angina?
A. Verapamil (Non-dihydropyridine CCB) [CORRECT]
B. Nifedipine (Dihydropyridine CCB)
C. Digoxin
D. Nitroglycerin SL only
Correct Answer: A
Rationale: Non-dihydropyridine CCBs (Verapamil/Diltiazem) reduce heart rate and contractility,
making them suitable alternatives to beta-blockers for angina. Dihydropyridines (Amlodipine)
cause reflex tachycardia.
Key Review Point: Angina + Asthma (Beta-blocker contraindicated) = Use Non-DHP CCB
(Verapamil/Diltiazem).
Q5: Which murmur is best heard at the left upper sternal border (LUSB) and increases with
inspiration?
A. Aortic Regurgitation
B. Pulmonic Stenosis
C. Tricuspid Regurgitation [CORRECT]
D. Mitral Stenosis
Correct Answer: C
Rationale: Tricuspid regurgitation is a holosystolic murmur heard best at the LLSB or LUSB
that increases with inspiration (Carvallo's sign).
Key Review Point: TR Murmur = Increases with Inspiration (Carvallo's sign).
.
, Q6: A 65-year-old male presents with leg pain that occurs after walking 2 blocks and resolves
within 10 minutes of rest. Ankle-Brachial Index (ABI) is 0.65. What is the diagnosis?
A. Mild PAD
B. Moderate PAD [CORRECT]
C. Severe PAD
D. Normal
Correct Answer: B
Rationale: ABI 0.41-0.69 indicates moderate PAD. 0.70-0.90 is mild. <0.40 is severe.
Key Review Point: ABI Grading: Mild (0.7-0.9), Moderate (0.4-0.69), Severe (<0.4).
Q7: A patient with a history of DVT is on Warfarin. INR is 6.0, but the patient is asymptomatic
(no bleeding). What is the management?
A. Vitamin K 10mg IV
B. Hold Warfarin, restart at lower dose when INR < 5.0 [CORRECT]
C. Fresh Frozen Plasma
D. Protamine Sulfate
Correct Answer: B
Rationale: Asymptomatic elevated INR >5.0 requires holding warfarin and possibly giving oral
Vitamin K (if INR >10). IV Vitamin K or FFP is for severe bleeding.
Key Review Point: Asymptomatic High INR (>5) = Hold Warfarin + Optional Oral Vit K.
Q8: A 30-year-old female presents with low-grade fever, non-productive cough, and malaise.
CXR shows "patchy" infiltrates. Cold agglutinins are positive. What is the pathogen?
A. Mycoplasma pneumoniae [CORRECT]
B. Streptococcus pneumoniae
C. Legionella
D. Haemophilus influenzae
Correct Answer: A
.