2026 COMPREHENSIVE ASSESSMENT SCRIPT
SOLVED QUESTIONS ANSWERS UPDATED
REVIEW SET
◉ other than atherosclerosis leading to renal artery stenosis and
secondary HTN, what is another causes of a renal-associated
secondary HTN?
Answer: fibromuscular dysplasia (usually in a young pt)
◉ most important modifable risk factor for AAA?
Answer: smoking cessation!
◉ when is it okay to do screening survelliance for AAA rather than
repair and how often should you screen?
Answer: 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?
Answer: 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
Moderate physical therapy may also limit aneurysm expansion. In
experimental aneurysms, increased aortic blood flow appears to
inhibit AAA expansion
However, heavy lifting, especially while holding the breath, and
other activities that lead to Valsalva transiently induce significant
increases in blood pressure and should be avoided
◉ gold standard for dx renal artery stenosis? what can be used to
monitor disease progression?
Answer: renal arteriography
But really a spiral CT angiography is very useful and probably more
likely done first
duplex doppler US can be used to monitor disease progression
◉ what are some symptoms of mitral valve prolapse syndrome?
Answer: various nonspecific symptoms such as palpitations,
dyspnea, exercise intolerance, anxiety disorders, and dizziness
,◉ since symptoms are relatively uncommon, what physical exam
findings are associated with mitral valve prolapse?
Answer: non-ejection click in systole
click is mobile, meaning its timing varies with maneuvers that
change the left ventricular volume, occurring earlier in systole with
sitting, standing, or other interventions that reduce ventricular size,
or later with those interventions that increase chamber size such as
squatting
People with MVP tend to have lower BMIs
◉ how would you distinguish vasospastic angina and angina
associated with CAD?
Answer: quality of the CP is typically indistinguishable of the two
patients with vasospastic angina report that their episodes are
predominantly at rest and that many occur from midnight to early
morning, while effort tolerance is usually preserved. CP generally
lasts 5 to 15 minutes
Patients with vasospastic angina are often younger and exhibit fewer
classic cardiovascular risk factors and may be associated with other
vasospastic disorders, such as Raynaud's phenomenon and migraine
headache
, Exercise does not usually provoke an episode of spasm
ECG may reveal transient ST-segment elevation or depression in
multiple lead but troponins will not be elevated
◉ where do karposi sarcoma lesions typically occur? describe their
appearance.
Answer: often on distal extremities, such as lower legs and feet
purplish, reddish blue, or dark brown/black macules, plaques, and
nodules on the skin. Nodular lesions may ulcerate and bleed easily
common in poorly controlled HIV
◉ how would you treat hidradenitis suppurativa?
Answer: topical clindamycin
if fail topical therapy, oral tetracyclines are suggested
Antiandrogenic drugs and metformin are additional treatment
options that may be used alone or in conjunction with antibiotic
therapy