CEA PREP: FULL PRACTICE EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS
TheA2patientA2isA2exhibitingA2aA2productiveA2coughA2andA2aA2low-gradeA2fever.A2ChestA2X-
rayA2onA2PAA2viewA2showsA2aA2leftA2lowerA2chestA2areaA2ofA2consolidationA2adjacentA2toA2t
heA2leftA2borderA2ofA2theA2heartA2approximatelyA22A2ribA2spacesA2aboveA2theA2costophreni
cA2angle.A2TheA2lateralA2x-
rayA2viewA2showsA2thisA2lesionA2absentA2ofA2theA2windowA2posteriorA2toA2theA2cardiacA2sil
houette.A2WhichA2isA2theA2mostA2likelyA2locationA2ofA2thisA2areaA2ofA2focalA2consolidation?
*LeftA2upperA2lobeA2apex
*RightA2middleA2lobe
*LeftA2upperA2lobeA2lingula
*LeftA2lowerA2lobeA2-A2Ans--A2LeftA2upperA2lobeA2lingula
Ratonale:A2LingularA2consolidationA2isA2describedA2inA2thisA2questionA2precisely.A2IfA2theA2
cardiacA2margin/
silhouetteA2isA2obliteratedA2byA2theA2mass,A2theA2lesionA2isA2eitherA2rightA2middleA2lobeA2or
A2leftA2upperA2lobeA2lingula.
TheA2inabilityA2toA2fullyA2relaxA2theA2myocardiumA2duringA2relaxationA2isA2aA2trademarkA2of
A2whichA2ofA2theA2followingA2diagnoses?A2-A2Ans--A2DiastolicA2dysfunction
Rationale:A2TheA2inabilityA2forA2theA2heartA2toA2relaxA2isA2aA2trademarkA2ofA2theA2diagnosis
A2ofA2diastolicA2dysfunctionA2andA2isA2commonA2inA2patientsA2withA2thickenedA2hypertrophi
cA2myocardium.
AnA2otherwiseA2healthyA2AfricanA2AmericanA2adultA2maleA2hasA2beenA2diagnosedA2withA2
hypertension.A2HeA2hasA2beenA2restrictingA2hisA2saltA2intake,A2eatingA2aA2DASHA2(Dietary
A2ApproachesA2toA2StopA2Hypertension)A2diet,A2andA2exercisingA2more,A2butA2hisA2bloodA2
pressureA2isA2stillA2elevated.A2WhichA2isA2theA2BESTA2medicationA2toA2prescribeA2him?A2-
A2Ans--A2CalciumA2channelA2blocker
Rationale:A2AfricanA2AmericanA2patientsA2perA2JNC8A2HypertensionA2GuidelinesA2shouldA
2beA2managedA2withA2aA2dihydropyridineA2calciumA2channelA2blockerA2suchA2asA2amlodipi
neA2(Norvasc)A2asA2firstA2lineA2managementA2therapyA2forA2hypertensionA2notA2atA2goalA2
withA2DASHA2andA2lifestyleA2modifications.
YourA2patientA2hasA2beenA2diagnosedA2withA2aA24.5cmA2ascendingA2aorticA2aneurysm.A2
WhichA2medicalA2imagingA2isA2consideredA2standardA2ofA2careA2forA2serialA2surveillance?
A2-A2Ans--A2CTA2angiographyA2ofA2theA2chest
Rationale:A2CTA2angiographyA2isA2consideredA2theA2standardA2ofA2careA2forA2measuringA2
vascularA2luminalA2dimensionsA2withA2contrast.A2CTA2PEA2protocolA2isA2notA2timedA2prope
rlyA2forA2theA2aortaA2(it'sA2timedA2forA2theA2pulmonaryA2artery).A2AlthoughA2aA2plainA2filmA2i
sA2ableA2toA2catchA2largeA2aneurysmsA2atA2times,A2theyA2areA2notA2ableA2toA2provideA2mult
i-
axisA2reconstructionA2neededA2toA2accuratelyA2measureA2theA2size.A2TransesophagealA2e
,choA2isA2notA2neededA2toA2accuratelyA2measureA2theA2aortaA2andA2requiresA2theA2patientA2
toA2undergoA2sedationA2whichA2isA2unnecessary.
WhichA2ofA2theA2followingA2medicationsA2doesA2notA2causeA2betaA21A2stimulation?A2-
A2Ans--A2phenylephrine
Rationale:A2PhenylephrineA2onlyA2stimulatesA2alphaA21A2receptors.A2TheA2remainingA2thre
eA2allA2haveA2betaA2receptorA2activity.
AA250-year-
oldA2womanA2withA2aA2historyA2ofA2hypertensionA2presentsA2withA2dyspneaA2onA2exertionA
2andA2orthopnea.A2OnA2examination,A2sheA2hasA2jugularA2venousA2distentionA2andA2bilate
ralA2cracklesA2onA2lungA2auscultation.A2WhatA2isA2theA2mostA2likelyA2diagnosis?A2-A2Ans--
A2CongestiveA2heartA2failure
Rationale:A2OfA2theA2availableA2options,A2theA2mostA2accurateA2responseA2isA2congestiveA
2heartA2failureA2asA2itA2isA2signifyingA2bothA2aA2rightA2ventricularA2backA2upA2withA2jugularA2
venousA2extensionA2andA2cracklesA2onA2lungA2assault,A2whichA2areA2suggestiveA2ofA2leftA2
ventricularA2backA2up.A2itA2isA2possibleA2theA2patientA2mayA2haveA2anA2acuteA2myocardialA
2infarctionA2thatA2precipitatedA2this,A2however,A2aA2patientA2hasA2notA2describedA2that,A2rat
herA2isA2onlyA2describingA2dyspneaA2onA2exertionA2andA2orthopnea,A2whichA2bothA2speakA
2toA2aA2stateA2ofA2fluidA2overload.A2TheA2onlyA2appropriate A2responseA2ofA2theseA2availabl
eA2isA2congestiveA2heartA2failure.
YourA2patientA2withA2aA2historyA2ofA2HFrEFA2(heartA2failureA2withA2reducedA2ejectionA2fract
ion)A2withA2anA2ejectionA2fractionA2ofA240%A2whoA2isA2alsoA2notA2onA2optimalA2medicalA2th
erapyA2hasA2beenA2diagnosedA2withA2aA2myocardialA2infarctionA2thisA2admissionA2andA2re
ceivedA2emergentA2placementA2ofA2aA2drug-
elutingA2stentA2toA2theA2leftA2anteriorA2descendingA2artery.A2AsA2theA2medicalA2homeA2who
A2willA2manageA2thisA2patientA2afterA2discharge,A2whichA2medicationA2strategyA2wouldA2yo
uA2expectA2toA2beA2aA2priorityA2inA2theA2patient'sA2care?A2-A2Ans--
A2OrderingA2aA2transthoracicA2echocardiogramA2andA2orderA2aA2LifevestA2ifA2EFA2isA2lessA2
thanA235%
Rationale:A2TheA2patientA2shouldA2haveA2aA2protectiveA2mechanismA2suchA2asA2anA2impla
ntableA2automatedA2cardioverterA2defibrillatorA2(AICD)A2orA2aA2LifevestA2ifA2theA2EFA2isA2le
ssA2thanA235%A2dueA2toA2theA2increasedA2riskA2ofA2suddenA2cardiacA2deathA2withA2lowA2E
FA2states.A2SinceA2mostA2patientsA2areA2notA2eligibleA2forA290A2daysA2forA2anA2AICDA2inA2t
hisA2state,A2optimizingA2theirA2medicationA2regimenA2andA2repeatingA2anA2echoA2inA22-
3A2monthsA2toA2re-
evaluateA2forA2improvementA2inA2theirA2EFA2isA2requiredA2byA2mostA2insuranceA2companie
s.A2AA2baselineA2echoA2isA2neededA2atA2dischargeA2toA2provideA2aA2baselineA2forA2improve
mentA2vsA2theirA2repeatA2echoA2inA22-3A2months.
DualA2anti-plateletA2therapyA2isA2requiredA2forA212A2monthsA2minimumA2post-MI.A2
AA2HolterA2monitorA2doesA2notA2provideA2anyA2conceivableA2benefitA2forA2thisA2patientA2as
A2presented.
WhichA2ofA2theA2followingA2peopleA2groupsA2representA2theA2leastA2riskA2ofA2cardiacA2dise
ase?A2-A2Ans--A2Caucasians
,Rationale:A2StatisticallyA2AfricanA2Americans,A2NativeA2Hawaiians,A2andA2AmericanA2Indi
ansA2areA2atA2atA2increasedA2riskA2ofA2cardiacA2diseaseA2dueA2toA2higherA2ratesA2ofA2hyper
tension,A2diabetes,A2andA2obesityA2thanA2Caucasians.
AA265-year-oldA2womanA2presentsA2forA2aA2follow-
upA2examination.A2SheA2isA2aA2smoker,A2andA2herA2hypertensionA2isA2nowA2adequatelyA2c
ontrolledA2withA2medication.A2HerA2motherA2diedA2atA2ageA240A2fromA2aA2heartA2attack.A2T
heA2fastingA2lipidA2profileA2showsA2cholesterolA2=A2240A2mg/
dL,A2HDLA2=A230,A2andA2LDLA2=A2200.A2InA2additionA2toA2startingA2therapeuticA2lifestyleA2c
hanges,A2theA2nurseA2practitionerA2shouldA2startA2theA2patientA2on:A2-A2Ans--
A2aA2statinA2drug.
Rationale:A2BileA2acidA2sequestrantsA2andA2cholesterolA2absorptionA2inhibitorsA2mayA2beA
2usefulA2inA2reducingA2ASVDA2risk,A2butA2forA2aA2patientA2whoA2isA2anA2activeA2smokerA2wi
thA2prematureA2coronaryA2diseaseA2historyA2(lessA2thanA2ageA265A2forA2women),A2hasA2hy
pertensionA2andA2isA2farA2fromA2anA2LDLA2goal,A2thisA2patientA2isA2mostA2certainlyA2aA2can
didateA2forA2statinA2therapy,A2whichA2representsA2theA2mostA2aggressiveA2therapyA2option
A2ofA2theseA2fourA2listed.
WhichA2ofA2theA2followingA2end-
organA2sequelaeA2isA2notA2directlyA2causedA2byA2uncontrolledA2hypertension?A2-A2Ans--
A2PeripheralA2neuropathy
Ratioanle:A2AlthoughA2patientsA2withA2hypertensionA2frequentlyA2haveA2peripheralA2neuro
pathy,A2itA2isA2onlyA2directlyA2attributedA2toA2patientsA2whoA2areA2alsoA2diabeticA2andA2isA2c
ommonlyA2foundA2inA2non-
hypertensiveA2diabeticA2patients.A2Proteinuria,A2AVA2nicking,A2andA2hemorrhagicA2strokeA
2areA2allA2causedA2byA2uncontrolledA2hypertension.
PreventiveA2cardiacA2careA2shouldA2focusA2primarilyA2onA2addressingA2allA2theA2followingA
2except?A2-A2Ans--A2GeneticA2predisposition
Rationale:A2SmokingA2cessation,A2exercise,A2andA2medicationA2complianceA2allA2represe
ntA2modifiableA2riskA2factorsA2andA2shouldA2beA2theA2focusA2ofA2preventiveA2care.A2Non-
modifiableA2riskA2factorsA2suchA2asA2age,A2gender,A2genetic/
familyA2historyA2shouldA2notA2beA2theA2primaryA2focusA2ofA2prevention.
AA233-year-
oldA2womanA2presentsA2withA2irregularA2menstrualA2cycles,A2hirsutism,A2andA2obesity.A2La
boratoryA2testsA2revealA2elevatedA2serumA2testosteroneA2andA2LHA2ratioA2>A22:1.A2WhatA2i
sA2theA2mostA2appropriateA2initialA2treatment?A2-A2Ans--A2OralA2contraceptives
Rationale:A2TheseA2areA2classicA2symptomsA2ofA2polycysticA2ovarianA2syndromeA2andA2th
eA2patientA2shouldA2beA2treatedA2withA2oralA2contraceptivesA2toA2helpA2stabilizeA2theirA2est
rogenA2andA2progesterone.A2Additionally,A2theyA2mayA2beA2managedA2onA2metforminA2an
d/orA2spironolactoneA2forA2theirA2PCOS.
OralA2contraceptiveA2pillsA2(OCPs)A2areA2oftenA2theA2firstA2pharmacologicalA2treatmentA2f
orA2polycysticA2ovaryA2syndromeA2(PCOS)A2becauseA2theyA2helpA2manageA2inA2severalA2
ways:
, MenstrualA2irregularities:A2OCPsA2canA2helpA2regulateA2menstrualA2cycles,A2makingA2peri
odsA2lighterA2andA2moreA2regular.A2ThisA2isA2importantA2becauseA2irregularA2ovulationA2ca
nA2leadA2toA2endometrialA2hyperplasia,A2whichA2isA2aA2buildupA2ofA2uterineA2tissueA2thatA2c
anA2increaseA2theA2riskA2ofA2uterineA2cancer.
AndrogenA2excess:A2OCPsA2canA2reduceA2androgenA2productionA2andA2increaseA2sexA2h
ormone-
bindingA2globulinA2(SHBG),A2whichA2bindsA2androgens.A2ThisA2canA2helpA2reduceA2sympt
omsA2likeA2acne,A2hirsutismA2(unwantedA2bodyA2andA2facialA2hair),A2andA2androgenicA2alo
peciaA2(maleA2patternA2baldness).
EndometriumA2protection:A2OCPsA2canA2protectA2theA2endometriumA2byA2ensuringA2regul
arA2ovulation
AA250-year-
oldA2womanA2withA2hypertensionA2andA2diabetesA2comesA2inA2forA2aA2routineA2check-
up.A2WhatA2screeningA2testA2shouldA2beA2regularlyA2performedA2toA2monitorA2forA2earlyA2si
gnsA2ofA2diabeticA2nephropathy?A2-A2Ans--A2UrineA2dipstickA2forA2protein
Rationale:A2TheA2mostA2sensitiveA2indicatorA2ofA2diabeticA2nephropathyA2wouldA2beA2theA2
evidenceA2ofA2smallA2proteinsA2inA2theA2urineA2(proteinuria)A2asA2foundA2onA2urinalysis.A2T
heA2otherA2optionsA2mightA2describeA2macro-organA2functionA2(suchA2asA2BUN/
CreatA2fromA2aA2BMP,A2aA2renalA2biopsyA2whichA2isA2notA2indicatedA2forA2routineA2diabetic
A2nephropathyA2testing,A2andA2aA2AbdA2CT,A2whichA2isA2moreA2akinA2toA2evaluationA2ofA2le
ssA2subtleA2findings),A2butA2atA2theA2functionalA2levelA2ofA2theA2nephron,A2namelyA2theA2gl
omerulus,A2evidenceA2ofA2glucose-
relatedA2damageA2isA2easilyA2identifiedA2withA2proteinuriaA2fromA2aA2UA.
WhichA2ofA2theA2followingA2isA2atA2highestA2riskA2forA2DMII?A2-A2Ans--
A2AnA2adultA2womanA2withA2aA2BMIA2ofA227A2whoA2justA2deliveredA2aA2babyA2weighingA29A2
1/2A2lbs
Rationale:A2OfA2theseA2options,A2anA2adultA2womanA2withA2aA2BMIA2ofA227A2whoA2justA2del
iveredA2aA2babyA2weighingA29A21/2A2lbsA2isA2theA2mostA2likelyA2dueA2toA2theirA2increasedA2
BMIA2andA2theA2largeA2sizeA2ofA2theA2baby.A2givingA2birthA2toA2aA2largeA2baby,A2alsoA2know
nA2asA2aA2large-for-gestational-
ageA2(LGA)A2baby,A2canA2increaseA2theA2riskA2ofA2developingA2typeA22A2diabetesA2laterA2i
nA2life.A2WomenA2whoA2giveA2birthA2toA2aA2LGAA2babyA2areA210%A2moreA2likelyA2toA2devel
opA2DMIIA210-
14A2yearsA2afterA2pregnancyA2comparedA2toA2womenA2whoA2giveA2birthA2toA2babiesA2ofA2a
verageA2gestationalA2ageA2(AGA).A2ThisA2increasedA2riskA2isA2evenA2afterA2adjustingA2forA
2otherA2riskA2factors,A2suchA2asA2age,A2obesity,A2highA2bloodA2pressure,A2andA2familyA2hist
oryA2ofA2diabetes.
AA2startingA2doseA2forA2aA2elderlyA2adultA2patientA2withA2aA2BMIA2ofA220A2needingA2levothr
yoxineA2-A2Ans--A225A2mcg
Rationale:A2TheA2widelyA2consideredA2bestA2practiceA2forA2treatmentA2ofA2hypothyroidism
A2inA2theA2elderlyA2isA2toA2"goA2slowA2andA2startA2low".A225A2mcgA2isA2theA2mostA2appropria
teA2lowA2doseA2toA2startA2withA2ofA2theseA2options.A2ItA2isA2possibleA2thatA2overA2timeA2theA
QUESTIONS AND CORRECT VERIFIED
ANSWERS
TheA2patientA2isA2exhibitingA2aA2productiveA2coughA2andA2aA2low-gradeA2fever.A2ChestA2X-
rayA2onA2PAA2viewA2showsA2aA2leftA2lowerA2chestA2areaA2ofA2consolidationA2adjacentA2toA2t
heA2leftA2borderA2ofA2theA2heartA2approximatelyA22A2ribA2spacesA2aboveA2theA2costophreni
cA2angle.A2TheA2lateralA2x-
rayA2viewA2showsA2thisA2lesionA2absentA2ofA2theA2windowA2posteriorA2toA2theA2cardiacA2sil
houette.A2WhichA2isA2theA2mostA2likelyA2locationA2ofA2thisA2areaA2ofA2focalA2consolidation?
*LeftA2upperA2lobeA2apex
*RightA2middleA2lobe
*LeftA2upperA2lobeA2lingula
*LeftA2lowerA2lobeA2-A2Ans--A2LeftA2upperA2lobeA2lingula
Ratonale:A2LingularA2consolidationA2isA2describedA2inA2thisA2questionA2precisely.A2IfA2theA2
cardiacA2margin/
silhouetteA2isA2obliteratedA2byA2theA2mass,A2theA2lesionA2isA2eitherA2rightA2middleA2lobeA2or
A2leftA2upperA2lobeA2lingula.
TheA2inabilityA2toA2fullyA2relaxA2theA2myocardiumA2duringA2relaxationA2isA2aA2trademarkA2of
A2whichA2ofA2theA2followingA2diagnoses?A2-A2Ans--A2DiastolicA2dysfunction
Rationale:A2TheA2inabilityA2forA2theA2heartA2toA2relaxA2isA2aA2trademarkA2ofA2theA2diagnosis
A2ofA2diastolicA2dysfunctionA2andA2isA2commonA2inA2patientsA2withA2thickenedA2hypertrophi
cA2myocardium.
AnA2otherwiseA2healthyA2AfricanA2AmericanA2adultA2maleA2hasA2beenA2diagnosedA2withA2
hypertension.A2HeA2hasA2beenA2restrictingA2hisA2saltA2intake,A2eatingA2aA2DASHA2(Dietary
A2ApproachesA2toA2StopA2Hypertension)A2diet,A2andA2exercisingA2more,A2butA2hisA2bloodA2
pressureA2isA2stillA2elevated.A2WhichA2isA2theA2BESTA2medicationA2toA2prescribeA2him?A2-
A2Ans--A2CalciumA2channelA2blocker
Rationale:A2AfricanA2AmericanA2patientsA2perA2JNC8A2HypertensionA2GuidelinesA2shouldA
2beA2managedA2withA2aA2dihydropyridineA2calciumA2channelA2blockerA2suchA2asA2amlodipi
neA2(Norvasc)A2asA2firstA2lineA2managementA2therapyA2forA2hypertensionA2notA2atA2goalA2
withA2DASHA2andA2lifestyleA2modifications.
YourA2patientA2hasA2beenA2diagnosedA2withA2aA24.5cmA2ascendingA2aorticA2aneurysm.A2
WhichA2medicalA2imagingA2isA2consideredA2standardA2ofA2careA2forA2serialA2surveillance?
A2-A2Ans--A2CTA2angiographyA2ofA2theA2chest
Rationale:A2CTA2angiographyA2isA2consideredA2theA2standardA2ofA2careA2forA2measuringA2
vascularA2luminalA2dimensionsA2withA2contrast.A2CTA2PEA2protocolA2isA2notA2timedA2prope
rlyA2forA2theA2aortaA2(it'sA2timedA2forA2theA2pulmonaryA2artery).A2AlthoughA2aA2plainA2filmA2i
sA2ableA2toA2catchA2largeA2aneurysmsA2atA2times,A2theyA2areA2notA2ableA2toA2provideA2mult
i-
axisA2reconstructionA2neededA2toA2accuratelyA2measureA2theA2size.A2TransesophagealA2e
,choA2isA2notA2neededA2toA2accuratelyA2measureA2theA2aortaA2andA2requiresA2theA2patientA2
toA2undergoA2sedationA2whichA2isA2unnecessary.
WhichA2ofA2theA2followingA2medicationsA2doesA2notA2causeA2betaA21A2stimulation?A2-
A2Ans--A2phenylephrine
Rationale:A2PhenylephrineA2onlyA2stimulatesA2alphaA21A2receptors.A2TheA2remainingA2thre
eA2allA2haveA2betaA2receptorA2activity.
AA250-year-
oldA2womanA2withA2aA2historyA2ofA2hypertensionA2presentsA2withA2dyspneaA2onA2exertionA
2andA2orthopnea.A2OnA2examination,A2sheA2hasA2jugularA2venousA2distentionA2andA2bilate
ralA2cracklesA2onA2lungA2auscultation.A2WhatA2isA2theA2mostA2likelyA2diagnosis?A2-A2Ans--
A2CongestiveA2heartA2failure
Rationale:A2OfA2theA2availableA2options,A2theA2mostA2accurateA2responseA2isA2congestiveA
2heartA2failureA2asA2itA2isA2signifyingA2bothA2aA2rightA2ventricularA2backA2upA2withA2jugularA2
venousA2extensionA2andA2cracklesA2onA2lungA2assault,A2whichA2areA2suggestiveA2ofA2leftA2
ventricularA2backA2up.A2itA2isA2possibleA2theA2patientA2mayA2haveA2anA2acuteA2myocardialA
2infarctionA2thatA2precipitatedA2this,A2however,A2aA2patientA2hasA2notA2describedA2that,A2rat
herA2isA2onlyA2describingA2dyspneaA2onA2exertionA2andA2orthopnea,A2whichA2bothA2speakA
2toA2aA2stateA2ofA2fluidA2overload.A2TheA2onlyA2appropriate A2responseA2ofA2theseA2availabl
eA2isA2congestiveA2heartA2failure.
YourA2patientA2withA2aA2historyA2ofA2HFrEFA2(heartA2failureA2withA2reducedA2ejectionA2fract
ion)A2withA2anA2ejectionA2fractionA2ofA240%A2whoA2isA2alsoA2notA2onA2optimalA2medicalA2th
erapyA2hasA2beenA2diagnosedA2withA2aA2myocardialA2infarctionA2thisA2admissionA2andA2re
ceivedA2emergentA2placementA2ofA2aA2drug-
elutingA2stentA2toA2theA2leftA2anteriorA2descendingA2artery.A2AsA2theA2medicalA2homeA2who
A2willA2manageA2thisA2patientA2afterA2discharge,A2whichA2medicationA2strategyA2wouldA2yo
uA2expectA2toA2beA2aA2priorityA2inA2theA2patient'sA2care?A2-A2Ans--
A2OrderingA2aA2transthoracicA2echocardiogramA2andA2orderA2aA2LifevestA2ifA2EFA2isA2lessA2
thanA235%
Rationale:A2TheA2patientA2shouldA2haveA2aA2protectiveA2mechanismA2suchA2asA2anA2impla
ntableA2automatedA2cardioverterA2defibrillatorA2(AICD)A2orA2aA2LifevestA2ifA2theA2EFA2isA2le
ssA2thanA235%A2dueA2toA2theA2increasedA2riskA2ofA2suddenA2cardiacA2deathA2withA2lowA2E
FA2states.A2SinceA2mostA2patientsA2areA2notA2eligibleA2forA290A2daysA2forA2anA2AICDA2inA2t
hisA2state,A2optimizingA2theirA2medicationA2regimenA2andA2repeatingA2anA2echoA2inA22-
3A2monthsA2toA2re-
evaluateA2forA2improvementA2inA2theirA2EFA2isA2requiredA2byA2mostA2insuranceA2companie
s.A2AA2baselineA2echoA2isA2neededA2atA2dischargeA2toA2provideA2aA2baselineA2forA2improve
mentA2vsA2theirA2repeatA2echoA2inA22-3A2months.
DualA2anti-plateletA2therapyA2isA2requiredA2forA212A2monthsA2minimumA2post-MI.A2
AA2HolterA2monitorA2doesA2notA2provideA2anyA2conceivableA2benefitA2forA2thisA2patientA2as
A2presented.
WhichA2ofA2theA2followingA2peopleA2groupsA2representA2theA2leastA2riskA2ofA2cardiacA2dise
ase?A2-A2Ans--A2Caucasians
,Rationale:A2StatisticallyA2AfricanA2Americans,A2NativeA2Hawaiians,A2andA2AmericanA2Indi
ansA2areA2atA2atA2increasedA2riskA2ofA2cardiacA2diseaseA2dueA2toA2higherA2ratesA2ofA2hyper
tension,A2diabetes,A2andA2obesityA2thanA2Caucasians.
AA265-year-oldA2womanA2presentsA2forA2aA2follow-
upA2examination.A2SheA2isA2aA2smoker,A2andA2herA2hypertensionA2isA2nowA2adequatelyA2c
ontrolledA2withA2medication.A2HerA2motherA2diedA2atA2ageA240A2fromA2aA2heartA2attack.A2T
heA2fastingA2lipidA2profileA2showsA2cholesterolA2=A2240A2mg/
dL,A2HDLA2=A230,A2andA2LDLA2=A2200.A2InA2additionA2toA2startingA2therapeuticA2lifestyleA2c
hanges,A2theA2nurseA2practitionerA2shouldA2startA2theA2patientA2on:A2-A2Ans--
A2aA2statinA2drug.
Rationale:A2BileA2acidA2sequestrantsA2andA2cholesterolA2absorptionA2inhibitorsA2mayA2beA
2usefulA2inA2reducingA2ASVDA2risk,A2butA2forA2aA2patientA2whoA2isA2anA2activeA2smokerA2wi
thA2prematureA2coronaryA2diseaseA2historyA2(lessA2thanA2ageA265A2forA2women),A2hasA2hy
pertensionA2andA2isA2farA2fromA2anA2LDLA2goal,A2thisA2patientA2isA2mostA2certainlyA2aA2can
didateA2forA2statinA2therapy,A2whichA2representsA2theA2mostA2aggressiveA2therapyA2option
A2ofA2theseA2fourA2listed.
WhichA2ofA2theA2followingA2end-
organA2sequelaeA2isA2notA2directlyA2causedA2byA2uncontrolledA2hypertension?A2-A2Ans--
A2PeripheralA2neuropathy
Ratioanle:A2AlthoughA2patientsA2withA2hypertensionA2frequentlyA2haveA2peripheralA2neuro
pathy,A2itA2isA2onlyA2directlyA2attributedA2toA2patientsA2whoA2areA2alsoA2diabeticA2andA2isA2c
ommonlyA2foundA2inA2non-
hypertensiveA2diabeticA2patients.A2Proteinuria,A2AVA2nicking,A2andA2hemorrhagicA2strokeA
2areA2allA2causedA2byA2uncontrolledA2hypertension.
PreventiveA2cardiacA2careA2shouldA2focusA2primarilyA2onA2addressingA2allA2theA2followingA
2except?A2-A2Ans--A2GeneticA2predisposition
Rationale:A2SmokingA2cessation,A2exercise,A2andA2medicationA2complianceA2allA2represe
ntA2modifiableA2riskA2factorsA2andA2shouldA2beA2theA2focusA2ofA2preventiveA2care.A2Non-
modifiableA2riskA2factorsA2suchA2asA2age,A2gender,A2genetic/
familyA2historyA2shouldA2notA2beA2theA2primaryA2focusA2ofA2prevention.
AA233-year-
oldA2womanA2presentsA2withA2irregularA2menstrualA2cycles,A2hirsutism,A2andA2obesity.A2La
boratoryA2testsA2revealA2elevatedA2serumA2testosteroneA2andA2LHA2ratioA2>A22:1.A2WhatA2i
sA2theA2mostA2appropriateA2initialA2treatment?A2-A2Ans--A2OralA2contraceptives
Rationale:A2TheseA2areA2classicA2symptomsA2ofA2polycysticA2ovarianA2syndromeA2andA2th
eA2patientA2shouldA2beA2treatedA2withA2oralA2contraceptivesA2toA2helpA2stabilizeA2theirA2est
rogenA2andA2progesterone.A2Additionally,A2theyA2mayA2beA2managedA2onA2metforminA2an
d/orA2spironolactoneA2forA2theirA2PCOS.
OralA2contraceptiveA2pillsA2(OCPs)A2areA2oftenA2theA2firstA2pharmacologicalA2treatmentA2f
orA2polycysticA2ovaryA2syndromeA2(PCOS)A2becauseA2theyA2helpA2manageA2inA2severalA2
ways:
, MenstrualA2irregularities:A2OCPsA2canA2helpA2regulateA2menstrualA2cycles,A2makingA2peri
odsA2lighterA2andA2moreA2regular.A2ThisA2isA2importantA2becauseA2irregularA2ovulationA2ca
nA2leadA2toA2endometrialA2hyperplasia,A2whichA2isA2aA2buildupA2ofA2uterineA2tissueA2thatA2c
anA2increaseA2theA2riskA2ofA2uterineA2cancer.
AndrogenA2excess:A2OCPsA2canA2reduceA2androgenA2productionA2andA2increaseA2sexA2h
ormone-
bindingA2globulinA2(SHBG),A2whichA2bindsA2androgens.A2ThisA2canA2helpA2reduceA2sympt
omsA2likeA2acne,A2hirsutismA2(unwantedA2bodyA2andA2facialA2hair),A2andA2androgenicA2alo
peciaA2(maleA2patternA2baldness).
EndometriumA2protection:A2OCPsA2canA2protectA2theA2endometriumA2byA2ensuringA2regul
arA2ovulation
AA250-year-
oldA2womanA2withA2hypertensionA2andA2diabetesA2comesA2inA2forA2aA2routineA2check-
up.A2WhatA2screeningA2testA2shouldA2beA2regularlyA2performedA2toA2monitorA2forA2earlyA2si
gnsA2ofA2diabeticA2nephropathy?A2-A2Ans--A2UrineA2dipstickA2forA2protein
Rationale:A2TheA2mostA2sensitiveA2indicatorA2ofA2diabeticA2nephropathyA2wouldA2beA2theA2
evidenceA2ofA2smallA2proteinsA2inA2theA2urineA2(proteinuria)A2asA2foundA2onA2urinalysis.A2T
heA2otherA2optionsA2mightA2describeA2macro-organA2functionA2(suchA2asA2BUN/
CreatA2fromA2aA2BMP,A2aA2renalA2biopsyA2whichA2isA2notA2indicatedA2forA2routineA2diabetic
A2nephropathyA2testing,A2andA2aA2AbdA2CT,A2whichA2isA2moreA2akinA2toA2evaluationA2ofA2le
ssA2subtleA2findings),A2butA2atA2theA2functionalA2levelA2ofA2theA2nephron,A2namelyA2theA2gl
omerulus,A2evidenceA2ofA2glucose-
relatedA2damageA2isA2easilyA2identifiedA2withA2proteinuriaA2fromA2aA2UA.
WhichA2ofA2theA2followingA2isA2atA2highestA2riskA2forA2DMII?A2-A2Ans--
A2AnA2adultA2womanA2withA2aA2BMIA2ofA227A2whoA2justA2deliveredA2aA2babyA2weighingA29A2
1/2A2lbs
Rationale:A2OfA2theseA2options,A2anA2adultA2womanA2withA2aA2BMIA2ofA227A2whoA2justA2del
iveredA2aA2babyA2weighingA29A21/2A2lbsA2isA2theA2mostA2likelyA2dueA2toA2theirA2increasedA2
BMIA2andA2theA2largeA2sizeA2ofA2theA2baby.A2givingA2birthA2toA2aA2largeA2baby,A2alsoA2know
nA2asA2aA2large-for-gestational-
ageA2(LGA)A2baby,A2canA2increaseA2theA2riskA2ofA2developingA2typeA22A2diabetesA2laterA2i
nA2life.A2WomenA2whoA2giveA2birthA2toA2aA2LGAA2babyA2areA210%A2moreA2likelyA2toA2devel
opA2DMIIA210-
14A2yearsA2afterA2pregnancyA2comparedA2toA2womenA2whoA2giveA2birthA2toA2babiesA2ofA2a
verageA2gestationalA2ageA2(AGA).A2ThisA2increasedA2riskA2isA2evenA2afterA2adjustingA2forA
2otherA2riskA2factors,A2suchA2asA2age,A2obesity,A2highA2bloodA2pressure,A2andA2familyA2hist
oryA2ofA2diabetes.
AA2startingA2doseA2forA2aA2elderlyA2adultA2patientA2withA2aA2BMIA2ofA220A2needingA2levothr
yoxineA2-A2Ans--A225A2mcg
Rationale:A2TheA2widelyA2consideredA2bestA2practiceA2forA2treatmentA2ofA2hypothyroidism
A2inA2theA2elderlyA2isA2toA2"goA2slowA2andA2startA2low".A225A2mcgA2isA2theA2mostA2appropria
teA2lowA2doseA2toA2startA2withA2ofA2theseA2options.A2ItA2isA2possibleA2thatA2overA2timeA2theA
