PAEA EOC & SUMMATIVE PRACTICE EXAM NEWEST
2024-2025 QUESTIONS AND CORRECT ANSWERS
what exactly causes the occlusive vascular disease of thromboangiitis obliterans? - CORRECT
ANSWER✅✅✅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? - CORRECT ANSWER✅✅✅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? -
CORRECT ANSWER✅✅✅ACE inhibitors
beta blockers can also reduce M&M
diuretics have no reduction in mortality
how would you manage a patient with a MI in the setting of cocaine use? - CORRECT
ANSWER✅✅✅benzodiazepine early
no beta blockers
If PCI cannot be done for a STEMI patient within 120 minutes, what should be done? -
CORRECT ANSWER✅✅✅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? -
CORRECT ANSWER✅✅✅catheter-based arteriography (digital subtraction arteriography)
provides the most useful information. can also help with treatment
can help distinguish between thrombosis and embolus
where are arterial emboli often found? - CORRECT ANSWER✅✅✅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? - CORRECT ANSWER✅✅✅24-hour ambulatory monitoring (to ensure
not white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
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? - CORRECT ANSWER✅✅✅fibromuscular
dysplasia (usually in a young pt)
most important modifable risk factor for AAA? - CORRECT ANSWER✅✅✅smoking
cessation!
when is it okay to do screening survelliance for AAA rather than repair and how often should
you screen? - CORRECT 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? - CORRECT
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? -
CORRECT 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? - CORRECT
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? - CORRECT 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? - CORRECT
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. - CORRECT
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
2024-2025 QUESTIONS AND CORRECT ANSWERS
what exactly causes the occlusive vascular disease of thromboangiitis obliterans? - CORRECT
ANSWER✅✅✅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? - CORRECT ANSWER✅✅✅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? -
CORRECT ANSWER✅✅✅ACE inhibitors
beta blockers can also reduce M&M
diuretics have no reduction in mortality
how would you manage a patient with a MI in the setting of cocaine use? - CORRECT
ANSWER✅✅✅benzodiazepine early
no beta blockers
If PCI cannot be done for a STEMI patient within 120 minutes, what should be done? -
CORRECT ANSWER✅✅✅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? -
CORRECT ANSWER✅✅✅catheter-based arteriography (digital subtraction arteriography)
provides the most useful information. can also help with treatment
can help distinguish between thrombosis and embolus
where are arterial emboli often found? - CORRECT ANSWER✅✅✅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? - CORRECT ANSWER✅✅✅24-hour ambulatory monitoring (to ensure
not white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
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? - CORRECT ANSWER✅✅✅fibromuscular
dysplasia (usually in a young pt)
most important modifable risk factor for AAA? - CORRECT ANSWER✅✅✅smoking
cessation!
when is it okay to do screening survelliance for AAA rather than repair and how often should
you screen? - CORRECT 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? - CORRECT
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? -
CORRECT 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? - CORRECT
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? - CORRECT 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? - CORRECT
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. - CORRECT
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
