CEA PREP: FULL PRACTICE EXAM
WITH VERIFIED SOLUTIONS
The rpatient ris rexhibiting ra rproductive rcough rand ra rlow-grade rfever. rChest rX-ray ron
rPA rview rshows ra rleft rlower rchest rarea rof rconsolidation radjacent rto rthe rleft rborder
rof rthe rheart rapproximately r2 rrib rspaces rabove rthe rcostophrenic rangle. rThe rlateral
rx-ray rview rshows rthis rlesion rabsent rof rthe rwindow rposterior rto rthe rcardiac
rsilhouette. rWhich ris rthe rmost rlikely rlocation rof rthis rarea rof rfocal rconsolidation?
*Left rupper rlobe rapex
*Right rmiddle rlobe
*Left rupper rlobe rlingula
*Left rlower rlobe r- rcorrect ranswers r-Left rupper rlobe rlingula
Ratonale: rLingular rconsolidation ris rdescribed rin rthis rquestion rprecisely. rIf rthe
rcardiac rmargin/silhouette ris robliterated rby rthe rmass, rthe rlesion ris reither rright
rmiddle rlobe ror rleft rupper rlobe rlingula.
The rinability rto rfully rrelax rthe rmyocardium rduring rrelaxation ris ra rtrademark rof rwhich
rof rthe rfollowing rdiagnoses? r- rcorrect ranswers r-Diastolic rdysfunction
,Rationale: rThe rinability rfor rthe rheart rto rrelax ris ra rtrademark rof rthe rdiagnosis rof
rdiastolic rdysfunction rand ris rcommon rin rpatients rwith rthickened rhypertrophic
rmyocardium.
An rotherwise rhealthy rAfrican rAmerican radult rmale rhas rbeen rdiagnosed rwith
rhypertension. rHe rhas rbeen rrestricting rhis rsalt rintake, reating ra rDASH r(Dietary
rApproaches rto rStop rHypertension) rdiet, rand rexercising rmore, rbut rhis rblood
rpressure ris rstill relevated. rWhich ris rthe rBEST rmedication rto rprescribe rhim? r-
rcorrect ranswers r-Calcium rchannel rblocker
Rationale: rAfrican rAmerican rpatients rper rJNC8 rHypertension rGuidelines rshould rbe
rmanaged rwith ra rdihydropyridine rcalcium rchannel rblocker rsuch ras ramlodipine
r(Norvasc) ras rfirst rline rmanagement rtherapy rfor rhypertension rnot rat rgoal rwith
rDASH rand rlifestyle rmodifications.
Your rpatient rhas rbeen rdiagnosed rwith ra r4.5cm rascending raortic raneurysm. rWhich
rmedical rimaging ris rconsidered rstandard rof rcare rfor rserial rsurveillance? r- rcorrect
ranswers r-CT rangiography rof rthe rchest
Rationale: rCT rangiography ris rconsidered rthe rstandard rof rcare rfor rmeasuring
rvascular rluminal rdimensions rwith rcontrast. rCT rPE rprotocol ris rnot rtimed rproperly rfor
rthe raorta r(it's rtimed rfor rthe rpulmonary rartery). rAlthough ra rplain rfilm ris rable rto
rcatch rlarge raneurysms rat rtimes, rthey rare rnot rable rto rprovide rmulti-axis
rreconstruction rneeded rto raccurately rmeasure rthe rsize. rTransesophageal recho ris
rnot rneeded rto raccurately rmeasure rthe raorta rand rrequires rthe rpatient rto rundergo
rsedation rwhich ris runnecessary.
Which rof rthe rfollowing rmedications rdoes rnot rcause rbeta r1 rstimulation? r- rcorrect
ranswers r-phenylephrine
Rationale: rPhenylephrine ronly rstimulates ralpha r1 rreceptors. rThe rremaining rthree rall
rhave rbeta rreceptor ractivity.
A r50-year-old rwoman rwith ra rhistory rof rhypertension rpresents rwith rdyspnea ron
rexertion rand rorthopnea. rOn rexamination, rshe rhas rjugular rvenous rdistention rand
rbilateral rcrackles ron rlung rauscultation. rWhat ris rthe rmost rlikely rdiagnosis? r- rcorrect
ranswers r-Congestive rheart rfailure
Rationale: rOf rthe ravailable roptions, rthe rmost raccurate rresponse ris rcongestive rheart
rfailure ras rit ris rsignifying rboth ra rright rventricular rback rup rwith rjugular rvenous
rextension rand rcrackles ron rlung rassault, rwhich rare rsuggestive rof rleft rventricular
rback rup. rit ris rpossible rthe rpatient rmay rhave ran racute rmyocardial rinfarction rthat
rprecipitated rthis, rhowever, ra rpatient rhas rnot rdescribed rthat, rrather ris ronly
rdescribing rdyspnea ron rexertion rand rorthopnea, rwhich rboth rspeak rto ra rstate rof
rfluid roverload. rThe ronly rappropriate rresponse rof rthese ravailable ris rcongestive rheart
rfailure.
Your rpatient rwith ra rhistory rof rHFrEF r(heart rfailure rwith rreduced rejection rfraction)
rwith ran rejection rfraction rof r40% rwho ris ralso rnot ron roptimal rmedical rtherapy rhas
rbeen rdiagnosed rwith ra rmyocardial rinfarction rthis radmission rand rreceived remergent
,rplacement rof ra rdrug-eluting rstent rto rthe rleft ranterior rdescending rartery. rAs rthe
rmedical rhome rwho rwill rmanage rthis rpatient rafter rdischarge, rwhich rmedication
rstrategy rwould ryou rexpect rto rbe ra rpriority rin rthe rpatient's rcare? r- rcorrect ranswers
r-Ordering ra rtransthoracic rechocardiogram rand rorder ra rLifevest rif rEF ris rless rthan
r35%
Rationale: rThe rpatient rshould rhave ra rprotective rmechanism rsuch ras ran rimplantable
rautomated rcardioverter rdefibrillator r(AICD) ror ra rLifevest rif rthe rEF ris rless rthan r35%
rdue rto rthe rincreased rrisk rof rsudden rcardiac rdeath rwith rlow rEF rstates. rSince rmost
rpatients rare rnot religible rfor r90 rdays rfor ran rAICD rin rthis rstate, roptimizing rtheir
rmedication rregimen rand rrepeating ran recho rin r2-3 rmonths rto rre-evaluate rfor
rimprovement rin rtheir rEF ris rrequired rby rmost rinsurance rcompanies. rA rbaseline
recho ris rneeded rat rdischarge rto rprovide ra rbaseline rfor rimprovement rvs rtheir rrepeat
recho rin r2-3 rmonths.
Dual ranti-platelet rtherapy ris rrequired rfor r12 rmonths rminimum rpost-MI. r
A rHolter rmonitor rdoes rnot rprovide rany rconceivable rbenefit rfor rthis rpatient ras
rpresented.
Which rof rthe rfollowing rpeople rgroups rrepresent rthe rleast rrisk rof rcardiac rdisease? r-
rcorrect ranswers r-Caucasians
Rationale: rStatistically rAfrican rAmericans, rNative rHawaiians, rand rAmerican rIndians
rare rat rat rincreased rrisk rof rcardiac rdisease rdue rto rhigher rrates rof rhypertension,
rdiabetes, rand robesity rthan rCaucasians.
A r65-year-old rwoman rpresents rfor ra rfollow-up rexamination. rShe ris ra rsmoker, rand
rher rhypertension ris rnow radequately rcontrolled rwith rmedication. rHer rmother rdied rat
rage r40 rfrom ra rheart rattack. rThe rfasting rlipid rprofile rshows rcholesterol r= r240
rmg/dL, rHDL r= r30, rand rLDL r= r200. rIn raddition rto rstarting rtherapeutic rlifestyle
rchanges, rthe rnurse rpractitioner rshould rstart rthe rpatient ron: r- rcorrect ranswers r-a
rstatin rdrug.
Rationale: rBile racid rsequestrants rand rcholesterol rabsorption rinhibitors rmay rbe
ruseful rin rreducing rASVD rrisk, rbut rfor ra rpatient rwho ris ran ractive rsmoker rwith
rpremature rcoronary rdisease rhistory r(less rthan rage r65 rfor rwomen), rhas
rhypertension rand ris rfar rfrom ran rLDL rgoal, rthis rpatient ris rmost rcertainly ra
rcandidate rfor rstatin rtherapy, rwhich rrepresents rthe rmost raggressive rtherapy roption
rof rthese rfour rlisted.
Which rof rthe rfollowing rend-organ rsequelae ris rnot rdirectly rcaused rby runcontrolled
rhypertension? r- rcorrect ranswers r-Peripheral rneuropathy
Ratioanle: rAlthough rpatients rwith rhypertension rfrequently rhave rperipheral
rneuropathy, rit ris ronly rdirectly rattributed rto rpatients rwho rare ralso rdiabetic rand ris
rcommonly rfound rin rnon-hypertensive rdiabetic rpatients. rProteinuria, rAV rnicking, rand
rhemorrhagic rstroke rare rall rcaused rby runcontrolled rhypertension.
Preventive rcardiac rcare rshould rfocus rprimarily ron raddressing rall rthe rfollowing
rexcept? r- rcorrect ranswers r-Genetic rpredisposition
, Rationale: rSmoking rcessation, rexercise, rand rmedication rcompliance rall rrepresent
rmodifiable rrisk rfactors rand rshould rbe rthe rfocus rof rpreventive rcare. rNon-modifiable
rrisk rfactors rsuch ras rage, rgender, rgenetic/family rhistory rshould rnot rbe rthe rprimary
rfocus rof rprevention.
A r33-year-old rwoman rpresents rwith rirregular rmenstrual rcycles, rhirsutism, rand
robesity. rLaboratory rtests rreveal relevated rserum rtestosterone rand rLH rratio r> r2:1.
rWhat ris rthe rmost rappropriate rinitial rtreatment? r- rcorrect ranswers r-Oral
rcontraceptives
Rationale: rThese rare rclassic rsymptoms rof rpolycystic rovarian rsyndrome rand rthe
rpatient rshould rbe rtreated rwith roral rcontraceptives rto rhelp rstabilize rtheir restrogen
rand rprogesterone. rAdditionally, rthey rmay rbe rmanaged ron rmetformin rand/or
rspironolactone rfor rtheir rPCOS.
Oral rcontraceptive rpills r(OCPs) rare roften rthe rfirst rpharmacological rtreatment rfor
rpolycystic rovary rsyndrome r(PCOS) rbecause rthey rhelp rmanage rin rseveral rways:
Menstrual rirregularities: rOCPs rcan rhelp rregulate rmenstrual rcycles, rmaking rperiods
rlighter rand rmore rregular. rThis ris rimportant rbecause rirregular rovulation rcan rlead rto
rendometrial rhyperplasia, rwhich ris ra rbuildup rof ruterine rtissue rthat rcan rincrease rthe
rrisk rof ruterine rcancer.
Androgen rexcess: rOCPs rcan rreduce randrogen rproduction rand rincrease rsex
rhormone-binding rglobulin r(SHBG), rwhich rbinds randrogens. rThis rcan rhelp rreduce
rsymptoms rlike racne, rhirsutism r(unwanted rbody rand rfacial rhair), rand randrogenic
ralopecia r(male rpattern rbaldness).
Endometrium rprotection: rOCPs rcan rprotect rthe rendometrium rby rensuring rregular
rovulation
A r50-year-old rwoman rwith rhypertension rand rdiabetes rcomes rin rfor ra rroutine rcheck-
up. rWhat rscreening rtest rshould rbe rregularly rperformed rto rmonitor rfor rearly rsigns rof
rdiabetic rnephropathy? r- rcorrect ranswers r-Urine rdipstick rfor rprotein
Rationale: rThe rmost rsensitive rindicator rof rdiabetic rnephropathy rwould rbe rthe
revidence rof rsmall rproteins rin rthe rurine r(proteinuria) ras rfound ron rurinalysis. rThe
rother roptions rmight rdescribe rmacro-organ rfunction r(such ras rBUN/Creat rfrom ra
rBMP, ra rrenal rbiopsy rwhich ris rnot rindicated rfor rroutine rdiabetic rnephropathy
rtesting, rand ra rAbd rCT, rwhich ris rmore rakin rto revaluation rof rless rsubtle rfindings),
rbut rat rthe rfunctional rlevel rof rthe rnephron, rnamely rthe rglomerulus, revidence rof
rglucose-related rdamage ris reasily ridentified rwith rproteinuria rfrom ra rUA.
Which rof rthe rfollowing ris rat rhighest rrisk rfor rDMII? r- rcorrect ranswers r-An radult
rwoman rwith ra rBMI rof r27 rwho rjust rdelivered ra rbaby rweighing r9 r1/2 rlbs
Rationale: rOf rthese roptions, ran radult rwoman rwith ra rBMI rof r27 rwho rjust rdelivered ra
rbaby rweighing r9 r1/2 rlbs ris rthe rmost rlikely rdue rto rtheir rincreased rBMI rand rthe
rlarge rsize rof rthe rbaby. rgiving rbirth rto ra rlarge rbaby, ralso rknown ras ra rlarge-for-
gestational-age r(LGA) rbaby, rcan rincrease rthe rrisk rof rdeveloping rtype r2 rdiabetes
rlater rin rlife. rWomen rwho rgive rbirth rto ra rLGA rbaby rare r10% rmore rlikely rto rdevelop
rDMII r10-14 ryears rafter rpregnancy rcompared rto rwomen rwho rgive rbirth rto rbabies rof
raverage rgestational rage r(AGA). rThis rincreased rrisk ris reven rafter radjusting rfor
WITH VERIFIED SOLUTIONS
The rpatient ris rexhibiting ra rproductive rcough rand ra rlow-grade rfever. rChest rX-ray ron
rPA rview rshows ra rleft rlower rchest rarea rof rconsolidation radjacent rto rthe rleft rborder
rof rthe rheart rapproximately r2 rrib rspaces rabove rthe rcostophrenic rangle. rThe rlateral
rx-ray rview rshows rthis rlesion rabsent rof rthe rwindow rposterior rto rthe rcardiac
rsilhouette. rWhich ris rthe rmost rlikely rlocation rof rthis rarea rof rfocal rconsolidation?
*Left rupper rlobe rapex
*Right rmiddle rlobe
*Left rupper rlobe rlingula
*Left rlower rlobe r- rcorrect ranswers r-Left rupper rlobe rlingula
Ratonale: rLingular rconsolidation ris rdescribed rin rthis rquestion rprecisely. rIf rthe
rcardiac rmargin/silhouette ris robliterated rby rthe rmass, rthe rlesion ris reither rright
rmiddle rlobe ror rleft rupper rlobe rlingula.
The rinability rto rfully rrelax rthe rmyocardium rduring rrelaxation ris ra rtrademark rof rwhich
rof rthe rfollowing rdiagnoses? r- rcorrect ranswers r-Diastolic rdysfunction
,Rationale: rThe rinability rfor rthe rheart rto rrelax ris ra rtrademark rof rthe rdiagnosis rof
rdiastolic rdysfunction rand ris rcommon rin rpatients rwith rthickened rhypertrophic
rmyocardium.
An rotherwise rhealthy rAfrican rAmerican radult rmale rhas rbeen rdiagnosed rwith
rhypertension. rHe rhas rbeen rrestricting rhis rsalt rintake, reating ra rDASH r(Dietary
rApproaches rto rStop rHypertension) rdiet, rand rexercising rmore, rbut rhis rblood
rpressure ris rstill relevated. rWhich ris rthe rBEST rmedication rto rprescribe rhim? r-
rcorrect ranswers r-Calcium rchannel rblocker
Rationale: rAfrican rAmerican rpatients rper rJNC8 rHypertension rGuidelines rshould rbe
rmanaged rwith ra rdihydropyridine rcalcium rchannel rblocker rsuch ras ramlodipine
r(Norvasc) ras rfirst rline rmanagement rtherapy rfor rhypertension rnot rat rgoal rwith
rDASH rand rlifestyle rmodifications.
Your rpatient rhas rbeen rdiagnosed rwith ra r4.5cm rascending raortic raneurysm. rWhich
rmedical rimaging ris rconsidered rstandard rof rcare rfor rserial rsurveillance? r- rcorrect
ranswers r-CT rangiography rof rthe rchest
Rationale: rCT rangiography ris rconsidered rthe rstandard rof rcare rfor rmeasuring
rvascular rluminal rdimensions rwith rcontrast. rCT rPE rprotocol ris rnot rtimed rproperly rfor
rthe raorta r(it's rtimed rfor rthe rpulmonary rartery). rAlthough ra rplain rfilm ris rable rto
rcatch rlarge raneurysms rat rtimes, rthey rare rnot rable rto rprovide rmulti-axis
rreconstruction rneeded rto raccurately rmeasure rthe rsize. rTransesophageal recho ris
rnot rneeded rto raccurately rmeasure rthe raorta rand rrequires rthe rpatient rto rundergo
rsedation rwhich ris runnecessary.
Which rof rthe rfollowing rmedications rdoes rnot rcause rbeta r1 rstimulation? r- rcorrect
ranswers r-phenylephrine
Rationale: rPhenylephrine ronly rstimulates ralpha r1 rreceptors. rThe rremaining rthree rall
rhave rbeta rreceptor ractivity.
A r50-year-old rwoman rwith ra rhistory rof rhypertension rpresents rwith rdyspnea ron
rexertion rand rorthopnea. rOn rexamination, rshe rhas rjugular rvenous rdistention rand
rbilateral rcrackles ron rlung rauscultation. rWhat ris rthe rmost rlikely rdiagnosis? r- rcorrect
ranswers r-Congestive rheart rfailure
Rationale: rOf rthe ravailable roptions, rthe rmost raccurate rresponse ris rcongestive rheart
rfailure ras rit ris rsignifying rboth ra rright rventricular rback rup rwith rjugular rvenous
rextension rand rcrackles ron rlung rassault, rwhich rare rsuggestive rof rleft rventricular
rback rup. rit ris rpossible rthe rpatient rmay rhave ran racute rmyocardial rinfarction rthat
rprecipitated rthis, rhowever, ra rpatient rhas rnot rdescribed rthat, rrather ris ronly
rdescribing rdyspnea ron rexertion rand rorthopnea, rwhich rboth rspeak rto ra rstate rof
rfluid roverload. rThe ronly rappropriate rresponse rof rthese ravailable ris rcongestive rheart
rfailure.
Your rpatient rwith ra rhistory rof rHFrEF r(heart rfailure rwith rreduced rejection rfraction)
rwith ran rejection rfraction rof r40% rwho ris ralso rnot ron roptimal rmedical rtherapy rhas
rbeen rdiagnosed rwith ra rmyocardial rinfarction rthis radmission rand rreceived remergent
,rplacement rof ra rdrug-eluting rstent rto rthe rleft ranterior rdescending rartery. rAs rthe
rmedical rhome rwho rwill rmanage rthis rpatient rafter rdischarge, rwhich rmedication
rstrategy rwould ryou rexpect rto rbe ra rpriority rin rthe rpatient's rcare? r- rcorrect ranswers
r-Ordering ra rtransthoracic rechocardiogram rand rorder ra rLifevest rif rEF ris rless rthan
r35%
Rationale: rThe rpatient rshould rhave ra rprotective rmechanism rsuch ras ran rimplantable
rautomated rcardioverter rdefibrillator r(AICD) ror ra rLifevest rif rthe rEF ris rless rthan r35%
rdue rto rthe rincreased rrisk rof rsudden rcardiac rdeath rwith rlow rEF rstates. rSince rmost
rpatients rare rnot religible rfor r90 rdays rfor ran rAICD rin rthis rstate, roptimizing rtheir
rmedication rregimen rand rrepeating ran recho rin r2-3 rmonths rto rre-evaluate rfor
rimprovement rin rtheir rEF ris rrequired rby rmost rinsurance rcompanies. rA rbaseline
recho ris rneeded rat rdischarge rto rprovide ra rbaseline rfor rimprovement rvs rtheir rrepeat
recho rin r2-3 rmonths.
Dual ranti-platelet rtherapy ris rrequired rfor r12 rmonths rminimum rpost-MI. r
A rHolter rmonitor rdoes rnot rprovide rany rconceivable rbenefit rfor rthis rpatient ras
rpresented.
Which rof rthe rfollowing rpeople rgroups rrepresent rthe rleast rrisk rof rcardiac rdisease? r-
rcorrect ranswers r-Caucasians
Rationale: rStatistically rAfrican rAmericans, rNative rHawaiians, rand rAmerican rIndians
rare rat rat rincreased rrisk rof rcardiac rdisease rdue rto rhigher rrates rof rhypertension,
rdiabetes, rand robesity rthan rCaucasians.
A r65-year-old rwoman rpresents rfor ra rfollow-up rexamination. rShe ris ra rsmoker, rand
rher rhypertension ris rnow radequately rcontrolled rwith rmedication. rHer rmother rdied rat
rage r40 rfrom ra rheart rattack. rThe rfasting rlipid rprofile rshows rcholesterol r= r240
rmg/dL, rHDL r= r30, rand rLDL r= r200. rIn raddition rto rstarting rtherapeutic rlifestyle
rchanges, rthe rnurse rpractitioner rshould rstart rthe rpatient ron: r- rcorrect ranswers r-a
rstatin rdrug.
Rationale: rBile racid rsequestrants rand rcholesterol rabsorption rinhibitors rmay rbe
ruseful rin rreducing rASVD rrisk, rbut rfor ra rpatient rwho ris ran ractive rsmoker rwith
rpremature rcoronary rdisease rhistory r(less rthan rage r65 rfor rwomen), rhas
rhypertension rand ris rfar rfrom ran rLDL rgoal, rthis rpatient ris rmost rcertainly ra
rcandidate rfor rstatin rtherapy, rwhich rrepresents rthe rmost raggressive rtherapy roption
rof rthese rfour rlisted.
Which rof rthe rfollowing rend-organ rsequelae ris rnot rdirectly rcaused rby runcontrolled
rhypertension? r- rcorrect ranswers r-Peripheral rneuropathy
Ratioanle: rAlthough rpatients rwith rhypertension rfrequently rhave rperipheral
rneuropathy, rit ris ronly rdirectly rattributed rto rpatients rwho rare ralso rdiabetic rand ris
rcommonly rfound rin rnon-hypertensive rdiabetic rpatients. rProteinuria, rAV rnicking, rand
rhemorrhagic rstroke rare rall rcaused rby runcontrolled rhypertension.
Preventive rcardiac rcare rshould rfocus rprimarily ron raddressing rall rthe rfollowing
rexcept? r- rcorrect ranswers r-Genetic rpredisposition
, Rationale: rSmoking rcessation, rexercise, rand rmedication rcompliance rall rrepresent
rmodifiable rrisk rfactors rand rshould rbe rthe rfocus rof rpreventive rcare. rNon-modifiable
rrisk rfactors rsuch ras rage, rgender, rgenetic/family rhistory rshould rnot rbe rthe rprimary
rfocus rof rprevention.
A r33-year-old rwoman rpresents rwith rirregular rmenstrual rcycles, rhirsutism, rand
robesity. rLaboratory rtests rreveal relevated rserum rtestosterone rand rLH rratio r> r2:1.
rWhat ris rthe rmost rappropriate rinitial rtreatment? r- rcorrect ranswers r-Oral
rcontraceptives
Rationale: rThese rare rclassic rsymptoms rof rpolycystic rovarian rsyndrome rand rthe
rpatient rshould rbe rtreated rwith roral rcontraceptives rto rhelp rstabilize rtheir restrogen
rand rprogesterone. rAdditionally, rthey rmay rbe rmanaged ron rmetformin rand/or
rspironolactone rfor rtheir rPCOS.
Oral rcontraceptive rpills r(OCPs) rare roften rthe rfirst rpharmacological rtreatment rfor
rpolycystic rovary rsyndrome r(PCOS) rbecause rthey rhelp rmanage rin rseveral rways:
Menstrual rirregularities: rOCPs rcan rhelp rregulate rmenstrual rcycles, rmaking rperiods
rlighter rand rmore rregular. rThis ris rimportant rbecause rirregular rovulation rcan rlead rto
rendometrial rhyperplasia, rwhich ris ra rbuildup rof ruterine rtissue rthat rcan rincrease rthe
rrisk rof ruterine rcancer.
Androgen rexcess: rOCPs rcan rreduce randrogen rproduction rand rincrease rsex
rhormone-binding rglobulin r(SHBG), rwhich rbinds randrogens. rThis rcan rhelp rreduce
rsymptoms rlike racne, rhirsutism r(unwanted rbody rand rfacial rhair), rand randrogenic
ralopecia r(male rpattern rbaldness).
Endometrium rprotection: rOCPs rcan rprotect rthe rendometrium rby rensuring rregular
rovulation
A r50-year-old rwoman rwith rhypertension rand rdiabetes rcomes rin rfor ra rroutine rcheck-
up. rWhat rscreening rtest rshould rbe rregularly rperformed rto rmonitor rfor rearly rsigns rof
rdiabetic rnephropathy? r- rcorrect ranswers r-Urine rdipstick rfor rprotein
Rationale: rThe rmost rsensitive rindicator rof rdiabetic rnephropathy rwould rbe rthe
revidence rof rsmall rproteins rin rthe rurine r(proteinuria) ras rfound ron rurinalysis. rThe
rother roptions rmight rdescribe rmacro-organ rfunction r(such ras rBUN/Creat rfrom ra
rBMP, ra rrenal rbiopsy rwhich ris rnot rindicated rfor rroutine rdiabetic rnephropathy
rtesting, rand ra rAbd rCT, rwhich ris rmore rakin rto revaluation rof rless rsubtle rfindings),
rbut rat rthe rfunctional rlevel rof rthe rnephron, rnamely rthe rglomerulus, revidence rof
rglucose-related rdamage ris reasily ridentified rwith rproteinuria rfrom ra rUA.
Which rof rthe rfollowing ris rat rhighest rrisk rfor rDMII? r- rcorrect ranswers r-An radult
rwoman rwith ra rBMI rof r27 rwho rjust rdelivered ra rbaby rweighing r9 r1/2 rlbs
Rationale: rOf rthese roptions, ran radult rwoman rwith ra rBMI rof r27 rwho rjust rdelivered ra
rbaby rweighing r9 r1/2 rlbs ris rthe rmost rlikely rdue rto rtheir rincreased rBMI rand rthe
rlarge rsize rof rthe rbaby. rgiving rbirth rto ra rlarge rbaby, ralso rknown ras ra rlarge-for-
gestational-age r(LGA) rbaby, rcan rincrease rthe rrisk rof rdeveloping rtype r2 rdiabetes
rlater rin rlife. rWomen rwho rgive rbirth rto ra rLGA rbaby rare r10% rmore rlikely rto rdevelop
rDMII r10-14 ryears rafter rpregnancy rcompared rto rwomen rwho rgive rbirth rto rbabies rof
raverage rgestational rage r(AGA). rThis rincreased rrisk ris reven rafter radjusting rfor
