PAEA INTERNAL MEDICINE EOR TEST PAPER 2025/2026
QUESTIONS WITH ANSWERS MARKED A+
✔✔Treatment of superficial thrombophlebitis - ✔✔rest, heat, elevation, NSAIDs
✔✔How do you diagnose a pulmonary embolism? - ✔✔US, D-dimer, CTA (test of
choice to rule out PE), V/Q scan if can't do CT (ie. contrast allergy)
✔✔Transudative Pleural Effusion - ✔✔caused by fluid leaking into pleural space, CHF
common cause
✔✔Exudative Pleural Effusion - ✔✔caused by blocked blood vessels or lymph vessels,
inflammation, lung injury, tumors
✔✔Signs and Symptoms of a pleural effusion - ✔✔cough, fever, hiccups, tachypnea,
short of breath, chest pain
✔✔Light's Criteria - ✔✔to determine if pleural effusion is exudative or transudative
✔✔Treatment of pleural effusion - ✔✔-thoracentesis, chest tube, treat cause, if infection
tx with abx
✔✔Rheumatic fever - ✔✔systemic immune response occurring 2-3 weeks following
strep pharyngitis. Most commonly affects heart, joints, skin, CNS. Most common in
recent immigrants but new US outbreaks have occurred. Kids 5-15 years old are most
often affected. May lead to heart disease affecting Mitral valve.
✔✔JONES criteria for rheumatic fever - ✔✔Need 2 major or 1 major PLUS 2 minor
Minor: fever, polyarthralgias, reversible prolonged PR interval, elevated ESR/CRP
✔✔Rheumatic fever treatment - ✔✔rest, IM PCN (if documented strep infection),
salicylates for fever, steroids for joint pain
✔✔Mitral Stenosis - ✔✔-can result from rheumatic fever
-diastolic heart murmur
-opening high pitched snap heard after S2
-best heard LLD with bell of stethoscope
✔✔Aortic Regurgiation - ✔✔-diastolic heart murmur
✔✔Patent ductus arteriosus - ✔✔-heard throughout diastole and systole
✔✔ Q waves on EKG indicate what? - ✔✔old infarct
, ✔✔What is the 1st cardiac enzyme to rise? - ✔✔Troponin, elevated 3 hrs post MI and
stay elevated up to 10-14 days post MI
-Negative Troponin between 6-72 hrs post CP onset indicates strong evidence against
MI
✔✔CK-MB - ✔✔The MB type is specific to myocardial cells. The CK level will increase
approximately 3-4 hours after an MI, peaks at 24 hrs, and stays elevated for 3-4 days.
✔✔MI treatment - ✔✔MONA (morphine, O2, nitrates, ASA), BB, ACEI, thrombolytics
✔✔Beck's triad - ✔✔JVD, hypotension, muffled heart tones
(tamponade)
✔✔S/S of systolic HF - ✔✔orthopnea, nocturnal dyspnea, JVD, edema
✔✔What is diastolic heart failure and what are signs and symptoms of it? - ✔✔ventricle
can't relax which leads to higher filling pressure, pulmonary congestion and decreased
cardiac return
✔✔Treatment for heart failure - ✔✔diuretics
ARNI or ACEI
BB
Spironolactone
SGLT2i
✔✔Dilated Cardiomyopathy - ✔✔most common type of cardiomyopathy; reduced
ventricular contraction results in dilation of LV
✔✔Diagnosis of dilated cardiomyopathy - ✔✔ECHO: LV dilation
EKG: nonspecific ST and T wave changes
CXR: cardiomegaly, pulmonary congestion
✔✔Hypertrophic Cardiomyopathy - ✔✔small LV, massive hypertrophy especially the
septum, diastolic dysfunction
-transmitted genetically
✔✔Tx for hypertrophic cardiomyopathy - ✔✔BB/CCB, surgical ablation, dual chamber
pacing
QUESTIONS WITH ANSWERS MARKED A+
✔✔Treatment of superficial thrombophlebitis - ✔✔rest, heat, elevation, NSAIDs
✔✔How do you diagnose a pulmonary embolism? - ✔✔US, D-dimer, CTA (test of
choice to rule out PE), V/Q scan if can't do CT (ie. contrast allergy)
✔✔Transudative Pleural Effusion - ✔✔caused by fluid leaking into pleural space, CHF
common cause
✔✔Exudative Pleural Effusion - ✔✔caused by blocked blood vessels or lymph vessels,
inflammation, lung injury, tumors
✔✔Signs and Symptoms of a pleural effusion - ✔✔cough, fever, hiccups, tachypnea,
short of breath, chest pain
✔✔Light's Criteria - ✔✔to determine if pleural effusion is exudative or transudative
✔✔Treatment of pleural effusion - ✔✔-thoracentesis, chest tube, treat cause, if infection
tx with abx
✔✔Rheumatic fever - ✔✔systemic immune response occurring 2-3 weeks following
strep pharyngitis. Most commonly affects heart, joints, skin, CNS. Most common in
recent immigrants but new US outbreaks have occurred. Kids 5-15 years old are most
often affected. May lead to heart disease affecting Mitral valve.
✔✔JONES criteria for rheumatic fever - ✔✔Need 2 major or 1 major PLUS 2 minor
Minor: fever, polyarthralgias, reversible prolonged PR interval, elevated ESR/CRP
✔✔Rheumatic fever treatment - ✔✔rest, IM PCN (if documented strep infection),
salicylates for fever, steroids for joint pain
✔✔Mitral Stenosis - ✔✔-can result from rheumatic fever
-diastolic heart murmur
-opening high pitched snap heard after S2
-best heard LLD with bell of stethoscope
✔✔Aortic Regurgiation - ✔✔-diastolic heart murmur
✔✔Patent ductus arteriosus - ✔✔-heard throughout diastole and systole
✔✔ Q waves on EKG indicate what? - ✔✔old infarct
, ✔✔What is the 1st cardiac enzyme to rise? - ✔✔Troponin, elevated 3 hrs post MI and
stay elevated up to 10-14 days post MI
-Negative Troponin between 6-72 hrs post CP onset indicates strong evidence against
MI
✔✔CK-MB - ✔✔The MB type is specific to myocardial cells. The CK level will increase
approximately 3-4 hours after an MI, peaks at 24 hrs, and stays elevated for 3-4 days.
✔✔MI treatment - ✔✔MONA (morphine, O2, nitrates, ASA), BB, ACEI, thrombolytics
✔✔Beck's triad - ✔✔JVD, hypotension, muffled heart tones
(tamponade)
✔✔S/S of systolic HF - ✔✔orthopnea, nocturnal dyspnea, JVD, edema
✔✔What is diastolic heart failure and what are signs and symptoms of it? - ✔✔ventricle
can't relax which leads to higher filling pressure, pulmonary congestion and decreased
cardiac return
✔✔Treatment for heart failure - ✔✔diuretics
ARNI or ACEI
BB
Spironolactone
SGLT2i
✔✔Dilated Cardiomyopathy - ✔✔most common type of cardiomyopathy; reduced
ventricular contraction results in dilation of LV
✔✔Diagnosis of dilated cardiomyopathy - ✔✔ECHO: LV dilation
EKG: nonspecific ST and T wave changes
CXR: cardiomegaly, pulmonary congestion
✔✔Hypertrophic Cardiomyopathy - ✔✔small LV, massive hypertrophy especially the
septum, diastolic dysfunction
-transmitted genetically
✔✔Tx for hypertrophic cardiomyopathy - ✔✔BB/CCB, surgical ablation, dual chamber
pacing
