Page |1
CEA Prep: Full Practice Exam Questions
and Correct Answers With Rationales/
Latest Update / Already Graded
The patient is exhibiting a productive cough and a low-grade fever.
Chest X-ray on PA view shows a left lower chest area of consolidation
adjacent to the left border of the heart approximately 2 rib spaces
above the costophrenic angle. The lateral x-ray view shows this lesion
absent of the window posterior to the cardiac silhouette. Which is the
most likely location of this area of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
Ans: Left upper lobe lingula
Ratonale: Lingular consolidation is described in this question
precisely. If the cardiac margin/silhouette is obliterated by the
mass, the lesion is either right middle lobe or left upper lobe
lingula.
The inability to fully relax the myocardium during relaxation is a
trademark of which of the following diagnoses?
Ans: Diastolic dysfunction
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, Page |2
Rationale: The inability for the heart to relax is a trademark of
the diagnosis of diastolic dysfunction and is common in patients
with thickened hypertrophic myocardium.
An otherwise healthy African American adult male has been diagnosed
with hypertension. He has been restricting his salt intake, eating a
DASH (Dietary Approaches to Stop Hypertension) diet, and exercising
more, but his blood pressure is still elevated. Which is the BEST
medication to prescribe him?
Ans: Calcium channel blocker
Rationale: African American patients per JNC8 Hypertension
Guidelines should be managed with a dihydropyridine calcium
channel blocker such as amlodipine (Norvasc) as first line
management therapy for hypertension not at goal with DASH
and lifestyle modifications.
Your patient has been diagnosed with a 4.5cm ascending aortic
aneurysm. Which medical imaging is considered standard of care for
serial surveillance?
Ans: CT angiography of the chest
Rationale: CT angiography is considered the standard of care
for measuring vascular luminal dimensions with contrast. CT PE
protocol is not timed properly for the aorta (it's timed for the
pulmonary artery). Although a plain film is able to catch large
All rights reserved © 2025/ 2026 |
, Page |3
aneurysms at times, they are not able to provide multi -axis
reconstruction needed to accurately measure the size.
Transesophageal echo is not needed to accurately measure the
aorta and requires the patient to undergo sedation which is
unnecessary.
Which of the following medications does not cause beta 1 stimulation?
Ans: phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity.
A 50-year-old woman with a history of hypertension presents with
dyspnea on exertion and orthopnea. On examination, she has jugular
venous distention and bilateral crackles on lung auscultation. What is
the most likely diagnosis?
Ans: Congestive heart failure
Rationale: Of the available options, the most accurate response
is congestive heart failure as it is signifying both a right
ventricular back up with jugular venous extension and crackles
on lung assault, which are suggestive of left ventricular bac k up.
it is possible the patient may have an acute myocardial
infarction that precipitated this, however, a patient has not
described that, rather is only describing dyspnea on exertion
and orthopnea, which both speak to a state of fluid overload.
All rights reserved © 2025/ 2026 |
, Page |4
The only appropriate response of these available is congestive
heart failure.
Your patient with a history of HFrEF (heart failure with reduced
ejection fraction) with an ejection fraction of 40% who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a drug-
eluting stent to the left anterior descending artery. As the medical
home who will manage this patient after discharge, which medication
strategy would you expect to be a priority in the patient's care?
Ans: Ordering a transthoracic echocardiogram and order a
Lifevest if EF is less than 35%
Rationale: The patient should have a protective mechanism
such as an implantable automated cardioverter defibrillator
(AICD) or a Lifevest if the EF is less than 35% due to the
increased risk of sudden cardiac death with low EF states. Since
most patients are not eligible for 90 days for an AICD in this
state, optimizing their medication regimen and repeating an
echo in 2-3 months to re-evaluate for improvement in their EF is
required by most insurance companies. A baseline echo is
needed at discharge to provide a baseline for improvement vs
their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months minimum
post-MI.
A Holter monitor does not provide any conceivable benefit for
this patient as presented.
All rights reserved © 2025/ 2026 |
CEA Prep: Full Practice Exam Questions
and Correct Answers With Rationales/
Latest Update / Already Graded
The patient is exhibiting a productive cough and a low-grade fever.
Chest X-ray on PA view shows a left lower chest area of consolidation
adjacent to the left border of the heart approximately 2 rib spaces
above the costophrenic angle. The lateral x-ray view shows this lesion
absent of the window posterior to the cardiac silhouette. Which is the
most likely location of this area of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
Ans: Left upper lobe lingula
Ratonale: Lingular consolidation is described in this question
precisely. If the cardiac margin/silhouette is obliterated by the
mass, the lesion is either right middle lobe or left upper lobe
lingula.
The inability to fully relax the myocardium during relaxation is a
trademark of which of the following diagnoses?
Ans: Diastolic dysfunction
All rights reserved © 2025/ 2026 |
, Page |2
Rationale: The inability for the heart to relax is a trademark of
the diagnosis of diastolic dysfunction and is common in patients
with thickened hypertrophic myocardium.
An otherwise healthy African American adult male has been diagnosed
with hypertension. He has been restricting his salt intake, eating a
DASH (Dietary Approaches to Stop Hypertension) diet, and exercising
more, but his blood pressure is still elevated. Which is the BEST
medication to prescribe him?
Ans: Calcium channel blocker
Rationale: African American patients per JNC8 Hypertension
Guidelines should be managed with a dihydropyridine calcium
channel blocker such as amlodipine (Norvasc) as first line
management therapy for hypertension not at goal with DASH
and lifestyle modifications.
Your patient has been diagnosed with a 4.5cm ascending aortic
aneurysm. Which medical imaging is considered standard of care for
serial surveillance?
Ans: CT angiography of the chest
Rationale: CT angiography is considered the standard of care
for measuring vascular luminal dimensions with contrast. CT PE
protocol is not timed properly for the aorta (it's timed for the
pulmonary artery). Although a plain film is able to catch large
All rights reserved © 2025/ 2026 |
, Page |3
aneurysms at times, they are not able to provide multi -axis
reconstruction needed to accurately measure the size.
Transesophageal echo is not needed to accurately measure the
aorta and requires the patient to undergo sedation which is
unnecessary.
Which of the following medications does not cause beta 1 stimulation?
Ans: phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity.
A 50-year-old woman with a history of hypertension presents with
dyspnea on exertion and orthopnea. On examination, she has jugular
venous distention and bilateral crackles on lung auscultation. What is
the most likely diagnosis?
Ans: Congestive heart failure
Rationale: Of the available options, the most accurate response
is congestive heart failure as it is signifying both a right
ventricular back up with jugular venous extension and crackles
on lung assault, which are suggestive of left ventricular bac k up.
it is possible the patient may have an acute myocardial
infarction that precipitated this, however, a patient has not
described that, rather is only describing dyspnea on exertion
and orthopnea, which both speak to a state of fluid overload.
All rights reserved © 2025/ 2026 |
, Page |4
The only appropriate response of these available is congestive
heart failure.
Your patient with a history of HFrEF (heart failure with reduced
ejection fraction) with an ejection fraction of 40% who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a drug-
eluting stent to the left anterior descending artery. As the medical
home who will manage this patient after discharge, which medication
strategy would you expect to be a priority in the patient's care?
Ans: Ordering a transthoracic echocardiogram and order a
Lifevest if EF is less than 35%
Rationale: The patient should have a protective mechanism
such as an implantable automated cardioverter defibrillator
(AICD) or a Lifevest if the EF is less than 35% due to the
increased risk of sudden cardiac death with low EF states. Since
most patients are not eligible for 90 days for an AICD in this
state, optimizing their medication regimen and repeating an
echo in 2-3 months to re-evaluate for improvement in their EF is
required by most insurance companies. A baseline echo is
needed at discharge to provide a baseline for improvement vs
their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months minimum
post-MI.
A Holter monitor does not provide any conceivable benefit for
this patient as presented.
All rights reserved © 2025/ 2026 |
