AQUIFER IM EXAM 180 QUESTIONS & CORRECT
ANSWERS LATEST 2025
In a patient presenting with possible ACS, what are the next steps in
management? (3) - ANSWER-EKG, aspirin, troponins
Most likely diagnoses for chest pain? (5) - ANSWER-GERD, muscular strain,
NSTEMI, PE, unstable angina
What management for a patient with ongoing chest pain due to unstable angina?
(6) - ANSWER-Angiography with PCI; aspirin; beta blocker; heparin; statin;
sublingual nitroglycerin --> *NO ACE*
Appropriate admission orders for unstable angina? (4) - ANSWER-*Bed rest*, PO
metoprolol, telemetry monitoring, *LMWH*
What are the absolute contraindications for thrombolytics? (3) - ANSWER-active
internal bleeding, *prior hemorrhagic stroke, recent head trauma*
Patient with STEMI should go home on what drugs? (6) - ANSWER-ACE inhibitor,
aspirin, beta blocker, clopidogrel, statin, sublingual nitro PRN
What are the top differential diagnoses for intermittent exertional chest pain and
SOB? (2) - ANSWER-angina, GERD
,What are risk factors for coronary artery disease? (8) - ANSWER-*age > 55 in
females*, DM, dyslipidemia, family history of sudden death or premature CAD,
HTN, male sex, obesity, smoking
How to evaluate suspected angina? (4) - ANSWER-BMP, CBC, fasting lipid panel,
TSH
What is first-line imaging for suspected angina? - ANSWER-CXR
What is the next step after an abnormal treadmill stress test? - ANSWER-coronary
angiogram
What are the drug classes for angina? (3) - ANSWER-beta blockers, *calcium
channel blockers, nitrates*
Most likely diagnoses for syncope? (4) - ANSWER-*Valvular cardiac disease*;
arrhythmia; *neurocardiogenic syncope; ACS*
Recommended evaluation of syncope? (4) - ANSWER-EKG, CXR, cardiac enzymes,
TSH
What meds control the ventricular rate in afib? (3) - ANSWER-Beta blocker,
calcium channel blocker, digoxin
What anticoagulation is most appropriate for afib? - ANSWER-Warfarin po daily
(or heparin)
, What is on the differential of dyspnea with lower extremity edema? (6) -
ANSWER-CHF, PE, angina, interstitial lung disease, pulmonary HTN, CKD
What are causes of 2/6 mid systolic murmur at aortic area? (4) - ANSWER-anemia,
aortic sclerosis, aortic stenosis, fever
What are recommendations for HFrEF? (6) - ANSWER-adhere to medicines, check
weight daily, exercise training, immunizations, risk factor control, salt and fluid
restriction
What are meds for systolic heart failure shown to decrease mortality?(6) -
ANSWER-ACE inhibitors, aldosterone blockers, ARBs, beta blockers, hydralazine
and nitrates, sacubitril & valsartan
What are the two most likely causes of heart failure? - ANSWER-CAD and HTN
What to look for on HTN PE? (6) - ANSWER-displaced PMI, discrepant BP b/w
arms & legs, pulsatile abdominal mass, renal artery bruit, retinopathy,
thyromegaly
What tests to get on initial evaluation of HTN? In addition to EKG, electrolytes (4)
- ANSWER-diabetes screening, fasting lipid panel, hematocrit, TSH, urinalysis
When to follow up on BP that is 125/76? - ANSWER-six months
What are potential side effects of lisinopril? (6) - ANSWER-angioedema, cough,
fatigue, hyperkalemia, hypotension, worsening renal insufficiency
ANSWERS LATEST 2025
In a patient presenting with possible ACS, what are the next steps in
management? (3) - ANSWER-EKG, aspirin, troponins
Most likely diagnoses for chest pain? (5) - ANSWER-GERD, muscular strain,
NSTEMI, PE, unstable angina
What management for a patient with ongoing chest pain due to unstable angina?
(6) - ANSWER-Angiography with PCI; aspirin; beta blocker; heparin; statin;
sublingual nitroglycerin --> *NO ACE*
Appropriate admission orders for unstable angina? (4) - ANSWER-*Bed rest*, PO
metoprolol, telemetry monitoring, *LMWH*
What are the absolute contraindications for thrombolytics? (3) - ANSWER-active
internal bleeding, *prior hemorrhagic stroke, recent head trauma*
Patient with STEMI should go home on what drugs? (6) - ANSWER-ACE inhibitor,
aspirin, beta blocker, clopidogrel, statin, sublingual nitro PRN
What are the top differential diagnoses for intermittent exertional chest pain and
SOB? (2) - ANSWER-angina, GERD
,What are risk factors for coronary artery disease? (8) - ANSWER-*age > 55 in
females*, DM, dyslipidemia, family history of sudden death or premature CAD,
HTN, male sex, obesity, smoking
How to evaluate suspected angina? (4) - ANSWER-BMP, CBC, fasting lipid panel,
TSH
What is first-line imaging for suspected angina? - ANSWER-CXR
What is the next step after an abnormal treadmill stress test? - ANSWER-coronary
angiogram
What are the drug classes for angina? (3) - ANSWER-beta blockers, *calcium
channel blockers, nitrates*
Most likely diagnoses for syncope? (4) - ANSWER-*Valvular cardiac disease*;
arrhythmia; *neurocardiogenic syncope; ACS*
Recommended evaluation of syncope? (4) - ANSWER-EKG, CXR, cardiac enzymes,
TSH
What meds control the ventricular rate in afib? (3) - ANSWER-Beta blocker,
calcium channel blocker, digoxin
What anticoagulation is most appropriate for afib? - ANSWER-Warfarin po daily
(or heparin)
, What is on the differential of dyspnea with lower extremity edema? (6) -
ANSWER-CHF, PE, angina, interstitial lung disease, pulmonary HTN, CKD
What are causes of 2/6 mid systolic murmur at aortic area? (4) - ANSWER-anemia,
aortic sclerosis, aortic stenosis, fever
What are recommendations for HFrEF? (6) - ANSWER-adhere to medicines, check
weight daily, exercise training, immunizations, risk factor control, salt and fluid
restriction
What are meds for systolic heart failure shown to decrease mortality?(6) -
ANSWER-ACE inhibitors, aldosterone blockers, ARBs, beta blockers, hydralazine
and nitrates, sacubitril & valsartan
What are the two most likely causes of heart failure? - ANSWER-CAD and HTN
What to look for on HTN PE? (6) - ANSWER-displaced PMI, discrepant BP b/w
arms & legs, pulsatile abdominal mass, renal artery bruit, retinopathy,
thyromegaly
What tests to get on initial evaluation of HTN? In addition to EKG, electrolytes (4)
- ANSWER-diabetes screening, fasting lipid panel, hematocrit, TSH, urinalysis
When to follow up on BP that is 125/76? - ANSWER-six months
What are potential side effects of lisinopril? (6) - ANSWER-angioedema, cough,
fatigue, hyperkalemia, hypotension, worsening renal insufficiency
