AND CORRECT ANSWERS (VERIFIED QUESTIONS AND ANSWERS) | GUARANTEED
PASS A+ [2026]
1. A 67-year-old man presents with acute, sharp left-sided chest pain worsened by deep
inspiration. ECG shows diffuse ST elevations and PR depressions. What is the most likely
diagnosis?
Answer: Acute pericarditis
Rationale: Diffuse ST elevation with PR depression is classic for pericarditis, unlike MI, which
shows regional changes.
2. A patient with COPD has a PaCO₂ of 58 mmHg and bicarbonate of 34 mEq/L. What does this
pattern most likely represent?
Answer: Chronic respiratory acidosis with metabolic compensation
Rationale: Elevated PaCO₂ + compensatory ↑HCO₃⁻ suggests chronic CO₂ retention.
3. Which medication improves mortality in HFrEF (EF 30%)?
Answer: ACE inhibitors
Rationale: ACE-Is, ARBs, ARNI, β-blockers, aldosterone antagonists reduce mortality;
diuretics only improve symptoms.
4. First-line treatment for newly diagnosed Graves’ disease in pregnancy?
Answer: Propylthiouracil (PTU) in the first trimester
Rationale: PTU preferred early due to lower teratogenic risk vs methimazole.
,5. A patient with ascites and a SAAG of 1.8 g/dL likely has…
Answer: Portal hypertension
Rationale: SAAG ≥1.1 indicates portal hypertensive etiologies (cirrhosis, HF).
6. Best initial test for suspected pulmonary embolism in a hemodynamically stable patient?
Answer: CT pulmonary angiography
Rationale: CTPA is first-line unless contraindicated.
7. A diabetic patient with burning foot pain worse at night likely has…
Answer: Peripheral neuropathy
Rationale: Classic “stocking-glove” neuropathic symptoms.
8. Treatment for hypertensive emergency with acute aortic dissection?
Answer: IV β-blocker (esmolol)
Rationale: Reduces shear stress and heart rate before vasodilation.
9. Rheumatoid arthritis is most associated with which joint findings?
Answer: MCP and PIP involvement
Rationale: DIP involvement suggests osteoarthritis, not RA.
10. Kidney injury with granular casts (“muddy brown”) indicates…
Answer: Acute tubular necrosis
Rationale: Pathognomonic finding.
DOMAIN: SURGERY
, 11. A patient with sudden severe abdominal pain, rigid abdomen, and free air under the
diaphragm likely has…
Answer: Perforated viscus (e.g., peptic ulcer perforation)
Rationale: Free air suggests pneumoperitoneum.
12. Best treatment for acute cholecystitis?
Answer: Early laparoscopic cholecystectomy
Rationale: Standard of care unless unstable.
13. A postoperative patient with fever POD #1 most likely has…
Answer: Atelectasis
Rationale: Classic cause of early postoperative fever.
14. Most appropriate imaging for suspected appendicitis in adults?
Answer: CT abdomen/pelvis with contrast
Rationale: Most accurate in adults.
15. Suspected small bowel obstruction shows which radiographic findings?
Answer: Dilated loops with air-fluid levels
Rationale: Classic SBO pattern.
DOMAIN: PEDIATRICS
16. A 4-year-old with barking cough and inspiratory stridor likely has…
Answer: Croup
Rationale: Parainfluenza virus; steeple sign on X-ray.