assistant exam, EOC questions and answers, PAEA 450
questions, PA exam prep, graded A+
how should you educate a patient with AAA on exercise? - SELECTED ANSWER
👀 Patients should be counseled that moderate physical activity such as running,
biking, swimming, hiking, or sexual activity and activities such as gardening,
golfing, and horseback riding do not precipitate AAA rupture
Moderate physical therapy may also limit aneurysm expansion. In experimental
aneurysms, increased aortic blood flow appears to inhibit AAA expansion
However, heavy lifting, especially while holding the breath, and other activities
that lead to Valsalva transiently induce significant increases in blood pressure and
should be avoided
gold standard for dx renal artery stenosis? what can be used to monitor disease
progression? - SELECTED ANSWER 👀 renal arteriography
But really a spiral CT angiography is very useful and probably more likely done
first
duplex doppler US can be used to monitor disease progression
what are some symptoms of mitral valve prolapse syndrome? - SELECTED
ANSWER 👀 various nonspecific symptoms such as palpitations, dyspnea,
exercise intolerance, anxiety disorders, and dizziness
,since symptoms are relatively uncommon, what physical exam findings are
associated with mitral valve prolapse? - SELECTED ANSWER 👀 non-ejection
click in systole
click is mobile, meaning its timing varies with maneuvers that change the left
ventricular volume, occurring earlier in systole with sitting, standing, or other
interventions that reduce ventricular size, or later with those interventions that
increase chamber size such as squatting
People with MVP tend to have lower BMIs
how would you distinguish vasospastic angina and angina associated with CAD? -
SELECTED ANSWER 👀 quality of the CP is typically indistinguishable of the two
patients with vasospastic angina report that their episodes are predominantly at
rest and that many occur from midnight to early morning, while effort tolerance is
usually preserved. CP generally lasts 5 to 15 minutes
Patients with vasospastic angina are often younger and exhibit fewer classic
cardiovascular risk factors and may be associated with other vasospastic
disorders, such as Raynaud's phenomenon and migraine headache
Exercise does not usually provoke an episode of spasm
ECG may reveal transient ST-segment elevation or depression in multiple lead but
troponins will not be elevated
,where do karposi sarcoma lesions typically occur? describe their appearance. -
SELECTED ANSWER 👀 often on distal extremities, such as lower legs and feet
purplish, reddish blue, or dark brown/black macules, plaques, and nodules on the
skin. Nodular lesions may ulcerate and bleed easily
common in poorly controlled HIV
how would you treat hidradenitis suppurativa? - SELECTED ANSWER 👀 topical
clindamycin
if fail topical therapy, oral tetracyclines are suggested
Antiandrogenic drugs and metformin are additional treatment options that may
be used alone or in conjunction with antibiotic therapy
Pt with hypertriglyceridemia >885 mg/dL that required medical therapy due to no
improvement after lifestyle changes and statin. how would you treat? - SELECTED
ANSWER 👀 fenofibrate
fenofibrate is better than gemfibrozil bc can be used with a statin. Gemfibrozil has
a higher risk of muscle toxicity
how would you initially treat a pt with hypertriglyceridemia? - SELECTED
ANSWER 👀 lifestyle changes (reduce EtOH consumption, aerobic exercise,
better glycemic control) and statin
, what causes subacute thyroiditis? - SELECTED ANSWER 👀 presumed to be
caused by a viral infection or a postviral inflammatory process. Many patients
have a history of an upper respiratory infection prior to the onset of thyroiditis
seasonal incidence (higher in summer)
Large-needle thyroid biopsies reveal widespread infiltration with neutrophils,
lymphocytes, histiocytes and giant cells, disruption and collapse of thyroid
follicles, and necrosis of thyroid follicular cells
how is the diagnosis of subacute thyroiditis made? - SELECTED ANSWER 👀
clinical dx
neck pain, thyroid tenderness
suppressed TSH
T3/T4 mildly elevated
if clinical dx is not certain, US can be used to distinguish subacute from Graves.
Graves has increased flow and subacute has decreased flow. FNA rarely
needed/used
what is the first step in evaluation of a suspected thyroid nodule? - SELECTED
ANSWER 👀 US
Apparent nodularity in Hashimoto's thyroiditis may represent focal enlargement
from lymphocytic infiltrates, TSH-induced hyperplasia of follicular tissue, or a