1-a 48 years old woman comes to the office with chest pain that has been occurin

g over the last several weeks.

this pain is not reliably related to exertion.she is comfortable now.the locatio
n of pain is retrosternal.
the pain is sometimes associated with nausea.there is no shortness of breath and
the pain does not radiate beyond chest.
she has no past medical history.
what is the most likely diagnosis?
ANSWER IS GERD(Most common cause of retrosternal chest pain)
2-Drugs proved to reduce mortality in chronic congestive heart failure include a
ll of the following EXCEPT
(A) Captopril (B) Carvedilol (C) Digoxin (D) Enalapril (E) Spironolactone
ANSWER IS C.....Cardiac Glycosides can only improve symptoms
3-Which of the following is most dangerous to a patient in terms of risk of coro
nary artery disease?
A:elevated TG
B:elevated total cholesterol
C:decreased HDL
D:increased LDL
E:obesity
ANSWER IS D....most dangerous is LDH high hdl is related to por prognosis long t
erm ..
TG also dangerous but not poor
prognosis obesity lead to increase cardiac output due to increase abdomial grit
h
4-All of the following statements are true EXCEPT:
a- Aneurysms larger than 5 cm should be treated surgically
b- Fusiform aneurysms smaller than 4 cm can be managed conservatively
c-Tenderness of an aneurysm may be an indication for surgery
d- Most patients complain of back pain
e-The most common presentation of an aneurysm is as an incidental finding
ANSWER IS C
5-35 year old present with chest pain with dyspnea and cough ,,pain worse in sup
ine position and relief
with lean position
... apex beat not palpable and there is rapid y decent..DX
ANSWER IS CONSTRICTIVE PERICARDITIS(Y descent is indicative of constrictive type
)
6-A 72 y old male wid hypertension presents for routine chkup,,,,,he is a chroni
c smoker
,,,,,wat screening if any is indicated???????
Abdominal USG for Abdominal aortic aneurysm
All male above 65 who are chronic smokers are at high risk of developing AAA
7-A 56 year old male has a history of aortic stenosis. Which of the following is
associated with aortic stenosis?
a) Atrial fibrillation
b) Systolic ejection murmur
c) Increased pulse pressure
d) Diastolic murmur
e) Right heart failure
ANSWER IS B
8-38 years old male patient came to the ER with headache vomiting and confusion.
B.P 210/120. The condition is called ???????hw to manage it?
ANSWER IS HYPERTENSIVE URGENCY
GRADUALLY LOWER THE BP OVER SEVERAL HOURS
9-A 29 y old ovrwt pt has come for medical checkup,,dare r no commplaints,,exami
nation is unremarkable
,,except bp of 180/110 on three occasions,,,,,diagnosis nd managment?
ANSWER IS SECONDARY HYPERTENSION
10-A 35 y old female had bn taking pills to avoid mensturation,,she had a right
swollen calf nd hd bn complaining of dyspnea nd chest pain,,she suddenly collaps
ed,at hospital she was pale nd calmy wid tachycardia,bp of 70/40,,o/e her jvp wa
s raised
she had a loud p2 at left sternal border,,,nd clear lung fields,,,,,,,DIAGNOSIS
PULMONARY EMBOLISM SECONDARY TO DVT
11-A 60 y old male wid poor compliance to his antihypertensive treatment for las
t 15 yr hv bn complaiing of dyspnea nd exertion,which has worsend over da last t
hree months,there is no chest pain.o/e bp is 210/110,
chest has b/l basal crepts,dere is b/l piting edema,,,,,DIAGNOSIS????????
CHF(Features of both RHF and LHF)
12-Correcting which of the following risk factors for CAD will result in most im
mediate benefit for the patient?
A:DM
B:tobacco smoking
C:hypertension
D:hyperlipedemia
E:weight loss
CORRECT ANSWER IS B
13-A 48 years old females comes to the office with the chest pain that has been
occuring for the paste several weeks.the pain is not reliably related to exertio
n.she is comfortable now.the location of pain is retrosternal.she has no past me
dical history and ecg is normal.what is most appropriate next step in management
?
A: CK-MB
B:troponin
C:echo
D:exercie tolerance test
E:holter monitor
CORRECT ANSWER IS D