- Judy a 25 yo, comes in and complains of fever, night sweats, arthralgia and weight loss. You noticed upon examination that she has decreased peripheral pulses. You also notice that she has some arm claudication. You send her for an angiogram and it shows a string of beads. She has what?a. Subclavian stealb. Giant cell arteritisc. Takayasud. Buerger disease
- Lenny is a 65 year old white male, and this is his third time with a high blood pressure reading in your office of 140/90. You decide to initiate some medications for his HTN, what would be your first choice of medication?a. Lisinoprilb. Spironolactonec. Amlodipine d. Metoprolol
- A 62 year old female presents complaining of increasing fatigue for the past 6 months. She states she often feels weak and short of breath. On PE the patient is afebrile. You note moderate jugular venous distension. Crackles are present in the lower third of the lungs bilaterally. Cardiac auscultation reveals a regular S1 and S2 with an S3. There is moderate pitting edema of both lower extremities. What diagnosis does this presentation suggest?a. Atypical pneumoniab. Congestive Heart Failurec. Idiopathic pulmonary fibrosisd. Influenzae. Pulmonary Embolism
- Ana, a 30-year-old, has a history of asthma and is now diagnosed with hypertension. Which of the following hypertensive medications should be avoided?a. Metolazone b. Diltiazemc. Amlodipine d. Propranolol
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- A 63 year old male with a history of smoking, hypertension, and hyperlipidemia presents with pain and cramping in his right leg that worsens with exercise. He complains that the pain extends to his buttock and also admits to erectile dysfunction that he blames on this "stupid sciatica." On physical exam you palpate weakened popliteal and dorsalis pedis pulses and smooth shiny skin as compared to his left leg. Which of the following is a likely diagnosis?a. femoral-popliteal PADb. acute limb ischemiac. aorto-Iliac PADd. Buerger Disease
- Danny has a fever of 103 degrees that is not responding to tylenol, their pressure is 97/50, 130 HR, low urine output, and serum lactate is elevated. He has had no recent travel, but did have an abcess drained recently, but did not pick up his antibiotics because he couldn't pay for them. What kind of shock is the patient in?a. Distributive b. Cardiogenicc. Obstructived. Shockingly dead
- A 40 year old woman comes into your office for a follow up after being told she was in remission for her Stage II breast cancer. She has been undergoing years of chemotherapy and radiation. On PE, you notice pitting edema of her R. leg, the same side as her breast cancer. Her PE & ROS is unremarkable other than the unilateral pitting edema. What is the most likely diagnosis?a. DVTb. Lymphedema c. CHFd. MI
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- A 63 yo AA male presents with pain in his chest, fatigue, dyspnea and reports that he passed out yesterday. Upon physical exam you note lower extremity edema b/l. You observe low voltage on his EKG with no other findings. His echocardiogram shows dilated atria, thickened ventricular walls without chamber dilation and an ejection fraction of 60%. Genetic testing reveals a mutated transthyretin gene. What is the most likely cause of your patient's symptoms?a. Dilated cardiomyopathy b. DVTc. Restrictive cardiomyopathyd. Hypertrophic cardiomyopathy
- A 55 y/o Scandinavian female presents to your clinic today complaining of claudication of the jaw, radiating to her temples and scalp for the past week. She has a PMH of polymyalgia rheumatica. After running some tests you determine she has a high erythrocyte sedimentation rate as well as elevated alkaline phosphatase. How would you treat this patient?a. Prednisone + Tocilizumabb. Metoprolol (BB)c. Atorvastatin (statin)d. Entresto (sacubitril/ valsartan)
- 60 yrs old woman comes to your clinic because of progressive fatigue and SOB for 2 months, the dyspnea happens with exterion. Her vitals are within normal range but during auscultation, you heard a systolic murmur at the midclavicular 5th LT intercostal space at the area of the apex. Which is the most likely diagnosis?a. Mitral valve regurgitation b. Pericarditisc. Aortic valve regurgitation d. Pulmonary valve stenosis
- A 21 y/o anorexic male comes to the ED complaining of throbbing pain in his right leg. He reports cutting his leg while trying to jump a fence to get away from the cops at a house party a few days ago. Where the wound is there is a small abscess and the leg is showing signs of cellulitis that is tender and you notice his inguinal lymph nodes are enlarged. He is sweating, has a rapid pulse, and has a temperature of 102°F. His girlfriend drove him to the ED and pointed out that there is a "weird red line" running down his leg. What is your suspected diagnosis?a. Lymphedemab. DVTc. Superficial Thrombophlebitis d. Lymphangitis & lymphadenitis
- A 65 y/o female that is a regular to your clinic presents with swelling in her legs. You have previously diagnosed her with lymphedema and recommended her to elevate her legs to get the fluid out. When you examine her for this visit, you notice that the edema is pitting and the patient states your recommendation of elevation does not help her. What stage of lymphedema is this patient in?a. Stage 0 b. Stage 1 c. Stage 2 d. Stage 3
- 32 yr old Lola is status post surgery 1 week. She complains of left calf pain. There is some swelling on her left leg. You assume she might have...a. Pulmonary Embolismb. Deep vein thrombosisc. Peripheral arterial diseased. Varicose veins
- A 68 year old male patient comes to your office for a yearly physical. On physical exam you auscultate and hear muffled heart sounds and you measure an elevated JVP. The patient's blood pressure is 98/68 mmHg. What is a likely differential diagnosis?a. Pericardial Tamponadeb. Secondary Hypertensionc. Lymphedema d. Mitral Stenosis
- 50 y/o patient Harry presents to the ER with a GSW (gunshot wound) to the abdomen. He is bleeding profusely from the bullet's entry point. What type of shock is he most at risk of?a.. Hypovolemic b. Cardiogenicc. Obstructive d. Distributive
- Patient Ethan presents to the ED with chest pain, dyspnea, and SOB. He is currently being treated for lung cancer. He is hypotensive and physical examination reveals muffled heart sounds and JVD. Based on your suspicions, what is the diagnostic tool of choice?a. EKG b. Echoc. CT d. MRI
- A 19 year old boy comes into the ED after a car accident on his way to school with penetrating trauma at the level of his R. 5th rib. On CXR you document a mediastinal shift and pleural line. On PE, you hear unequal breath sounds when comparing R. to L., hyperresonance to percussion, and decreased chest wall movement on the R. side. What type of shock is he experiencing?a. Obstructive b. Distributive c. Hypovolemicd. Cardiogenic
- A 60-year-old, heavy smoker, presents for the evaluation of facial swelling. Upon examination, you note swelling, not only of the face but also of the neck and upper extremities. You appreciate diminished breath sounds and tactile fremitus in the right upper lobe. Which of the following diagnosis is most likely.a. Pancoast tumor b. Tuberculosisc. Pneumothoraxd. Superior vena cava syndrome