PAEA EOC & Summative Practice Exam Questions and Answers Latest Updat
2024-2025 Verified Answers
1. what exactly causes the occlusive vascular disease of thromboangiitis
obliterans?: aka Buerger's disease
inflammatory thrombi affecting the medium and small vessels (nonatherosclerosis)
polymorphonuclear leukocytes, microabscesses, and multinucleated giant cells may
be presen
2. Treatment options for thromboangiitis obliterans?: smoking cessation most
important!
cilostazol (PDE 3 inhibitor) has vasodilator properties (alleviated symptoms)
if raynauds also present, CCB (nifedipine)
3. what heart failure treatment provides a benefit of reduction in morbidity and
mortality?: ACE inhibitors
beta blockers can also reduce M&M
diuretics have no reduction in mortality
4. how would you manage a patient with a MI in the setting of cocaine use?: -
benzodiazepine early
no beta blockers
5. If PCI cannot be done for a STEMI patient within 120 minutes, what should
be done?: fibrolytic therapy
then do PCI & coronary angiography when it can be done
ideally PCI is done within 90 minutes
fibrolytic therapy can be used up to 12 hours of symptoms
6. If you suspect an acute limb ischemia due to arterial embolism, what imag-
ing should you get?: catheter-based arteriography (digital subtraction arteriogra-
phy) provides the most useful information. can also help with treatment
can help distinguish between thrombosis and embolus
7. where are arterial emboli often found?: lower extremities more common than
upper extremities
The common femoral, common iliac, and popliteal artery bifurcations are frequent
locations
majority originate in the heart
,PAEA EOC & Summative Practice Exam Questions and Answers Latest Updat
2024-2025 Verified Answers
fun fact: Compared with thromboemboli, atheroemboli are less likely to produce
symptoms of acute limb ischemia
8. how would you work up a patient with treatment resistant hypertension that
you suspect a secondary cause?: 24-hour ambulatory monitoring (to ensure not
white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
labs (electrolytes, glucose, creatinine, UA)
If pheo suspected: measure fractionated metanephrines and catecholamines in a
24-hour urine collection
9. other than atherosclerosis leading to renal artery stenosis and secondary
HTN, what is another causes of a renal-associated secondary HTN?: fibromus-
cular dysplasia (usually in a young pt)
10. most important modifable risk factor for AAA?: smoking cessation!
11. when is it okay to do screening survelliance for AAA rather than repair and
how often should you screen?: if AAA is <5.5 cm then annual screening with US
is recommended. may need every 6 months if rapidly expanding or other concerns
12. how should you educate a patient with AAA on exercise?: 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
13. gold standard for dx renal artery stenosis? what can be used to monitor
disease progression?: 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
14. what are some symptoms of mitral valve prolapse syndrome?: various
nonspecific symptoms such as palpitations, dyspnea, exercise intolerance, anxiety
disorders, and dizziness
, PAEA EOC & Summative Practice Exam Questions and Answers Latest Updat
2024-2025 Verified Answers
15. since symptoms are relatively uncommon, what physical exam findings
are associated with mitral valve prolapse?: non-ejection click in systole
click is mobile, meaning its timing varies with maneuvers that change the left ventric-
ular 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
16. how would you distinguish vasospastic angina and angina associated with
CAD?: 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 cardio-
vascular 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
17. where do karposi sarcoma lesions typically occur? describe their appear-
ance.: 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
18. how would you treat hidradenitis suppurativa?: 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
19. Pt with hypertriglyceridemia >885 mg/dL that required medical therapy
due to no improvement after lifestyle changes and statin. how would you
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