PAEA EOC AND SUMMATIVE
PRACTICE EXAM 2024-2025 LATEST
UPDATED 170 ACTUAL QUESTIONS
WITH VERIFIED CORRECT ANSWERS.
A+ GRADE RATED
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
imaging should you get?: catheter-based arteriography (digital subtraction
arteriography) 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
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?: fibromuscular 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
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
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
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
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
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