AQUIFER INTERNAL MEDICINE END OF CASE ACTUAL EXAM QUESTIONS EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | Latest Update

AQUIFER INTERNAL MEDICINE END
OF CASE ACTUAL EXAM QUESTIONS
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES | Latest Update
A 68-year-old male presents with concern for substernal chest
pressure with exertion lasting five minutes and alleviated with
rest. He has a remote history of a myocardial infarction (MI). He
recently presented with angina symptoms and had a cardiac
catheterization which did not reveal any concerning areas of
stenosis. He has not been taking his medications. Physical
examination shows his pulse is 88 beats/minute, respiration rate
is 16 breaths/minute, and blood pressure is 130/80 mmHg. His
lung –
ANSWER The answer is C. From IM 02.
This patient has stable angina and should be treated with a beta
blocker. The beta blocker will reduce angina by slowing his heart
rate and decreasing his blood pressure, thus decreasing
myocardial oxygen consumption.
A 31-year-old male with previously diagnosed hypertension
comes in for a follow-up visit. He currently takes 10 mg of
amlodipine daily, 40 mg of enalapril daily, and 100 mg of atenolol
daily. His pulse is 65 beats/minute. His blood pressure is 190/100
mmHg in his right arm and 188/100 mmHg in his left leg. He
reports adherence to all of his medications, and he took all of
them this morning. He reports no headache, vision changes,
chest pain, palpitations, or shortness of breath. He does not take -
ANSWER The answer is D. From IM 06.
A 63-year-old male comes to you for a new-patient visit. He has a
past medical history of a myocardial infarction (MI) and
hyperlipidemia one year ago. He ran out of his previous
medications several weeks ago and cannot remember what they
were. He is asymptomatic and has a normal physical exam
except for a blood pressure of 165/92 mmHg. His labs come back
with a hemoglobin A1c of 5.4%, an elevated LDL, and normal
electrolytes and renal function. In addition to a statin and daily
aspirin, what ot - ANSWER The answer is E. From IM 06.
A 42-year-old female comes to the clinic for a follow-up of newly
diagnosed type 2 diabetes mellitus. She is asymptomatic and has
a normal physical exam. Her blood pressure is 142/76 mmHg,
which is consistent with previous blood pressure measurements
at home. Results of lab work show 1+ protein on her urinalysis
and a normal-basic metabolic panel. What is the most appropriate
treatment for the patient?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Metoprolol
E. No further treatment - ANSWER The answer is C. From IM 06.
Mr. Sands is a 63-year-old male with a 25-year history of
hypertension and type 2 diabetes mellitus who presents to the
office for a follow-up of his blood pressure. Given Mr. Sands' longstanding history of poor blood pressure control, you evaluate him
for end-organ effects of long-standing hypertension. Which of the
following findings would be most specific for possible end-organ
damage from hypertension?
A. Decreased monofilament sensation on bilateral feet
B. Left basilar crackles on lung ex - ANSWER The answer is E.
From IM 06.
A 53-year-old male comes in for his yearly checkup. He has no
past medical history and takes no medications. He rushes in five
minutes after his appointment time because his bus ran late, and
he had to run one block to get to the office. He is sweaty and still
breathing heavy. His blood pressure taken by the medical
assistant is 157/85 mmHg in his right arm. What is the next best
step?
A. Check a basic metabolic panel (BMP) for possible hypertensive
renal disease
B. Prescribe ambulatory blood pr - ANSWER The answer is D.
From IM 06.
A 21-year-old male with history of hepatitis C, cholelithiasis,
sickle cell disease, and alcohol use disorder presents to the
hospital with one day of severe abdomin