PAEA EOC & Summative Practice Exam
2024 | PAEA EOC Summative Practice
Actual Exam Update 2024 Questions and
Correct Answers Rated A+
What exactly causes the occlusive vascular disease of thromboangiitis
obliterans? -answer-aka buerger's disease
Inflammatory thrombi affecting the medium and small vessels
(nonatherosclerosis)
Polymorphonuclear leukocytes, microabscesses, and multinucleated
giant cells may be presen
Treatment options for thromboangiitis obliterans? -answer-smoking
cessation most important!
Cilostazol (pde 3 inhibitor) has vasodilator properties (alleviated
symptoms)
If raynauds also present, ccb (nifedipine)
What heart failure treatment provides a benefit of reduction in
morbidity and mortality? -answer-ace inhibitors
Beta blockers can also reduce m&m
Diuretics have no reduction in mortality
How would you manage a patient with a mi in the setting of cocaine
use? -answer-benzodiazepine early
No beta blockers
,If pci cannot be done for a stemi patient within 120 minutes, what
should be done? -answer-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
If you suspect an acute limb ischemia due to arterial embolism, what
imaging should you get? -answer-catheter-based arteriography (digital
subtraction arteriography) provides the most useful information. Can
also help with treatment
Can help distinguish between thrombosis and embolus
Where are arterial emboli often found? -answer-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
How would you work up a patient with treatment resistant
hypertension that you suspect a secondary cause? -answer-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
Other than atherosclerosis leading to renal artery stenosis and
secondary htn, what is another causes of a renal-associated
secondary htn? -answer-fibromuscular dysplasia (usually in a young
pt)
Most important modifable risk factor for aaa? -answer-smoking
cessation!
When is it okay to do screening survelliance for aaa rather than repair
and how often should you screen? -answer-if aaa is <5.5 cm then
annual screening with us is recommended. May need every 6 months
if rapidly expanding or other concerns
How should you educate a patient with aaa on exercise? -answer-
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
, Gold standard for dx renal artery stenosis? What can be used to
monitor disease progression? -answer-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
What are some symptoms of mitral valve prolapse syndrome? -
answer-various nonspecific symptoms such as palpitations, dyspnea,
exercise intolerance, anxiety disorders, and dizziness
Since symptoms are relatively uncommon, what physical exam
findings are associated with mitral valve prolapse? -answer-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
How would you distinguish vasospastic angina and angina associated
with cad? -answer-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
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