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Question 1 of 15
A 60 YO man with Hx of smoking and Diabetes presents complaining of 25 minutes of left side constricting chest pain radiating to his left shoulder. He was given Aspirin 300 mg and trinitrates for the pain. ECG was then done and showed ST elevation in leads V1-V4.
What is the most appropriate next step in management?CorrectIncorrect
Question 2 of 15
Ms. Lopez presents to the emergency department complaining of a sharp, central chest pain that began suddenly several hours ago. She describes the pain as worsening when she lies down and improving when she sits up and leans forward. She also notes a mild fever. She appears uncomfortable especially when lying flat. On cardiac auscultation, a pericardial friction rub is heard.
What is the most appropriate initial treatment?CorrectIncorrect
Question 3 of 15
Mr. Thompson, 55-Year-Old, presented with a history of intravenous drug use, presents to the clinic with a 2-week history of fever, malaise, and a new heart murmur. His temperature is 38.3°C.
What is the most appropriate initial investigation?CorrectIncorrect
Question 4 of 15
A 75-year-old female presents to the clinic with a history of increasing shortness of breath and fatigue on exertion over the last few months. She also mentions occasional chest discomfort while climbing stairs. On examination, the doctor notices a harsh systolic ejection murmur at the right upper sternal border. The murmur radiates to the neck and the carotid arteries. The doctor suspects aortic stenosis and decides to order an initial diagnostic test.
Which of the following is the most appropriate diagnostic test to confirm the diagnosis?CorrectIncorrect
Question 5 of 15
A 57-year-old man presents to your clinic with worsening shortness of breath and fatigue over the last few months. On physical examination, you note a high-pitched, decrescendo, early diastolic murmur best heard at the left sternal border with the patient sitting up, leaning forward, and holding their breath after exhalation. This suggests aortic regurgitation. The patient’s symptoms have been getting progressively worse and affecting his daily life.
Which of the following is the most appropriate next step in management?CorrectIncorrect
Question 6 of 15
A 68-year-old woman presents to your clinic with complaints of fatigue, palpitations, and shortness of breath, especially when lying flat. On physical examination, you detect a holosystolic murmur best heard at the apex with radiation to the axilla. Given these findings, you suspect mitral regurgitation.
Which of the following would be the best choice of investigation to confirm your diagnosis?CorrectIncorrect
Question 7 of 15
A 75-year-old woman with a history of hypertension and diabetes is brought into the emergency room by her son, who noticed that she had been increasingly lethargic over the past few days. On examination, her blood pressure is 90/60 mmHg, her pulse is irregular, and she appears somewhat confused. An ECG reveals an irregular rhythm, with some P waves not followed by QRS complexes. The PR interval does not lengthen progressively before the dropped beat.
Based on her ECG findings, which of the following is the most likely diagnosis?CorrectIncorrect
Question 8 of 15
A 60-year-old man with a known history of ischemic heart disease presents to the emergency department complaining of sudden onset palpitations and dizziness. His blood pressure is 90/70 mmHg, and his heart rate is approximately 210 beats per minute. An ECG reveals a wide-complex tachycardia with a regular rhythm.
Which of the following is the most appropriate initial management for this patient?CorrectIncorrect
Question 9 of 15
A 45-year-old woman presents to the emergency department with palpitations and shortness of breath that started suddenly while she was gardening an hour ago. She has no past medical history of note, and she denies any chest pain, dizziness, or syncope. On examination, her heart rate is regular and fast, estimated to be about 180 beats per minute, and her blood pressure is 110/70 mmHg. An ECG is obtained, which shows a narrow complex tachycardia with no identifiable P waves.
Which of the following is the most likely diagnosis?CorrectIncorrect
Question 10 of 15
A 62-year-old man with a history of ischemic heart disease collapses at a local gym. Emergency medical services (EMS) arrives at the scene, and the automated external defibrillator (AED) registers a chaotic, irregular heart rhythm without a discernible pattern.
Which of the following is the most appropriate next step in managing this patient?CorrectIncorrect
Question 11 of 15
A 73-year-old woman presents to the emergency department with palpitations and mild shortness of breath that started a few hours ago. She has a history of hypertension and type 2 diabetes mellitus. Her pulse is irregularly irregular, and her blood pressure is 135/85 mmHg.
Which of the following is the most appropriate next step to confirm the diagnosis?CorrectIncorrect
Question 12 of 15
A 56-year-old male patient who had a myocardial infarction three weeks ago now presents with sharp, pleuritic chest pain that worsens with lying flat and deep breathing. He also has low-grade fever and general malaise. On auscultation, a pericardial friction rub is heard.
What is your diagnosis?CorrectIncorrect
Question 13 of 15
A 65-year-old African American woman presents with complaints of recurring headaches and occasional dizziness for the past few weeks. She has a history of type 2 diabetes mellitus. Her blood pressure readings have consistently been high at 145/95 mmHg. You decide to initiate her on antihypertensive medication.
Which is the most appropriate initial antihypertensive therapy in this patient?CorrectIncorrect
Question 14 of 15
An 80-year-old woman presents to your clinic reporting recurrent episodes of dizziness and light-headedness for the past two weeks. She explains that these symptoms primarily occur when she stands up from a seated or lying position. She has a medical history of hypertension and type 2 diabetes, for which she is taking multiple medications. Given her history and the described symptoms, you suspect postural (orthostatic) hypotension.
Which of the following investigations would you immediately perform ?CorrectIncorrect
Question 15 of 15
A 72-year-old man presents to the emergency department with severe, sudden-onset abdominal and back pain. He describes the pain as the worst he has ever experienced, likening it to a tearing sensation. He also reports feeling light-headed and appears to be in severe distress. On examination, you notice a pulsatile abdominal mass that is tender to the touch and his blood pressure is lower than expected 90/60 mmhg. Given the symptoms, you suspect a ruptured abdominal aortic aneurysm (AAA).
Which of the following investigations would you immediately prioritise?CorrectIncorrect