Manuel's Fcm Post-Exam Questions

Front 1

After 12 days of hosp in the icu, a prev comatose 24 yo car acc survivor opens his eyes for 1st time. Pt appears alert but unaware of his surroundings. Stays awake intermitt thru day and sleeps at night. Although his pupilary reflex appear intact, his eye movements seem to be nonpurposeful. Which best described patient’s condition?

Back 1

b) pt is neurovegetative state and although his RAS may be intact.

Front 2

2. An abnormality of which of the foll in a pat neuro cond WILL NOT result in alter

Front 3

3. previuously healthy stock broker. BP 210/90; hx of HTN. All should be considered EXCEPT

Back 3

b) lumbar puncture should be done immediately to rule out a subdural bleed (lp cannot see subd)

Front 4

4. 68 yr old male long hx of tobacco; worstening shortness of breath. Lately incr difficutly compl tasks. Room air 02 sat of 88%. All true EXCEPT

Back 4

c) hypoxia is likely caused by a true pulmonary shunt

Front 5

5. 78 yo male with hx of CHF. Heart displaced to left. Vocal and tact fremitus is absent on same area / no egophony.

Back 5

a) rigth peural effusion

Front 6

6. which scenarios MOST LIKELY result in hypoxia due to pure right-to-left shunt:

Back 6

c) 4 yo child with ventri sept

Front 7

7. All commonly cause high in leukocyte count EXCEPT:

Back 7

d) severe migraine headache

Front 8

8. Which about Lymphocytes is NOT true:

Back 8

a) elevation commonly called “left shift”

Front 9

9. 72 yo female metastatic breast cancer admit w/ weakness and dizz. BP 88/45 and Hear rate 110. BUN is 28. all true EXCEPT:

Back 9

b) patient is dehydrated and would benefit from administration of free water (cuz Na is 133)

Front 10

10. Which is LEAST likely to cause high esonophil count:

Back 10

d) pneumococcal pneumonia

Front 11

11. All of the following agents are able to raise body temp. Which is NOT an exogenous pyrogen:

Back 11

a) cytokines

Front 12

12. Which of the following statements is TRUE about hyperthermia and fever?

Back 12

c) hyperthe can be said to be a state of high temp with a normal hypothalamus (hypothalamic set point)

Front 13

13. Which of the following is NOT an indication for mech lowering of body temp w high fever?

Back 13

e) west nile virus in elderly male with temp of 38 celsius

Front 14

14. 69 man retroster chest pain, ecert relieved by rest. Chol is 189 and ldl 125. BP 125/95 (narrow pulse pressure – KEY) with a pulse of 76. Fine rales in bases of lungs. Hearth, late-peaking crescendo-decrescendo systolic ejection murmur. Dx?

Back 14

c) critical aortic stenosis

Front 15

15 The path mech is most likely?

Back 15

b) sypply / demand mismatch with sub endocardial ischemia second to markedly incr left ventr pressure in face of ssign thick of the LV myocardium.

Front 16

16. 48 yo male hx of Grave’s disase compl of worsening dyspnea on exer and orthop & pedal edema. Exam holosystolic murmur that radiates to axila. Which of the following would be the MOST therapeutic rec?

Back 16

d) Mitr valve replacement with mechanical valve and be placed on anticoagulation for life

Front 17

17. all statements of aortic insuff EXCEPT:

Back 17

b) murmur of aortic ins is loud low pith and best heard at beginning of systole over the left precordium

Front 18

18. 42 yo woman tennis on warm day. Developed jaw pain, mild nausea, and SOB. On way home, dveloped crushing substern pain. Called 911. Glucose is 125. Graph showing ECG.

Back 18

STEMI

Back 19

d) rupture of vulnerable plaque in a major coronary artery with subsequent formation of an occlusive thrombus eliminating antegrade blood flow to a portion of myo

Front 20

20. ther inter known to improve

Back 20

c) beta blocker

Front 21

21. 55 yo man hx of DM and CAD. Which contribued most to chest pain

Back 21

a) cig smoking

Front 22

22. whock is NOT abs indica for cor art bypass surgery

Back 22

d) severe stenosis in the mid portion of LAD with patent coll circ

Front 23

23. young Japanese chest pain, (PRINZmel) EXCEP:

Back 23

c) ofter requires stenting and/or thrombolytic therapy

Front 24

24. 59 woman. 20 lbs overweight, fasting TG is 400 mg/dl. Which is NOT immed recomm in order to lower MI.

Back 24

e) implement pharm to reduce pts weight

Front 25

25. all ECG tracings

Back 25

e) all of the above

Front 26

26. a regular heart rate can be estimated by a simple rule measuring interval between two adjacent QRS.

Back 26

Answer: 300 / # of big boses

Front 27

28. Virchow’s Triad / VQ scan has [...] sensitivity

Back 27

28. Virchow’s Triad / VQ scan has high sensitivity

Front 28

29. “smothering sensation” CXR enlarged shadow. Which is true about pts condition

Back 28

e) he is likely to have adaptive mechanis for his heart failure which would include ventr remod and neurohormonal activation

Front 29

heart rate of 150 on ECG is ALWAYS […] until proven otherwise

Back 29

heart rate of 150 on ECG is ALWAYS A-flutter until proven otherwise

Front 30

31. the follow neuroend and cell changes are likely to be present in pts with syst heart fail EXCEPT

Back 30

b) decr levels of plasma NE

Front 31

32. all of the following are recomm in tx of pts with dil cardiomy EXCET

Back 31

c) incr NaCl intake

Front 32

34 Which is NOT cause of dilated cardio

Back 32

d) amyloid Cardiomyopathy

Front 33

35. severity of DAT is corr w/

Back 33

d) degree of synaptic loss

Front 34

37. not a cardinal feature of idiopathic Park

Back 34

e) flacid paresis

Front 35

40. all of the following are potential intrinsic causes of acute renal failure ECEPT

Back 35

e) ureteral obstruction

Front 36

41. Which of tollowing neuro-endocr is NOT likely

Front 37

45 most in distin chonic renal fail

Back 37

d) small and echogen kidney onn ultrasound

Front 38

46. BEST describes epilepsy

Back 38

d) recurrent, unprovoked seizures of unexplained or unkown etiology

Front 39

47. compensatory response to met alk charac by

Back 39

a) increase in PaCO2

Front 40

48. 67 male with long hx of smoking presents to hosp ER with progr SOB. Arterial blodd gas shows:Ph7.2
CO2: 58
P02: 65
HCO3: 33
What is the primary acid-base disorder?

Back 40

unknown