Question 1

An old patient presents with recurrent chest pain that goes away after a couple of minutes if he stops and rests. He also states that the pain has not increased in frequency or duration in the last several months. What is the correct diagnosis for this patient?

Accepted Answer

Typical angina (stable angina) is the most common type and is characterized by pain that results from exercise, stress, or excitement. The pain is promptly relieved by rest (which decreases oxygen demand) or nitroglycerin.

Question 2

Regarding MI, the levels of which one of the listed begin to increase 4 to 6 h after the onset of chest pain, reach maximal serum concentration in about 12 to 24 h, and remain elevated for about 3 to 10 days?

Accepted Answer

Serum enzymes that may be elevated after an MI include troponin, CPK, SGOT (AGT), and LDH, which are increased temporally in that order. The troponin complex is made up of three protein subunits: troponin I (Tn-I), troponin T, and troponin C- There are three isoforms of Tn-I: two in skeletal muscle and one in cardiac muscle (cTn-I). cTn-I levels begin to increase 4 to 6 h after the onset of chest pain, reach maximal serum concentration in about 12 to 24 h, and remain elevated for about 3 to 10 days.

Question 3

If a patient has a crescendo-decrescendo midsystolic ejection murmur with a paradoxically split second heart sound (S2) and the left ventricular pressure during systole is markedly greater than the aortic pressure, what is the correct diagnosis?

Accepted Answer

Aortic stenosis (AS) is usually the result of a bicuspid aortic valve (AV), degenerative calcification of a bicuspid valve, or rheumatic heart disease.

Question 4

Which of the following is the most frequent cause of aortic valve incompetence and regurgitation?

Accepted Answer

Aortic regurgitation (AR) is rheumatic in origin in approximately 70% of cases.

Question 5

If a 27-year-old female with a history of rheumatic fever during childhood presents with an early diastolic opening snap with a rumbling late diastolic murmur, what will be the possible diagnosis?

Accepted Answer

In mitral stenosis, patient usually comes with a history of rheumatic fever during childhood and presents with an early diastolic opening snap with a rumbling late diastolic murmur.

Question 6

Acute rheumatic fever classically develops in children 1 to 4 weeks after a group A hemolytic streptococcal (Streptococcus pyogenes) infection of which of the following organs?

Accepted Answer

Rheumatic fever (RF) is a systemic disease with the major findings of migratory polyarthritis of large joints, carditis, erythema marginatum of skin (although skin involvement is not very common), subcutaneous nodules, and Sydenham's chorea.

Question 7

Which of the following is the most characteristic and frequent feature of chronic rheumatic heart disease?

Accepted Answer

Rheumatic fever (RF) produces both acute and chronic manifestations. In contrast to acute RF, chronic RF produces damage to cardiac valves. The mitral valve is most commonly involved, followed by the aortic valve.

Question 8

Which disease has the combination of a ventricular septal defect with an aorta that overrides the septal defect, stenosis of the pulmonic valve, and increased thickness of the right ventricle?

Accepted Answer

The Tetralogy of Fallot consists of subaortic ventricular septal defect, obstruction to right ventricular outflow, aortic overriding of the ventricular septal defect (aortic dextroposition), and moderate right ventricular hypertrophy.

Question 9

Which one of the listed statements correctly describes the flow of blood in an individual with an atrial septal defect who develops Eisenmenger's syndrome?

Accepted Answer

Left-to-right congenital shunts are not initially cyanotic, but cyanosis may develop later (tardive cyanosis) if the shunt shifts to a right-to-left shunt due to increased pulmonary vascular resistance (Eisenmenger's complex).

Question 10

Which of the following microbiological classes includes the bacteria Neisseria gonorrhoeae?

Accepted Answer

Neisseria gonorrhoeae is a gram-negative cocci and causes a variety of serious infections including STDs.

Question 11

Which of the following microbiological classes includes the bacteria Staphylococcus aureus?

Accepted Answer

Staphylococcus aureus is a gram-positive cocci which is known to cause a variety of RTIs and skin and subcutaneous tissue infections.

Question 12

Which of the following bacteria has a major role in causing Syphilis?

Accepted Answer

Treponema pallidum has a key role as a causative organism in syphilis.

Question 13

Which of the following side effects is sometimes associated with increased levels of Digitalis?

Accepted Answer

Palpitations and muscle weakness are found with excessive levels of Digitalis.

Question 14

Which of the following clinical signs is NOT a sign of respiratory alkalosis?

Accepted Answer

Anxiety is a classic clinical sign associated with respiratory acidosis, not alkalosis.

Question 15

Which of the following bacteria does NOT cause UTIs?

Accepted Answer

Streptococcus pneumoniae is mainly linked to upper and lower respiratory tract infections like otitis, arthritis, sinusitis, and pneumonia and does not cause UTIs.

Question 16

Common clinical signs and symptoms of a right-sided heart failure include all of the following EXCEPT:

Accepted Answer

Left sided, not right sided, heart failure exhibits signs of pulmonary compromise i.e. shortness of breath or dyspnea.

Question 17

Which of the following types of cells secrete exocrine secretions?

Accepted Answer

Exocrine or ductless secretions are released by Acinar cells.

Question 18

Which of the following is the most common route for the transmission of Hepatitis C virus?

Accepted Answer

Hepatitis C requires parenteral exposure for transmission. It is most commonly spread through intravenous drug abuse.

Question 19

Which of the following can be used as the best tool to measure the extent of liver damage done by chronic hepatitis B or C infection?

Accepted Answer

Obtaining a piece of liver tissue is the only means to judge the histologic damage caused by chronic viral infection.

Question 20

What is the best diagnosis for the presence of gastroesophageal reflux?

Accepted Answer

The diagnosis of gastroesophageal reflux is best diagnosed by a medical history because of its typical presentation of retrosternal burning, usually postprandially and sometimes nocturnally.

Quiz 1: Physician Assistant