Posted on June 8, 2011 by Archer USMLE Reviews
Q175) A 28 Year old man is evaluated in your office during a pre-employment health check-up . His history is notable for severe hypertension for which he was started on beta blocker a year ago. He says he stopped the medication 6 months ago because it interfered with his sexual activity. On examination his blood pressure is 172/94. Cardiovascular examination revealed a systolic murmur that radiates to the back and associated with ejection click. Brachio-femoral delay in pulses is noted. The patient is agreeable to restart antihypertensive therapy. The most appropriate management option for this patient:
A) Cardiac catheterization with Stenting
B) Percutaneous coronary intervention
C) Surgery
D) Medical management of Hypertension
E) Aortic valvulotomy
Filed under: Uncategorized, USMLE Test Prep | Tagged: Archer cardiology, ARCHER NEPHROLOGY, USMLE STEP 3 CARDIOLOGY, usmle step 3 nephrology, USMLE Step 3 question bank, usmle step 3 questions | 7 Comments »
Posted on June 3, 2011 by Archer USMLE Reviews
166) A 42 year old woman with history of lupus nephritis presents with complaints of pain in her right thigh. Pain increases on walking and standing. Her kidney disease is under control on Prednisone maintenance for past one year. She denies any recent trauma. On physical examination, she is noted to have a right sided limp on walking. Her Hip X-ray is shown below:
The most likely etiology for the condition shown above:
A) Renal insufficiency
B) Secondary Hyperparathyroidism
C) Systemic Lupus Erythematosus
D) Vitamin D deficiency
E) Prednisone therapy
Filed under: USMLE Test Prep | Tagged: Archer cardiology, USMLE STEP 3 CARDIOLOGY, usmle step 3 questions | 4 Comments »
Posted on June 3, 2011 by Archer USMLE Reviews
165) A 42 year old woman with history of lupus nephritis presents with complaints of pain in her right thigh. Pain increases on walking and standing. Her kidney disease is under control on Prednisone maintenance for past one year. She denies any recent trauma. On physical examination, she is noted to have a right sided limp on walking. Her Hip X-ray is shown below:
The most likely diagnosis is:
A) Osteosarcoma
B) Osteonecrosis
C) Lupus arthritis
D) Osteoarthritis
E) Osteoporosis
Filed under: USMLE Test Prep | Tagged: Archer cardiology, USMLE STEP 3 CARDIOLOGY, usmle step 3 questions | 5 Comments »
Posted on June 2, 2011 by Archer USMLE Reviews
164) A 64 year old man is seen in the Emergency room for sharp sub sternal chest pain that started few hours ago. The pain increases on coughing and deep breathing. His history is significant for Acute Myocardial Infarction about 6 weeks ago. At that time, he was treated with percutaneous coronary intervention and stent placement. On physical examination, temperature is 100F, Heart rate 88/min, and Blood pressure 110/70 mm Hg. Pulsus paradoxus is 8mm Hg and lungs are clear to auscultation. A chest X-ray reveals enlargement of cardiac shadow. The most appropriate treatment for this patient’s presentation:
A) Pericardiocentesis
B) Oral Ibuprofen
C) Oral Prednisone
D) Metoprolol
E) Cardiac catheterization to evaluate stent re-occlusion
Filed under: USMLE Test Prep | Tagged: Archer cardiology, USMLE STEP 3 CARDIOLOGY, usmle step 3 questions | 4 Comments »
Posted on June 2, 2011 by Archer USMLE Reviews
163) A 62 year old man with past medical history significant for Congestive Heart Failure presents with progressively increasing shortness of breath over the past 2 months. He denies any chest pain on exertion or at rest. He was recently started on furosemide for management of peripheral edema and is compliant with low salt diet. An Echocardiogram obtained 3 months ago revealed an Ejection Fraction of 32% (Normal = above 55%) at which time he was started on Enalapril. On physical examination, there is trace ankle edema. There are no lung crackles on auscultation. Rest of the examination is normal. An EKG reveal changes of left ventricular hypertrophy with normal QRS duration. The most important intervention at this time that would most improve his survival is
A) Start Losartan
B) Start Carvedilol
C) Start Isosorbide and Hydralazine
D) Add Digoxin
E) Biventricular Pacing
Filed under: USMLE Test Prep | Tagged: Archer cardiology, archer usmle step 3, USMLE STEP 3 CARDIOLOGY | 7 Comments »
Posted on November 10, 2010 by Archer USMLE Reviews
Q100) A 52 year-old man presents to your office with complaints of exertional chest pain for the past 4 weeks. The chest pain is usually left sided, occurs on walking about three blocks and goes away with rest. He has developed a habit of taking rest when the chest pain comes and he did not think it needed medical attention until his friend told him yesterday that it might be a symptom of heart disease. He is concerned and requests your recommendation. He denies any chest pain or shortness of breath now. He also reports no change in quality or intensity of his chest pain. His past medical history is significant for Hypertension and Smoking . His medications include lisinopril and hydrochlorthiazide. Physical examination is benign. The next best step in establishing the diagnosis and prognosis in this patient is :
A) Electrocardiogram
B) 2 D -Echocadiogram
C) Exercise – EKG Stress Test
D) Persantin Stress Test
E) Cardiac Catheterization
Filed under: Uncategorized, USMLE Test Prep | Tagged: Archer cardiology, USMLE STEP 3 CARDIOLOGY | 4 Comments »
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