PAEA EOC & Summative Practice
Questions With Complete
Solutions
Course
PAEA
1. Cardiology
A 67-year-old man presents with chest pain radiating to the left arm for 45 minutes. ECG shows
ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Explanation:
Inferior wall myocardial infarction affects leads II, III, and aVF. The most common vessel
involved is the right coronary artery (RCA). LAD usually causes anterior MI.
2. Pulmonology
A 24-year-old woman presents with sudden shortness of breath and pleuritic chest pain after a
long flight. HR 118/min, oxygen saturation 89%. Which diagnostic test is most appropriate
initially?
A. Chest X-ray
B. ECG
C. CT pulmonary angiography
D. Spirometry
Answer: C. CT pulmonary angiography
Explanation:
The presentation strongly suggests pulmonary embolism. CT pulmonary angiography is the gold
standard imaging test in stable patients.
3. Endocrinology
,A patient with diabetes presents with confusion, dehydration, Kussmaul respirations, and glucose
of 580 mg/dL. What is the most likely diagnosis?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis
C. Hypoglycemia
D. Addisonian crisis
Answer: B. Diabetic ketoacidosis
Explanation:
DKA presents with hyperglycemia, metabolic acidosis, dehydration, and Kussmaul breathing.
Ketone production causes acidosis.
4. Infectious Disease
A patient develops fever, productive cough, and rust-colored sputum. Chest X-ray shows lobar
consolidation. Most likely organism?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Explanation:
Classic pneumococcal pneumonia presents with fever, pleuritic chest pain, rust-colored sputum,
and lobar consolidation.
5. Gastroenterology
A 45-year-old alcoholic presents with severe epigastric pain radiating to the back. Lipase is
elevated. Diagnosis?
A. Cholecystitis
B. Gastritis
C. Acute pancreatitis
D. Peptic ulcer disease
Answer: C. Acute pancreatitis
,Explanation:
Acute pancreatitis commonly presents with epigastric pain radiating to the back and elevated
lipase. Alcohol abuse is a major risk factor.
6. Neurology
A 70-year-old develops sudden right-sided weakness and aphasia. Which artery is most likely
affected?
A. Posterior cerebral artery
B. Middle cerebral artery
C. Basilar artery
D. Anterior spinal artery
Answer: B. Middle cerebral artery
Explanation:
MCA stroke commonly causes contralateral weakness and aphasia if the dominant hemisphere is
involved.
7. Renal
A patient has hematuria, hypertension, and periorbital edema two weeks after streptococcal
pharyngitis. Diagnosis?
A. IgA nephropathy
B. Minimal change disease
C. Post-streptococcal glomerulonephritis
D. Nephrolithiasis
Answer: C. Post-streptococcal glomerulonephritis
Explanation:
This classic presentation occurs after streptococcal infection and involves immune complex
deposition in glomeruli.
8. Hematology
A woman presents with fatigue and spoon-shaped nails. Labs show microcytic hypochromic
anemia. Most likely deficiency?
, A. Vitamin B12
B. Folate
C. Iron
D. Vitamin D
Answer: C. Iron
Explanation:
Iron deficiency anemia causes microcytic hypochromic RBCs and koilonychia (spoon nails).
9. Emergency Medicine
A trauma patient has hypotension, muffled heart sounds, and jugular venous distension.
Diagnosis?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Septic shock
Answer: B. Cardiac tamponade
Explanation:
Beck’s triad: hypotension, JVD, and muffled heart sounds indicates cardiac tamponade.
10. Obstetrics/Gynecology
A pregnant woman at 32 weeks presents with hypertension, proteinuria, and headache. Most
likely diagnosis?
A. Eclampsia
B. Gestational diabetes
C. Preeclampsia
D. Placenta previa
Answer: C. Preeclampsia
Explanation:
Preeclampsia is defined by hypertension after 20 weeks with proteinuria or end-organ
dysfunction. Seizures would indicate eclampsia.
11. Dermatology
Questions With Complete
Solutions
Course
PAEA
1. Cardiology
A 67-year-old man presents with chest pain radiating to the left arm for 45 minutes. ECG shows
ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Explanation:
Inferior wall myocardial infarction affects leads II, III, and aVF. The most common vessel
involved is the right coronary artery (RCA). LAD usually causes anterior MI.
2. Pulmonology
A 24-year-old woman presents with sudden shortness of breath and pleuritic chest pain after a
long flight. HR 118/min, oxygen saturation 89%. Which diagnostic test is most appropriate
initially?
A. Chest X-ray
B. ECG
C. CT pulmonary angiography
D. Spirometry
Answer: C. CT pulmonary angiography
Explanation:
The presentation strongly suggests pulmonary embolism. CT pulmonary angiography is the gold
standard imaging test in stable patients.
3. Endocrinology
,A patient with diabetes presents with confusion, dehydration, Kussmaul respirations, and glucose
of 580 mg/dL. What is the most likely diagnosis?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis
C. Hypoglycemia
D. Addisonian crisis
Answer: B. Diabetic ketoacidosis
Explanation:
DKA presents with hyperglycemia, metabolic acidosis, dehydration, and Kussmaul breathing.
Ketone production causes acidosis.
4. Infectious Disease
A patient develops fever, productive cough, and rust-colored sputum. Chest X-ray shows lobar
consolidation. Most likely organism?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Explanation:
Classic pneumococcal pneumonia presents with fever, pleuritic chest pain, rust-colored sputum,
and lobar consolidation.
5. Gastroenterology
A 45-year-old alcoholic presents with severe epigastric pain radiating to the back. Lipase is
elevated. Diagnosis?
A. Cholecystitis
B. Gastritis
C. Acute pancreatitis
D. Peptic ulcer disease
Answer: C. Acute pancreatitis
,Explanation:
Acute pancreatitis commonly presents with epigastric pain radiating to the back and elevated
lipase. Alcohol abuse is a major risk factor.
6. Neurology
A 70-year-old develops sudden right-sided weakness and aphasia. Which artery is most likely
affected?
A. Posterior cerebral artery
B. Middle cerebral artery
C. Basilar artery
D. Anterior spinal artery
Answer: B. Middle cerebral artery
Explanation:
MCA stroke commonly causes contralateral weakness and aphasia if the dominant hemisphere is
involved.
7. Renal
A patient has hematuria, hypertension, and periorbital edema two weeks after streptococcal
pharyngitis. Diagnosis?
A. IgA nephropathy
B. Minimal change disease
C. Post-streptococcal glomerulonephritis
D. Nephrolithiasis
Answer: C. Post-streptococcal glomerulonephritis
Explanation:
This classic presentation occurs after streptococcal infection and involves immune complex
deposition in glomeruli.
8. Hematology
A woman presents with fatigue and spoon-shaped nails. Labs show microcytic hypochromic
anemia. Most likely deficiency?
, A. Vitamin B12
B. Folate
C. Iron
D. Vitamin D
Answer: C. Iron
Explanation:
Iron deficiency anemia causes microcytic hypochromic RBCs and koilonychia (spoon nails).
9. Emergency Medicine
A trauma patient has hypotension, muffled heart sounds, and jugular venous distension.
Diagnosis?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Septic shock
Answer: B. Cardiac tamponade
Explanation:
Beck’s triad: hypotension, JVD, and muffled heart sounds indicates cardiac tamponade.
10. Obstetrics/Gynecology
A pregnant woman at 32 weeks presents with hypertension, proteinuria, and headache. Most
likely diagnosis?
A. Eclampsia
B. Gestational diabetes
C. Preeclampsia
D. Placenta previa
Answer: C. Preeclampsia
Explanation:
Preeclampsia is defined by hypertension after 20 weeks with proteinuria or end-organ
dysfunction. Seizures would indicate eclampsia.
11. Dermatology
