PAEA UPDATED COMPLETE QUESTIONS
AND CORRECT ANSWERS BUNDLED
RESOURCE
●● Treatment options for thromboangiitis obliterans?
Answer: smoking cessation most important!
cilostazol (PDE 3 inhibitor) has vasodilator properties (alleviated
symptoms)
if raynauds also present, CCB (nifedipine)
●● what heart failure treatment provides a benefit of reduction in
morbidity and mortality?
Answer: ACE inhibitors
beta blockers can also reduce M&M
diuretics have no reduction in mortality
●● how would you manage a patient with a MI in the setting of cocaine
use?
Answer: benzodiazepine early
no beta blockers
,●● If PCI cannot be done for a STEMI patient within 120 minutes, what
should be done?
Answer: fibrolytic therapy
then do PCI & coronary angiography when it can be done
ideally PCI is done within 90 minutes
fibrolytic therapy can be used up to 12 hours of symptoms
●● If you suspect an acute limb ischemia due to arterial embolism, what
imaging should you get?
Answer: catheter-based arteriography (digital subtraction arteriography)
provides the most useful information. can also help with treatment
can help distinguish between thrombosis and embolus
●● where are arterial emboli often found?
Answer: lower extremities more common than upper extremities
The common femoral, common iliac, and popliteal artery bifurcations
are frequent locations
,majority originate in the heart
fun fact: Compared with thromboemboli, atheroemboli are less likely to
produce symptoms of acute limb ischemia
●● how would you work up a patient with treatment resistant
hypertension that you suspect a secondary cause?
Answer: 24-hour ambulatory monitoring (to ensure not white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
labs (electrolytes, glucose, creatinine, UA)
If pheo suspected: measure fractionated metanephrines and
catecholamines in a 24-hour urine collection
●● other than atherosclerosis leading to renal artery stenosis and
secondary HTN, what is another causes of a renal-associated secondary
HTN?
Answer: fibromuscular dysplasia (usually in a young pt)
●● most important modifable risk factor for AAA?
Answer: smoking cessation!
, ●● when is it okay to do screening survelliance for AAA rather than
repair and how often should you screen?
Answer: if AAA is <5.5 cm then annual screening with US is
recommended. may need every 6 months if rapidly expanding or other
concerns
●● how should you educate a patient with AAA on exercise?
Answer: Patients should be counseled that moderate physical activity
such as running, biking, swimming, hiking, or sexual activity and
activities such as gardening, golfing, and horseback riding do not
precipitate AAA rupture
Moderate physical therapy may also limit aneurysm expansion. In
experimental aneurysms, increased aortic blood flow appears to inhibit
AAA expansion
However, heavy lifting, especially while holding the breath, and other
activities that lead to Valsalva transiently induce significant increases in
blood pressure and should be avoided
●● gold standard for dx renal artery stenosis? what can be used to
monitor disease progression?
Answer: renal arteriography
AND CORRECT ANSWERS BUNDLED
RESOURCE
●● Treatment options for thromboangiitis obliterans?
Answer: smoking cessation most important!
cilostazol (PDE 3 inhibitor) has vasodilator properties (alleviated
symptoms)
if raynauds also present, CCB (nifedipine)
●● what heart failure treatment provides a benefit of reduction in
morbidity and mortality?
Answer: ACE inhibitors
beta blockers can also reduce M&M
diuretics have no reduction in mortality
●● how would you manage a patient with a MI in the setting of cocaine
use?
Answer: benzodiazepine early
no beta blockers
,●● If PCI cannot be done for a STEMI patient within 120 minutes, what
should be done?
Answer: fibrolytic therapy
then do PCI & coronary angiography when it can be done
ideally PCI is done within 90 minutes
fibrolytic therapy can be used up to 12 hours of symptoms
●● If you suspect an acute limb ischemia due to arterial embolism, what
imaging should you get?
Answer: catheter-based arteriography (digital subtraction arteriography)
provides the most useful information. can also help with treatment
can help distinguish between thrombosis and embolus
●● where are arterial emboli often found?
Answer: lower extremities more common than upper extremities
The common femoral, common iliac, and popliteal artery bifurcations
are frequent locations
,majority originate in the heart
fun fact: Compared with thromboemboli, atheroemboli are less likely to
produce symptoms of acute limb ischemia
●● how would you work up a patient with treatment resistant
hypertension that you suspect a secondary cause?
Answer: 24-hour ambulatory monitoring (to ensure not white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
labs (electrolytes, glucose, creatinine, UA)
If pheo suspected: measure fractionated metanephrines and
catecholamines in a 24-hour urine collection
●● other than atherosclerosis leading to renal artery stenosis and
secondary HTN, what is another causes of a renal-associated secondary
HTN?
Answer: fibromuscular dysplasia (usually in a young pt)
●● most important modifable risk factor for AAA?
Answer: smoking cessation!
, ●● when is it okay to do screening survelliance for AAA rather than
repair and how often should you screen?
Answer: if AAA is <5.5 cm then annual screening with US is
recommended. may need every 6 months if rapidly expanding or other
concerns
●● how should you educate a patient with AAA on exercise?
Answer: Patients should be counseled that moderate physical activity
such as running, biking, swimming, hiking, or sexual activity and
activities such as gardening, golfing, and horseback riding do not
precipitate AAA rupture
Moderate physical therapy may also limit aneurysm expansion. In
experimental aneurysms, increased aortic blood flow appears to inhibit
AAA expansion
However, heavy lifting, especially while holding the breath, and other
activities that lead to Valsalva transiently induce significant increases in
blood pressure and should be avoided
●● gold standard for dx renal artery stenosis? what can be used to
monitor disease progression?
Answer: renal arteriography
