IM EOR EXAM QUESTIONS AND
ANSWERS COMPLETE AND VERIFIED A.
A 26-year-old man presents with an acute severe asthma exacerbation. You
decide to perform rapid sequence endotracheal intubation due to
impending respiratory failure. The patient has no known medication
allergies. Which of the following agents is most appropriate for induction in
this case?
A. Etomidate
B. Ketamine
C. Midazolam
D. Propofol
B. Ketamine
-Ketamine should be used as an induction agent for intubation in patients with
severe asthma.
A 23-year-old woman, with no risk factors for heart disease, presents to the
clinic with complaints of sternal chest pain, fatigue, and shortness of
breath. She was recently diagnosed with sarcoidosis. In your review of
systems check, other than pulmonary, what area do you want to focus on the
most?
A. Gastrointestinal
B. Musculoskeletal
C. Renal
D. Skin
D. Skin
-Skin and lymph nodes are the two most commonly affected areas, after the
lungs, by sarcoidosis. History and physical exam should include a thorough
review of skin changes.
,Sildenafil is prescribed for an otherwise healthy 54-year-old man who is
diagnosed with erectile dysfunction. Which of the following is a potential
adverse effect of this medication?
A. Constipation
B. Cyanopsia
C. Prostate-specific antigen elevation
D. Urinary retention
B. Cyanopsia
-Cyanopsia, or blue discoloration of vision, is a potential side effect of
sildenafil. The effect may be more likely with higher dosages of medication and
is usually temporary.
Which of the following patients meets the criteria for diagnosis of diabetes
mellitus?
A. A patient with a fasting plasma glucose of 125 mg/dL and a hemoglobin
A1C of 6.0 percent
B. A patient with polyuria, blurry vision, and a random glucose of 200 mg/dL
C. An asymptomatic patient with a fasting glucose of 130 mg/dL (day 1) and
80 mg/dL (day 2)
D. An asymptomatic patient with a random glucose of 250 mg/dL
B. A patient with polyuria, blurry vision, and a random glucose of 200 mg/dL
-Asymptomatic patients may also be diagnosed with diabetes mellitus if they
have a fasting plasma glucose level of 126 mg/dL or higher, a hemoglobin A1C
of 6.5 percent or higher, or a two-hour oral glucose tolerance test plasma
glucose of 200 mg/dL or higher.
What is the most common presenting symptom of bladder carcinoma?
A. Nocturia
B. Painless hematuria
C. Unintentional weight loss
D. Urinary frequency
,B. Painless hematuria
A 32-year-old man is evaluated in the emergency department for complaints
of shortness of breath and palpitations that began at rest approximately 30
minutes ago. He recalls experiencing similar symptoms three days ago that
self-resolved after 10 minutes. He denies additional medical history and is
not taking any prescription or alternative medications. On physical exam, he
has clear and equal breath sounds bilaterally. His blood pressure is 134/88
mm Hg, heart rate 180 beats per minute, and respiratory rate is 24. An ECG
shows a narrow-complex supraventricular tachycardia (SVT). You have him
perform vagal maneuvers but do not see a change in his heart rate or
rhythm. Which of the following is the next best treatment?
A. Adenosine 6 mg IV
B. Amiodarone 300 mg IV
C. Atropine 0.5 mg IV
D. Synchronized cardioversion
A. Adenosine 6 mg IV
- In stable patients, vagal maneuvers (e.g. bearing down) can be performed
initially
-If vagal maneuvers are unsuccessful in the stable patient, adenosine 6 mg IV
push should be rapidly administered due to its short half-life.
Which of the following represents the best treatment plan for correction of
systemic acidosis in status epilepticus?
A. Fomepizole 15 mg/kg IV infusion over 30 minutes
B. Intravenous insulin infusion at 0.1 units/kg/hour
C. Sodium bicarbonate 2-5 mEq/kg IV infusion over four to eight hours
D. Watchful waiting for auto-correction of the acidosis once seizure activity
is controlled
D. Watchful waiting for auto-correction of the acidosis once seizure activity is
controlled
, A 75-year-old woman presents with complaints of weakness. She has
difficulty getting up from a seated position, going up or down stairs, and
lifting heavier objects that she could before without difficulty. You decide to
order a muscle biopsy to rule out or confirm your suspicion of polymyositis.
What muscle do you most likely want biopsied?
A. Brachioradialis
B. Gastrocnemius
C. Latissimus dorsi
D. Quadriceps femoris
D. Quadriceps femoris
-Quadriceps femoris, or possibly anyone of the four large muscles of the thigh,
are most commonly used for biopsy in confirming the diagnosis of polymyositis
A 62-year-old man presents reporting urinary hesitancy, dribbling, and
feeling of incomplete voiding. He states his symptoms have been
progressively worsening for the last six months. He denies hematuria, pain
with urination, or scrotal swelling. Which of the following physical exam
findings is most consistent with the diagnosis of benign prostatic
hypertrophy?
A. Asymmetry of the prostate
B. Boggy consistency of the prostate
C. Decreased anal sphincter tone
D. Rubbery consistency of the prostate
D. Rubbery consistency of the prostate
A 28-year-old male presents to the clinic with a four-year history of
abdominal bloating, flatulence, diarrhea, and a pruritic rash on his buttocks
and knees. He states his symptoms are worse with the consumption of
pasta. Which of the following is most likely to confirm the diagnosis?
A. 25-hydroxyvitamin D
B. Duodenal biopsy
ANSWERS COMPLETE AND VERIFIED A.
A 26-year-old man presents with an acute severe asthma exacerbation. You
decide to perform rapid sequence endotracheal intubation due to
impending respiratory failure. The patient has no known medication
allergies. Which of the following agents is most appropriate for induction in
this case?
A. Etomidate
B. Ketamine
C. Midazolam
D. Propofol
B. Ketamine
-Ketamine should be used as an induction agent for intubation in patients with
severe asthma.
A 23-year-old woman, with no risk factors for heart disease, presents to the
clinic with complaints of sternal chest pain, fatigue, and shortness of
breath. She was recently diagnosed with sarcoidosis. In your review of
systems check, other than pulmonary, what area do you want to focus on the
most?
A. Gastrointestinal
B. Musculoskeletal
C. Renal
D. Skin
D. Skin
-Skin and lymph nodes are the two most commonly affected areas, after the
lungs, by sarcoidosis. History and physical exam should include a thorough
review of skin changes.
,Sildenafil is prescribed for an otherwise healthy 54-year-old man who is
diagnosed with erectile dysfunction. Which of the following is a potential
adverse effect of this medication?
A. Constipation
B. Cyanopsia
C. Prostate-specific antigen elevation
D. Urinary retention
B. Cyanopsia
-Cyanopsia, or blue discoloration of vision, is a potential side effect of
sildenafil. The effect may be more likely with higher dosages of medication and
is usually temporary.
Which of the following patients meets the criteria for diagnosis of diabetes
mellitus?
A. A patient with a fasting plasma glucose of 125 mg/dL and a hemoglobin
A1C of 6.0 percent
B. A patient with polyuria, blurry vision, and a random glucose of 200 mg/dL
C. An asymptomatic patient with a fasting glucose of 130 mg/dL (day 1) and
80 mg/dL (day 2)
D. An asymptomatic patient with a random glucose of 250 mg/dL
B. A patient with polyuria, blurry vision, and a random glucose of 200 mg/dL
-Asymptomatic patients may also be diagnosed with diabetes mellitus if they
have a fasting plasma glucose level of 126 mg/dL or higher, a hemoglobin A1C
of 6.5 percent or higher, or a two-hour oral glucose tolerance test plasma
glucose of 200 mg/dL or higher.
What is the most common presenting symptom of bladder carcinoma?
A. Nocturia
B. Painless hematuria
C. Unintentional weight loss
D. Urinary frequency
,B. Painless hematuria
A 32-year-old man is evaluated in the emergency department for complaints
of shortness of breath and palpitations that began at rest approximately 30
minutes ago. He recalls experiencing similar symptoms three days ago that
self-resolved after 10 minutes. He denies additional medical history and is
not taking any prescription or alternative medications. On physical exam, he
has clear and equal breath sounds bilaterally. His blood pressure is 134/88
mm Hg, heart rate 180 beats per minute, and respiratory rate is 24. An ECG
shows a narrow-complex supraventricular tachycardia (SVT). You have him
perform vagal maneuvers but do not see a change in his heart rate or
rhythm. Which of the following is the next best treatment?
A. Adenosine 6 mg IV
B. Amiodarone 300 mg IV
C. Atropine 0.5 mg IV
D. Synchronized cardioversion
A. Adenosine 6 mg IV
- In stable patients, vagal maneuvers (e.g. bearing down) can be performed
initially
-If vagal maneuvers are unsuccessful in the stable patient, adenosine 6 mg IV
push should be rapidly administered due to its short half-life.
Which of the following represents the best treatment plan for correction of
systemic acidosis in status epilepticus?
A. Fomepizole 15 mg/kg IV infusion over 30 minutes
B. Intravenous insulin infusion at 0.1 units/kg/hour
C. Sodium bicarbonate 2-5 mEq/kg IV infusion over four to eight hours
D. Watchful waiting for auto-correction of the acidosis once seizure activity
is controlled
D. Watchful waiting for auto-correction of the acidosis once seizure activity is
controlled
, A 75-year-old woman presents with complaints of weakness. She has
difficulty getting up from a seated position, going up or down stairs, and
lifting heavier objects that she could before without difficulty. You decide to
order a muscle biopsy to rule out or confirm your suspicion of polymyositis.
What muscle do you most likely want biopsied?
A. Brachioradialis
B. Gastrocnemius
C. Latissimus dorsi
D. Quadriceps femoris
D. Quadriceps femoris
-Quadriceps femoris, or possibly anyone of the four large muscles of the thigh,
are most commonly used for biopsy in confirming the diagnosis of polymyositis
A 62-year-old man presents reporting urinary hesitancy, dribbling, and
feeling of incomplete voiding. He states his symptoms have been
progressively worsening for the last six months. He denies hematuria, pain
with urination, or scrotal swelling. Which of the following physical exam
findings is most consistent with the diagnosis of benign prostatic
hypertrophy?
A. Asymmetry of the prostate
B. Boggy consistency of the prostate
C. Decreased anal sphincter tone
D. Rubbery consistency of the prostate
D. Rubbery consistency of the prostate
A 28-year-old male presents to the clinic with a four-year history of
abdominal bloating, flatulence, diarrhea, and a pruritic rash on his buttocks
and knees. He states his symptoms are worse with the consumption of
pasta. Which of the following is most likely to confirm the diagnosis?
A. 25-hydroxyvitamin D
B. Duodenal biopsy
