PAEA EOC 2025, PAEA
Summative Practice, physician
assistant PRACTICE EXAM
QUESTIONS WITH CORRECT
DETAILED ANSWERS |
ALREADY GRADED A+<RECENT
VERSION>
1. what exactly causes the occlusive vascular disease of thromboangiitis obliterans? -
ANSWER aka Buerger's disease
2. 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
3. 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)
4. If pheo suspected: measure fractionated metanephrines and catecholamines in a 24-hour
urine collection
5. 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)
, 6. most important modifable risk factor for AAA? - ANSWER smoking cessation!
7. 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
8. 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
9. 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
10. gold standard for dx renal artery stenosis? what can be used to monitor disease progression?
ANSWER renal arteriography
But really a spiral CT angiography is very useful and probably more likely done first
duplex doppler US can be used to monitor disease progression
11. what are some symptoms of mitral valve prolapse syndrome? - ANSWER various
nonspecific symptoms such as palpitations, dyspnea, exercise intolerance, anxiety disorders,
and dizziness
12. since symptoms are relatively uncommon, what physical exam findings are associated with
mitral valve prolapse? - ANSWER non-ejection click in systole
click is mobile, meaning its timing varies with maneuvers that change the left ventricular
volume, occurring earlier in systole with sitting, standing, or other interventions that reduce
ventricular size, or later with those interventions that increase chamber size such as squattin
People with MVP tend to have lower BMIs
13. how would you distinguish vasospastic angina and angina associated with CAD? -
ANSWER quality of the CP is typically indistinguishable of the two
, patients with vasospastic angina report that their episodes are predominantly at rest and that
many occur from midnight to early morning, while effort tolerance is usually preserved. CP
generally lasts 5 to 15 minu
14. where do karposi sarcoma lesions typically occur? describe their appearance. - ANSWER
often on distal extremities, such as lower legs and feet
15. purplish, reddish blue, or dark brown/black macules, plaques, and nodules on the skin.
Nodular lesions may ulcerate and bleed easily
common in poorly controlled HIV
16. how would you treat hidradenitis suppurativa? - ANSWER topical clindamycin
if fail topical therapy, oral tetracyclines are suggested
Antiandrogenic drugs and metformin are additional treatment options that may be used
alone or in conjunction with antibiotic therapy
17. Pt with hypertriglyceridemia >885 mg/dL that required medical therapy due to no
improvement after lifestyle changes and statin. how would you treat? - ANSWER
fenofibrate
fenofibrate is better than gemfibrozil bc can be used with a statin. Gemfibrozil has a higher
risk ofmuscle toxicity
18. how would you initially treat a pt with hypertriglyceridemia? - ANSWER lifestyle changes
(reduce EtOH consumption, aerobic exercise, better glycemic control) and statin
inflammatory thrombi affecting the medium and small vessels (nonatherosclerosis)
polymorphonuclear leukocytes, microabscesses, and multinucleated giant cells may be
presen
19. 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)
20. 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
45.how would you manage a patient with a MI in the setting of cocaine use? - ANSWER
benzodiazepine early
, no beta blockers
21. 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 minutesfibrolytic therapy can be used up to 12 hours of
symptoms
22. 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
23. 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
24. 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
25. 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)
26. most important modifable risk factor for AAA? - ANSWER smoking cessation!
27. 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
Summative Practice, physician
assistant PRACTICE EXAM
QUESTIONS WITH CORRECT
DETAILED ANSWERS |
ALREADY GRADED A+<RECENT
VERSION>
1. what exactly causes the occlusive vascular disease of thromboangiitis obliterans? -
ANSWER aka Buerger's disease
2. 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
3. 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)
4. If pheo suspected: measure fractionated metanephrines and catecholamines in a 24-hour
urine collection
5. 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)
, 6. most important modifable risk factor for AAA? - ANSWER smoking cessation!
7. 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
8. 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
9. 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
10. gold standard for dx renal artery stenosis? what can be used to monitor disease progression?
ANSWER renal arteriography
But really a spiral CT angiography is very useful and probably more likely done first
duplex doppler US can be used to monitor disease progression
11. what are some symptoms of mitral valve prolapse syndrome? - ANSWER various
nonspecific symptoms such as palpitations, dyspnea, exercise intolerance, anxiety disorders,
and dizziness
12. since symptoms are relatively uncommon, what physical exam findings are associated with
mitral valve prolapse? - ANSWER non-ejection click in systole
click is mobile, meaning its timing varies with maneuvers that change the left ventricular
volume, occurring earlier in systole with sitting, standing, or other interventions that reduce
ventricular size, or later with those interventions that increase chamber size such as squattin
People with MVP tend to have lower BMIs
13. how would you distinguish vasospastic angina and angina associated with CAD? -
ANSWER quality of the CP is typically indistinguishable of the two
, patients with vasospastic angina report that their episodes are predominantly at rest and that
many occur from midnight to early morning, while effort tolerance is usually preserved. CP
generally lasts 5 to 15 minu
14. where do karposi sarcoma lesions typically occur? describe their appearance. - ANSWER
often on distal extremities, such as lower legs and feet
15. purplish, reddish blue, or dark brown/black macules, plaques, and nodules on the skin.
Nodular lesions may ulcerate and bleed easily
common in poorly controlled HIV
16. how would you treat hidradenitis suppurativa? - ANSWER topical clindamycin
if fail topical therapy, oral tetracyclines are suggested
Antiandrogenic drugs and metformin are additional treatment options that may be used
alone or in conjunction with antibiotic therapy
17. Pt with hypertriglyceridemia >885 mg/dL that required medical therapy due to no
improvement after lifestyle changes and statin. how would you treat? - ANSWER
fenofibrate
fenofibrate is better than gemfibrozil bc can be used with a statin. Gemfibrozil has a higher
risk ofmuscle toxicity
18. how would you initially treat a pt with hypertriglyceridemia? - ANSWER lifestyle changes
(reduce EtOH consumption, aerobic exercise, better glycemic control) and statin
inflammatory thrombi affecting the medium and small vessels (nonatherosclerosis)
polymorphonuclear leukocytes, microabscesses, and multinucleated giant cells may be
presen
19. 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)
20. 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
45.how would you manage a patient with a MI in the setting of cocaine use? - ANSWER
benzodiazepine early
, no beta blockers
21. 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 minutesfibrolytic therapy can be used up to 12 hours of
symptoms
22. 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
23. 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
24. 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
25. 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)
26. most important modifable risk factor for AAA? - ANSWER smoking cessation!
27. 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
