2 Item: 1 of 3 ljl f> Mark <::J t::>

Q. ld: 5022 Previous Next

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A 38-year-old w oman comes to the physician for a routine checkup. She has no current complaints. The
patient's past medical history is significant for hypertension and type 2 diabetes mellitus. Her medications
include low -dose hydrochlorothiazide, lisinopril, metformin, and glyburide. She smokes 1/2 pack of cigarettes
daily and drinks alcohol occasionally. Her last menstrual period w as 2 w eeks ago. Blood pressure is 130/85
mm Hg and pulse is 85/min. The patient's body mass index is 32 kg/m 2. The remainder of the physical
examination is w ithin normal limits. Her fasting blood glucose is 120 mg/dl and HbA1C level is 6.7%. W hich
of the follow ing factors is the most significant predictor of future cardiovascular events in this patient?

r A. Age
r B. Alcohol consumption
r C. Diabetes mellitus
r D. Gender
r E. Hypertension
r F. Obesity
r G. Smoking
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Item: 2 of 3
Q. ld: 5309 [
ljl f> Mark <::J
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t::>
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A 17-year-old African American male comes to the w alk-in clinic complaining of frequent headaches. He
plays basketball on w eekends but over the last 3 months he has noticed decreased exercise tolerance due to
shortness of breath . He also describes low er extremity sw elling. His blood pressure is 210/ 120 mmHg and
his heart rate is 85/min. W hich of the follow ing is the most likely cause of this patient's condition?

r A. Adrenal cortical tumor

r B. Adrenal medullary tumor
r C. Congenital heart abnormality
r D. Renal artery stenosis
r E. Renal parenchymal disease
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2 Item: 3 of 3 ljl f> Mark <::J t::>
Q. ld: 6322 [ Previous Next

A 60-year-old man is found to have an incidental 3.5-cm abdominal aortic aneurysm on an imaging study. He
has no associated symptoms. Past medical history is significant for hypertension, type 2 diabetes,
hypercholesterolemia, and hypothyroidism. His medications include aspirin, metformin, glipiz ide,
chlorthalidone, lisinopril, atorvastatin, and levothyroxine. The patient has a 40-pack-year smoking history and
continues to smoke 1-2 packs a day. He drinks 3 or 4 glasses of w ine daily. His blood pressure is 160/90
mm Hg and pulse is 80/min. Cardiopulmonary examination is w ithin normal limits. Laboratory results are as
follow s:
Serum creatinine 1.3 mg/dL
Low density lipoprotein 150 mg/dL
HbA1C 8.5%
Serum thyroid-stimulating hormone 3.0 iJU/mL

W hich of the follow ing interventions w ould most decrease the likelihood of expansion of this patient's aortic
aneurysm?

r A. Aggressive diabetes management

r B. Improved blood pressure control
r C. Moderation of alcohol intake
r D. Optimized hyperlipidemia treatment
r E. Smoking cessation