General Medicine Tests

Test No1
60 y.o. Male visits the GP office for regular prophylactic consultation. Medical history of
smoking for 20 years, arterial hypertension from 10 years. His office blood pressure on
treatment with ACE inhibitors is 150/94 mmHg. The total cholesterol is 8 mmol/L, BMI +35,
TAGs 4.4 mmol/:, waist circumference 118 cm:

1. List components of metabolic syndrome

a. BMI
b. Cholesterol
c. TAGs
d. Waist circumference
2. Please list the risk factors included in the calculation of the SCORE of the patient
(mark with X)
a. Age - X
b. BMI -
c. Systolic BP - X
d. TAGs - X
e. Total cholesterol (?)
3. What is the definition of grade 1 hypertension (mark with X)
a. Systolic BP 140-159 mmHg and Diastolic BP 90-99 mmHg - X
b. Systolic BP 140-179 mmHg or Diastolic blood pressure 90-99 mmHg
c. Systolic BP 140-159 or diastolic BP 90-99 mmHg - X
d. Blah
e. Blah
4. What is the risk of fatal CVD event during next ten years (?)
a. Very high
b. High
c. Moderate
d. Low
5. Please explain your answer to Q 4
6. Please note the target levels of risk factors for this particular patient
a. Office blood pressure
b. Total cholesterol
c. Home BP
d. LDL-C
e. Fasting blood sugar
7. Which of the following measures and drugs would you prescribe (mark with x)
a. Change the ACE to a beta-blocker
b. Adding a CCB
c. Adding a loop diuretic
d. Inclusion of Statin
e. INclusion of Fibrate
f. Aspirin
g. Regular physical activity
Test 2
38 y.o. Female go to the GP for prophylactic consultation. Her office BP is 160/88 mmHG.
LDL-C is 2.4 mmol/L, TAGs 1.4 mmol/L, BMI 20, non smoker with FH of Diabetes

1. List the additional information that can be obtained by medical history or investigation
of the patient in order to calculate risk of CV event
a. .
b. .
c. .
d. .
2. List the risk factors included in the calculations of the SCORE
a. Diastolic BP
b. BMI
c. Systolic BP - X
d. Age - X
e. Family history of diabetes
3. Which of the following definitions of hypertension is wrong (X)
a. Nighttime abulator systolic BP >120 mmHg or diastolic BP >70 mmHg
b. Daytime ambulatory or home systolic >135 or diastolic >85
c. 24 hour ambulatory systolic BP >130 or diastolic >80
d. Office Systolic BP >140 mmHg or diastolic >90
e. Home systolic >140 mmHg or diastolic >90
4. What is the risk factor of fatal CV event in next ten years
a. Very high
b. High
c. Moderate
d. Low
5. Which of the following statements is true for home BP measurements
a. Should be performed every day in all patients
b. Are usually higher than clinic BP
c. Are usually lower than clinic pressure due to lack of ‘white coat effect’
d. Can be obtained with any commercially available electronic device
6. Note the target levels of risk factors for this patient
a. Office BP
b. Total Cholesterol
c. Home BP
d. LDL-C
e. Fasting blood sugar
7. Which of the following drugs and measures would you prescribe to achieve those
targets (X)
a. Monotherapy with centrally acting antihypertensive drug
b. Monotherapy with an ACE inhibitor
c. Starting with a combination antihypertensive therapy
d. Inclusion of statin
e. Aspirine
f. Promotion of physical activity
Test 3
64 year old female goes to the GP office for regular prophylactic consultation. She has a
history of diabetes treated with metformin (3x500mg). She has no history of coronary artery
disease in the family. BP is 150/90, while on beta blockers. Her cholesterol is 5.5 mmol/L,
HDL 0.8 mmol/L, TAGs 4.5 mmol/L, LDL-C 4.2 mmol/L.

1. One of the following parameters is not included in definition of metabolic syndrome

a. HDL
b. TAGs
c. LDL
d. BP
e. Waist circumferences
2. Please list the risk factors included in the calculation of the SCORE of a patient
a. Levels of systolic BP
b. We will not calculate the score
c. Age
d. Smoking
3. Which of the following statements on masked hypertension is not correct
a. The prevalence is rather high (20-30%)
b. Normalisation of the BP values in reference to ambulatory or home BP value
has to be obtained
c. Has the same prognosis as white coat hypertension
d. Should be suspected with the office BP are near the threshold values
e. Gives indication to search for existence of end organ damage
4. What is the risk of fatal CV event in next ten years
a. Very high
b. High
c. Moderate
d. Low
5. Explain 4
6. Please note the target values for this particular patient
a. Office BP
b. Total cholesterol
c. 24 hr ambulatory BP
d. LDL-C
e. HbA1C
7. Which of the following measures and drugs will you prescribe to try and achieve
these
a. Uputrate the beta blocker
b. Introduce ACE inhibitor
c. Introduce statin
d. Introduce fibrate
e. Aspirine
f. Regular physical activity
g. Include a loop diuretic
Test 4
72 y.o. Female goes to the GP for regular consultation. History of diabetes, treated with diet.
Performed coronary angiography which showed 50% stenosis of R coronary artery. BP
170/100, treated with centrally acting antihypertensives. Serum creatine is 158 micromol/L.
Weight 52 kg

1. List risk factors for SCORE (mark with X)

a. Levels of Systolic BP
b. We will not calculate SCORE
c. Age
d. Smoking
2. What does ECG Show
a. Isolated supraventricular extrasystole
b. Atrial fibrillation
c. Left ventricular hypertrophy
d. Isolated ventricular extrasystole
3. What is the risk of fatal CV even in next ten years
a. Very high
b. High
c. Moderate
d. Low
4. Explain 4
5. What is the risk of embolic stroke for this particular patient. Give explanation using
CHADSVASC score
6. What are target levels for this patient
a. Office BP
b. Total cholesterol
c. Home BP
d. LDL-C
e. HbA1C
7. Which of the following measures and drugs would you prescribe in order to achieve
these targets
a. Introduce beta blocker
b. Introduce statin
c. Starting a ?replacement? AH therapy
d. Aspirine
e. Anticoagulant
f. Including ACE inhibitor
Test 5 (a)
1. Which of the following definitions for hypertension are wrong:
a. Nighttime ambulatory systolic BP >120, diastolic BP >70
b. Daytime ambulatory or home systolic BP >135 or diastolic >85
c. 24 hr ambulatory systolic BP >130, or diastolic >90
d. Office systolic BP >140 or diastolic BP >90
e. Home systolic BP >140 or diastolic BP >90
2. The definition of masked hypertension relies on which of the following
a. Office BP 140/90, ambulatory BP or home BP >135/85
b. Office BP >140/90, ambulatory or home BP >135/85
c. Office BP >140/90, ambulatory or home BP <135/85
d. Office BP = 140/90, ambulatory or home BP =135/85
e. Office BP = 140/90, ambulatory BP or home BP <135/85
3. Which of the following statements on white coat hypertension is not correct
a. Rely on the performance of ambulatory or home BP measurements
b. Must be followed every second year
c. Has a rather good prognosis
d. ?
4. Which of following criteria is not included in the calculation of HAS-BLED score
a. Concomitant antiplatelet agent
b. Serum creatinine = 200 mmol/L
c. Previous stroke
d. Age > 60 y.o
e. Alcohol
5. Please note the target levels of risk factors for px with SCORE between 3-10%
a. Office BP
b. Total cholesterol
c. Home BP
d. LDL-C
e. Fasting Blood sugar
6. Sympathetic nervous activity is increase in
a. Hypertension
b. Renal failure
c. All of the above
d. Congestive HF
e. None of the above
7. Which of the following statements on non-rheumatic atrial fibrillation is correct
a. Is only a problem in pxs older than 80 years hypertension
b. Requires oral anticoagulants only in high risk groups
c. Affects all age groups but predominantly elderly subjects and is an important
predictor of premature death
d. Is an important risk factor for the development of atrial fibrillation and
peripheral embolism but not for death
e. Arterial hypertension has a positive effect on electrical atrial remodelling
Test 5 (b) ​(hard to read, am excluding many details, just writing questions to get an idea)
1. Which of the following can be used for diagnosis of metabolic syndrome
a. HDL (x val)
b. TAGs (x val)
c. LDL (x val)
d. BP 140/90
e. Fasting blood sugar (x val)
f. Waist circumference 110cm
2. Which results make diabetes
3. Which of the following factors are not included in calculation of the SCORE
4. Which of the following criteria are included in calculation of CHADSVASC score
5. Please note the target values for risk factors for patient with calculated SCORE of
1-5% for next 10 years
a. Ambulatory 24hr BP
b. Total cholesterol
c. Nighttime BP
d. LDL-C
e. HbA1c
6. Which of the following statements on masked hypertension is correct
7. Please give the full list of pxs in the group ‘high risk’ according to EU guidelines
8. Right HF is?
9. Combination with ACE-diuretic is indicated in patients with high CV risk without organ
damage
a. True
b. False
10. Arrange the following individuals aged 60 years without previous CVD or diabetes in
order of increased risk
Test 6
1. Which form of stroke is most frequent
a. Stroke due to hypoglycemia
b. Ischemic
c. Subdural hemorrhage
d. Hemorrhage
e. Stroke due to ??
2. What are the current goals for fasting blood glucose patients with hypertension and
diabetes
a. Blood glucose (BG) <5.5 mmol/L and HbA1C <6%
b. BG >5 mmol/L and HbA1C <5.5%
c. BG >6.5 mmol/L and HbA1C <7%
d. BG <6.0 mmol/L and HbA1C 6.5%
e. BG <7.0 mmol/L and HbA1C <7.5%
3. Which statement is not correct: Statin therapy is recommended in hypertensive
patients
a. With previous CV events
b. With diabetes
c. With high CV risk
d. With reduced renal function
e. With LDL cholesterol >2.5 mmol/l
4. Which of following criteria are included in the calculation of HASBLED score
a. Concomitant antihypertensive agents
b. Serum creatinine 56 picomole/L
c. Smoking
d. Age>65
e. Alcohol
5. Please note the target levels of risk factors for patient with calculated SCORE
between 1 and 5% for next ten years
a. Ambulatory 24 hr BP
b. Total cholesterol
c. Home BP
d. LDL-C
e. Fasting blood sugar
6. Which of the following definitions of hypertension are wrong
a. Nighttime ambulatory systolic BP >120 or diastolic BP >70
b. Daytime ambulatory or home systolic BP > 135 or diastolic BP >85
c. 24 hour ambulatory systolic BP >130 or diastolic BP >80
d. Home Systolic BP >130 or diastolic BP >90
7. Which subject has the highest absolute cardiovascular risk according to ESH risk
stratification table

Test 7
(don’t have questions)
Test 8
(don’t have questions)