CEA Prep: Full Practice Exam

CEA Prep: Full Practice Exam
The patient is exhibiting a productive cough and a low-grade fever. Chest X-ray on PA
view shows a left lower chest area of consolidation adjacent to the left border of the
heart approximately 2 rib spaces above the costophrenic angle. The lateral x-ray view
shows this lesion absent of the window posterior to the cardiac silhouette. Which is the
most likely location of this area of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
Rationale: Lingular consolidation is described in this question precisely. If the cardiac
margin/silhouette is obliterated by the mass, the lesion is either right middle lobe or left
upper lobe lingula.
The inability to fully relax the myocardium during relaxation is a trademark of which of
the following diagnoses?
Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark of the diagnosis of diastolic
dysfunction and is common in patients with thickened hypertrophic myocardium.
An otherwise healthy African American adult male has been diagnosed with
hypertension. He has been restricting his salt intake, eating a DASH (Dietary
Approaches to Stop Hypertension) diet, and exercising more, but his blood pressure is
still elevated. Which is the BEST medication to prescribe him?
Calcium channel blocker
Rationale: African American patients per JNC8 Hypertension Guidelines should be
managed with a dihydropyridine calcium channel blocker such as amlodipine (Norvasc)
as first line management therapy for hypertension not at goal with DASH and lifestyle
modifications.
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?
CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring vascular
luminal dimensions with contrast. CT PE protocol is not timed properly for the aorta (it's
timed for the pulmonary artery). Although a plain film is able to catch large aneurysms at
times, they are not able to provide multi-axis reconstruction needed to accurately
measure the size. Transesophageal echo is not needed to accurately measure the aorta
and requires the patient to undergo sedation which is unnecessary. 

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