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Multiple Choice Questions (MCQ)

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Category: Cardiology--->Peripheral Vascular Disease
Page: 2

Question 6#Print Question

A 15-year-old man presents to the clinic accompanied by his mother for evaluation of “red hands.” He earned money last winter clearing sidewalks of snow and plans to do so again in the upcoming weeks. He reports developing red discoloration of his hands after returning home from the cold. The discoloration persisted for a few minutes until his hands were rewarmed. He denies weakness, paresthesia, pain, or skin lesions. He is otherwise healthy. At the time of consultation, inspection of his hands is unrevealing. Radial and ulnar pulses are 2+/2 bilaterally. The Allen test and reverse Allen test reveal return of color to the hands in 7 seconds bilaterally. His mother reports that she and her mother both have Raynaud phenomenon. The patient’s mother expresses concern that her son may have systemic lupus and she requests further testing.

What is the most likely diagnosis?

a. Raynaud disease
b. Raynaud phenomenon
c. Normal physiologic cold response
d. Acrocyanosis
e. Thermal injury


Question 7#Print Question

A 15-year-old man presents to the clinic accompanied by his mother for evaluation of “red hands.” He earned money last winter clearing sidewalks of snow and plans to do so again in the upcoming weeks. He reports developing red discoloration of his hands after returning home from the cold. The discoloration persisted for a few minutes until his hands were rewarmed. He denies weakness, paresthesia, pain, or skin lesions. He is otherwise healthy. At the time of consultation, inspection of his hands is unrevealing. Radial and ulnar pulses are 2+/2 bilaterally. The Allen test and reverse Allen test reveal return of color to the hands in 7 seconds bilaterally. His mother reports that she and her mother both have Raynaud phenomenon. The patient’s mother expresses concern that her son may have systemic lupus and she requests further testing.

Of the following, which is the most appropriate next step to objectively evaluate this patient?

a. Obtain an upper extremity angiogram with selective imaging of the digital vessels and before and after administration of nitroglycerin
b. Obtain digital pulse volume recordings and transcutaneous partial pressure of oxygen measurements of the digits
c. Order a C-reactive protein level, erythrocyte sedimentation rate, and perform nailfold capillaroscopy
d. Order a C-reactive protein level, erythrocyte sedimentation rate, and plasma homocysteine level
e. Order antinuclear antibodies, erythrocyte sedimentation rate, and perform nailfold capillaroscopy


Question 8#Print Question

A 15-year-old man presents to the clinic accompanied by his mother for evaluation of “red hands.” He earned money last winter clearing sidewalks of snow and plans to do so again in the upcoming weeks. He reports developing red discoloration of his hands after returning home from the cold. The discoloration persisted for a few minutes until his hands were rewarmed. He denies weakness, paresthesia, pain, or skin lesions. He is otherwise healthy. At the time of consultation, inspection of his hands is unrevealing. Radial and ulnar pulses are 2+/2 bilaterally. The Allen test and reverse Allen test reveal return of color to the hands in 7 seconds bilaterally. His mother reports that she and her mother both have Raynaud phenomenon. The patient’s mother expresses concern that her son may have systemic lupus and she requests further testing.

When would be the most appropriate time to schedule a follow-up appointment?

a. 5 years
b. 3 years
c. 2 years
d. 1 year
e. As needed


Question 9#Print Question

A 49-year-old man presents to the clinic with complaints of progressive exertional dyspnea for several weeks. His speech is mildly breathless. Neck veins are distended bilaterally and there is moderate lower extremity edema. He denies chest pain. Electrocardiogram (ECG) shows sinus tachycardia without ST-segment abnormality. Physical examination reveals a parasternal heave and systolic ejection murmur. Past medical history is significant for splenectomy after a car accident several years ago.

Which of the following will most accurately confirm the underlying cause of this patient’s symptoms? 

a. Chest computed tomography (CT) with IV contrast
b. Transthoracic echocardiogram
c. Transesophageal echocardiogram
d. Pulmonary arteriogram
e. Ventilation–perfusion scan


Question 10#Print Question

A 49-year-old man presents to the clinic with complaints of progressive exertional dyspnea for several weeks. His speech is mildly breathless. Neck veins are distended bilaterally and there is moderate lower extremity edema. He denies chest pain. Electrocardiogram (ECG) shows sinus tachycardia without ST-segment abnormality. Physical examination reveals a parasternal heave and systolic ejection murmur. Past medical history is significant for splenectomy after a car accident several years ago.

Which of the following statements is most accurate concerning this patient’s underlying diagnosis?

a. Inflammatory mechanisms have not been implicated in the pathogenesis
b. Patients should be anticoagulated with a vitamin K antagonist and target INR of 2.5 to 3.5
c. IV epoprostenol is an effective therapy in patients with advanced disease
d. Inhaled iloprost has been demonstrated to improve exercise capacity
e. Bosentan has been shown to improve exercise capacity in patients with mild-to-moderate liver disease




Category: Cardiology--->Peripheral Vascular Disease
Page: 2 of 10