Simulado 1

Question 1

What is the normal range for MCV?

Answer 1

80 to 100

Question 2

Vitamin B12 deficiency can increase serum _____, implicated as a strong risk factor for CV disease

Answer 2

Homocysteine

Question 3

What is Colles fracture?

Answer 3

Fracture of the distal 3cm of the radius - cast should include wrist and forearm but not thumb and elbow

Question 4

If aortic dissection is suspected, what is the appropriate initial management?

Answer 4

Morphine for pain control
Beta blockers to maintain systolic blood pressure < 120mmHg
Transesophageal sonography

Question 5

What is the best imaging to evaluate aortic dissection?

Answer 5

Transoesophageal echocardiography (TOE)

Question 6

What confirms the diagnosis of aortic dissection on imaging?

Answer 6

When two lumpen’s are separated by an íntimas flap

Question 7

What is the treatment for acute aortic dissections?

Answer 7

Ascending aorta = surgical repair of aortic root
Descending aorta = medical treatment unless progression of dissection, uncontralable pain or extra-aortic blood

Question 8

Epigastric pain that radiates to lower back + low blood pressure + signs of chock indicates which diagnosis?

Answer 8

Ruptured abdominal aortic aneurysm

Question 9

What is the definition of an aneurysm?

Answer 9

An artery that has enlarges > 1,5x the expected diameter

Question 10

What size of aortic aneurysms are at significant risk of rupture and should be repaired?

Answer 10

Men < 5,5cm
Women > 5cm

Question 11

What is the first line treatment for scabies?

Answer 11

Permethrin 5% cream

Question 12

What is the second-line therapy for scabies?

Answer 12

Benzoyl benzoato - if treatment with permethrin fails - but it’s more irritating to the skin and more likely to fail dure to inadequate adherence

Question 13

What is intradyalitic hypertension (IDH?)

Answer 13

• Increase in mean arterial blood pressure >/= 15mmHg during of immediately after hemodialysis
• Increase in SBP > 10mmHg pre to post dialysis
• Hypertension during the second or third hour of hemodialysis after significant ultrafiltration
• Increase in BP resistant to ultrafiltration

Question 14

What is the correct recommendation for driving after a isolated episode of seizure?

Answer 14

1 episode of seizure after at least 12 months of well controled by drugs
- 4 weeks of no driving if provocative factor identified
- 3 months if no cause is found

Question 15

What are the characteristic of a physiologic murmur on healthy children and adolescentes?

Answer 15

7 S’s
1. SENSITIVE = changes with position or respiration
2. SHORT DURATION = not holosystolic
3. SINGLE = no associated clicks or gallops
4. SMALL = limited to a small area and non radiating
5. SOFT = low amplitude
6. SWEET = no harsh sounding
7. SYSTOLIC = limited to systole

Question 16

What are the characteristics of a pathological murmur on children/infants?

Answer 16

> Grade 3/6 or higher murmurs
Harsh quality
Abnormal S2
Presence of a systolic click
Symptomatic
Increased intensity when venous return decreases (e.g. standing)