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Cardio and Blood 1SM

Total questions: 24

Worksheet time: 12mins

Name
Class
Date
1.

Roger is a 43-year-old CPA. He smokes two packs of cigarettes per day. He has no history of heart disease, diabetes, or blood pressure problems. He now complains about back pain, which is going to his left shoulder, causing pain that lasts 3-4 minutes. The pain is intense, and there is no pain in his arm. He has been working 16-hour days and is very stressed. During the acupuncture treatment, the shoulder pain returns, and he asks to be repositioned, but the pain is not relieved. He says that the pain is getting worse and is making him sweat. What is the presumptive diagnosis?

a)

Acute myocardial infarction

b)

Fever of unknown origin

c)

Hysteria

d)

Ventricular tachycardia

2.

Ramon is a 37-year-old bus driver born in Bolivia. He goes to the doctor complaining of swelling of his feet, mild shortness of breath, and trouble lying flat at night. He says he sleeps best in a chair. He feels drowsy when he drives a bus so he takes NoDoz to stay awake. Examination reveals 3+ pitting edema of both ankles extending up to mid-calf. There are no varicose veins. His lungs have fine rales in both lung bases. His liver is palpable three fingerbreadths below the right costal margin. His jugular veins are prominent when he lies down. What is the most likely diagnosis?

a)

Chronic fatigue

b)

Pulmonary emphysema

c)

Insomnia with apnea

d)

Congestive heart failure

3.

A 65-year-old man has Pernicious Anemia. What did the peripheral blood smear lab tests show?

a)

green-tinged erythrocytes

b)

oddly shaped RBCs

c)

large and fragile erythrocytes

d)

small RBCs

4.

A 44-year-old female has Idiopathic Thrombocytopenic Purpura. What are her symptoms?

a)

small, raised bumps that leak fluid when scratched

b)

red patches of skin covered with silvery scales

c)

pruritus and skin rash

d)

petechiae and mucosal bleeding

5.

A 65-year-old man has Pernicious Anemia. What are his symptoms?

a)

weakness, sore tongue, numbness-tingling in the extremities

b)

weakness, fatigue, shortness of breath on exertion, pale face

c)

weakness, tachycardia, shortness of breath, petechia

d)

weakness, craving for ice, dirt, or paint, concave nails

6.

A 67-year-old male patient reports increasing fatigue and achy legs during the last three months. He has leg pain in both legs when walking long distances. His leg pain stops when he walks ends or when he elevates his legs. The patient describes the aching in the legs as a sensation of heaviness. He has noticed lower extremity swelling in both legs during the day, but it is never present on waking in the morning, as he sleeps with his legs elevated. He denies night pain. He reports having a painless lesion on his ankle. The patient denies trauma, chest pain, shortness of breath, or palpitations. He denies a cardiac history, current heart problems, or renal dysfunction. He drinks beer 1-3 times per week and smokes one pack of cigarettes per week. He has a history of hypertension, dyslipidemia, and diabetes mellitus. His medications include Bystolic (nebivolol) for blood pressure, Lipitor (atorvastatin) for cholesterol, and Glucophage (metformin) for diabetes. Vital signs: • BP 130/85 • HR 72 and regular • RR 14 and regular • BMI is 29 Examination of the skin on the legs shows an ulcer with ragged edges measuring 0.5 cm × 0.5 cm on the left ankle above the medial malleolus. The lower extremities show a reddish-brown pigment of the calves with the skin that is thick and warm. There are visible and palpable varicosities on both legs. Ankle edema is present with pitting +2. HEENT is negative. Heart and lungs are negative. What is the most likely diagnosis?

a)

Chronic venous insufficiency

b)

Diabetic neuropathy

c)

Deep vein thrombosis

d)

Peripheral artery disease

7.

A 60-year-old male commodities broker complains of chest pain. He reports that the pain is +5/10 and has been increasing during the past three days. When he walks, he has both chest pain and dyspnea. The chest pain lessens by sitting upright and leaning forward. He denies radiation to his jaw, back, or arms. Family history: • Father died at age 58 from an MI • Mother died at age 75 with COPD Medications: • Allopurinol for gout • Ibuprofen for joint pain • Famotidine for acid reflux He has no allergies. His facial complexion is ashen. Vital signs: • BP 142/94 • Pulse 95 • Respiration 28 • Body temperature 100.8°F • Height 6 ft 4 • Weight 247 lbs HEENT is negative. Cardiovascular exam: • S1/S2 are strong with pericardial friction rub. • He has ankle edema. What is the most likely diagnosis for the chest pain?

a)

Myocardial infarction

b)

GERD

c)

Dilated cardiomyopathy

d)

Pericarditis

8.

A 65-year-old man has Pernicious Anemia. What is the treatment?

a)

Vitamin B-12

b)

Vitamin K

c)

Vitamin B6, Vitamin B1

d)

Vitamin C, Vitamin D

9.

A 62-year-old man has Chronic Lymphocytic Leukemia. What are his symptoms?

a)

persistent bleeding, pain, weight loss, frequent voiding

b)

palpable and painful lymph nodes, thyroid enlargement, dysphagia, mental apathy, sensitivity to cold and heat

c)

fatigue, painless lymph node enlargement, fever, abdominal fullness, bone tenderness

d)

weight loss, abdominal and back pain, jaundice, diarrhea, clay-colored stools, skin lesions

10.

A 44-year-old female has Idiopathic Thrombocytopenic Purpura. What will the lab findings reveal?

a)

increased white blood cell count

b)

increased MCH

c)

decreased platelet count

d)

decreased MCV

11.

A 44-year-old female has Idiopathic Thrombocytopenic Purpura. What are her symptoms?

a)

small, raised bumps that leak fluid when scratched

b)

petechiae and mucosal bleeding

c)

pruritus and skin rash

d)

red patches of skin covered with silvery scales

12.

A 22-year-old man has Hodgkin's Lymphoma. What are his symptoms?

a)

easy bruising, gum bleeding, epistaxis, enlarged liver and spleen

b)

painless lump in the neck, low-grade fever, night sweats, weight loss

c)

sweat gland dysfunction, wheezing, dyspnea, clubbing fingers and toes

d)

arthralgia, erythema nodosum, breathlessness, cough, enlarged spleen

13.

A 62-year-old man has Chronic Lymphocytic Leukemia. How was the diagnosis confirmed?

a)

thrombocytopenia with peripheral blood lymphoblasts

b)

elevated uric acid with immunophenotyping of bone marrow

c)

increased RBCs in the bone marrow

d)

peripheral blood smear and increased lymphocytes in the bone marrow

14.

A 45-year-old female has symptomatic Atherosclerosis. What treatments can be prescribed?

a)

lipid-lowering agents, dietary changes, and exercise

b)

anti-coagulant drugs, lipid-lowering agents

c)

SSRIs, lipid-lowering agents, anti-coagulant drugs

d)

statins, dietary changes, anti-coagulant drugs

15.

A 65-year-old female has Congestive Heart Failure. What are the symptoms?

a)

dyspnea worse lying down and improves sitting up, ankle swelling, edema, fatigue

b)

fatigue, extreme exhaustion, unrefreshing sleep, unexplained muscle pain, enlarged lymph nodes

c)

chest pain is better with rest and worse after exertion or strong emotions

d)

substernal pain with radiation to jaw and left arm, dyspnea, nausea, sweating

16.

A 72-year-old male has Angina Pectoris. Possible treatments can include

a)

angiotensin II receptor blocker, anticoagulant drugs, calcium channel blockers, long-acting nitrates

b)

anticoagulant drugs, calcium channel blockers, long-acting and short-acting nitrates

c)

anticoagulant drugs, calcium channel blockers, short-acting but not long-acting nitrates

d)

anticoagulant drugs, calcium channel blockers, long-acting but not short-acting nitrates

17.

A 65-year-old female has Congestive Heart Failure. Which tests confirm the diagnosis?

a)

chest x-ray, ECG

b)

chest x-ray, ECG, ferritin test

c)

chest x-ray, ECG, echocardiography

d)

ferritin test, ECG, echocardiography

18.

A 72-year-old male has Angina Pectoris. What are the symptoms?

a)

chest pain is better with rest and worse after exertion or strong emotions

b)

chest pain at the costosternal joints that is worse with deep breaths and coughing

c)

chest pain behind the sternum and mediastinal pain that it is not aggravated by exercise

d)

pain behind the sternum, which worsens bending forward, sour taste in the mouth, nausea

19.

A 60-year-old male smoker has Deep Venous Thrombosis in the calf. What tests are done to confirm the diagnosis?

a)

serum heparin

b)

Liver enzymes

c)

CBC

d)

duplex ultrasonography

20.

A 47-year-old woman is having a Myocardial Infarction. What are the symptoms?

a)

numbness on left side of chest, sore esophagus, difficulty breathing, bitter blood taste in mouth

b)

sharp, stabbing, well-localized chest pain which is aggravated on deep inspiration

c)

crushing, substernal pain with radiation to jaw and left arm, dyspnea, nausea, sweating

d)

middle of chest pain, fast breathing, palpitations, sense of doom, agoraphobia

21.

A 47-year-old woman has had a Myocardial Infarction. Which tests confirm the diagnosis?

a)

elevated AST and ALT

b)

elevated ESR and hsCRP

c)

ECG and Troponin I, CK

d)

ECG and chest x-ray

22.

A 55-year-old male has been diagnosed with Hypertension. Treatment can include

a)

diuretics (HCTZ), ACE inhibitors, or beta blockers

b)

tricyclics, diuretics (HCTZ), ACE inhibitors, or beta blockers

c)

lifestyle changes, diuretics (HCTZ), ACE inhibitors, or beta blockers

d)

tricyclics, lifestyle changes

23.

A 55-year-old male has been diagnosed with essential Hypertension. What are the most likely visible symptoms and signs?

a)

stiff neck, akinesia, tremors, muscle rigidity, dysarthria

b)

headache, fever, ataxia, tremors, nausea, vomiting

c)

stiff neck, positive Brudzinski, headache, vomiting

d)

dizziness, flushed face, headache, epistaxis, fatigue

24.

A 60-year-old male smoker has Deep Venous Thrombosis in the calf. What are his symptoms?

a)

arrhythmia, exertional syncope, palpable peripheral pulses

b)

varicose veins, itchy rash, sweating, sciatica

c)

calf pain, tenderness of the veins, edema, erythema

d)

restlessness, numbness, tingling, or burning sensations in the legs