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WorksheetsAnticoagulation in Atrial Fibrillation and Mitral Stenosis
Total questions: 20
Worksheet time: 10mins
A patient with atrial fibrillation and moderate mitral stenosis needs anticoagulation. What is the best choice?
Apixaban
Rivaroxaban
Dabigatran
Warfarin
A widened pulse pressure is most characteristic of which condition?
Aortic stenosis
Aortic regurgitation
Mitral stenosis
Mitral regurgitation
A patient with septic shock remains hypotensive despite fluids and norepinephrine. Lactate is persistently elevated. What best explains lactate elevation in sepsis?
Tissue hypoxia alone
Impaired hepatic clearance
Increased aerobic glycolysis from beta-adrenergic stimulation
Mitochondrial failure exclusively
A man with long-standing diabetes presents with orthostatic hypotension, resting tachycardia, and gastroparesis. What is the underlying mechanism?
Sympathetic overactivity
Baroreceptor hypersensitivity
Autonomic neuropathy affecting parasympathetic fibers first
Volume depletion
A 45-year-old woman has dyspnea, normal spirometry, decreased DLCO, and echocardiography showing RV dilation. What is the most likely diagnosis?
Interstitial lung disease
Pulmonary arterial hypertension
Chronic bronchitis
Left-sided heart failure
Which finding is classic for nephrotic syndrome?
RBC casts
Proteinuria >3.5 g/day
Low cholesterol
Decreased risk of thrombosis
Which organism is associated with reactive arthritis?
Staphylococcus aureus
Chlamydia trachomatis
Streptococcus pyogenes
Borrelia burgdorferi
A 62-year-old man with cirrhosis presents with confusion. Labs show Na 124, serum osmolality 260, urine Na 8, urine osmolality 600. Which mechanism is primarily responsible?
Renal sodium wasting
ADH-mediated water retention
Primary polydipsia
Cerebral salt wasting
A hospitalized patient develops hyponatremia after starting carbamazepine. Which lab pattern supports SIADH?
Urine osmolality <100
Urine sodium <10
Euvolemia with urine sodium >40
Elevated BUN/Cr ratio
Which drug can cause drug-induced lupus?
Methotrexate
Hydralazine
Azathioprine
Cyclophosphamide
A patient with long-standing rheumatoid arthritis (RA) develops splenomegaly and neutropenia. What is the most likely diagnosis?
Adult Still disease
Felty syndrome
Large granular lymphocyte leukemia
Secondary amyloidosis
A patient with chronic diarrhea, dermatitis, and dementia likely has a deficiency of:
Thiamine
Riboflavin
Niacin
Pyridoxine
A patient develops torsades de pointes. Which electrolyte abnormality most predisposes to this?
Hyperkalemia
Hypercalcemia
Hypomagnesemia
Hypernatremia
A patient with macrocytic anemia has elevated homocysteine but normal methylmalonic acid. What is the most likely diagnosis?
Vitamin B12 deficiency
Folate deficiency
Alcohol-induced anemia
Myelodysplastic syndrome
What is the most common cause of secondary hypertension overall?
Pheochromocytoma
Renal artery stenosis
Primary aldosteronism
Chronic kidney disease
Which medication reduces mortality in chronic systolic heart failure?
Furosemide
Digoxin
ACE inhibitors
Nitrates
What is the best initial test for suspected pulmonary embolism in a low-risk patient?
CT pulmonary angiography
V/Q scan
D-dimer
Doppler ultrasound
Which condition is associated with Kayser–Fleischer rings?
Hemochromatosis
Wilson disease
Alpha-1 antitrypsin deficiency
Primary biliary cholangitis
What is the most common cause of acute pancreatitis in the U.S.?
Gallstones
Alcohol
Hypertriglyceridemia
Medications
A patient with persistent fever, cytopenias, hyperferritinemia, and transaminitis. Bone marrow shows hemophagocytosis. Diagnosis?
Sepsis
Adult-onset Still disease
HLH
TTP
