تجميعات برومترك الباطنة — أسئلة اختبار الهيئة

1. A patient presented with chest pain, fever and arthralgia. He suffered a myocardial infarction 5 weeks earlier What is the most likely diagnosis?

1. Dressler's syndrome ✓
2. Meigs syndrome
3. Myocardial infarction
4. Pulmonary edema

الشرح: Dressler's syndrome هو post-MI pericarditis مناعي يظهر بعد أسابيع (2–10) من الاحتشاء بألم صدر وحمى والتهاب مفاصل/مصليات. Meigs syndrome هو ورم مبيض حميد مع ascites وpleural effusion، والاحتشاء المتكرر لا يسبب حمى وarthralgia، وPulmonary edema يسبب ضيق نفس لا حمى وألم مفاصل. المعلومة المفتاحية: ألم صدر + حمى بعد أسابيع من MI = Dressler's.

2. A 60-year-old man with diabetes and hypertension presented to the Emergency Department with 3-hour continuous retrosternal heaviness associated with profuse sweating. Physical examination reveals tachycardia and an S4 gallop on heart auscultation. The patient is commenced on aspirin, clopidogrel, metoprolol, and nitroglycerin infusion (see reports). Electrocardiogram: Sinus tachycardia with left bundle branch block. Previous ECG was normal. Cardiac enzymes: Pending. Which of the following is the most appropriate next step in management?

1. Start lidocaine infusion
2. Perform exercise ECG testing
3. Administer thrombolytic therapy ✓
4. Wait for the results of cardiac enzymes

الشرح: New LBBB مع أعراض ACS يعادل STEMI ويحتاج reperfusion؛ المعلومة المفتاحية: New LBBB = STEMI equivalent.

3. Elderly patient in 70s Hx of HTN, brought by his son. He stated to forget recent events but remembers old events. He forgets names. He misplaced his items and can't find them, social activities withdrawal due to lack of interest. Mini Mental exam was done and the result was low (i can't remember exactly the number) On MRI: There was cortical atrophy What medication to start?

1. Antipsychotic
2. Antidepressant
3. Cholinesterase inhibitor ✓

الشرح: Alzheimer مع cortical atrophy يعالج بـ cholinesterase inhibitor؛ المعلومة المفتاحية: Donepezil first-line.