ENAM Practice (Peru National Medical Examination) · Internal Medicine

Cardiovascular and respiratory medicine

13 practice questions, each with the answer and an explanation.

Practise Cardiovascular and respiratory medicine now

Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 13 questions

  1. A 62-year-old man has chest pain for 30 minutes, and the ECG shows ST elevation in leads V1 to V4. Which coronary artery is most likely occluded?
  2. A 70-year-old woman has dyspnoea, orthopnoea and bilateral leg oedema. Echocardiography shows an ejection fraction of 30%. Which drug class reduces mortality in this condition?
  3. A 68-year-old man has an irregularly irregular pulse and no P waves on the ECG. What is the most important complication to prevent?
  4. A 25-year-old man has fever, a new murmur and splinter haemorrhages. He injects drugs. Which valve is most commonly involved?
  5. A 45-year-old man has pleuritic chest pain that improves on leaning forward, and a friction rub is heard. What is the most likely diagnosis?
  6. A 75-year-old woman has syncope on exertion, angina and a crescendo-decrescendo systolic murmur radiating to the carotids. What is the most likely diagnosis?
  7. A 30-year-old woman has episodic wheeze and cough at night, and her symptoms worsen with exercise. Which test confirms the diagnosis?
  8. A 65-year-old smoker has chronic productive cough and dyspnoea, with an FEV1/FVC ratio of 0.62 after bronchodilator. What is the most appropriate first-line inhaled therapy?
  9. A 28-year-old woman on oral contraceptives has sudden pleuritic chest pain and tachycardia, and her chest radiograph is normal. What is the best initial test if she is haemodynamically stable?
  10. A 55-year-old man has fever, productive cough and consolidation in the right lower lobe. Which organism is the most common cause of community-acquired pneumonia?
  11. A 40-year-old man from a high-altitude region has cough for four weeks, night sweats and weight loss. The smear shows acid-fast bacilli. What is the standard initial regimen for drug-susceptible tuber…
  12. A 22-year-old tall thin man develops sudden right-sided pleuritic pain and dyspnoea. A chest radiograph shows a visible pleural line with no lung markings beyond it. What is the diagnosis?
  13. A 58-year-old man has hypertension of 170/100 mmHg on three occasions. Which is the first-line drug class in a non-pregnant adult without comorbidities?

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