ECFMG Medical Knowledge & Clinical Science 2

Question 1

A 45-year-old man presents with episodic hypertension, headache, and diaphoresis. 24-hour urine shows elevated catecholamines. Which imaging is the FIRST-LINE localization study?

Accepted Answer

CT of abdomen and pelvis

Answer

CT of the abdomen and pelvis is the first-line imaging for pheochromocytoma localization due to its wide availability and high sensitivity.

Question 2

A 28-year-old woman at 32 weeks gestation presents with BP 158/102, proteinuria, and headache. Which medication is CONTRAINDICATED for acute BP control?

Accepted Answer

ACE inhibitor

Answer

ACE inhibitors are contraindicated in pregnancy due to fetal renal toxicity, oligohydramnios, and fetal growth restriction.

Question 3

A 60-year-old smoker presents with a lung mass and hyponatremia. Serum osmolality is low and urine osmolality is high. What is the most likely cause of hyponatremia?

Accepted Answer

SIADH

Answer

SIADH is classically associated with small cell lung carcinoma and causes euvolemic hyponatremia with inappropriately concentrated urine.

Question 4

A patient with rheumatoid arthritis on methotrexate develops megaloblastic anemia and oral ulcers. What is the mechanism of methotrexate's toxicity here?

Accepted Answer

Folate antagonism via DHFR inhibition

Answer

Methotrexate inhibits dihydrofolate reductase, blocking folate metabolism and causing folate-deficiency manifestations including megaloblastic anemia.

Question 5

A 55-year-old man has ST-segment elevation in leads II, III, and aVF on ECG. Which coronary artery is most likely occluded?

Accepted Answer

Right coronary artery

Answer

Inferior STEMI (ST elevation in II, III, aVF) is most commonly caused by occlusion of the right coronary artery.

(ECFMG) Educational Commission for Foreign Medical Graduates Practice Test

(ECFMG) Educational Commission for Foreign Medical Graduates Practice Test

ECFMG Medical Knowledge & Clinical Science 2