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SPEX Analysis Exam Flashcards

7 cards from real SPEX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 40-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. TSH is 12 mIU/L with a low free T4. What is the most appropriate treatment?

    Answer: Levothyroxine (T4) replacement

    Levothyroxine (synthetic T4) is the standard treatment for hypothyroidism because peripheral conversion to T3 provides adequate hormonal replacement.

  2. A 30-year-old man presents with hematuria, flank pain, and a palpable abdominal mass. Urinalysis shows RBCs without casts. What is the most concerning diagnosis?

    Answer: Renal cell carcinoma

    The classic triad of hematuria, flank pain, and palpable mass strongly suggests renal cell carcinoma and warrants urgent imaging.

  3. A patient develops septic shock. After fluid resuscitation fails to maintain MAP ≥ 65 mmHg, what is the first-line vasopressor?

    Answer: Norepinephrine

    Norepinephrine is the first-line vasopressor for septic shock per Surviving Sepsis Campaign guidelines due to its strong alpha-adrenergic vasoconstrictor activity.

  4. A 62-year-old woman with a history of osteoporosis has a T-score of -2.8. She has no prior fractures. Which intervention has the strongest evidence for fracture prevention?

    Answer: Bisphosphonate therapy such as alendronate

    Bisphosphonates like alendronate have the strongest evidence base for reducing vertebral and hip fracture risk in osteoporosis.

  5. Which finding on spirometry is most consistent with obstructive lung disease such as COPD?

    Answer: FEV1/FVC ratio < 0.70 with normal or increased TLC

    Obstructive disease is characterized by FEV1/FVC < 0.70 post-bronchodilator, with air trapping leading to normal or elevated TLC.

  6. A patient with chronic hepatitis C and cirrhosis develops confusion, asterixis, and elevated ammonia. What is the immediate management priority?

    Answer: Administer lactulose and identify precipitating factors

    Hepatic encephalopathy is managed with lactulose to reduce ammonia absorption and identification of precipitating factors such as infection or GI bleeding.

  7. A physician treating a patient discovers that a colleague is impaired by substance abuse and is practicing unsafely. What is the physician's obligation?

    Answer: Report the colleague to the appropriate medical board or hospital authority

    Physicians have a professional and ethical obligation to report an impaired colleague to protect patient safety, even if it involves reporting to licensing boards.