SPEX SPEX Analysis Exam 2

Question 1

A 58-year-old man presents with sudden-onset severe headache described as 'the worst headache of my life.' What is the most critical diagnosis to rule out?

Accepted Answer

Subarachnoid hemorrhage

Answer

A sudden, severe 'thunderclap' headache must be presumed to be subarachnoid hemorrhage until proven otherwise by CT and lumbar puncture.

Question 2

Which of the following is the MOST appropriate initial antibiotic choice for community-acquired pneumonia in a healthy outpatient without comorbidities?

Accepted Answer

Azithromycin or amoxicillin

Answer

Current IDSA/ATS guidelines recommend azithromycin or amoxicillin as first-line therapy for outpatient CAP in patients without comorbidities.

Question 3

A 45-year-old woman with Type 2 diabetes has a blood pressure of 138/88 mmHg on two separate visits. Which antihypertensive drug class is preferred as first-line therapy?

Accepted Answer

ACE inhibitors or ARBs

Answer

ACE inhibitors and ARBs are preferred in diabetic patients with hypertension due to their renoprotective effects.

Question 4

On a 12-lead ECG, which finding is most consistent with an acute ST-elevation myocardial infarction (STEMI) of the anterior wall?

Accepted Answer

ST elevation in leads V1–V4

Answer

ST elevation in the precordial leads V1–V4 indicates anterior STEMI, most commonly due to left anterior descending artery occlusion.

Question 5

A physician is unsure whether a 70-year-old patient with newly diagnosed prostate cancer would benefit from aggressive treatment. What is the most appropriate next step?

Accepted Answer

Obtain a Gleason score and stage the cancer

Answer

Risk stratification using Gleason score, PSA level, and clinical stage is essential before deciding on treatment in prostate cancer.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX SPEX Analysis Exam 2