SPEX SPEX Analysis Exam 5

Question 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?

Accepted Answer

Levothyroxine (T4) replacement

Answer

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

Question 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?

Accepted Answer

Renal cell carcinoma

Answer

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

Question 3

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

Accepted Answer

Norepinephrine

Answer

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

Question 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?

Accepted Answer

Bisphosphonate therapy such as alendronate

Answer

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

Question 5

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

Accepted Answer

FEV1/FVC ratio < 0.70 with normal or increased TLC

Answer

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

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX SPEX Analysis Exam 5