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Question 1
A 64-year-old man presents with recurrent episodes of retrosternal chest pressure occurring at rest over the past 12 hours. His ECG shows 1.5-mm horizontal ST-segment depression in leads V4 through V6 and T-wave inversion in lead aVL. High-sensitivity cardiac troponin I is elevated at 480 ng/L (reference < 14 ng/L). His calculated GRACE risk score is 158. He is hemodynamically stable with a blood pressure of 135/85 mmHg and a heart rate of 76 bpm. Which of the following is the most appropriate next step in management?
Correct Answer:
Early invasive coronary angiography within 24 hours
Question 2
A 58-year-old woman with ischemic cardiomyopathy and heart failure with reduced ejection fraction (LVEF 28%, NYHA functional class II) is evaluated in the clinic. Her current medications include guideline-target doses of enalapril and bisoprolol. Her vital signs are: BP 118/74 mmHg, HR 64 bpm. Laboratory evaluation shows serum sodium 139 mEq/L, potassium 4.2 mEq/L, and eGFR 68 mL/min/1.73 m2. Which of the following medications should be added next to improve survival according to guideline-directed medical therapy (GDMT)?
Correct Answer:
Empagliflozin
Question 3
A 46-year-old man with active Staphylococcus aureus aortic valve endocarditis suddenly develops acute respiratory distress and severe orthopnea. On examination, his blood pressure is 95/70 mmHg, heart rate is 118 bpm, and respiratory rate is 32 breaths/min. Auscultation reveals a soft, short early diastolic murmur along the left sternal border and bilateral pulmonary rales. Transthoracic echocardiography demonstrates severe acute aortic regurgitation with large mobile vegetations and premature closure of the mitral valve in early diastole. Which of the following is the most appropriate definitive management?
Correct Answer:
Urgent surgical aortic valve replacement
Question 4
A 72-year-old woman is diagnosed with newly discovered non-valvular paroxysmal atrial fibrillation. Her medical history includes hypertension, type 2 diabetes mellitus, and a transient ischemic attack (TIA) two years ago. Her serum creatinine is 0.9 mg/dL (eGFR 72 mL/min/1.73 m2). Which of the following is the most appropriate initial therapy for thromboembolic stroke prevention?
Correct Answer:
Apixaban
Question 5
A 28-year-old previously healthy man presents with sharp, retrosternal chest pain that began 24 hours ago. The pain worsens with deep inspiration and when lying flat on his back, but improves when sitting upright and leaning forward. A 12-lead ECG demonstrates widespread concave-upward ST-segment elevation with PR-segment depression in leads I, II, aVF, and V3 through V6, along with PR-segment elevation in lead aVR. High-sensitivity troponin levels are within normal limits. Which of the following is the first-line pharmacologic treatment for this patient?
Correct Answer:
High-dose ibuprofen plus colchicine
Question 1
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Prepare with the Arab Board IM Final Written Practice Questions - Arab Board Internal Medicine Final Written Examination Exam practice quiz. This question bank includes 100 questions covering year-old, serum, presents, reveals, and blood. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Arab Board IM Final Written Practice Questions - Arab Board Internal Medicine Final Written Examination Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, serum, presents, reveals, and blood. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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