ERES Bonaerense Medicina Practice Questions - Buenos Aires Province Health Residencies Examination (Examen de Residencias del Sistema de Salud Bonaerense - ERES Medicina) Exam - ERES Bonaerense Medicina Practice Questions - Buenos Aires Province Health Residencies Examination (Examen de Residencias del Sistema de Salud Bonaerense

Question 1

A 58-year-old man presents to the emergency department in a provincial hospital in Buenos Aires with 90 minutes of crushing retrosternal chest pain radiating to his left arm and jaw. An immediate 12-lead electrocardiogram (ECG) reveals 3 mm ST-segment elevation in leads V1–V4. The nearest facility with a cardiac catheterization laboratory capable of primary percutaneous coronary intervention (PCI) is 3 hours away. Blood pressure is 135/85 mmHg, heart rate is 82 bpm, and oxygen saturation is 97% on room air. There are no contraindications to thrombolysis. According to Argentine and international acute coronary syndrome guidelines, what is the most appropriate next step in management?

Immediate administration of systemic intravenous fibrinolytic therapy (e.g., tenecteplase or alteplase) along with dual antiplatelet therapy and anticoagulation Immediate transfer for primary PCI regardless of the expected transfer delay because PCI is always superior to fibrinolysis Administration of sublingual nitrates and oral beta-blockers alone while awaiting serial cardiac troponin results Emergency coronary artery bypass grafting (CABG) as first-line revascularization for anterior STEMI

Correct Answer:

Immediate administration of systemic intravenous fibrinolytic therapy (e.g., tenecteplase or alteplase) along with dual antiplatelet therapy and anticoagulation

Question 2

A 67-year-old woman with a history of ischemic cardiomyopathy (left ventricular ejection fraction 30%) presents to the emergency service with severe dyspnea, orthopnea, and pink frothy sputum. Physical examination reveals blood pressure 180/100 mmHg, heart rate 110 bpm, respiratory rate 32 breaths/min, oxygen saturation 84% on room air, bilateral pulmonary crackles extending to the upper lung fields, and jugular venous distension. What is the most appropriate immediate therapeutic combination?

High-dose intravenous beta-blocker (metoprolol) bolus and rapid isotonic crystalloid infusion (2000 mL normal saline) Intravenous furosemide, sublingual/intravenous nitroglycerin, and non-invasive positive pressure ventilation (CPAP/BiPAP) Immediate endotracheal intubation, intravenous dopamine infusion, and low-dose spironolactone Intravenous digoxin bolus, oral enalapril, and continuous loop diuretics via subcutaneous route

Correct Answer:

Intravenous furosemide, sublingual/intravenous nitroglycerin, and non-invasive positive pressure ventilation (CPAP/BiPAP)

Question 3

A 52-year-old man presents to the emergency room with a blood pressure reading of 210/120 mmHg. He reports a mild generalized tension headache but denies chest pain, shortness of breath, visual changes, or focal neurological deficits. Fundoscopic examination is normal without papilledema or flame hemorrhages. Serum creatinine, electrolytes, and urinalysis are within normal limits. An ECG shows voltage criteria for left ventricular hypertrophy without acute ischemic changes. What is the most appropriate management for this patient?

Diagnose hypertensive emergency and administer intravenous sodium nitroprusside to lower mean arterial pressure by 50% in the first hour Administer sublingual nifedipine capsules immediately to rapidly normalize blood pressure to < 120/80 mmHg Diagnose hypertensive urgency and initiate or adjust oral antihypertensive medication with planned outpatient follow-up within 24 to 72 hours Admit the patient to the intensive care unit for continuous intravenous labetalol infusion and arterial line placement

Correct Answer:

Diagnose hypertensive urgency and initiate or adjust oral antihypertensive medication with planned outpatient follow-up within 24 to 72 hours

Question 4

A 72-year-old man with a history of hypertension and type 2 diabetes mellitus presents for a routine check-up. He is asymptomatic, but physical examination reveals an irregularly irregular pulse at 88 bpm. An ECG confirms atrial fibrillation. Transthoracic echocardiogram shows normal left ventricular function and mild left atrial enlargement without valvular heart disease. His CHA2DS2-VASc score is calculated as 3 (Age 65-74 = 1, Hypertension = 1, Diabetes = 1). According to clinical guidelines, what is the best strategy for stroke prevention in this patient?

Dual antiplatelet therapy with aspirin 100 mg daily plus clopidogrel 75 mg daily Aspirin 325 mg daily alone as monotherapy No antithrombotic therapy is indicated because the patient is entirely asymptomatic and normofrequent Oral anticoagulation with a direct oral anticoagulant (DOAC, e.g., apixaban, dabigatran, or rivaroxaban) or a vitamin K antagonist (acenocoumarol/warfarin)

Correct Answer:

Oral anticoagulation with a direct oral anticoagulant (DOAC, e.g., apixaban, dabigatran, or rivaroxaban) or a vitamin K antagonist (acenocoumarol/warfarin)

Question 5

A 70-year-old woman is brought to the emergency department with a 3-day history of productive cough with rust-colored sputum, right-sided pleuritic chest pain, and high fever (38.8°C). Physical examination reveals confusion (disoriented to time and place), respiratory rate of 34 breaths/min, blood pressure of 85/55 mmHg, and heart rate of 105 bpm. Chest radiography confirms right lower lobe consolidation. Laboratory testing reveals blood urea nitrogen (BUN) of 28 mg/dL (urea 60 mg/dL). What is her CURB-65 score and the recommended site of care?

CURB-65 score of 5; requires urgent hospital admission with consideration for intensive care unit (ICU) monitoring CURB-65 score of 1; suitable for outpatient oral antibiotic treatment CURB-65 score of 2; requires brief observation in the emergency department and same-day discharge CURB-65 score of 0; indicates low-risk pneumonia manageable with symptomatic home therapy

Correct Answer:

CURB-65 score of 5; requires urgent hospital admission with consideration for intensive care unit (ICU) monitoring

Question 1

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Prepare with the ERES Bonaerense Medicina Practice Questions - Buenos Aires Province Health Residencies Examination (Examen de Residencias del Sistema de Salud Bonaerense - ERES Medicina) Exam practice quiz. This question bank includes 100 questions covering year-old, presents, blood, reveals, and examination. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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ERES Bonaerense Medicina Practice Questions - Buenos Aires Province Health Residencies Examination (Examen de Residencias del Sistema de Salud Bonaerense - ERES Medicina) Exam

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ERES Bonaerense Medicina Practice Questions - Buenos Aires Province Health Residencies Examination (Examen de Residencias del Sistema de Salud Bonaerense - ERES Medicina) Exam

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