EUNACOM Sección Teórica Practice Questions - Chile EUNACOM Sección Teórica - Examen Único Nacional de Conocimientos de Medicina Exam - EUNACOM Sección Teórica Practice Questions - Chile EUNACOM Sección Teórica - Examen Único Nacional de Conocimientos de Medicina Exam

Question 1

A 58-year-old male with a history of hypertension and smoking presents to the emergency department with 90 minutes of retrosternal crushing chest pain radiating to the left arm and jaw. An immediate 12-lead ECG reveals 3 mm ST-segment elevation in leads V1–V4. Blood pressure is 145/90 mmHg, heart rate is 88 bpm, and oxygen saturation is 97% on room air. The hospital has a functional catheterization laboratory ready to perform primary percutaneous coronary intervention (PCI) within 45 minutes. What is the immediate first-line management protocol for this patient under Chilean GES clinical guidelines?

Administer oral chewable aspirin 250–300 mg, a loading dose of a P2Y12 inhibitor (such as ticagrelor or clopidogrel), and transfer immediately for primary PCI Administer IV recombinant tissue plasminogen activator (tPA) immediately before transferring to the catheterization laboratory Administer sublingual nitroglycerin, high-flow supplemental oxygen by non-rebreather mask, and wait for initial serum troponin results before invasive therapy Administer therapeutic subcutaneous low-molecular-weight heparin and admit to the coronary care unit for elective coronary angiography at 48 hours

Correct Answer:

Administer oral chewable aspirin 250–300 mg, a loading dose of a P2Y12 inhibitor (such as ticagrelor or clopidogrel), and transfer immediately for primary PCI

Question 2

A 64-year-old female with ischemic cardiomyopathy has chronic heart failure with reduced ejection fraction (LVEF 28%). She is in NYHA functional class II, taking enalapril 10 mg twice daily and bisoprolol 5 mg daily. Her blood pressure is 122/76 mmHg, heart rate is 64 bpm, serum potassium is 4.2 mEq/L, and estimated GFR is 68 mL/min/1.73 m2. According to international and Chilean clinical practice guidelines, which additional medication class should be added next to reduce cardiovascular mortality?

A mineralocorticoid receptor antagonist (spironolactone) and an SGLT2 inhibitor (dapagliflozin or empagliflozin) A non-dihydropyridine calcium channel blocker (diltiazem) to optimize rate control Oral digoxin to increase myocardial contractility and improve ejection fraction Oral hydralazine plus isosorbide dinitrate to replace ACE inhibitor therapy

Correct Answer:

A mineralocorticoid receptor antagonist (spironolactone) and an SGLT2 inhibitor (dapagliflozin or empagliflozin)

Question 3

A 71-year-old male with a history of hypertension, type 2 diabetes mellitus, and a prior ischemic stroke 2 years ago is diagnosed with non-valvular atrial fibrillation during a routine clinic visit. His pulse is irregular at 82 bpm, and blood pressure is 134/80 mmHg. What is his CHA2DS2-VASc score, and what is the recommended stroke prevention management?

Score = 5; oral anticoagulation with a direct oral anticoagulant (DOAC) or warfarin is strongly indicated Score = 3; antiplatelet monotherapy with aspirin 100 mg daily is recommended Score = 2; dual antiplatelet therapy with aspirin and clopidogrel is sufficient Score = 1; no antithrombotic therapy is required because the ventricular rate is controlled

Correct Answer:

Score = 5; oral anticoagulation with a direct oral anticoagulant (DOAC) or warfarin is strongly indicated

Question 4

A 45-year-old male with a history of bicuspid aortic valve presents with low-grade fever, malaise, night sweats, and weight loss over 4 weeks. Physical examination reveals a new 3/6 regurgitant diastolic murmur at the left sternal border and subungual splinter hemorrhages. Transthoracic echocardiography shows a 9 mm mobile vegetation on the aortic valve. What is the most appropriate initial diagnostic microbiological strategy before starting empiric antimicrobial therapy?

Draw at least 3 separate sets of blood cultures from different venipuncture sites separated by at least 30–60 minutes prior to administering antibiotics Draw a single aerobic blood culture tube and immediately start high-dose broad-spectrum oral amoxicillin Perform an immediate diagnostic pericardiocentesis to culture pericardial fluid Initiate IV ceftriaxone immediately and obtain blood cultures 24 hours later once fever subsides

Correct Answer:

Draw at least 3 separate sets of blood cultures from different venipuncture sites separated by at least 30–60 minutes prior to administering antibiotics

Question 5

A 68-year-old male presents to a primary care clinic (CESFAM) with 3 days of productive cough with rust-colored sputum, right pleuritic chest pain, and fever. Vital signs: BP 105/65 mmHg, HR 92 bpm, RR 26 bpm, temperature 38.4 °C, SpO2 95% on room air. He is fully alert and oriented with no confusion (BUN is 14 mg/dL / urea 30 mg/dL). Right lung base auscultation reveals crackles and bronchial breath sounds. What is his CURB-65 score and the recommended management setting under Chilean GES guidelines for Community-Acquired Pneumonia?

CURB-65 = 1 (age >=65); outpatient management with oral amoxicillin or amoxicillin-clavulanate and close clinical follow-up within 48 hours CURB-65 = 0; outpatient symptomatic treatment with cough suppressants without antimicrobial therapy CURB-65 = 3; immediate referral for intensive care unit (ICU) admission and mechanical ventilation CURB-65 = 2; mandatory hospital admission for intravenous levofloxacin monotherapy

Correct Answer:

CURB-65 = 1 (age >=65); outpatient management with oral amoxicillin or amoxicillin-clavulanate and close clinical follow-up within 48 hours

Question 1

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Prepare with the EUNACOM Sección Teórica Practice Questions - Chile EUNACOM Sección Teórica - Examen Único Nacional de Conocimientos de Medicina Exam practice quiz. This question bank includes 100 questions covering year-old, presents, reveals, male, 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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EUNACOM Sección Teórica Practice Questions - Chile EUNACOM Sección Teórica - Examen Único Nacional de Conocimientos de Medicina Exam

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EUNACOM Sección Teórica Practice Questions - Chile EUNACOM Sección Teórica - Examen Único Nacional de Conocimientos de Medicina Exam

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