Internal Medicine Board Practice Questions - Saudi Board Internal Medicine Final Written Exam - Internal Medicine Board Practice Questions - Saudi Board Internal Medicine Final Written Exam

Question 1

A 58-year-old man presents to the emergency department with 2 hours of crushing substernal chest pain. The ECG reveals 3-mm ST-segment elevation in leads V2-V4. The nearest PCI-capable hospital is 90 minutes away, but transfer and door-to-balloon time is expected to exceed 120 minutes. What is the most appropriate reperfusion strategy?

Immediate fibrinolytic therapy with tenecteplase followed by transfer for coronary angiography Transfer for primary percutaneous coronary intervention (PCI) despite the expected delay Intravenous heparin infusion and double antiplatelet therapy with delayed outpatient angiography Emergency coronary artery bypass grafting (CABG) surgery

Correct Answer:

Immediate fibrinolytic therapy with tenecteplase followed by transfer for coronary angiography

Question 2

A 64-year-old woman with a history of chronic heart failure with reduced ejection fraction (HFrEF, EF 32%) presents for a routine follow-up. She is currently asymptomatic on bisoprolol 5 mg daily and lisinopril 10 mg daily. Her blood pressure is 118/76 mmHg and heart rate is 64 bpm. Which of the following is the most appropriate next step in optimizing her medical therapy?

Switch lisinopril to sacubitril-valsartan, and add spironolactone and an SGLT2 inhibitor (dapagliflozin/empagliflozin) Increase lisinopril to 20 mg daily and follow up in 3 months Add digoxin to improve left ventricular contractility Add amlodipine for additional blood pressure and heart rate control

Correct Answer:

Switch lisinopril to sacubitril-valsartan, and add spironolactone and an SGLT2 inhibitor (dapagliflozin/empagliflozin)

Question 3

A 71-year-old man with hypertension, type 2 diabetes, and chronic kidney disease (eGFR 42 mL/min/1.73 m²) is newly diagnosed with nonvalvular atrial fibrillation. What is the most appropriate management for stroke prevention in this patient?

Oral anticoagulation with a direct oral anticoagulant (DOAC) such as apixaban Dual antiplatelet therapy with aspirin and clopidogrel Oral anticoagulation with warfarin targeting an INR of 2.0-3.0 Aspirin 81 mg daily monotherapy

Correct Answer:

Oral anticoagulation with a direct oral anticoagulant (DOAC) such as apixaban

Question 4

A 28-year-old woman is referred for evaluation of resistant hypertension. She has been on three antihypertensive medications (amlodipine, lisinopril, hydrochlorothiazide) at optimal doses for 6 months. On physical examination, a bruit is heard over her right flank. Renal artery duplex ultrasound suggests stenosis of the mid-to-distal right renal artery. What is the most likely diagnosis and preferred management?

Fibromuscular dysplasia (FMD); percutaneous transluminal angioplasty (PTA) without stenting Atherosclerotic renal artery stenosis (ARAS); renal artery stenting Pheochromocytoma; surgical resection of the adrenal gland Primary aldosteronism; spironolactone titration

Correct Answer:

Fibromuscular dysplasia (FMD); percutaneous transluminal angioplasty (PTA) without stenting

Question 5

A 34-year-old man presents with sharp, retrosternal chest pain that is worse when lying flat and improves when sitting forward. He reports having a mild upper respiratory tract infection 2 weeks ago. His ECG shows diffuse, concave-upward ST-segment elevation with PR-segment depression in lead II and PR-segment elevation in lead aVR. What is the first-line pharmacotherapy for this patient?

High-dose ibuprofen or aspirin combined with colchicine Intravenous thrombolysis with alteplase Low-dose oral prednisone monotherapy Immediate coronary angiography and percutaneous coronary intervention

Correct Answer:

High-dose ibuprofen or aspirin combined with colchicine

Question 1

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Prepare with the Internal Medicine Board Practice Questions - Saudi Board Internal Medicine Final Written Exam practice quiz. This question bank includes 100 questions covering year-old, presents, woman, history, and serum. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Internal Medicine Board Practice Questions - Saudi Board Internal Medicine Final Written Exam

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

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Internal Medicine Board Practice Questions - Saudi Board Internal Medicine Final Written Exam

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