1. All of the following are true concerning inhaled glucocorticoids (steroids) in COPD EXCEPT [1]:

   A. Reduce incidence of respiratory illness
   B. Reduce decline in FEV1 over time
   C. Reduce airway hyperreactivity
   D. Do not counteract the effects of smoking
   E. May lead to reduced bone density

2. All of the following are common complications of chronic lymphocytic leukemia (CLL) EXCEPT [2]:

   A. Autoimmune Hemolytic Anemia
   B. Hypogammaglobulinemia
   C. Atypical Mycobacterial Infection
   D. Disease Transformation to leukemia or lymphoma
   E. Increased risk of unrelated cancers

3. Which ONE of the following is true concerning phenylpropanolamine [3] ?

   A. Associated with increased risk of hemorrhagic stroke in men but not women
   B. Causes marked increases in blood pressure in patients with borderline hypertension
   C. Blocks both histamine H1 and H2 receptor types
   D. Has been withdrawn from over-the-counter medications for both obesity and cold symptoms
   E. Causes vasodilation of nasal and other blood vessels

4. All of the following are well-described causes of heart block and bradyarrhythmias EXCEPT [8]:

   A. ß-Adrenergic Agonists
   B. Myocardial Infarction - particularly inferior MI
   C. Anti-Ro and/or Anti-La autoantibodies
   D. Digoxin
   E. Calcium Channel Blockers

5. All of the following are true concerning somatostatin and its analogs in treatment of bleeding esophageal varices EXCEPT [5]:

   A. Octreotide (a somatostatin analog, Sandostatin®) given intravenously reduces rebleeding by ~90% combined with endoscopic ligation alone
   B. Another somatostatin analog, vapreotide, reduces rebleeding by >60%
   C. Somatostatin and its analogs may reduce need for blood transfusion
   D. Natural somatostatin combined with sclerotherapy reduced acute bleeding episodes []
   E. Somatostatin and its analogs have been shown to reduce mortality associated with variceal bleeding

6. The key cell type involved in VERY EARLY initiation of atopic (allergic) responses is:

   A. Mast Cell
   B. Eosinophil
   C. Neutrophil
   D. Type 2 T helper Lymphocyte
   E. B Lymphocyte

7. All of the following are true concerning percutaneous transluminal coronary angioplasty (PTCA) for the treatment of patients with stable angina EXCEPT [7]:

A. PTCA is very effective for treatment of single-vessel coronary artery disease (CAD)
B. Coronary artery bypass grafting (CABG) is typically preferred over PTCA for multivessel CAD
C. PTCA without stenting is associated with ~30% incidence of restenosis within 2 years
D. PTCA is effective in graft revascularization following CABG
E. PTCA is associated with less post-procedure angina and less emergent CABG than medical therapy alone

8. While all of the following are useful for treatment of venous stasis ulcers, which ONE of the following is MOST effective [8] ?

   A. Initial debridement
   B. Leg elevation
   C. Compression therapy
   D. Surgery for superficial valvular incompetence
   E. Pentoxifylline

9. All of the following are true concerning the diagnosis of peripheral arterial (vascular) disease EXCEPT [9]:

   A. Angiography is the gold standard for the diagnosis
   B. Duplex ultrasonography is relatively inexpensive and reasonably accurate for diagnosis
   C. Ankle-brachial blood pressure comparisons (A-B index) is a reasonable screening tool
   D. Renal function need not be evaluated in most patients with peripheral arterial disease
   E. Magnetic resonance angiography (MRA) is a modality of choice for initial diagnosis

10. Concerning the diagnosis of abdominal aortic aneurysms (AAA), which ONE of the following is TRUE [10] ?
A. Physical examination is adequate to screen patients with possible AAA
B. Initial ultrasound in all men >65 years of age reduces risk of AAA rupture by nearly 50%
C. Aneurysms >5.5cm should be followed up with ultrasound examination every 6 months
D. Physical examination has a higher positive predictive value for AAA in obese patients than in non-obese patients
E. Physical examination will detect >95% of AAA of width >5.4cm

Answers

1. B (No effect on FEV1 over time in COPD patients.)
2. C (Supperative infections and herpes zoster are increased.)
3. D (Alpha1 adrenergic agonist associated with increased stroke risk in women, not men.)
4. A
5. E
6. A
7. E (PTCA is associated with more emergent CABG than medical therapy.)
8. C
9. D
10. B