Part A

In this part of the test, you hear two different extracts. In each extract, a health
professional is talking to his patient. For questions 1 to 24 complete the notes with the
information you hear.

Now, look at the notes for extract 1.

Extract 1: Questions 1 to 12

You hear a doctor talking to a patient. For questions 1 to 12, complete the following notes
with a word or short phrase.

You now have thirty seconds to look at the notes.

Patient : James

Age : 21

Symptoms &disease : pain on right shoulder

Patient’s description of symptoms: throbbing pain on the right shoulder for (1)

: pain aggravates, as he plays baseball regularly also

participating in (2)

Medications : (3) I Drugs & muscle relaxant medications

Family history of illness : mother has (4)

Physical examination : blood pressure is 116/68, respiratory rate 16, heart rate 68

: weight 165 lbs

2/4, bilateral. Brachial pulses are 2/4 bilateral

: range o f motion of right shoulder shows (7) decreased

extension

: (8) decreased internal rotation and decreased external

rotation

: (9) is moderate

Diagnosis : x-ray report reveals presence of (10)

Further treatment : (11) tablet once a day,

: injection to shoulder joint with (12) 1.0 cc

Extract 2: Questions 13 to 24

You hear a physician talking to a patient called Mrs. Gonsalves. For questions 13 to 24,
complete the following notes with a word or short phrase.

You now have thirty seconds to look at the notes.

Patient : Mrs. Gonsalves

Age : 48

Symptoms &disease : sudden dizziness and had some cold sweats, shortness in breath &
became unconscious

Medical history : (13) diagnosed a year ago, had an IVC filter placed due
to massive (14) and sastric ulcers (15) and no anticoagulation due to
history o f (16) Coronary artery disease status was (17) had to stay in
the ICU for 3 weeks due to lower GI bleed again.
Medications : Aspirin, Potassium, Lasix, (18) I Lisinopril, Pacerone, Protonix,
Toprol, Vitamin B, Zetia, (19)

Physical examination : blood pressure is 155/57, pulse rate is 61, respirations 18 & (20)
is 95% on room air. No lymph nodes or masses. No lower extremity edema. No
redness or hotness.

Diagnosis : laboratory reports show (21) and hemoglobin 9.6. Your chest x-ray is
clear.

Impression : (22) to anticoagulation due to recurrent gastrointestinal bleed, status

post IVC filter.

: pulmonary hypertension suspected

: (23) disease, coronary artery disease, and (24) disease

per Cardiology
 Part B
In this part of the test, you will hear six different extracts. In each extract, you’ll hear people
talking in a different healthcare environment.

For questions 25 to 30 choose the answer (A, B, or C) which fits best according to what you
hear. You will have time to read each question before you listen to the audio. Complete the
answers as you listen the audio.

Now look at the question 25

Extract 1

25) You hear a discussion between a physician and nurse explaining about schistosomiasis
and its causes.

Which of the following is the infectious form of schistosomiasis?

A. Schistosoma mansoni

B. Cercariae

C. S. Haematobium

ANSWER: I

(26) You hear a discussion between two doctors about the importance of measuring serum
amylase or serum lipase

Which of the following statements is correct?

A. Measuring only serum amylase is adequate for diagnosing acute pancreatitis.

B. The sensitivity and specificity o f serum amylase is more than serum lipase.

C. Serum lipase rises more quickly and remains elevated longer.

ANSWER:
(27) You hear a discussion between two doctors about the misdiagnosing of acute
cardiorenal syndrome as renal injury due to hypovolemia.

What is the suggested method to differentiate acute cardiorenal syndrome & renal injury
due to hypovolemia?

A. Assessing the history of recent diuretic overuse

B. Evaluating the urine electrolytes

C. Diagnosing hypervolemia

ANSWER:

(28) You hear a physician explaining to his nurse about sepsis & infection.

Which of the following germs is also called staph?

A. Escherichia Coli

B. Streptococcus

C. Staphylococcus aureus

ANSWER:

(29) You hear a discussion between two doctors about brain imaging prior to lumbar
puncture in the suspected cases of bacterial meningitis.
Which of the following statement is correct?

A. Lumbar puncture should be delayed for patients with focal neurologic deficits.

B. Can start the treatment even without a lumbar puncture with obtaining the blood culture
report.

C. A brain imaging should be performed for all the patients with bacterial meningitis.

ANSWER:

(30) You hear a monologue by a physician about managing aneurysmal subarachnoid

hemorrhage.

Which of the following is a significant symptom of aneurysmal subarachnoid hemorrhage?

A. Rebleeding

B. Severe headache

C. Cardiac and pulmonary abnormalities

ANSWER:
 Part C
In this part of the test, you'll hear two different extracts. In each extract, you'll hear health
professionals talking about specific aspects of their work.

For questions 31 to 42 choose the answer (A, B, or C) which fits best according to what you
hear. Complete the answers as you listen the audio.

Now, look at extract one.

Extract 1

Questions 31 to 36

You hear the doctor’s lecture on Acutecardiorenal syndrome.

You have 90 seconds to read questions 31 to 36

(31) Which of the following statements is correct?

A. If the primary problem o f cardiorenal syndrome is in the heart it is called renocardiac

syndrome.

B. Acute exacerbation o f heart failure is called renocardiac syndrome.

C. If the primary problem is not in the heart or kidneys then the condition is called secondary
card iorenal syndrome.

ANSW ER:

(32) Which of the following involves the end-stage kidney disease?

A. RIFLE

B. AKIN

C. Acute cardiorenal syndrome

ANSWER:
(33) Cardiogenic shock is characterized by;

A. Worsening pulmonary

B. Hypoperfusion

C. Hypervolemia

ANSWER:

(34) Which of the following statements is correct?

A. Hypovolemic is the hallmark of acute heart failure.

B. Worsening pulmonary is a condition in cardiogenic shock.

C. Hypoperfusion can cause systemic organ damage.

ANSWER:

(35) Renal perfusion is reduced in acute heart failure due to

A. Renal venous congestion

B. Hypoperfusion

C. Abrupt decrease of cardiac pump function

ANSWER:
(36) Which of the following effects is not caused by aggravation in sympathetic
hyperactivity?

A. Increased renal perfusion

B. Constriction of efferent and afferent arterioles

C. Increased tubular sodium and water reabsorption

ANSWER:

Extract 2

Questions 37 to 42

You hear the doctor giving a lecture on anticoagulation therapy for patients with
endocarditis.

You have 90 seconds to read questions 37 to 42

(37) Which of the following statements is incorrect?

A. Anticoagulation is inevitable in the patients with endocarditis

B. Endocarditis alone is not an indication for anticoagulation

C. Anticoagulation may be suggested if the endocarditis patient has vein thrombosis

ANSWER:
(38) According to the studies, anticoagulation therapy;

A. Increased the cerebrovascular complications

B. Prevented the growth and propagation o f vegetation

C. Increased the vegetation size

ANSWER:

(39) Which of the following statements is incorrect?

A. Ischemic stroke in patients who received anticoagulation was underestimated.

B. The beneficial effects at least counterbalance the harmful effects of anticoagulation.

C. There was no increase in the rate of hemorrhagic lesions in the patients who received
anticoagulation therapy.

ANSWER:

(40) The studies show that anticoagulation was beneficial;

A. Once antimicrobial therapy had begun

B. When the patients received warfarin before diagnosis

C. For the patients with non native valve

ANSWER:
(41) Which of the following statements is incorrect?

A. Patients suspected for stroke should continue with anticoagulation therapy

B. Patients with pathogens such as Candida spp should suspend anticoagulation therapy

C. Anticoagulation therapy for the sole purpose of stroke prevention is not advised for the
patients with newly diagnosed endocarditis.

A N SW ER :

(42) Low-molecular weight heparin can be given if;

A. Surgery is considered

B. Surgery is not anticipated

C. In both the cases

A N SW ER:
 ANSWERS

1. The Past Five Months

2. Basketball
3. Non-steroidal Anti-inflammatory
to

4. Arthritis
5. Swelling And Tenderness
6. Radial Pulses
7. Decreased Flexion
8. Decreased Adduction Rotation
9. Rotator Cuff Impingement
10. Cuff Arthropathy
11. Vioxx 25 Mg
12. CelestoneSoluspan
13. Pulmonary Embolism to

14. Gastrointestinal Bleeding Diverticulosis

15. Paroxysmal Atrial Fibrillation
to'

16. Gastrointestinal Bleed

17. Post Bypass Graft Surgery
18. Levothvroxine to

19. Zvrtec
to-

20. Oxygen Saturation

21. Creatinine 2.1
22. Pulmonary Embolism With Contraindication
23. Mitral Valve
24. Peripheral Vascular
25. B
26. C
27. A
28. C
29. B
30. B
31. C
32. A
33. B
34. C
35. A
36. A
37. C
38. B
39. A
40. B
41. A
42. A