A 40-year-old male patient complains of shortness of breath, weight loss, and night sweats for the past six weeks. Despite being generally healthy, he is experiencing these symptoms. During the examination, the patient’s fingers show clubbing, and his temperature is 37.8°C. His pulse is 88 beats per minute, and his blood pressure is 128/80 mmHg. Upon listening to his heart, a pansystolic murmur is audible. What signs are likely to be found in this patient?
A 51-year-old woman has just had a right hemiarthroplasty and is now experiencing sudden onset of shortness of breath and sharp pleuritic pain on the right side of her chest. A chest x-ray is done as part of the initial evaluation, revealing a wedge-shaped opacification. What is the probable diagnosis?
A 57-year-old woman comes to see her GP to discuss the findings of her ABPM, which revealed a blood pressure reading of 145/90 mmHg, leading to a diagnosis of stage 1 hypertension. What is the most common symptom experienced by patients with this condition?
You are asked to evaluate a 5-day old cyanotic infant named Benjamin. Benjamin has had a chest x-ray which shows a heart appearance described as ‘egg-on-side’. What is the probable underlying diagnosis?
A 68-year-old man arrives at the emergency department complaining of intense abdominal pain that spreads to his back. His medical history shows that he has an abdominal aortic aneurysm. During a FAST scan, it is discovered that the abdominal aorta is widely dilated, with the most significant expansion occurring at the point where it divides into the iliac arteries. What vertebral level corresponds to the location of the most prominent dilation observed in the FAST scan?
A 57-year-old woman visits her doctor with complaints of flushing and warmth. She has been in good health lately, except for a stomach bug she had two weeks ago. Her medical history includes hyperlipidemia, hypertension, myocardial infarction, and type II diabetes mellitus. Although she used to smoke, she has quit and does not drink alcohol. She lives with her husband in a bungalow.
During the consultation, she reveals that her cardiologist recently prescribed niacin to her. Her recent lab results show an increase in total cholesterol.
Which of the following is responsible for the adverse effects observed in this patient?
Substance P
15%
Bradykinin
20%
Prostaglandins
48%
Serotonin
9%
Kallikreins
8%
The adverse effects of niacin, such as flushing, warmth, and itching, are caused by prostaglandins.
A parent brings their toddler to the Emergency Department after noticing a pale yellow fluid leaking from their umbilicus. The doctor explains that this is due to the incomplete closure of a remnant from embryological development. What is the name of this remnant, which used to be part of the umbilical ligament?
A 20-year-old man undergoes a routine ECG during his employment health check. The ECG reveals sinus arrhythmia with varying P-P intervals and slight changes in the ventricular rate. The P waves exhibit normal morphology, and the P-R interval remains constant. The patient has a history of asthma and has been using inhalers more frequently due to an increase in running mileage. What is the probable cause of this rhythm, and how would you reassure the patient about the ECG results?
A 50-year-old Afro-Caribbean woman comes to your clinic with symptoms of a malar rash, joint pain, and oral ulcers. Her blood test results reveal low hemoglobin levels, decreased platelets count, and a low white blood cell count. Additionally, she tests positive for anti-dsDNA antibodies. You inform her about her diagnosis and ask your medical trainee to educate her about medications that she should avoid.
Which of the following drugs is contraindicated for her?
Which one of the following types of beta-blocker is the most lipid soluble?