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Question 1
Correct
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A 55-year-old man presents to the clinic with abnormal liver function tests (LFTs). He reports drinking no more than 3 units of alcohol per week and has no significant medical history. The patient was prescribed amoxicillin by his primary care physician for a sinus infection two weeks ago.
During the physical examination, the patient's BMI is found to be 40 kg/m2, indicating obesity. The LFTs reveal:
- ALT 120 U/L (5-40)
- AST 130 U/L (10-40)
- Alkaline phosphatase 200 U/L (45-105)
What is the most likely cause of this liver function test derangement?Your Answer: Non-alcoholic fatty liver disease
Explanation:Non-Alcoholic Fatty Liver Disease (NAFLD) as a Cause of Liver Enzyme Abnormalities
Non-alcoholic fatty liver disease (NAFLD) is a common cause of liver enzyme abnormalities, characterized by the accumulation of fat in the liver leading to inflammation. It is often associated with obesity, hypertension, dyslipidemia, and insulin resistance, which are part of the metabolic syndrome. However, other causes of hepatitis should be ruled out before making a diagnosis of NAFLD.
Patients who are obese and diabetic are advised to lose weight and control their diabetes. A low-fat, low-calorie diet is usually recommended alongside treatment to lower HbA1c. Patients with NAFLD should avoid alcohol or other substances that could be harmful to the liver.
It is important to note that deranged liver enzymes are not listed as side effects for amoxicillin in the British National Formulary. Therefore, if a patient presents with liver enzyme abnormalities, NAFLD should be considered as a possible cause and appropriate investigations should be carried out to confirm the diagnosis.
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This question is part of the following fields:
- Gastroenterology
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Question 2
Incorrect
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This is the full blood count result of a 72-year-old male who presents with fatigue following his retirement 6 months ago:
Hb 130 g/L (120-160)
RBC 4.5 ×1012/L -
Haematocrit 0.39 (0.36-0.46)
MCV 86.5 fL (80-100)
MCH 28.1 pg (27-32)
Platelets 180 ×109/L (150-400)
WBC 6.5 ×109/L (4-11)
Neutrophils 3.8 ×109/L (2-7)
Lymphocytes 1.9 ×109/L (1-4)
Monocytes 0.5 ×109/L (0.2-1)
Eosinophils 0.2 ×109/L (0-0.5)
Basophils 0.1 ×109/L (0-0.1)
He is brought into the clinic by his wife who is concerned that her husband is constantly tired, has lost interest in his hobbies and has trouble sleeping.
Examination is pretty much normal except that he appears fatigued. There are no abnormalities on chest, abdominal or respiratory examination. Neurological examination is normal.
What is the most likely cause of this blood picture?Your Answer: Antidepressant drug therapy
Correct Answer: Alcohol excess
Explanation:Delayed Grief Reaction and Elevated MCV in a Patient
Explanation:
The patient in question is displaying a delayed grief reaction following the recent death of her husband. Her FBC shows a normal picture except for an elevated MCV, which suggests alcohol excess. If the cause of macrocytosis were folate or B12 deficiency, it would be expected to cause anemia in association with the macrocytosis. Hypothyroidism may also cause macrocytosis, but the patient’s weight loss argues against this diagnosis. For further information on macrocytosis, refer to the BMJ Practice article Macrocytosis: pitfalls in testing and summary of guidance, the BMJ Endgames case report A woman with macrocytic anemia and confusion, and the BMJ Best Practice article Assessment of anemia. -
This question is part of the following fields:
- Haematology
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Question 3
Incorrect
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A newly born infant is observed to have clubfoot on both feet. What is the preferred treatment for this condition?
Your Answer: Surgical correction at 1 year
Correct Answer: Manipulation and progressive casting starting soon after birth
Explanation:Talipes Equinovarus: A Common Foot Deformity in Newborns
Talipes equinovarus, also known as club foot, is a foot deformity characterized by an inward turning and plantar flexed foot. It is a common condition that affects 1 in 1,000 newborns, with a higher incidence in males. In about 50% of cases, the deformity is present in both feet. While the cause of talipes equinovarus is often unknown, it can be associated with conditions such as spina bifida, cerebral palsy, and oligohydramnios.
Diagnosis of talipes equinovarus is typically made during the newborn exam, and imaging is not usually necessary. The deformity is not passively correctable, and the diagnosis is based on clinical examination.
In recent years, there has been a shift towards conservative management of talipes equinovarus, with the Ponseti method being the preferred approach. This method involves manipulation and progressive casting of the foot, starting soon after birth. The deformity is usually corrected within 6-10 weeks, and an Achilles tenotomy may be required in some cases. Night-time braces are then used until the child is 4 years old to prevent relapse, which occurs in about 15% of cases.
Overall, talipes equinovarus is a common foot deformity in newborns that can be effectively managed with conservative methods such as the Ponseti method.
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This question is part of the following fields:
- Musculoskeletal
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Question 4
Correct
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An 80-year-old man comes to the Emergency Department with a progressive decline in mental status and a past medical history of worsening gait and frequent falls. An MRI scan shows enlargement of the ventricular system, suggesting hydrocephalus. What other symptom would indicate a diagnosis of normal pressure hydrocephalus?
Your Answer: Urinary incontinence
Explanation:Understanding Normal Pressure Hydrocephalus: Symptoms and Diagnosis
Normal pressure hydrocephalus (NPH) is a condition characterized by the enlargement of cerebral ventricles, which can lead to a classical triad of symptoms including dementia, urinary incontinence, and gait apraxia. While it is typically seen in the elderly, it is a gradual and progressive disorder that can be potentially reversible. However, it is important to note that symptoms such as loss of inhibitions and inappropriate behavior are more likely to lead to a diagnosis of frontotemporal dementia rather than NPH. Resting tremors, seizures, and hallucinations are also not typically associated with NPH. Diagnosis involves testing mental status before and after a lumbar puncture, and treatment may involve therapeutic drainage of cerebrospinal fluid or placement of a ventriculoperitoneal shunt.
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This question is part of the following fields:
- Neurosurgery
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Question 5
Correct
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A 72-year-old woman is admitted with renal failure. She has a history of congestive heart failure and takes ramipril 10 mg daily and furosemide 80 mg daily.
Investigations:
Investigation Result Normal value
Haemoglobin 102 g/l 115–155 g/l
Platelets 180 × 109/l 150–400 × 109/l
White cell count (WCC) 6.1 × 109/l 4–11 × 109/l
Sodium (Na+) 143 mmol/l 135–145 mmol/l
Potassium (K+) 6.2 mmol/l 3.5–5.0 mmol/l
Creatinine 520 μmol/l 50–120 µmol/l
Chest X-ray: no significant pulmonary oedema
Peripheral fluid replacement is commenced and a right subclavian central line is inserted. She complains of pleuritic chest pain; saturations have decreased to 90% on oxygen via mask.
Which of the following is the most likely diagnosis?Your Answer: Iatrogenic pneumothorax
Explanation:Differential Diagnosis for a Patient with Pleuritic Chest Pain and Desaturation after Subclavian Line Insertion
Subclavian line insertion carries a higher risk of iatrogenic pneumothorax compared to other routes, such as the internal jugular route. Therefore, if a patient presents with pleuritic chest pain and desaturation after subclavian line insertion, iatrogenic pneumothorax should be considered as the most likely diagnosis. Urgent confirmation with a portable chest X-ray is necessary, and formal chest drain insertion is the management of choice.
Other complications of central lines include local site and systemic infection, arterial puncture, haematomas, catheter-related thrombosis, air embolus, dysrhythmias, atrial wall puncture, lost guidewire, anaphylaxis, and chylothorax. However, these complications would not typically present with pleuritic chest pain and desaturation.
Developing pulmonary oedema is an important differential, but it would not explain the pleuritic chest pain. Similarly, lower respiratory tract infection is a possibility, but the recent line insertion makes iatrogenic pneumothorax more likely. Costochondritis can cause chest pain worse on inspiration and chest wall tenderness, but it would not explain the desaturation.
In conclusion, when a patient presents with pleuritic chest pain and desaturation after subclavian line insertion, iatrogenic pneumothorax should be the primary consideration, and urgent confirmation with a portable chest X-ray is necessary.
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This question is part of the following fields:
- Respiratory
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Question 6
Incorrect
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You are requested to assess a 76-year-old female patient who has been admitted with severe diarrhea. She had recently undergone a course of ciprofloxacin for a urinary tract infection and reports that the diarrhea started a few days after starting the antibiotics. Upon examination, she appears severely dehydrated and has a BP of 130/80 mmHg, with a 30 mmHg postural drop and an elevated pulse rate. You suspect that she may be suffering from Clostridium difficile infection. What measures can be taken to reduce its spread?
Your Answer:
Correct Answer: Patients should be barrier nursed, and staff should use infectious precautions
Explanation:The SIGHT Protocol for Dealing with Clostridium Difficile Infection
The SIGHT protocol provides guidelines for proper barrier nursing, use of protective gear, and effective hand washing when dealing with patients suspected of having Clostridium difficile infection. Patients with suspected C. difficile should be isolated, and if the infection is confirmed, they should remain isolated until they are free of diarrhea for at least 48 hours. It is important to note that alcohol hand rub should never be used as a substitute for thorough hand washing. Additionally, it is crucial to list Clostridium difficile as the cause of death on the death certificate for monitoring purposes.
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This question is part of the following fields:
- Clinical Sciences
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Question 7
Incorrect
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A 25-year-old tripped and fell while running, injuring his left calf. He experienced a dull ache, tightness, and mild swelling in the calf. Despite the discomfort, he continued running for another 20 minutes before stopping. However, the pain gradually increased, and he felt extreme discomfort when stretching and pulling his toes up. His partner convinced him to seek medical attention at the emergency department.
During the examination, the doctor noticed that the left calf was 6cm larger in circumference than the right calf. The anterior compartment musculature was tender, and passive dorsiflexion caused a significant amount of pain. However, all peripheral pulses were present, and there were no changes in sensation or color.
What initial investigation could be performed to confirm the diagnosis?Your Answer:
Correct Answer: Compartment pressure monitoring
Explanation:Compartment syndrome is characterized by pain when the affected area is passively stretched.
When a patient presents with pain and swelling after recent trauma, compartment syndrome is a likely diagnosis. Pain that worsens over time and is exacerbated by passive stretching are key indicators of this condition. While other symptoms such as pulselessness, pallor, paraesthesia, and paralysis may also be present, they are not necessary for a suspicion of compartment syndrome.
Although compartment syndrome can be diagnosed clinically, measuring compartment pressure is the preferred method for confirming the diagnosis. X-rays are not useful in detecting compartment syndrome and may not show any abnormalities. The ankle-brachial pressure index is used to diagnose critical limb ischemia, not compartment syndrome. Doppler ultrasound can be used to examine the vasculature of the lower leg, but it is not a diagnostic tool for compartment syndrome.
Compartment syndrome is a complication that can occur after fractures or vascular injuries. It is characterized by increased pressure within a closed anatomical space, which can lead to tissue death. Supracondylar fractures and tibial shaft injuries are the most common fractures associated with compartment syndrome. Symptoms include pain, numbness, paleness, and possible paralysis of the affected muscle group. Diagnosis is made by measuring intracompartmental pressure, with pressures over 20 mmHg being abnormal and over 40 mmHg being diagnostic. X-rays typically do not show any pathology. Treatment involves prompt and extensive fasciotomies, with careful attention to decompressing deep muscles in the lower limb. Patients may develop myoglobinuria and require aggressive IV fluids. In severe cases, debridement and amputation may be necessary, as muscle death can occur within 4-6 hours.
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This question is part of the following fields:
- Musculoskeletal
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Question 8
Incorrect
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A 68-year-old man is brought to Accident and Emergency by ambulance, complaining of abdominal pain. He says the pain is 8/10 in strength, radiates to the groin, iliac fossae and back and began suddenly half an hour ago. He cannot identify anything that prompted the pain and has not yet eaten today. He says he also feels dizzy and faint. The man has had two stents after a cardiac arrest in 2011. He has hypertension and hypercholesterolaemia. He smokes 35 cigarettes a day but does not consume alcohol. On examination, the patient looks grey. His blood pressure is 100/70 mmHg, heart rate 126 bpm, respiratory rate 28 breaths/minute and temperature 37.4 °C. He has widespread abdominal tenderness on light palpation. You cannot palpate any masses.
What is the most likely diagnosis?Your Answer:
Correct Answer: Ruptured abdominal aortic aneurysm
Explanation:Differential Diagnosis for Abdominal Pain: Ruptured Abdominal Aortic Aneurysm, Pancreatitis, Pyelonephritis, Myocardial Infarction, and Acute Cholecystitis
Abdominal pain can be caused by a variety of conditions, and it is important to consider the patient’s symptoms and medical history to make an accurate diagnosis. In this case, the patient has multiple risk factors for cardiovascular disease, including hypertension, smoking, age, and being male. The sudden onset of pain radiating to the groin, back, and iliac fossae is typical of a ruptured abdominal aortic aneurysm, which can cause shock and requires immediate surgical intervention.
Pancreatitis is another possible cause of the patient’s pain, with pain radiating to the back and often accompanied by fever and jaundice. However, the patient has not eaten recently and does not drink alcohol, which are common triggers for gallstone-induced and alcohol-induced pancreatitis.
Pyelonephritis, or a kidney infection, can also cause back pain and septic shock, but the sudden onset of pain is less typical. A patient with severe pyelonephritis would also be expected to have a fever.
Although the patient has multiple cardiac risk factors, his pain is not typical of a myocardial infarction, or heart attack. Myocardial infarction can cause abdominal pain, but it is unlikely to radiate to the back and groin.
Acute cholecystitis, or inflammation of the gallbladder, typically causes right upper quadrant pain, jaundice, and fever, which are not present in this patient.
In summary, the patient’s symptoms and medical history suggest a ruptured abdominal aortic aneurysm as the most likely cause of his abdominal pain, but other conditions such as pancreatitis and pyelonephritis should also be considered. A thorough evaluation and prompt intervention are necessary to prevent further complications.
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This question is part of the following fields:
- Vascular
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Question 9
Incorrect
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A 42-year-old male is set to undergo a laparoscopic cholecystectomy under general anaesthesia due to the presence of gallstones on abdominal ultrasound. All of his blood tests are normal and he is deemed suitable for surgery. However, he mentions to the medical team just before the anaesthesia is administered that he had a glass of orange juice without pulp prior to arriving at the theatre.
What is the best course of action for this patient?Your Answer:
Correct Answer: Wait for 2 hours
Explanation:For elective procedures, patients are allowed to consume clear fluids such as water, fruit juice without pulp, coffee or tea without milk, and ice lollies up to 2 hours before their operation. This can help alleviate post-operative symptoms such as headaches, nausea, and vomiting. However, it is crucial to avoid proceeding with general anesthesia immediately due to the high risk of aspiration, which can be fatal. Patients are advised to fast from non-clear liquids and food for at least 6 hours before surgery.
Preparation for surgery varies depending on whether the patient is undergoing an elective or emergency procedure. For elective cases, it is important to address any medical issues beforehand through a pre-admission clinic. Blood tests, urine analysis, and other diagnostic tests may be necessary depending on the proposed procedure and patient fitness. Risk factors for deep vein thrombosis should also be assessed, and a plan for thromboprophylaxis formulated. Patients are advised to fast from non-clear liquids and food for at least 6 hours before surgery, and those with diabetes require special management to avoid potential complications. Emergency cases require stabilization and resuscitation as needed, and antibiotics may be necessary. Special preparation may also be required for certain procedures, such as vocal cord checks for thyroid surgery or bowel preparation for colorectal cases.
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This question is part of the following fields:
- Surgery
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Question 10
Incorrect
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A 25-year-old woman comes to her doctor with concerning symptoms. Ten weeks ago, she was in a serious car accident. Despite being physically fine, she has been experiencing flashbacks, heightened alertness when crossing the street, and difficulty concentrating at work. What characteristic would most strongly support the probable diagnosis?
Your Answer:
Correct Answer: Emotional detachment
Explanation:One of the common features of PTSD is emotional detachment, where patients may feel numb and unable to fully experience their emotions. Other symptoms include re-experiencing traumatic events through flashbacks and nightmares, avoiding people or situations, and hyperarousal such as hypervigilance and sleep problems. Delusional beliefs are not typically associated with PTSD, and excessive sleep and nystagmus are not common symptoms. However, there is a link between eyes and PTSD, as eye movement desensitisation and reprocessing therapy is a common treatment for the disorder.
Understanding Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop in individuals of any age following a traumatic event. This can include experiences such as natural disasters, accidents, or even childhood abuse. PTSD is characterized by a range of symptoms, including re-experiencing the traumatic event through flashbacks or nightmares, avoidance of situations or people associated with the event, hyperarousal, emotional numbing, depression, and even substance abuse.
Effective management of PTSD involves a range of interventions, depending on the severity of the symptoms. Single-session interventions are not recommended, and watchful waiting may be used for mild symptoms lasting less than four weeks. Military personnel have access to treatment provided by the armed forces, while trauma-focused cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR) therapy may be used in more severe cases.
It is important to note that drug treatments for PTSD should not be used as a routine first-line treatment for adults. If drug treatment is used, venlafaxine or a selective serotonin reuptake inhibitor (SSRI), such as sertraline, should be tried. In severe cases, NICE recommends that risperidone may be used. Overall, understanding the symptoms and effective management of PTSD is crucial in supporting individuals who have experienced traumatic events.
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This question is part of the following fields:
- Psychiatry
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Question 11
Incorrect
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A 55-year-old woman presents to the clinic with a 9-month history of rectal bleeding and pain. Her physician decides to perform a proctoscopy. The results show an erythematous ulcerated plaque near the pectinate line, and biopsy results suggest squamous cell carcinoma. What is the most significant risk factor for this diagnosis?
Your Answer:
Correct Answer: HPV infection
Explanation:The strongest risk factor for anal cancer is HPV infection, specifically the HPV16 or HPV18 subtypes that cause SCCs of the anus. While HIV infection, immunosuppressant drugs, and a past medical history of cervical cancer are also risk factors, HPV infection is the most significant.
Understanding Anal Cancer: Definition, Epidemiology, and Risk Factors
Anal cancer is a type of malignancy that occurs exclusively in the anal canal, which is bordered by the anorectal junction and the anal margin. The majority of anal cancers are squamous cell carcinomas, but other types include melanomas, lymphomas, and adenocarcinomas. The incidence of anal cancer is relatively rare, with an annual rate of about 1.5 in 100,000 in the UK. However, the incidence is increasing, particularly among men who have sex with men, due to widespread infection by human papillomavirus (HPV).
There are several risk factors associated with anal cancer, including HPV infection, anal intercourse, a high lifetime number of sexual partners, HIV infection, immunosuppressive medication, a history of cervical cancer or cervical intraepithelial neoplasia, and smoking. Patients typically present with symptoms such as perianal pain, perianal bleeding, a palpable lesion, and faecal incontinence.
To diagnose anal cancer, T stage assessment is conducted, which includes a digital rectal examination, anoscopic examination with biopsy, and palpation of the inguinal nodes. Imaging modalities such as CT, MRI, endo-anal ultrasound, and PET are also used. The T stage system for anal cancer is described by the American Joint Committee on Cancer and the International Union Against Cancer. It includes TX primary tumour cannot be assessed, T0 no evidence of primary tumour, Tis carcinoma in situ, T1 tumour 2 cm or less in greatest dimension, T2 tumour more than 2 cm but not more than 5 cm in greatest dimension, T3 tumour more than 5 cm in greatest dimension, and T4 tumour of any size that invades adjacent organ(s).
In conclusion, understanding anal cancer is crucial in identifying the risk factors and symptoms associated with this type of malignancy. Early diagnosis and treatment can significantly improve the prognosis and quality of life for patients.
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This question is part of the following fields:
- Surgery
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Question 12
Incorrect
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A 27-year-old nulliparous woman presents to the Emergency Department with severe nausea and vomiting, as well as a 3-hour history of spotting. Her last menstrual period was approximately ten weeks ago. She denies any abdominal pain, focal neurological deficits and headaches. She has had normal cervical screening results, denies any history of sexually transmitted infections and had her Mirena® coil removed one year ago. She has been having regular unprotected sex with a new partner for the past month. Her menstrual cycle length is normally 28 days, for which her period lasts five days, without bleeding in between periods.
She reports being previously fit and well, without regular medication. She is a non-smoker and drinks heavily once a week.
On examination, her heart rate is 81 bpm, blood pressure 115/80 mmHg and temperature 37.2 °C, and her fundal height was consistent with a 16-week-old pregnancy. A bimanual examination with a speculum revealed a closed cervical os. A full blood count reveals all normal results. A human chorionic gonadotrophin (hCG) level and a vaginal ultrasound scan are also carried out in the department, which reveal the following:
Serum hCG:
Investigation Result Impression
hCG 100,295 iu/l Grossly elevated
Transvaginal ultrasound:
Comment Anteverted, enlarged uterus. No fetal parts observed. Intrauterine mass with cystic components observed
What is the most likely diagnosis for this patient?Your Answer:
Correct Answer: Hydatidiform mole
Explanation:Diagnosis of Hydatidiform Mole in Early Pregnancy: Clinical Features and Treatment Options
Hydatidiform mole is a type of gestational trophoblastic disease that occurs due to abnormal fertilization of an ovum, resulting in a non-viable pregnancy. The condition presents with clinical features such as vaginal bleeding, excessive vomiting, a large-for-dates uterus, and a very high hCG level. Pelvic ultrasound may reveal a ‘snowstorm’ appearance from the intrauterine mass and cystic components.
The diagnosis of hydatidiform mole is crucial as it determines the treatment options. If the patient wishes to retain her fertility, dilation and evacuation are offered. However, if fertility is not desired, a hysterectomy is recommended. The former has fewer post-operative complications but carries a higher risk of post-operative gestational trophoblastic neoplasia. Antiemetics are prescribed to manage nausea and vomiting.
Twin pregnancy and complete miscarriage are differential diagnoses, but the absence of fetal parts and the grossly elevated hCG level point towards hydatidiform mole. Pre-eclampsia cannot be diagnosed before the second trimester, and endometrial carcinoma is unlikely to cause a uterine mass or elevated hCG levels.
In conclusion, early diagnosis of hydatidiform mole is crucial for appropriate management and prevention of complications.
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This question is part of the following fields:
- Gynaecology
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Question 13
Incorrect
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A 57-year-old man visits the urology clinic due to recurring renal colic episodes. His CT scans indicate the presence of several stones, and his 24-hour urine collection shows elevated urinary calcium levels. What is the most effective medication to decrease his stone formation?
Your Answer:
Correct Answer: Thiazide diuretic
Explanation:Thiazide diuretics can be used to decrease calcium excretion and stone formation in patients with hypercalciuria and renal stones. Allopurinol, cholestyramine, oral bicarbonate, and pyridoxine are not effective in reducing calcium stones, but may help with other types of stones. Thiazide diuretics work by increasing distal tubular calcium resorption, which reduces calcium in the urine and prevents stone formation.
The management of renal stones involves initial medication and investigations, including an NSAID for analgesia and a non-contrast CT KUB for imaging. Stones less than 5mm may pass spontaneously, but more intensive treatment is needed for ureteric obstruction or renal abnormalities. Treatment options include shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Prevention strategies include high fluid intake, low animal protein and salt diet, and medication such as thiazides diuretics for hypercalciuria and allopurinol for uric acid stones.
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This question is part of the following fields:
- Surgery
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Question 14
Incorrect
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A 67-year-old male presents to the emergency department with symptoms of nausea, diarrhoea, confusion, and blurred vision. He has a medical history of osteoarthritis, heart failure, and atrial fibrillation. His current medications include Adcal D3, Amiodarone, Bisoprolol, Digoxin, Losartan, and Paracetamol. The patient was recently started on amiodarone by his general practitioner. What is the probable cause of his current symptoms?
Your Answer:
Correct Answer: Digoxin toxicity
Explanation:When starting a patient on amiodarone who is already taking digoxin, it is important to reduce the dose to avoid the risk of digoxin toxicity. Amiodarone is a type of medication used to treat various heart conditions, such as ventricular tachycardia and atrial fibrillation. However, it can also cause side effects such as nausea, constipation, lethargy, tremors, and even serious conditions like interstitial pneumonitis, optic neuropathy, and corneal deposits. Additionally, amiodarone can inhibit the action of the cytochrome P450 enzyme, which can reduce the clearance of other drugs like ciclosporin, flecainide, sildenafil, simvastatin, theophylline, and warfarin.
Understanding Digoxin and Its Toxicity
Digoxin is a medication used for rate control in atrial fibrillation and for improving symptoms in heart failure patients. It works by decreasing conduction through the atrioventricular node and increasing the force of cardiac muscle contraction. However, it has a narrow therapeutic index and requires monitoring for toxicity.
Toxicity may occur even when the digoxin concentration is within the therapeutic range. Symptoms of toxicity include lethargy, nausea, vomiting, anorexia, confusion, yellow-green vision, arrhythmias, and gynaecomastia. Hypokalaemia is a classic precipitating factor, as it allows digoxin to more easily bind to the ATPase pump and increase its inhibitory effects. Other factors that may contribute to toxicity include increasing age, renal failure, myocardial ischaemia, electrolyte imbalances, hypoalbuminaemia, hypothermia, hypothyroidism, and certain medications such as amiodarone, quinidine, and verapamil.
Management of digoxin toxicity involves the use of Digibind, correction of arrhythmias, and monitoring of potassium levels. It is important to recognize the potential for toxicity and monitor patients accordingly to prevent adverse outcomes.
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This question is part of the following fields:
- Pharmacology
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Question 15
Incorrect
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A 42-year-old man visits his primary care physician complaining of thick, well-defined, red patches with silvery scales on the extensor surfaces of his elbows and knees. He has been experiencing these skin lesions intermittently for the past 3 years. The lesions tend to improve during the summer months, worsen during times of stress, and reappear at the site of trauma, particularly where he scratches. A skin biopsy specimen reveals epidermal hyperplasia and parakeratosis, with neutrophils present within the epidermis. What is the most probable diagnosis?
Your Answer:
Correct Answer: Plaque psoriasis
Explanation:Differentiating Skin Conditions: A Brief Overview
Psoriasis is a skin condition characterized by a rash with typical histology and location. The Koebner phenomenon, where lesions occur at sites of trauma, is a common feature of psoriasis. Treatment involves exposure to ultraviolet light, tar-based treatments, and immunosuppressant drugs. Pruritus is not always present.
Seborrhoeic dermatitis presents as itchy, ill-defined erythema and greasy scaling on the scalp, nasolabial folds, or post-auricular skin in adults and adolescents.
Lichen planus is characterized by flat-topped, pruritic, polygonal, red-to-violaceous papules or plaques. Lesions are often located on the wrist, with papules demonstrating central dimpling.
Atopic dermatitis is a chronic inflammatory skin disease characterized by itchy, red rashes often found in the flexor areas of joints.
Tinea corporis is a ringworm infection characterized by expanding patches with central clearing and a well-defined active periphery. The active periphery is raised, pruritic, moist, erythematosus, and scaly, with papules, vesicles, and pustules.
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This question is part of the following fields:
- Dermatology
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Question 16
Incorrect
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A 65-year-old woman comes to the clinic complaining of gradual onset discomfort on her right lateral hip for the past two weeks. She denies any history of trauma and is able to bear weight fully. However, she experiences the worst discomfort at night, which sometimes wakes her up when lying on her right side. What is the probable underlying diagnosis?
Your Answer:
Correct Answer: Greater trochanteric pain syndrome
Explanation:Trochanteric bursitis is characterized by pain in the lateral hip/thigh area, accompanied by tenderness over the greater trochanter. This condition, also known as greater trochanteric pain syndrome, is likely the cause of the patient’s symptoms, as there are no other systemic issues present. Iliotibial band syndrome typically affects the knee and does not usually cause nighttime symptoms, making it an unlikely diagnosis in this age group. Meralgia paresthetica, which results from compression of the lateral femoral cutaneous nerve, typically presents with numbness or tingling rather than pain. Osteoarthritis is unlikely to cause pain upon direct pressure over the greater trochanter.
Understanding Greater Trochanteric Pain Syndrome
Greater trochanteric pain syndrome, also known as trochanteric bursitis, is a condition that results from the repetitive movement of the fibroelastic iliotibial band. This condition is most commonly observed in women aged between 50 and 70 years. The primary symptom of this condition is pain experienced over the lateral side of the hip and thigh. Additionally, tenderness is observed upon palpation of the greater trochanter.
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This question is part of the following fields:
- Musculoskeletal
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Question 17
Incorrect
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A 4-year-old girl is brought to the Emergency department by her mother.
The girl is experiencing elbow pain and is refusing to use her arm. Her mother reports that she was lifted up by her outstretched arms earlier in the day.
What is the probable diagnosis for this case?Your Answer:
Correct Answer: Subluxation of the radial head
Explanation:Subluxation of the Radial Head in Children
Subluxation of the radial head, also known as pulled elbow, is a frequent injury in young children. It occurs when the arm is pulled directly, causing the radial head to dislocate from its ligament. The child may experience pain in the elbow and have limited movement in supination and extension. They may also refuse to use their arm.
Fortunately, a diagnosis can often be made without the need for an x-ray if the history is typical. Treatment involves providing pain relief and manipulating the elbow by supination while it is flexed at a 90° angle. With proper care, most children recover quickly from this injury.
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This question is part of the following fields:
- Emergency Medicine
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Question 18
Incorrect
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A 55-year-old woman with a history of multiple sclerosis visits her GP complaining of issues with her right eye and right shoulder pain. Upon examination, the GP notes ptosis on the right side, a small pupil, and narrowing of the palpebral fissure with right lid lag. The left eye appears normal, and fundoscopy reveals no abnormalities. The patient has a 30-year history of smoking 30 cigarettes daily and consuming 12 units of alcohol per week. She has also been taking paracetamol and ibuprofen for her shoulder pain. What is the most likely cause of her symptoms?
Your Answer:
Correct Answer: Horner's syndrome
Explanation:The patient is exhibiting symptoms consistent with Horner’s syndrome, including miosis (constricted pupil), ptosis (drooping eyelid), and enophthalmos (sunken eye). There may also be anhydrosis (lack of sweating) present. This could be indicative of a Pancoast tumor on the lung, which can infiltrate the brachial plexus and cause shoulder pain. It is important to note the patient’s smoking history in this case. Multiple sclerosis is not likely to be the cause of these symptoms. Argyll-Robertson pupil, Holmes-Adie pupil, and oculomotor nerve palsy are not applicable to this case.
Horner’s syndrome is a medical condition that is characterized by a set of symptoms including a small pupil (miosis), drooping of the upper eyelid (ptosis), sunken eye (enophthalmos), and loss of sweating on one side of the face (anhidrosis). The presence of heterochromia, or a difference in iris color, is often seen in cases of congenital Horner’s syndrome. Anhidrosis is also a distinguishing feature that can help differentiate between central, Preganglionic, and postganglionic lesions. Pharmacologic tests, such as the use of apraclonidine drops, can be helpful in confirming the diagnosis of Horner’s syndrome and localizing the lesion.
Central lesions, Preganglionic lesions, and postganglionic lesions can all cause Horner’s syndrome, with each type of lesion presenting with different symptoms. Central lesions can result in anhidrosis of the face, arm, and trunk, while Preganglionic lesions can cause anhidrosis of the face only. postganglionic lesions, on the other hand, do not typically result in anhidrosis.
There are many potential causes of Horner’s syndrome, including stroke, syringomyelia, multiple sclerosis, tumors, encephalitis, thyroidectomy, trauma, cervical rib, carotid artery dissection, carotid aneurysm, cavernous sinus thrombosis, and cluster headache. It is important to identify the underlying cause of Horner’s syndrome in order to determine the appropriate treatment plan.
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This question is part of the following fields:
- Ophthalmology
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Question 19
Incorrect
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A 30-year-old man comes to the dermatology clinic with several small fleshy nodules around and under his finger and toe nails. Upon further inquiry, it is revealed that the patient has a history of seizures that are hard to manage.
What is the probable underlying condition?Your Answer:
Correct Answer: Tuberous sclerosis
Explanation:Genetic Tumor Disorders and Their Skin Manifestations
There are several genetic disorders that predispose individuals to the formation of tumors, including those in the nervous system. These disorders can also have distinct skin manifestations that aid in their diagnosis.
Tuberous Sclerosis: This rare multisystem genetic disease is caused by abnormalities on chromosome 9 and leads to the formation of benign tumors (hamartomas) in various organs, including the brain, eyes, skin, kidney, and heart. Skin problems associated with tuberous sclerosis include periungual fibromas, adenoma sebaceum, ‘ash leaf’ hypomelanotic macules, café-au-lait patches, subcutaneous nodules, and shagreen patches. Neurological symptoms such as seizures, developmental delay, behavioral problems, and learning difficulties can also occur.
Neurofibromatosis I: This inherited condition causes tumors (neurofibromas) to grow within the nervous system and is characterized by café-au-lait spots on the skin.
Von Hippel-Lindau Disease: This inherited tumor disorder is caused by a mutation in a tumor suppressor gene on chromosome 3 and is commonly associated with angiomatosis, hemangioblastomas, and pheochromocytomas.
Neurofibromatosis II: This disorder presents with bilateral hearing loss due to the development of bilateral acoustic neuromas.
Sturge-Weber Syndrome: This congenital disorder is identified by a port-wine stain on the forehead, scalp, or around the eye.
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This question is part of the following fields:
- Dermatology
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Question 20
Incorrect
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A 35-year-old woman comes to the obstetric clinic during her 28th week of pregnancy. She has been diagnosed with gestational diabetes and has been taking metformin for the past two weeks. However, her blood glucose levels are still elevated despite following a strict diet and taking the maximum dose of metformin. What is the next best course of action to manage her blood glucose levels?
Your Answer:
Correct Answer: Add on insulin therapy
Explanation:When a woman has gestational diabetes, it is important to control her blood glucose levels to prevent complications such as premature birth, stillbirth, and macrosomia. If diet and exercise changes along with metformin do not meet blood glucose targets, insulin therapy should be added, according to NICE guidelines. Sulfonylureas are not recommended for gestational diabetes as they are less effective than the metformin and insulin combination and have been shown to be teratogenic in animals. Metformin should not be stopped as it increases insulin sensitivity, which is lacking during pregnancy. SGLT-2 antagonists are also not recommended due to their teratogenic effects in animals. Continuing metformin alone for two weeks despite high blood glucose levels increases the risk of complications, so insulin therapy should be added at this stage.
Gestational diabetes is a common medical disorder affecting around 4% of pregnancies. Risk factors include a high BMI, previous gestational diabetes, and family history of diabetes. Screening is done through an oral glucose tolerance test, and diagnostic thresholds have recently been updated. Management includes self-monitoring of blood glucose, diet and exercise advice, and medication if necessary. For pre-existing diabetes, weight loss and insulin are recommended, and tight glycemic control is important. Targets for self-monitoring include fasting glucose of 5.3 mmol/l and 1-2 hour post-meal glucose levels.
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This question is part of the following fields:
- Obstetrics
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Question 21
Incorrect
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A 75-year-old male presents with bilateral buttock pain that radiates through his thighs and calves. The pain worsens with standing and walking, limiting his ability to walk for more than 10 minutes or 2 to 3 blocks. However, the pain is relieved by sitting or forward flexion of the spine. There is no history of bladder or bowel dysfunction, and motor and sensory neurological examination of the lower limbs is normal. What is the most probable cause of these symptoms?
Your Answer:
Correct Answer: Lumbar spinal stenosis
Explanation:AS, also known as ankylosing spondylitis, is a type of arthritis that primarily affects the spine. It causes inflammation and stiffness in the joints between the vertebrae, leading to fusion of the spine over time. AS can also affect other joints, such as the hips, shoulders, and knees, and can cause fatigue and eye inflammation. It is a chronic condition that typically develops in early adulthood and is more common in men than women. There is no cure for AS, but treatment options such as medication, exercise, and physical therapy can help manage symptoms and improve quality of life.
Lumbar spinal stenosis is a condition where the central canal in the lower back is narrowed due to degenerative changes, such as a tumor or disk prolapse. Patients may experience back pain, neuropathic pain, and symptoms similar to claudication. However, one distinguishing factor is that the pain is positional, with sitting being more comfortable than standing, and walking uphill being easier than downhill. Degenerative disease is the most common cause, starting with changes in the intervertebral disk that lead to disk bulging and collapse. This puts stress on the facet joints, causing cartilage degeneration, hypertrophy, and osteophyte formation, which narrows the spinal canal and compresses the nerve roots of the cauda equina. MRI scanning is the best way to diagnose lumbar spinal stenosis, and treatment may involve a laminectomy.
Overall, lumbar spinal stenosis is a condition that affects the lower back and can cause a range of symptoms, including pain and discomfort. It is often caused by degenerative changes in the intervertebral disk, which can lead to narrowing of the spinal canal and compression of the nerve roots. Diagnosis is typically done through MRI scanning, and treatment may involve a laminectomy. It is important to note that the pain associated with lumbar spinal stenosis is positional, with sitting being more comfortable than standing, and walking uphill being easier than downhill.
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This question is part of the following fields:
- Musculoskeletal
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Question 22
Incorrect
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Can you review a 73-year-old man who has experienced an inferior myocardial infarction? Upon admission, he presents with bradycardia, with a heart rate of 41, and a BP of 100/60 mmHg. Bilateral basal crackles consistent with heart failure are heard upon chest auscultation. Do you know which coronary artery typically supplies the sinoatrial node?
Your Answer:
Correct Answer: Right coronary artery
Explanation:The Coronary Arteries and Blood Supply to the Heart
The heart is supplied with blood by the right and left coronary arteries, which arise from small openings called aortic sinuses. These arteries are unique as they fill during diastole. The right coronary artery supplies the right atrium and ventricle, while the left coronary artery divides into the left anterior descending artery and the circumflex artery. The left anterior descending artery supplies the anterior septum and the anterior left ventricular wall, while the circumflex artery gives off branches to the left atrium and the left ventricle. Variations in the branching patterns of the coronaries are common.
Most people have an equal blood supply to the heart from both the right and left coronary arteries. However, in some cases, the sinoatrial artery branching off from the origin of the right coronary artery supplies the SA node, while in others, the SA nodal branch arises from the circumflex branch of the circumflex artery. Some blood from the capillary beds in the heart wall drains directly into the heart cavities, while the majority returns through veins that accompany the arteries and empty into the right atrium via the coronary sinus.
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This question is part of the following fields:
- Clinical Sciences
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Question 23
Incorrect
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An obese 60-year-old man presents to his General Practitioner (GP) with ongoing vague abdominal pain and fatigue for the last three months. His past medical history is significant for type 2 diabetes mellitus and hypertension.
Physical examination suggests hepatomegaly. Laboratory studies reveal a negative hepatitis panel and normal iron studies. Antibodies for autoimmune liver disease are also normal.
A diagnosis of non-alcoholic fatty liver disease (NAFLD) is likely.
Which of the following is the most appropriate treatment for this patient?Your Answer:
Correct Answer: Weight loss
Explanation:Management of Hepatomegaly and Non-Alcoholic Fatty Liver Disease (NAFLD)
Hepatomegaly and non-alcoholic fatty liver disease (NAFLD) are common conditions that require appropriate management to prevent progression to liver cirrhosis and other complications. The following are important considerations in the management of these conditions:
Diagnosis: Diagnosis of NAFLD involves ruling out other causes of hepatomegaly and demonstrating hepatic steatosis through liver biopsy or radiology.
Conservative management: Most patients with NAFLD can be managed conservatively with maximized control of cardiovascular risk factors, weight loss, immunizations to hepatitis A and B viruses, and alcohol abstinence. Weight loss in a controlled manner is recommended, with a 10% reduction in body weight over a 6-month period being an appropriate recommendation to patients. Rapid weight loss should be avoided, as it can worsen liver inflammation and fibrosis. Unfortunately, no medications are currently licensed for the management of NAFLD.
Liver transplant: Patients with NAFLD do not require a liver transplant at this stage. Conservative management with weight loss and controlling cardiovascular risk factors is the recommended approach.
Oral steroids: Oral steroids are indicated in patients with autoimmune hepatitis. Patients with autoimmune hepatitis typically present with other immune-mediated conditions like pernicious anemia and ulcerative colitis.
Penicillamine: Penicillamine is the treatment for patients with Wilson’s disease, a rare disorder of copper excretion that leads to excess copper deposition in the liver and brain. Patients typically present with neurological signs like tremor, ataxia, clumsiness, or abdominal signs like fulminant liver failure.
Ursodeoxycholic acid: Ursodeoxycholic acid is used in the management of primary biliary cholangitis (PBC), a condition more common in women. Given this patient’s normal autoimmune screen, PBC is an unlikely diagnosis.
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This question is part of the following fields:
- Gastroenterology
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Question 24
Incorrect
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A 35-year-old man was bitten by a stray dog during his travels. The dog bit him on his leg, causing a deep wound with bleeding. The dog appeared sickly and there was a high possibility that it was infected with rabies. As a precautionary measure, the dog was euthanized and its tissues were tested. The results confirmed that the dog was indeed positive for rabies. What is the recommended course of treatment for this individual?
Your Answer:
Correct Answer: Wash the wound thoroughly, give the vaccination and give rabies immune globulin
Explanation:Rabies and Post-Exposure Treatment
Rabies is a severe viral infection that affects the blood and central nervous system. It is a zoonotic disease, meaning it is transmitted from animals to humans. Symptoms of rabies in humans include fever, itch at the site of infection, hydrophobia, and changes in personality, including aggressive behavior. The World Health Organization (WHO) has categorized three types of contact that determine the need for post-exposure treatment.
Category I contact involves touching or feeding animals or licks on the skin, which requires no treatment. Category II contact includes nibbling of uncovered skin, minor scratches or abrasions without bleeding, and licks on broken skin, which requires immediate vaccination. Category III contact involves single or multiple transdermal bites or scratches, contamination of mucous membrane with saliva from licks, or exposure to bat bites or scratches, which requires immediate vaccination and administration of rabies immune globulin.
It is crucial to note that all bites and wounds require immediate and thorough washing and flushing. Post-exposure prophylaxis is used when there are no symptoms, as once symptoms develop, rabies is almost always fatal, and treatment is based on symptom control. This case describes a category III contact, and the correct treatment is immediate vaccination and administration of rabies immune globulin.
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This question is part of the following fields:
- Infectious Diseases
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Question 25
Incorrect
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You assess a client who complains of excessive sweating.
What is the physiological process through which sweating results in heat dissipation?Your Answer:
Correct Answer: Increased conduction
Explanation:The Effect of Humidity on Heat Loss
Sweating is a natural response of the body to regulate its temperature. When sweat evaporates from the skin, it takes away heat and cools the body. However, the effectiveness of this process is affected by the humidity in the air. High humidity reduces the rate of evaporation, which means less heat is taken away from the body. As a result, individuals may feel hotter and more uncomfortable in humid conditions.
This phenomenon is due to the fact that humidity affects the efficacy of heat loss via conduction. When the air is dry, sweat evaporates quickly, leading to increased heat conduction away from the skin. However, when the air is humid, the moisture in the air makes it harder for sweat to evaporate. This reduces the rate of heat loss and makes it more difficult for the body to regulate its temperature.
Overall, the effect of humidity on heat loss is an important factor to consider when assessing the comfort level of individuals in different environments. this relationship can help us design better cooling systems and improve our ability to adapt to different weather conditions.
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This question is part of the following fields:
- Clinical Sciences
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Question 26
Incorrect
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A 63-year-old man is admitted to hospital with two days of loin pain, fever, nausea and rigors. He reports having had a recent urinary tract infection, with associated dysuria and haematuria. He has a past medical history of hypertension and diabetes.
Upon examination, he has right-sided flank pain with some tenderness. Observations show mild hypotension and a raised temperature. Blood tests support an infective picture. The medical team decides to start the patient on an antibiotic.
The following day, the patient experiences a seizure, witnessed by the nursing staff. The doctors suspect that the antibiotic may have triggered the seizure.
Which antibiotic was prescribed to the patient?Your Answer:
Correct Answer: Ciprofloxacin
Explanation:Ciprofloxacin is the only medication known to lower the seizure threshold in epileptic patients, which is important to consider in the diagnosis of acute pyelonephritis where ciprofloxacin is commonly used. cephalexin and co-amoxiclav are alternative antibiotics that do not affect the seizure threshold, while flucloxacillin is not typically used in the treatment of pyelonephritis.
Understanding Quinolones: Antibiotics that Inhibit DNA Synthesis
Quinolones are a type of antibiotics that are known for their bactericidal properties. They work by inhibiting DNA synthesis, which makes them effective in treating bacterial infections. Some examples of quinolones include ciprofloxacin and levofloxacin.
The mechanism of action of quinolones involves inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV. However, bacteria can develop resistance to quinolones through mutations to DNA gyrase or by using efflux pumps that reduce the concentration of quinolones inside the cell.
While quinolones are generally safe, they can have adverse effects. For instance, they can lower the seizure threshold in patients with epilepsy and cause tendon damage, including rupture, especially in patients taking steroids. Additionally, animal models have shown that quinolones can damage cartilage, which is why they are generally avoided in children. Quinolones can also lengthen the QT interval, which can be dangerous for patients with heart conditions.
Quinolones should be avoided in pregnant or breastfeeding women and in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Overall, understanding the mechanism of action, mechanism of resistance, adverse effects, and contraindications of quinolones is important for their safe and effective use in treating bacterial infections.
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This question is part of the following fields:
- Pharmacology
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Question 27
Incorrect
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A 67-year-old woman presents to her GP with a four month history of general malaise, weight loss, night sweats and fevers.
Examination shows a non-blanching rash across her lower legs, feet and hands. She has mild widespread wheeze and a systolic murmur consistent with her known COPD and aortic stenosis.
Temperature is 38°C, BP 150/100 mmHg. Urine dipstick is positive for blood and protein. Bloods show a raised creatinine at 140 umol/l, CRP of 230 mg/l, ESR of 45 mm/hr, with mild anaemia and mild leucocytosis. Her autoimmune screen is pending.
She is admitted for further investigation. What would be the next investigation of choice?Your Answer:
Correct Answer: Peripheral blood cultures
Explanation:Diagnosis and Investigation of a Patient with Chronic Symptoms
The most probable diagnosis for a patient presenting with constitutional symptoms, a known valve lesion, fever, vasculitic rash, and raised inflammatory markers is subacute bacterial endocarditis (SBE). Therefore, the most appropriate investigation would be blood cultures. Although her symptoms are consistent with a chronic infection, inflammatory process, or malignancy, the combination of her symptoms makes bacterial endocarditis the most likely diagnosis. A false positive ANCA test can be seen in chronic infections, and it is well described in SBE.
A chest radiograph would be appropriate to look for malignancy or infection in a woman with a smoking history and known COPD. However, the examination findings are not consistent with a lung malignancy, and the history is too chronic for pneumonia. It is important to consider the patient’s symptoms and medical history when determining the appropriate investigation and diagnosis. Proper diagnosis and investigation can lead to effective treatment and management of the patient’s condition.
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This question is part of the following fields:
- Nephrology
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Question 28
Incorrect
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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?
Your Answer:
Correct Answer: Splinter haemorrhages
Explanation:Symptoms and Diagnosis of Infective Endocarditis
This individual has a lengthy medical history of experiencing night sweats and has developed clubbing of the fingers, along with a murmur. These symptoms are indicative of infective endocarditis. In addition to splinter hemorrhages in the nails, other symptoms that may be present include Roth spots in the eyes, Osler’s nodes and Janeway lesions in the palms and fingers of the hands, and splenomegaly instead of cervical lymphadenopathy. Cyanosis is not typically associated with clubbing and may suggest idiopathic pulmonary fibrosis or cystic fibrosis in younger individuals. However, this individual has no prior history of cystic fibrosis and has only been experiencing symptoms for six weeks.
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This question is part of the following fields:
- Cardiology
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Question 29
Incorrect
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You are called to see a 62-year-old man who has suddenly deteriorated after pacemaker insertion. He has sudden-onset shortness of breath and is cold and clammy. On examination, his blood pressure is 90/50 mmHg, pulse 100 bpm and regular. His jugular venous pressure (JVP) is markedly elevated and his heart sounds are muffled. You give him oxygen and plasma volume expanders intravenously (iv).
Which of the following is the next most appropriate intervention?Your Answer:
Correct Answer: Prepare for pericardiocentesis
Explanation:Management of Cardiac Tamponade
Cardiac tamponade is a medical emergency that requires urgent intervention. The condition is characterized by a large amount of fluid in the pericardial sac, which can lead to compression of the heart and subsequent haemodynamic instability.
The first step in managing cardiac tamponade is to perform pericardiocentesis, which involves draining the fluid from the pericardial sac. Delaying this procedure can result in cardiac arrest and death.
While echocardiography can aid in diagnosis, it should not delay the initiation of pericardiocentesis. Similarly, a chest X-ray is not necessary for management. Swann-Ganz catheter insertion and inotropic support are also not recommended as they do not address the underlying cause of the condition.
In summary, prompt recognition and treatment of cardiac tamponade is crucial for patient survival.
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This question is part of the following fields:
- Cardiology
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Question 30
Incorrect
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What is the brain region responsible for controlling body temperature?
Your Answer:
Correct Answer: Pre-optic hypothalamus
Explanation:The Hypothalamus and Temperature Regulation
The hypothalamus plays a crucial role in regulating body temperature. This area of the brain is responsible for maintaining a stable internal temperature, regardless of external conditions. It is important to note that this process is completely automatic and not related to the sensation of heat or cold.
However, certain drugs can interfere with the hypothalamus’s ability to regulate temperature. Neuroleptics, amphetamine-like compounds, and SSRIs are examples of drugs that can disrupt this process. It is important for individuals taking these medications to be aware of the potential side effects and to consult with their healthcare provider if they experience any changes in body temperature.
In summary, the hypothalamus is responsible for temperature regulation, and certain drugs can interfere with this process. the role of the hypothalamus in maintaining a stable internal temperature is important for maintaining overall health and well-being.
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This question is part of the following fields:
- Clinical Sciences
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