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Medicine ELOOPS > 2011 > Flashcards

2011 Flashcards

1
Q

A 60 year old patient presented with dizziness and frequent episodes of syncope. He is a known case of heart disease. This is his ECG:
1. What is the diagnosis?
2. What is the treatment?

A
  1. Third degree AV block
  2. Permanent Pacemaker
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2
Q

A man developed an arrhythmia after having a myocardial infarction
1. What is the likely diagnosis?
2. What is the management for the following case?

A
  1. Ventricular tachycardia
  2. DC shock
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3
Q

A 45 year old male presented with acute retrosternal chest pain that lasted for hours and not relieved by anything.
1. What is the diagnosis based on the ECG?
2. What is the pathophysiology behind this condition?

A
  1. Inferior wall ST elevated myocardial infarction
  2. Rupture of atherosclerotic plaque and thrombus formation leading to obstruction in the right coronary artery
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4
Q

Patient develops palpitations of abrupt onset offset for the past two weeks.
1. What is you diagnosis based on the ECG?
2. Rx?

A
  1. Supraventricular tachycardia
  2. IV adenosine
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5
Q

A 27 year old man suddenly develops an episode of palpitations and fatigue that resolved spontaneously
1. Describe the findings in ECG
2. What is the diagnosis?

A
  1. Short PR interval and delta waves giving a wide QRS morphology
  2. Wolf Parkinson White syndrome
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6
Q

A 58 year old man develops crushing retrosternal pain that lasted longer than usual along with palpitations and sweating.
1. What is the diagnosis?
2. What is the underlying pathophysiology?

A
  1. Anterior wall ST elevation myocardial infarction
  2. Rupture of an atherosclerotic plaque resulted in thrombus formation and occlusion of the coronary artery (LAD)
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7
Q

A 25 year old female presented with progressive shortness of breath, palpitations, and 2 episodes of hemoptysis.
1. Mention 2 things you see on the CXR.
2. What is the most likely diagnosis

A
  1. Mitralization [straightening] of the left border of the heart
    Double cardiac density shadow Widening of the carina
  2. Mitral stenosis
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8
Q

Patient presented with a four week history of fever, purulent cough of smelly green sputum
1. What is the abnormality (diagnosis):
2. What are two causative organisms?

A
  1. Lung abscess
  2. Staphylococcus Aureus Klebsiella Pneumoniae Anaerobes
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9
Q

A 60 year old male, with a history of heart attack one year ago, presented with progressive SOB on exertion and unable to climb the stairs, cough with frothy, bloody stain sputum. When lying flat the patient experienced dyspnea.
1. What is the diagnosis based on the CXR?
2. Explain the pathophysiology
3. Mention a drug that is given for immediate symptomatic relief

A
  1. Pulmonary edema
  2. The history of MI is a risk factor for CHF, which result in high pulmonary pressure that can lead to Pulmonary edema
  3. Diuretics
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10
Q

A 22 year old patient presents with sudden onset of SOB. His chest x-ray is shown.
1. What is the diagnosis based on the chest x-ray, specify on which side.
2. Mention 3 findings on physical examination.

A
  1. Right sided pneumothorax.
  2. Hyperresonant percussion of right side. Decreased breath sounds on the right side. Decreased vocal resonance on the right side.
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11
Q

A 23 year old female presented with exertional dyspnea and hemoptysis. A picture of an x-ray was shown.
1. What is the diagnosis?
2. What could be the underlying cause?

A
  1. Mitral Stenosis
  2. Rheumatic Heart Disease
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12
Q

A 37 year old man has a chronic history of purulent productive cough, fever and chest pain.
1. What does the red arrow point at?
2. What does the white arrow point at?

A
  1. The deviated trachea
  2. Collapsed right upper lobe
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13
Q
  1. What is this sign called
  2. What lab test would you order?
A
  1. Xanthelasma
  2. Lipid profile (serum cholesterol and lipoproteins)
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14
Q

A 56 year old male presented to the hospital complaining of sudden attack of shortness of breath. He also complained of inability to lie flat and sudden awake from sleep at night with shortness of breath during the past 2 months. Chest X-ray shown below
1. What is the diagnosis?
2. What is the pathophysiology of this condition?

A
  1. Pulmonary edema complicating acute left ventricular failure
  2. Left-sided heart failure leads to increased left atrial pressure backwards, leading to increased pulmonary pressures, pulmonary congestion, and edema
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15
Q

A 9 year old boy has a recent history of sore throat after which he developed skin lesions and joint pain. / A 15 year old girl with past history of multiple sore throats presented with this and a pansystolic murmur at the apex.
1. What is the sign shown?
2. What is the diagnosis?

A
  1. Sydenham’s chorea
  2. Acute rheumatic fever
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16
Q

This patient has a hereditary syndrome.
1. What is the most common cardiac abnormality in these types of patients
2. What is the best method to diagnose the cardiac abnormality?

A
  1. Ventricular Septal Defect
  2. Ultrasound or Cardiac Catheterization
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17
Q

This patient has a hereditary syndrome.
1. Mention one cardiac condition typically associated with this syndrome
2. How would you confirm the diagnosis?

A
  1. Endocardial cushion defects
  2. By chromosomal analysis (karyotyping)
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18
Q

Flow volume curve of 50 year old patient with cough for 15 years. A flow volume curve is shown.
1. What is the pattern seen in the picture?
2. How would you confirm
your diagnosis?
What are the symptoms?

A
  1. Obstructive pattern
  2. Reversibility with bronchodilators
  3. -
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19
Q

Identify
1. What is this sign?
2. Mention two associated conditions

A
  1. Finger clubbing
  2. Bronchiectasis, lung abscess, empyema, cystic fibrosis, bronchogenic carcinoma, idiopathic pulmonary fibrosis, cyanotic congenital heart disease, subacute bacterial endocarditis, cirrhosis, celiac disease, inflammatory bowel disease, primary sclerosing cholangitis, Graves disease
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20
Q

Methacholine challenge test figure.
1. How much FEV1 has to decrease in order to diagnose asthma?
2. What is contraindicated before doing the test?

A
  1. By 20%
  2. Taking bronchodilators, taking cholinergic drug (Ipratropium Bromide), drinking coffee or tea.
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21
Q

A 30 year old male presented with productive cough. A picture of his CT is shown.
1. Describe what you see in the CT.
2. What is the diagnosis?

A
  1. Dilated airways
  2. Bronchiectasis
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22
Q

A 69 year old man presents with a breathing limitation that persisted for many years. A spirometry was performed.
1. Which limb does the red arrow point at?
2. Which limb does the blue arrow point at?
3. What pattern of ventilatory defect does the diagram indicate?

A
  1. Expiratory limb
  2. Inspiratory limb
  3. Obstructive pattern
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23
Q

A 27 year old male has been diagnosed with lower respiratory tract infection after suffering from influenza
1. What is the name of the test shown?
2. Describe the findings of the test and name the organism

A
  1. Gram stain
  2. Gram positive cocci in clusters (staphylococci); staphylococcus aureus
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24
Q

This is a CT chest of 59 year old male.
1. What does the red arrow point at
2. What does the blue arrow point at?
3. What can be the cause of the lesion pointed at by the white arrow?

A
  1. The trachea
  2. The esophagus
  3. Tuberculosis, bronchogenic carcinoma
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25
Q

Patient Came to the ER with this vision.
1. Name the abnormality.
2. Mention one cause.

A
  1. Right Upper homonymous quadrantanopia
  2. Stroke in the left temporal lobe
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26
Q
  1. What is the diagnosis
  2. Mention 2 causes.
A
  1. Abducent nerve palsy/ 6th cranial nerve palsy/ CN6 palsy.
  3. Tumor compressing the nerve
  4. Infection
  5. Ischemia localized to the nerve
  6. Cavernous sinus thrombosis
  7. Hypertension
  8. Tumor
  9. Diabetes mellitus
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27
Q
  1. Which response is abnormal?
  2. Where can an abnormal response be found?
A
  1. B
  2. In upper motor neuron lesions (stroke)
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28
Q

A 56 year old man presented with Diplopia.
1. What is the diagnosis?
2. Mention two causes

A
  1. Oculomotor nerve palsy
  2. Diabetes mellitus, multiple sclerosis, posterior communicating artery berry aneurysm
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29
Q

Perimetry performed in a patient who presented with visual loss.
1. What is the diagnosis?
2. Where is the site of the lesion?

A
  1. Right homonymous hemianopia
  2. Left optic tract
30
Q

42 year old woman presents with one year history of blurred vision. The abnormality shown was in both eyes on fundoscopy
1. What is the diagnosis?
2. Mention two causes?

A
  1. Papilledema
  2. Increased intracranial pressure due to e.g. brain tumor, Hypertensive retinopathy
31
Q

https://docs.google.com/file/d/1MI5h9Z-JOHQJB5QJvnP9Lvsv7OCq0d8C/preview
1. What is the sign shown?
2. Where is the lesion?

A
  1. Fasciculations
  2. In lower motor neurons
32
Q

https://docs.google.com/file/d/1U5yIlJ4zPLUXYBYDS3UjojgC-TlbJLne/preview
1. What is the finding shown
2. What is the clinical diagnosis?

A
  1. Resting tremor
  2. Benign essential tremor
33
Q

https://docs.google.com/file/d/1_iqoDZz0I_8-06Pph4qaEZAQglj9jQBM/preview
1. What abnormality does this patient have?
2. What is the cause?

A
  1. Inability to abduct her right eye
  2. Right abducens nerve palsy
34
Q

https://docs.google.com/file/d/1rohmukAYphYFu1lKCLYG6YL472EwPTge/preview
1. What is the sign shown?
2. Name two other signs this patient might have on neurological examination

A
  1. Intention tremor
  2. Dysdiadochokinesia, rebound phenomenon, nystagmus
35
Q

42 year old woman presents with one year history of blurred vision. The abnormality shown was in both eyes on fundoscopy
1. What is the diagnosis?
2. Mention two causes?

A
  1. Papilledema
  2. Increased intracranial pressure due to e.g. brain tumor, Hypertensive retinopathy
36
Q

https://docs.google.com/file/d/1tXhMNo6mlL8PdARwb181xCEy6qOBO0EH/preview
A patient presented with right-sided weakness.
1. What is the doctor checking in this video?
2. What does it indicate?

A
  1. Plantar response
  2. Upper motor neuron lesion
37
Q

A patient complains of loss of some of his visual field. The results of his perimetry are shown.
1. What is the visual field defect?
2. Mention one possible cause?

A
  1. Bitemporal hemianopia
  2. Pituitary adenoma compressing the optic chiasm
38
Q
  1. What is the name of the examination in the first picture?
  2. What is the most likely abnormality if the patient has a pituitary adenoma?
A
  1. Visual field test
  2. Bitemporal hemianopia
39
Q

https://www.youtube.com/watch?v=ZkM-1MLn0_A
1. What is the sign that you see?
2. Where is the lesion located?

A
  1. Intention tremor
  2. Left sided cerebellar lesion
40
Q

https://docs.google.com/file/d/1wJsREZlqsk_u89sYX0v80ItTbMFk6MmJ/preview
1. What is the diagnosis?
2. Mention one complication

A
  1. Bell’s palsy
  2. Corneal scarring
41
Q

A 54-year-old patient presented with a two month history of progressive dysphagia for solid and liquid. A picture of his barium swallow is shown.
1. What is the diagnosis:
2. What is the next step?

A
  1. Esophageal carcinoma
  2. Upper GI endoscopy & Biopsy followed by Endoscopic US for staging
42
Q

https://docs.google.com/file/d/1xzwhfBWkc9jSFCPZXpc2g8rVeJgsd5x0/preview
A 67-year-male with a history of constipation was found to have iron deficiency anemia. Colonoscopy was performed.
1. What is the diagnosis?
2. How can the incidence of this condition be reduced?

A
  1. Colorectal carcinoma
  2. By screening with colonoscopy at 45 years of age
43
Q

A 26 year old female with a history of chronic bloody diarrhea presents with severe abdominal pain.
1. Describe the finding in this abdominal x-ray
2. What is the diagnosis?
3. What is the most feared complication?

A
  1. Colon dilation more than 6 cm
  2. Toxic megacolon
  3. Perforation/ shock/ sepsis
44
Q

A 19 year old male with a history of chronic diarrhea and weight loss was examined. He presented with painful raised red nodules over bilateral shins.
1. Name the lesion shown
2. What is the underlying gastrointestinal disease?

A
  1. Erythema nodosum
  2. Inflammatory bowel disease
45
Q

https://docs.google.com/file/d/10iWbb9hO4e2AeZ1NBCzOkIMvzj5sAw5F/preview
1. What is the sign shown?
2. Name two associated conditions

A
  1. Flapping tremor (asterixis)
  2. Cirrhosis, CO2 retention, uremia
46
Q

A 67 year old male reports a history of constipation. He was found to have iron deficiency anemia which was investigated.
1. What is the finding shown?
2. How can the mortality from this disease be reduced in the population?

A
  1. A large mass occupying the colonic lumen, most likely colorectal carcinoma
  2. By screening with colonoscopy at 50 years in average risk population (45 years in Kuwait)
47
Q

Young patient presented with RUQ abdominal pain. CT scan shows cyst in the liver and aspiration showed fluid with anchovy sauce consistency.
1. Diagnosis?
2. What medical treatment would you offer?

A
  1. Amoebic abscess due to Entamoeba histolytica
  2. Metronidazole
48
Q

A 56 year old diabetic woman was found to have a BMI of 31 kg/m2. Her investigations are shown in the table
1. Describe the histological findings shown
2. What is the diagnosis?

A
  1. Steatosis and neutrophilic inflammatory infiltrate
  2. Non-alcoholic steatohepatitis
49
Q

A 23 year old man presenting with history of diarrhea with mucus and blood. He complained that he had lost weight in the past month. Video of colonoscopy is shown.
1. Describe what you see in the colonoscopy?
2. What is your diagnosis?

A
  1. Pseudo-polyps
  2. Inflammatory Bowel Disease – Ulcerative Colitis (Both are correct)
50
Q

Patient with history of acute pancreatitis presenting with abdominal fullness, high amylase and lipase. Picture of his abdominal CT is shown.
1. What does the CT scan show?
2. List 2 complications

A
  1. Edematous gastric wall
  2. Hemorrhage Pseudocyst
51
Q

This patient had a history of arthralgia, and stiffness mainly in the morning
1. What is the finding shown in the figure?
2. What is the diagnosis?

A
  1. Nail pitting
  2. Psoriatic arthritis
52
Q

A 57 year old female experienced pain in her fingers and noticed some color changes.
1. What is this sign?
2. Name two associated conditions

A
  1. Raynaud’s phenomenon
  2. Systemic lupus erythematosus Rheumatoid Arthritis Scleroderma
53
Q

A 42 year old man developed a sudden severe pain in his foot around the great toe.
1. Describe the findings shown
2. What is the diagnosis?

A
  1. Swelling and redness of the first MTP joint
  2. Acute gout (podagra)
54
Q

A 23 year old female complains of a rash that appeared on her cheeks and swelling of the small joints of her hands.
1. What is the diagnosis?
2. What serological tests would be ordered?

A
  1. Systemic lupus erythematosus
  2. ANAs, anti-dsDNA, anti-Sm Abs
55
Q

A 35 year old female developed pain in her hand joints.
1. Describe the findings shown
2. Mention two differential diagnoses

A
  1. Swelling of the PIP, DIP and MCP joints of the hand
  2. Rheumatoid arthritis Systemic lupus erythematosus
56
Q

A 51 year old woman with chronic symmetric polyarticular arthritis.
1. Describe the x-ray findings
2. What is the diagnosis?

A
  1. Erosion and destruction of the PIPs, MCPs and wrist joint
  2. Rheumatoid arthritis
57
Q

A 36 year old woman reports recent weight gain and easy bruising.
1. Mention two findings as shown in the pictures?
2. What is the diagnosis?

A
  1. moon facies, facial plethora,
    hirsutism,purple abdominal striae
  2. Cushing’s syndrome
58
Q

A 42 year old man presents with postural hypotension and weight loss
1. What’s the diagnosis?
2. Mention two biochemical abnormalities this patient is likely to have
3. What’s the key diagnostic test?

A
  1. Addison’s disease
  2. Hyponatremia and hyperkalemia
  3. Short ACTH (synacthen) stimulation test
59
Q

A 29 year old woman with a weight of 76 kg and a height of 163 cm wants to lose 10 kilos to fit into her wedding dress.
1. Classify her nutritional status according to her BMI
2. Name the parameter is being measured in the picture shown and mention one importance

A
  1. She’s overweight
  2. Waist circumference; high values (more than 80 in females) are associated with increased risk of developing type 2 diabetes mellitus
60
Q

30 year old patient complains of vision problems and that his wedding ring is becoming tighter. Picture of hand of patient.
1. What is the best laboratory investigation to diagnose this condition?
2. If the patient complains of hand pain, what could be the cause?

A
  1. IGF-1 level
  2. Carpal-Tunnel syndrome, median nerve entrapment
61
Q

Patient with history of thyroidectomy presented on follow up with this sign. Picture of patient’s hand.
1. What is this sign called?
2. Mention 2 biochemical causes

A
  1. Trousseau’s sign
  2. Hypocalcemia
62
Q

Patient presented to the hospital looking like this. Picture of face of patient.
1. What is the cause?
2. Mention 2 other signs you would see.

A
  1. Hypothyroidism
  2. Hair loss, delayed ankle jerk reflex, myxedematous face, dry skin.
63
Q

69 year old male suffers from weight loss and excessive sweating.
1. Mention two findings on physical examination (one from the picture shown and another from the rest of the examination)
2. What is the diagnosis?

A
  1. multinodular swelling in the neck (multinodular goiter)
    palmar erythema, tachycardia, lid lag, lid retraction, onycholysis
  2. Toxic multinodular goiter
64
Q

A 68 years old man presented with 3 months history of low back pain and fatigue. Investigations revealed hypercalcemia and M spike.
1. Describe the finding in the x ray
2. What is the most likely diagnosis?

A
  1. Multiple osteolytic [punched out] lesions in the skull
  2. Multiple myeloma
65
Q

A 34 year old female suffers from shortness of breath, fatigue and palpitations on exertion.
1. What is the sign ?
2. What is the diagnosis?

A
  1. Koilonychia
  2. Iron deficiency anemia
66
Q

A 56-year-old patient presented with headache, pruritus (itchiness), palmar erythema, and facial plethora. CBC shows pancytopenia. His BP was high
1. What is the diagnosis
2. What is the test confirmed the diagnosis?

A
  1. Polycythemia vera
  2. Genetic testing for JAK2
67
Q

15-years old boy developed jaundice after eating falafel (fava beans).
1. Diagnose
2. What is shown in the blood smear?

A
  1. G6PD deficiency
  2. Heinz bodies
68
Q

A 10 year old boy presented with a swollen knee joint that had been fallen on many times. His mom recalls that her child bled profusely after a dental extraction last year.
1. What is the likely cause of his knee joint swelling?
2. What is the diagnosis?

A
  1. Hemarthrosis (bleeding into the joint)
  2. Hemophilia
69
Q

A 13 year old boy has been noticed by his mother to have developed lesions on his face and scalp with loss of hair.
1. What is the diagnosis?
2. Name one diagnostic test that can be used

A
  1. A. Tinea capitis B. Tinea corporis
  2. KOH and cultures
70
Q

A 53 diabetic patient complains of painful vesicles that appeared on a dermatome of his lateral chest.
1. What is the diagnosis?
2. What is the causative organism?

A
  1. Shingles
  2. Varicella zoster virus (VZV)

Medicine ELOOPS (9 decks)

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