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Medicine ELOOPS > 2014 > Flashcards

2014 Flashcards

1
Q

Patient presented with severe retrosternal chest pain of 2 hours duration. Shown is his ECG (ST segment elevation in V1-V4 only)
1. What is the diagnosis based on the ECG?
2. Mention two definitive Rx?

A
  1. Anterior wall ST segment elevation myocardial infarction
  2. Thrombolytic therapy, percutaneous coronary intervention (PCI)
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2
Q
  1. Write 2 findings you see in this ECG?
  2. What is the diagnosis?
A
  1. Absence of P waves and irregularly irregular rhythm.
  2. Atrial fibrillation
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3
Q

A 25 year old male developed shortness of breath and chest pain.
1. What are two ECG changes?
2. What is your clinical diagnosis?

A
  1. Deep S waves in V1, V2, and Tall R waves in V6
  2. Left ventricular hypertrophy, Hypertrophic cardiomyopathy (HCOM)
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4
Q

Patient reports falling unconscious in the bathroom. A supraorbital cut was noticed. Shown is his ambulatory ECG.
1. What is the diagnosis?
2. Rx?

A
  1. Sinus arrest
  2. Pacemaker
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5
Q

A 69 year old man has a long history of chronic kidney disease.
1. What is the ECG diagnosis?
2. What is the management for this patient?

A
  1. Hyperkalemia
  2. IV calcium gluconate and IV fluids
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6
Q

A young patient develops palpitations of abrupt onset and abrupt offset for the past two weeks.
1. What is the diagnosis?
2. Which drug you would give immediately?

A
  1. Paroxysmal supraventricular tachycardia (Re-entry tachycardia)
  2. IV adenosine
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7
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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8
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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9
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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10
Q

A 30 years old male with a central chest pain for a few days comes to the ER. A CXR was done.
1. Describe the findings in his CXR?
2. What is the diagnosis?

A
  1. Increased cardiothoracic ratio/ cardiac shadow, with a flask shaped heart.
  2. Pericardial effusion complicating acute pericarditis.
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11
Q

Patient is IVD abuser, who developed severe shortness of breath associated with production of blood-tinged sputum.
1. What is the diagnosis?
2. mention one auscultatory finding in the infrascapular region and one for the cardiac apex.

A
  1. Pulmonary edema
  2. Basal lung crepitations/crackles
    S3 heart sound
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12
Q

Patient is an injection drug abuser who went into shock. Shown is his CXR.
1. What is the reason for his shock?
2. What is the immediate management?

A
  1. Tension pneumothorax
  2. Needle decompression
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13
Q

There was a scenario and it mentioned that the patient had hoarseness of the voice
1. What are the x-ray findings?
2. What is the anatomical structure affected that led to his voice problem?

A
  1. Depends on the x-ray
  2. Left atrium compressing on the recurrent laryngeal nerve leading to recurrent laryngeal nerve palsy and
    hoarseness of the voice (this is known as Ortner’s syndrome the most common cause is LA dilatation caused by
    mitral stenosis but it can also be due to pulmonary hypertension)
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14
Q
  1. What finding would you notice in this patient JVP?
  2. What is the finding in this patient pulse?
A
  1. Raised JVP with inspiration (kussmaul’s sign)
  2. Pulse maybe regular or irregularly irregular (one third have Afib)
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15
Q

A x-ray of a patient with mitralization (the he had right sided weakeness)
1. What are two mechanisms that explain his condition?
2. What is the initial investigation to be carried out to diagnose?

A

-

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16
Q

The patient has asthma, and is on the highest dose of inhaled corticosteroid, but symptoms are not under control.
1. What drug would you add for the patient?
2. You provided the patient with oral steroids, mention two complications of long-term oral corticosteroids.

A
  1. LABA
  2. Osteoporosis, weight gain and purple abdominal striae, HTN
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17
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 pairs (diplococci); streptococcus pneumonia
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18
Q

There was a scenario and it mentioned that the patient had hoarseness of the voice

A
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19
Q

Identify

A

A = Barrel chest
B = Pectus carinatum
C = Pectus excavatum
D = Scoliosis

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20
Q
  1. What is the abnormality shown in the figure?
  2. Is it acute or chronic condition?
  3. What is the cause?
  4. Is the lesion a LMN or UMN?
A
  1. ● Deviation of the protruded tongue to the left
    ● Tongue wasting and fasciculations
  2. Chronic condition
  3. Left LMN hypoglossal (CN XII) palsy
  4. LMN (CN 12)
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21
Q

https://www.youtube.com/watch?v=ZkM-1MLn0_A
1. Write 2 signs of cerebellar disease you see in the video?
2. Is the site of cerebellar lesion ipsilateral or contralateral to the signs?

A
  1. Intention tremor and hypermetria/ past-pointing/dysmetria
  2. Ipsilateral
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22
Q

https://www.grepmed.com/images/5175/video-clinical-clonus-physicalexam-neuro
1. Mention two causes for this finding?
2. Mention two other findings?

A
  1. MS, CVA/stroke
  2. Hyperreflexia, hypertonia
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23
Q

The patient complains of ptosis and fatigability especially at night. Shown is the nerve stimulation test results.
1. Dx?
2. Name one test to confirm the Dx?

A
  1. Myasthenia gravis
  2. Tensilon test
24
Q

The patient complains of right hearing loss. Performing the illustrated test shows the patient hearing louder on the right side.
1. What is the test shown in the picture?
2. What is the type of hearing loss?

A
  1. Weber’s test
  2. Conductive hearing loss
25
Q

Video showing inability to adduct right eye
1. Describe the finding.
2. What is the damaged structure?

A
  1. As above
  2. Right oculomotor nerve
26
Q

https://www.youtube.com/watch?v=0-t4RTQ0EsM
1. What is the finding shown?
2. What is the clinical diagnosis?

A
  1. Pill-rolling resting tremor
  2. Parkinson’s disease
27
Q

A 60 years old female complains of odynophagia, dysphagia, and 15 kg weight loss in the last 3 months. A barium swallow was done.
1. How to confirm the diagnosis?
2. What is the most appropriate management of this case?

A
  1. Esophageal manometry
  2. Botulinum toxin injections, CCB, endoscopic balloon dilation, Heller’s myotomy
28
Q

A young female presented with odynophagia and dysphagia. She was at the dermatology clinic one week ago. Upper endoscopy was done.
1. What is the diagnosis?
2. What is the treatment?

A
  1. Esophageal candidiasis
  2. Antifungal drug (e.g. Fluconazole)
29
Q
  1. Give a brief but accurate description of the following ulcer?
  2. What is the endoscopic treatment option for it, if any?
A
  1. Well-defined erythematous rounded erosion/ulcer with a bleeding base, surrounded by white fibrous tissue
  2. At least 2 of the following: Epinephrine injection, thermocoagulation, or clipping
30
Q
  1. What does the following picture show?
  2. Mention two hematological causes?
A
  1. Massive splenomegaly
  2. Leukemia Lymphoma
31
Q

There was a scenario mentioning that this patient has a long history of liver disease
1. Identify A?
2. Identify B?

A
  1. Spider angiomata
  2. Palmar erythema
32
Q

A Patient with type 2 diabetes Mellitus. HbA1c is 8.8
1. What is the name of the test ?
2. What is it used to assess?

A
  1. Monofilament test
  2. Diabetic polyneuropathy
33
Q

Shown is the patient’s elbow (pic is slightly different. It just shows slight redness over the elbow)
1. What is the initial investigation?
2. Mention three entities that can give rise to such presentation?

A
  1. X-ray of the affected joint/Joint fluid aspiration
  2. Septic arthritis
    Osteoarthritis
    Gouty arthritis.
34
Q

Shown is a picture of a female patient complaining of bilateral joint pain
1. What is the rash called?
2. Mention one investigation present in most of those affected with this disease?

A
  1. Malar/butterfly rash
  2. Anti-DsDNA antibody
35
Q

A patient complains of back pain
What is the diagnosis?

A

Psoriatic arthritis

36
Q
  1. What substance does this cell release?
  2. List two causes where this cell count is high.
A
  1. Histamine
    • Parasitic infections
    • Churg Strauss syndrome

Although most if not all of us answered the first question as (histamine), I believe an eosinophil doesn’t contain histamine but other substances including: Major basic protein, eosinophil cationic protein

37
Q
  1. What substance does this cell release?
  2. List two causes where this cell count is high.
A
  1. Histamine
    • Parasitic infections
    • Churg Strauss syndrome

Although most if not all of us answered the first question as (histamine), I believe an eosinophil doesn’t contain histamine but other substances including: Major basic protein, eosinophil cationic protein

38
Q

Vegan for 5 years with numbness
1. What is the abnormality?
2. What are the deficiency?
3. Mention 2 neurological manifestations

A
  1. Hypersegmented neutrophil
  2. Vit b12
  3. Subacute combined degeneration of the spinal cord, dementia, polyneuropathy.
39
Q

Table of ABG (PH is low, CO2 high, HCO3 high)
1. What is the diagnosis based on the previous ABG?
2. Mention a cause of this condition.

A
  1. Partially compensated respiratory acidosis.
  2. Any cause of hypoventilation /respiratory depression: narcotics/sedatives, brain trauma
40
Q

ABG results were shown. The patient has weakness and fatigability
1. What is the acid-base abnormality?
2. What is the underlying cause? (Urinary Na was 10, high anion gap, hyperchloremic)

A
  1. Partially compensated metabolic acidosis
  2. Salicylate poisoning/overdose
41
Q

A child had an episode of fever, fatigue, and sore throat. A few days later he developed a rash all over his body and involving his oral mucosa. This is a picture of the rash.
1. What is the diagnosis?
2. What are the target lesions of this rash called?

A
  1. Erythema multiforme
  2. Target lesions
42
Q
  1. What is the diagnosis?
  2. How can this disease be prevented?
A
  1. Chickenpox
  2. Vaccination against varicella zoster virus
43
Q
  1. What is the finding shown?
  2. What is the clinical diagnosis?
A
  1. Pill-rolling resting tremor
  2. Parkinson’s disease
44
Q
  1. What is the finding u would notice in this patient JVP?
  2. What is the finding in this patient pulse?
A
  1. Raised JVP with inspiration (kussmaul’s sign)
  2. Pulse maybe regular or irregularly irregular (one third have Afib) this answer is from 250 cases
45
Q
  1. Identify A & B?
  2. Identify C & D?
A
  1. A= barrel chest
    B= pectus carinatum
  2. C= Pectus excavatum
    D= scoliosis
46
Q
  1. What does the following picture show?
  2. Mention two hematological causes?
A
  1. Massive splenomegaly
  2. Leukemia Lymphoma
47
Q

There was a scenario mentioning that this patient has a long history of liver disease 9.
1. Identify A?
2. Identify B?

A
  1. Spider angiomata
  2. Palmar erythema
48
Q
  1. What is the likely diagnosis?
  2. What is the management for the following case?
A
  1. Ventricular tachycardia
  2. DC shock
49
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 pairs (diplococci); streptococcus pneumonia
50
Q

A 69 year old man has a long history of chronic kidney disease.
1. What is the ECG diagnosis?
2. What is the management for this patient?

A
  1. Hyperkalemia
  2. IV calcium gluconate and IV fluids
51
Q

This is not the exact picture we had in the exam but the idea was that the heart looked enlarged especially the left atrium.
There was a scenario and it mentioned that the patient had hoarseness of the voice

  1. What are the x-ray findings?
  2. What is the anatomical structure affected that led to his voice problem?
A
  1. Depends on the x-ray
  2. Left atrium compressing on the recurrent laryngeal nerve leading to recurrent laryngeal nerve palsy and hoarseness of the voice (this is known as Ortner’s syndrome the most common cause is LA dilatation caused by mitral stenosis but it can also be due to pulmonary hypertension)
52
Q

Identify the labels X and Y in figure (1)?

A

X- volume
Y- duration

53
Q
  1. mention 2 likely causes?
  2. what is your initial investigation to be done
A
  1. Inflammation infection etc
  2. some say x ray some say Joint fluid aspiration
54
Q

Xray patient with mitralization chna (the he had right sided weakeness) was asked about 2 mechanisms that explain his condition and what is the initial investigation to be carried to diagnose

A

-

55
Q

Onycholysis and the diagnosis was psoriatic arthritis in patient with back pain

A

-

Medicine ELOOPS (9 decks)

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