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Medicine ELOOPS > 2016 > Flashcards

2016 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

A 50- year old man with a previous history of MI presented to the ER unconscious. This is his ECG
1. What is the diagnosis
2. What is the definitive treatment?

A
  1. Ventricular tachycardia
  2. Synchronized cardioversion
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3
Q

This patient on histamine
What is the diagnosis?
What would you advice the patient?

A
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4
Q

A 40 year old man with central chest heaviness for 4 hrs with sweating. His ECG:
1. Interpret the the ECG:
2. What is the pathophysiology?

A
  1. Anterior ST elevation MI
  2. An atherosclerotic plaque develops on the wall of the artery, if this plaque has a thin fibrous cap, it is more likely to rupture, triggering platelet aggregation and formation of a platelet-rich clot that totally occludes the vessel. Vasoconstriction also occurs due to platelet release of serotonin and thromboxane. This all results in ischemia and eventually infarction of the myocardial tissue.
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5
Q

A patient presents with right sided hemiparesis of 1 hour duration. ECG shows atrial fibrillation.
What is the immediate management ?
What would you do for long term management?

A

-

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6
Q

Young patient present with recurrent episodes of sudden palpitation that last for 10-15 min.
1. What is the ECG findings.
2. What is the treatment.

A
  1. Delta wave and prolonged PR interval
  2. Ablation of the accessory pathway
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7
Q

A female patient with a history of breast cancer presented with shortness of breath. CXR is given:
1. What is the first investigation done to confirm diagnosis?
2. Which method can have both therapeutic and diagnostic benefits?

A

-

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8
Q

Name the structures pointed at by the red, blue, yellow arrows?
What structure the white arrow is pointing at and which part of the mediastinum does it represent?

A

-

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9
Q

A 26 year old male presented to the hospital with 4 days history of fever, chest pain, and a productive cough. X ray shown below
1. Which lobe is involved?
2. What is the diagnosis?
3. What are three important investigations?

A
  1. Right middle lobe
  2. Pneumonia
  3. -
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10
Q
  1. What is the area pointed at by the red arrow?
  2. What is the structure pointed at the tip of the blue arrow?
  3. What is the area represented by the yellow circle ?
A
  1. Left hilum
  2. Stomach (Gastric bubble)
  3. Aortopulmonary window
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11
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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12
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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13
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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14
Q

A 66-year-old male with a history of CABG complains of lower limb swelling. His CXR is given.
What is the JVP ?
What is your clinical diagnosis ?

A

-

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15
Q

A 66-year-old male with a history of CABG complains of lower limb swelling. His CXR is given.
What is the JVP ?
What is your clinical diagnosis ?

A

-

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16
Q

A young female had subcutaneous nodules on both shins. She has a history of a sore throat
1. What is your diagnosis?
2. What is the investigation to diagnose it?

A
  1. Erythema nodosum (Group A streptococcus bacteria)
  2. Serology (ASO)
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17
Q
  1. A 72 year old male with previous type 2 diabetes, hypertension, coronary artery disease, and chronic kidney disease. He was complaining of intermittent abdominal pain and 2 hours ago he developed severe right foot pain and discoloration as shown below. On presentation all his vital signs were normal and all pulses felt.
  2. What is your clinical diagnosis?
  3. What would a skin biopsy reveal?
A
  1. Cholesterol embolism
  2. Cholesterol crystals
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18
Q

A football player was complaining of chest pain that is aggravated by activity and relieved by rest. One day, he collapsed.
1. What are the findings of his physical exam?
2. What is the probable diagnosis?

A
  1. Ejection systolic murmur that improves with squatting or leg raise
  2. Hypertrophic (athletic) cardiomyopathy
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19
Q

Honeycombing on CT
1. Physical sign you will find during physical examination ?
2. Pulmonary function test finding

A

-

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20
Q

What type respiratory disease a person can develop from this animal other than asthma?
1. What is the name of the condition?
2. What type of allergic reaction it cause?

A
  1. Hypersensitivity pneumonitis
  2. Type 3 hypersensitivity
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21
Q

A young patient with purulent sputum And fever. Bacteria stained.
1. Mention the test used
2. What is the finding and causative organism

A
  1. Ziehl- Neelsen stain
  2. Acid-Fast bacilli, mycobacterium tuberculosis
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22
Q
  1. What is the name of the device?
  2. Name two indications/uses for the device
A
  1. Peak flow meter
  2. To monitor the response of treatment in asthmatic patients To assess the severity of asthma
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23
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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24
Q

Meningeal symptoms? CSF analysis of high neutrophils, normal levels of lymphocytes, high protein, low glucose
What is the diagnosis?
What is the most useful investigation?

A
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25
Q

What are the four cardinal signs of Parkinson disease ?
Which sign indicates that the disease is advanced ?

A
26
Q

A 22 year old female with visual impairment. Her CSF had oligoclonal.
1. Describe the MRI finding?
2. What is your Diagnosis?

A
  1. Multiple hyperintense periventricular plaques
  2. Multiple sclerosis
27
Q

A 34 year old patient presented with a sudden onset of severe headache and photophobia, a CSF sample was taken:
1. What is your diagnosis?
2. What is the most common cause for this problem?

A
  1. Subarachnoid hemorrhage
  2. Trauma
28
Q
  1. Name this test?
  2. What is the expected finding in sensorineural test?
A
  1. Rinne’s test
  2. The air conduction will be higher than the bone conduction
29
Q

Male with chronic right femoral nerve palsy.
1. When examining the right leg, which side will have a stronger reflex?
2. What are other clinical manifestation in this patient.

A
  1. The left will have stronger reflex
  2. Fasciculations, hypotonia, absence of plantar reflex
30
Q

A young female presented with fever, nick stiffness, and signs of meningeal irritation.
What does the the picture represent?
Why does this patient needs a lumbar puncture ?

A

-

31
Q

Patient came to the ER with this vision.
1. What is the finding?
2. Why is the macula spared in this case?

A
  1. Left homonymous hemianopia with sparing of the macula.
  2. The lesion is in the visual cortex, the part that represents macular vision has dual blood supply by the Posterior cerebral artery and middle cerebral artery.
32
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
33
Q

Patient presents with symptoms and signs of meningitis. The CSF table results:
What is the diagnosis ?
Tests?

A

-

34
Q

A patient presented with diplopia and inability to opened the left eye
1. Which cranial nerve is affected?
2. Mention TWO causes?

A
  1. Left Oculomotor nerve [3rd cranial nerve]
  2. Stroke
    DM
    PCA aneurysm
35
Q
  1. What is the test done?
  2. State its afferent and efferent limbs
A
  1. Corneal reflex
  2. Afferent by trigeminal nerve and efferent by facial nerve
36
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
37
Q

Young female, chronic non bloody diarrhea and fatigue. Upper Endoscopy picture was done.
1. Describe the picture.
2. Mention serology tests

A
  1. Vellus atrophy and folds with visible fissures and nodular appearance
  2. Anti-transglutaminase Ab Anti-endomysial Ab
38
Q
  1. What is the diagnosis?
  2. What are the possible complications?
A
  1. Diverticulosis
  2. Perforation and inflammation [diverticulitis]
39
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
40
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
41
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
42
Q

Patient with type 2 DM, 10 g monofilament test is used.
1. Describe how to do the test
2. Mark on the feet where you would apply the filament.

A
  1. Take consent. then I will take the filament and touch it on the patient hands and arm to show it is not painful, then place the filament on the designated areas on the foot, then hold the filament perpendicular to the skin then add pressure to filament to make it bend, with each touch and increase in bend of the filament ask the patient if they can feel it. And compare both feet.
    2.
43
Q

A Patient with type 2 diabetes Mellitus
1. What is the sign shown in the picture?
2. What is the most common underlying endocrine disorder?
3. What is the plasma insulin level in this patient ?

A
  1. Acanthosis nigricans
  2. Diabetes mellitus type 2
    3.
44
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
45
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
46
Q
  1. What are the 2 signs?
  2. What is the diagnosis?
A
  1. Heberden and Bouchard nodes
  2. Osteoarthritis
47
Q

A 21 year old male presented with 2 days history of knee swelling
What bedside examination would you perform ?
What is the initial investigation ?

A

?

48
Q

A 20-year-old female suffers from fever, fatigue, severe hair loss, and bilateral polyarthritis.
1. What is one blood test that you want to order?
2. What is two initial pulmonary complications?

A
  1. ANA
  2. Pleurisy
    Interstitial lung disease Pleural effusion
49
Q

A patient with Multiple Myeloma
1. Which one represent calcium and PTH level.
2. What is your explanation?

A
  1. D
  2. MM leads to osteolytic lesion which will result in hypercalcemia as a compensatory mechanism, PTH will be low
50
Q

A 28 year old female patient with vitamin D deficiency
1. Which of the following will she most likely have?
2. Explain your choice?

A
  1. -
  2. -
51
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
52
Q
  1. Name this cell
  2. What is the diagnosis?
A
  1. Reed Sternberg cell
  2. Hodgkin lymphoma
53
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
54
Q

Blood film shown of a patient with hypercalcemia and bone pain
1. What is the abnormal finding seen in the blood film?
2. What is the diagnosis?

A
  1. Rouleaux formation of RBCs
  2. Multiple myeloma
55
Q

A 45 year old man who died of intracranial catastrophe, the picture compares his two kidneys with a normal kidney
Describe what you see with the diagnosis ?
What is the cause of his death related to his condition (intracranial complication) ?

A

?

56
Q

Female 40 year old , presented with nephrotic syndrome picture of glomerulus was shown.
1. What’s the diagnosis.
2. What’s the possible causes

A
  1. Minimal change disease
  2. Hodgkin Lymphoma DM
    SLE
57
Q
  1. What’s the diagnosis.
  2. What’s the possible causes
A
  1. membranous neuropathy
  2. SLE
    HBV
    HCV
    IgG-related disease
58
Q

A diabetic patient with congestive heart failure had a one day history of mental confusion. He is on metformin.
Interpret ABG ?
What is the etiology ?

A

?

59
Q

Patient’s Arterial blood gas showed:
1. What is the diagnosis
2. What are the causes?

A
  1. Respiratory acidosis
  2. COPD Myasthenia gravis Obesity
60
Q

A patient developed fever, chills and a rash.
1. What is the diagnosis?
2. What is the treatment?
3. What is the other disease that affects a specific dermatome?

A
  1. Chickenpox
  2. -
  3. Shingles (herpes zoster).
61
Q

A 19 y/o with multiple 2-5 mm firm painless white to pink in color
1. Diagnosis.
2. What causes this lesion.

A
  1. Molluscum Contagiosum
  2. Poxvirus (Molluscum Contagiosum virus)

Medicine ELOOPS (9 decks)

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