LE6 Flashcards
1.A 30 year old female sought consultation due to weight loss of 5% in three month. She claimed to have fever to touch but when she checked her thermometer it was always normal. She can finish 3 plates full of food in one sitting and would not even gain weight. She tried taking appetite stimulants to gain weight during that time but to no avail. She defecates at least 3x in a day. On occasion, she had palpitations. During examination, patient was normotensive tachycardic, afebrile. Clear breath sounds, normal neuro exam except for presence of noticeable tremors.
What is the most likely cause of her weight loss?
A. Anxiety disorder
B. Hyperthyroidism
C. Ischemic heart disease
D. Diabetes mellitus
Hyperthyroidism (B)
The patient’s symptoms of weight loss despite increased appetite, frequent defecation, palpitations, and the presence of tremors, along with being normotensive but tachycardic, strongly suggest hyperthyroidism. These are classic symptoms of an overactive thyroid gland, which increases metabolism. Anxiety disorder, ischemic heart disease, and diabetes mellitus can have some overlapping symptoms but do not fit the overall clinical picture as well as hyperthyroidism does.
- A 35 year old patient lost weight for 3 months. He noticed that he is not gaining weight despite of his increased appetite and passion for food. He even bragged to his friends of his remarkable insatiable appetite. But when he weighed himself, he lost 15 pounds in 3 months.
He claims he drinks lots of water because he urinates at least 3-4 x at night. Among the most common causes of weight loss, what is the most likely cause of his problem?
A. Diabetes
B. Malignancy
C. Hyperthyroidism
D. Munchausen syndrome
Diabetes (A)
The description of significant weight loss despite an increased appetite, along with polyuria (urinating 3-4 times at night) and polydipsia (drinking lots of water), points towards uncontrolled diabetes mellitus, likely type 1 given the weight loss context, or possibly type 2 if there is an underlying insulin resistance with insufficient insulin production over time. Malignancy, hyperthyroidism, and Munchausen syndrome are differential diagnoses but the specific symptoms mentioned align most closely with diabetes.
- A 60 year old man noticed that he lost weight since his clothes don’t fit him as they used to and had to wear suspenders to keep his pants from falling. His appetite has not changed, nor did he change is physical activities. He now weighs 120 lbs from 140 lbs. How much weight loss is clinically significant?
A. 3% of body weight loss in 6-12 months
B. At least 5 pounds in 6-12 months
C. 5% body weight in 24 months
D. At least 10 pounds in 6-12 months
D. At least 10 pounds in 6-12 months
This answer aligns with the definition of clinically significant weight loss, which is often considered to be a loss of more than 5% of body weight over 6 to 12 months, or specifically, at least 10 pounds in the same timeframe. In the scenario described, the man lost 20 pounds (from 140 lbs to 120 lbs), which significantly exceeds the minimum criteria for clinically important weight loss. This indicates a need for further medical evaluation to identify any underlying causes.
- True or false: The greatest incidence of weight loss is seen among patients with cystic tumors.
A. False
B. Maybe
C. True
False (A)
The statement regarding the greatest incidence of weight loss being seen among patients with cystic tumors is too specific and not universally true. Weight loss can be a symptom of many conditions, including but not limited to malignancies (not just cystic tumors), chronic diseases such as COPD or heart failure, psychiatric conditions, and infectious diseases. Therefore, stating it is the greatest in incidence among patients with cystic tumors without specifying the context is misleading.
- The most common malignant cause of unintentional weight loss is:
A. Pulmonary
B. Hematologic
C. Gastrointestinal
D. Hepatobiliary
Gastrointestinal (C)
The most common malignant cause of unintentional weight loss is typically associated with gastrointestinal cancers. This is because tumors in the GI tract can cause a decrease in nutrient absorption and a general systemic response that often leads to weight loss. Pulmonary, hematologic, and hepatobiliary malignancies can also cause weight loss, but GI malignancies are more directly associated with changes in appetite, nutrient absorption, and metabolic rate, making them a more common cause of significant weight loss.
6.All elderly patients with unintentional weight loss should be asked to do the mini-mental state exam to identify patients with:
A. stroke with disorientation
B. Anxiety
C. Depression
D. Dementia
D. Dementia
The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive function and can help in identifying patients with cognitive impairments such as dementia. Unintentional weight loss in elderly patients could be related to several factors, including cognitive decline, where the individual may forget to eat or how to prepare food. While stroke, anxiety, and depression can also affect nutritional status, the MMSE specifically targets cognitive impairment, making dementia the most directly relevant condition to assess in the context of unintentional weight loss when cognitive decline might be a contributing factor.
7 .Sarcopenia is a major manifestation of unintentional weight loss. It is defined as:
A. prerenal contraction of intravascular volume due to inadequate hydration
B. loss of muscle mass alone
C. loss of appetite
D. a syndrome of weight loss, loss of muscle and adipose tissue, anorexia and weakness
B. Loss of muscle mass alone
Sarcopenia is defined as the loss of skeletal muscle mass and strength with aging. It is a major component of the frailty syndrome and contributes to the risk of adverse outcomes such as falls, fractures, physical disability, and reduced quality of life among older adults. While sarcopenia can be associated with other conditions like weight loss, anorexia, and weakness, the core definition centers on the loss of muscle mass alone.
- Cachexia is another major manifestation of unintentional weight loss defined as:
A. a syndrome of weight loss, loss of muscle and adipose tissue, anorexia and weakness
B. prerenal contraction of intravascular volume due to inadequate hydration
C. loss of muscle mass
D. loss of appetite
A. A syndrome of weight loss, loss of muscle and adipose tissue, anorexia and weakness
Cachexia is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The presence of cachexia is indicative of a severe underlying condition, such as cancer, chronic kidney disease, heart failure, or chronic obstructive pulmonary disease (COPD), and is associated with poor prognosis. Cachexia includes a combination of weight loss, muscle and adipose tissue loss, anorexia, and weakness, distinguishing it from other forms of weight loss.
- True or false: It is better to advise patients to consume supplements between meals rather than with a meal.
A. True
B. False
C. Maybe
A. True
Advising patients to consume supplements between meals rather than with meals can be beneficial, particularly for those who need to gain weight or prevent unintentional weight loss. Consuming supplements between meals can help increase overall caloric intake without causing the individual to feel too full to eat their regular meals, thereby providing additional nutrients and calories that might not be achieved if supplements were taken with meals, potentially leading to increased satiety and decreased intake of nutrient-dense foods.
- among the common endocrine problems listed below, which of the following will not lead to unintentional weight loss?
A. diabetes insipidus
B. hypothyroidism
C. hyperthyroidism
D. diabetes mellitus
B. Hypothyroidism
Among the options listed, hypothyroidism is the condition that typically does not lead to unintentional weight loss; it is more commonly associated with weight gain or difficulty losing weight due to a decreased metabolic rate. Hyperthyroidism, diabetes mellitus, and, to a lesser extent, diabetes insipidus can all lead to unintentional weight loss. Hyperthyroidism increases metabolism, diabetes mellitus may lead to weight loss due to the body’s inability to properly utilize glucose, and diabetes insipidus involves significant fluid loss that might contribute to weight loss, though it’s not a primary symptom like in the other conditions mentioned.
11.The area postrema, also known as the Chemoreceptor Trigger Zone, responds to the bloodborne stimuli such as emetogenic drugs, bacterial toxins, uremia, hypoxia and ketoacidosis. The area postrema is located in the:
A. Pons
B. Cerebrum
C. Medulla
D. Hypothalamus
C. Medulla
The area postrema, known as the Chemoreceptor Trigger Zone (CTZ), is located in the medulla oblongata. It is responsible for detecting toxins and other substances in the blood and cerebrospinal fluid, triggering the vomiting reflex when necessary. This area’s location allows it direct access to the bloodstream and cerebrospinal fluid to monitor for emetogenic substances.
- High resolution esophageal manometry should be ordered among GERD patients if:
A. Patient has chronic GERD >5 years duration with good response to therapy
B. Surgery is contemplated in the presence of low les pressure and failure to therapy
C. Patient is a newly diagnosed GERD case and need to evaluate probable response to antacids and prokinetics
D. GI tuberculosis is being entertained as a causative factor
B. Surgery is contemplated in the presence of low LES pressure and failure to therapy
High-resolution esophageal manometry is a diagnostic tool used to evaluate the motility of the esophagus and the function of the lower esophageal sphincter (LES). It is particularly indicated for GERD patients when surgical intervention is being considered, especially in cases where there is low LES pressure contributing to reflux and when medical therapy has failed to alleviate symptoms. This test helps in assessing the esophagus’ motility patterns, aiding in the surgical planning and determination of the best treatment approach.
13.Which of the following phenomena is/are exhibit/s volitional control?
A. Emesis
B. All of the above regurgitation
C. Rumination and regurgitation only
D. Rumination
D. Rumination
Rumination is a condition characterized by the voluntary or semi-voluntary bringing up of food from the stomach into the mouth, which may then be re-chewed, re-swallowed, or spit out. Unlike emesis (vomiting), which is an involuntary reflex, rumination involves a degree of volitional control and does not typically involve nausea or gastrointestinal distress. Regurgitation, in the context of gastroesophageal reflux, is generally not under voluntary control. Therefore, among the options provided, rumination is the phenomenon that exhibits volitional control.
- True or false: Regurgitation is the effortless repeated passage of gastric contents into the mouth which may be rechewed and swallowed.
A. False
B. True
C. Maybe
A. False
Regurgitation, as described, is more accurately associated with rumination syndrome rather than being a general characteristic of regurgitation related to gastroesophageal issues. In gastroesophageal regurgitation, the content moves from the stomach back into the esophagus and possibly the mouth, but it is not typically rechewed and swallowed again. Rumination syndrome involves the effortless regurgitation of recently ingested food into the mouth, where it may be rechewed, reswallowed, or spit out.
15.A patient was brought to your attention due to vomiting within an hour of eating. The most likely differential diagnoses to consider are:
A. Rumination syndrome
B. Zenker’s diverticulum or achalasia
C. Colonic and distal intestinal obstruction
D. Gastroparesis and pyloric obstruction
D. Gastroparesis and pyloric obstruction
Vomiting within an hour of eating suggests a disorder affecting the stomach’s ability to empty properly. Gastroparesis, characterized by delayed gastric emptying in the absence of a mechanical obstruction, and pyloric obstruction, which is a physical blockage at the stomach outlet, are common conditions that can cause these symptoms. Both conditions can lead to early satiety, nausea, and vomiting soon after meals, making them likely differential diagnoses in this scenario.
16.A 68 year old patient with weight loss, low grade fever and vomiting of feculent material was brought to the ER by a concerned friend. The possible problem of feculent emesis is due to:
A. Zenker’s diverticular or achalasia
B. Gastroparesis and pyloric obstruction
C. Rumination syndrome
D. Colonic and distal intestinal obstruction
D. Colonic and distal intestinal obstruction
Feculent emesis (vomiting of material that smells or looks like feces) suggests a severe form of intestinal obstruction, where the obstruction is so distal that the contents of the intestine have nowhere to go but back up. This condition is more consistent with colonic or distal intestinal obstruction rather than issues related to the upper digestive tract like Zenker’s diverticulum, achalasia, gastroparesis, pyloric obstruction, or rumination syndrome.
17.Extraperitoneal disorder/s that can cause nausea and vomiting is/are:
A. Cerebrovascular bleeding
B. All of the above
C. Myocardial infarction with or without heart failure
D. Orthopedic surgery
E. None of the above
B. All of the above
Extraperitoneal disorders that can cause nausea and vomiting include a wide range of conditions that affect the body outside of the abdominal cavity. This includes cerebrovascular bleeding (such as a hemorrhagic stroke), myocardial infarction (heart attack) with or without heart failure, and even significant events like orthopedic surgery due to the stress and pain they cause, which can stimulate the vomiting center in the brain.
- The most common cause/s of indigestion (dyspepsia) is/are:
A. all of the above
B. gastroesophageal reflux
C. functional dyspepsia
D. none of the above
A. All of the above
B. Gastroesophageal reflux (GERD): This condition, where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus), is a well-known cause of indigestion. The backwash (acid reflux) can irritate the lining of your esophagus, leading to discomfort.
C. Functional dyspepsia: This is characterized by signs and symptoms of indigestion that have no obvious cause. It’s a common condition that leads to a feeling of fullness or discomfort in the upper abdomen.
- Alarm symptoms in GERD that necessitate further investigation (upper Gl endoscopy):
A. unexplained weight loss
B. none of the above
C. all of the above
D. jaundice
E. dysphagia or odynophagia
C. All of the above
Alarm symptoms in GERD that necessitate further investigation include unexplained weight loss, dysphagia (difficulty swallowing), odynophagia (painful swallowing), and jaundice (though less commonly associated directly with GERD, it could indicate a more serious underlying condition). These symptoms suggest a more serious underlying condition that could require immediate attention, including but not limited to esophageal cancer or severe esophagitis.
- Indication of Endoscopy among patients >50 years old and >5 years of heartburn is:
A. assess response to acid suppressants
B. assess prior to fundoplication
C. to screen for Barrett’s esophagus
D. AOTA
C. To screen for Barrett’s esophagus
In patients over 50 years old who have had more than 5 years of heartburn, an indication for endoscopy is to screen for Barrett’s esophagus, a condition where the esophageal lining changes, potentially increasing the risk of developing esophageal adenocarcinoma. Screening for Barrett’s esophagus in this demographic is crucial for early detection and management of potential precancerous changes.
- Endogenous solutes like glucose and urea lead to osmotic diuresis by:
A. All of the above
B. Impairing tubular reabsorption of water
C. None of the above
D. Impairing tubular reabsorption of sodium and chloride
B. Impairing tubular reabsorption of water
Endogenous solutes like glucose and urea can lead to osmotic diuresis by increasing the osmolarity of the tubular fluid, which impairs the tubular reabsorption of water. This process pulls water into the renal tubules, preventing its reabsorption and leading to increased urine output.
- The most appropriate resuscitation fluid for hyponatremic hypovolemic patients is:
A. D5 water
B. Lactated ringer’s solution
C. Colloid solution such as IV albumin
D. Plain normal saline solution (NSS)
D. Plain normal saline solution (NSS)
For hyponatremic hypovolemic patients, the most appropriate resuscitation fluid is typically isotonic saline (0.9% sodium chloride), or plain normal saline solution (NSS). This choice helps to restore both the volume and sodium deficits without risking further dilution of serum sodium levels.
- Hypernatremic hypovolemic patients with Diabetes Insipidus should receive which resuscitation fluid?
A. Lactated ringer’s solution
B. Colloid solution such as IV Albumin
C. D5 water
D. Plain normal saline solution (NSS)
C. D5 water
For hypernatremic hypovolemic patients, especially those with Diabetes Insipidus, the goal is to correct the water deficit. D5 water (5% dextrose in water) is often used to provide free water and help lower the serum sodium concentration. The choice of fluid depends on the patient’s specific needs and underlying conditions, but D5 water can be appropriate for addressing the free water deficit in hypernatremia.
- True or false: Hyponatremia is very common occurring in up to 22% of hospitalized patients.
A. Maybe
B. True
C. False
B. True
Hyponatremia is indeed very common in hospitalized patients, occurring in up to 22% of such individuals. It is the most common electrolyte disorder encountered in clinical practice, particularly among the elderly and those with underlying health conditions.
25 True or false: Hyponatremia is subdivided into three groups: hypovolemic, euvolemic and hypervolemic.
A. Maybe
B. True
C. False
B. True
Hyponatremia is indeed subdivided into three groups based on volume status: hypovolemic, euvolemic, and hypervolemic. This classification helps in understanding the underlying cause of hyponatremia and guiding appropriate treatment. Hypovolemic hyponatremia occurs with sodium and water loss, euvolemic hyponatremia occurs when there is normal body sodium but excess water, and hypervolemic hyponatremia occurs with sodium and water gain, with water gain exceeding sodium gain.
- The most common cause of euvolemic hyponatremia.
A. Burns
B. SIAD (syndrome of inappropriate antidiuresis)
C. Drugs such as furosemide
D. Intraabdominal surgery
B. SIAD (syndrome of inappropriate antidiuresis)
SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion) is a condition where there is excessive release of antidiuretic hormone (ADH) leading to water retention, which dilutes the sodium in the body, causing hyponatremia without affecting the body’s volume status, hence euvolemic hyponatremia.
- Beer potomania is a cause of:
A. Hyponatremia with low solute intake
B. Hyponatremia with expanded blood volume
C. Hyponatremia with euvolemia
A. Hyponatremia with low solute intake
Beer potomania is a condition characterized by poor dietary intake and excessive beer consumption, which provides a large volume of fluid with very little solute. This can lead to hyponatremia due to the dilution of serum sodium, as the kidneys are unable to excrete the excess water due to the lack of solute (mainly sodium and potassium) needed to produce urine.
- True or false: Chronic hyponatremia increases the risk of bony fractures owing to the associated neurologic dysfunction and to a hyponatremia-associated reduction in bone density.
A. False
B. True
C. Maybe
B. True
Chronic hyponatremia can lead to neurologic dysfunction, which increases the risk of falls and, consequently, fractures. Additionally, there is evidence to suggest that hyponatremia is associated with a reduction in bone density, further increasing the risk of fractures.
- Target correction of serum sodium per day is:
A. >10mm/24 hours
B. >20mm/12 hours
C. >5mm/12 hours
D. >5mm/24 hours
D. >5mm/24 hours
The recommended rate of correction for serum sodium to avoid the risk of osmotic demyelination syndrome (ODS) is to increase serum sodium by no more than 10-12 mmol/L in the first 24 hours and not more than 18 mmol/L in the first 48 hours. A target of >5 mmol/L in 24 hours is a safe initial goal, ensuring gradual correction.
- Beer potomania treatment is:
A. Colloid solution and increase dietary salt intake to 2.5g/day
B. D5 water and increase daily salt intake to 2.5g/day
C. Intravenous normal saline solution and resumption of normal diet
D. Lactated ringer’s solution and restrict sodium intake to less than 2g/day
C. Intravenous normal saline solution and resumption of normal diet
The treatment for beer potomania involves addressing the hyponatremia and its underlying cause. Administering intravenous normal saline can help correct the hyponatremia, while resuming a normal diet helps provide the necessary solutes (especially sodium) that were deficient, aiding in the normalization of serum sodium levels.
- The oropharyngeal dysphagia that results into nasal regurgitation and pulmonary aspiration is:
A. Odynophagia
B. Transfer dysphagia
C. Aphagia
D. Globus pharyngeus
B. Transfer dysphagia
Transfer dysphagia (or oropharyngeal dysphagia) involves difficulty in the initiation of swallowing, and it can lead to symptoms such as nasal regurgitation and pulmonary aspiration due to poor control of the food bolus in the pharyngeal phase of swallowing.
- The is the foreign body sensation localized in the neck but does not interfere with swallowing and can sometimes be relieved by swallowing.
A. Aphagia
B. Globus pharyngeus
C. Transfer dysphagia
D. Odynophagia
B. Globus pharyngeus
Globus pharyngeus is the sensation of a lump or foreign body in the throat that does not actually interfere with swallowing and can sometimes be relieved by swallowing. This sensation is often more noticeable when the individual is not eating.
33.A patient complained of severe cough with swallowing. This presentation is a sign of which disease?
A. Tracheoesophageal fistula
B. Pulmonary malignancy
C. Achalasia
D. GERD
A. Tracheoesophageal fistula
A tracheoesophageal fistula can cause severe coughing with swallowing due to the abnormal connection between the esophagus and the trachea, allowing food and liquids to enter the trachea and potentially the lungs, leading to coughing and risk of aspiration.
- A patient sought consultation due to hoarseness. Upon review, the hoarseness occurred after patient had dysphagia. What is the most likely cause of the hoarseness?
A. Damage to the larynx
B. All of the above
C. Food obstruction
D. Damage to the recurrent laryngeal nerve
D. Damage to the recurrent laryngeal nerve
Hoarseness following dysphagia could be indicative of damage to the recurrent laryngeal nerve, which innervates the muscles of the larynx. This damage could be secondary to various causes, including surgical procedures, tumors, or other pathologies that affect the nerve’s function.
- A patient complaining of dysphagia with a prolonged history of heartburn most likely has:
A. Schatzki ring
B. Eosinophilic esophagitis with a history of atopy
C. All of the above
D. Peptic stricture or esophageal adenocarcinoma
D. Peptic stricture or esophageal adenocarcinoma
A patient with a prolonged history of heartburn (suggestive of chronic gastroesophageal reflux disease, GERD) is at risk of developing complications such as peptic stricture or esophageal adenocarcinoma, both of which can lead to dysphagia. Chronic exposure of the esophagus to stomach acid can cause damage that leads to the narrowing of the esophagus (stricture) or the development of cancer, both of which can impede the passage of food.
36.The correct sequence of abdominal examination is:
A. Auscultation, percussion, inspection, palpation
B. Percussion, palpation, inspection, auscultation
C. Inspection, auscultation, palpation, percussion
D. Inspection, palpation, percussion, auscultation
C. Inspection, auscultation, palpation, percussion
The correct sequence of abdominal examination is to start with inspection, followed by auscultation (to avoid altering bowel sounds that might occur with palpation or percussion), then palpation, and finally percussion. This sequence is designed to minimize discomfort and avoid altering the findings, especially bowel sounds, before they are assessed.
- The pain associated with swallowing in odynophagia is due to:
A. Foreign body sensation in the neck
B. Anticipatory anxiety about food bolus obstruction
C. Mucosal ulceration within the oropharynx or esophagus
D. Esophageal obstruction
C. Mucosal ulceration within the oropharynx or esophagus
Odynophagia, or painful swallowing, is often due to mucosal ulceration within the oropharynx or esophagus. This condition can be caused by infections, inflammatory diseases, or the ingestion of irritants, leading to pain upon swallowing.
- The inability to swallow in Aphagia implies:
A. Psychological anxiety to food aspiration
B. Complete obstruction of the esophagus
C. Mucosal ulceration
D. Psychological anticipatory anxiety of food bolus obstruction
B. Complete obstruction of the esophagus
Aphagia, the inability to swallow, implies a severe impairment or obstruction in the swallowing mechanism. This could be due to a complete obstruction of the esophagus, among other causes, which prevents the passage of solids and liquids.
- The distal esophagus is innervated by:
A. None of the above
B. All of the above
C. Excitatory and inhibitory neurons from the esophageal myenteric plexus
D. Lower motor neurons of the Vagus nerve
C. Excitatory and inhibitory neurons from the esophageal myenteric plexus
The distal esophagus is innervated by excitatory (such as acetylcholine) and inhibitory (such as nitric oxide) neurons from the esophageal myenteric plexus. These neurons regulate the motility of the esophagus.
- The lower esophageal sphincter (LES) is contracted at rest because of excitatory ganglionic stimulation and its intrinsic myogenic tone.
A. Maybe
B. True
C. False
B. True
The statement is true. The lower esophageal sphincter (LES) is contracted at rest due to its intrinsic myogenic tone and excitatory ganglionic stimulation, primarily from acetylcholine. This contraction prevents the reflux of gastric contents into the esophagus. Relaxation of the LES occurs during swallowing to allow the passage of food into the stomach.
44.A B/C ratio or BUN/plasma creatinine ratio of >20:1 indicates:
A. Prerenal azotemia
B. All of the above
C. Obstructive uropathy
D. Intrinsic renal failure
A. Prerenal azotemia
A BUN (blood urea nitrogen)/plasma creatinine ratio of >20:1 typically indicates prerenal azotemia, a condition where the cause of kidney dysfunction is due to a decrease in blood flow to the kidneys (e.g., from dehydration, heart failure) and not to damage within the kidney itself. This condition leads to increased reabsorption of urea nitrogen relative to creatinine in the proximal tubules.
- Jaundice is the presence of hyperbilirubinemia which is a sign of:
A. Liver disease and biliary obstruction
B. Liver disease
C. Disorders of bilirubin metabolism and liver disease
D. Liver disease, hemolytic disorders and disorders of bilirubin metabolism
D. Liver disease, hemolytic disorders, and disorders of bilirubin metabolism
Jaundice, characterized by the yellowing of the skin and eyes, is caused by hyperbilirubinemia. It can result from liver disease (affecting bilirubin processing), hemolytic disorders (increasing bilirubin production), and disorders of bilirubin metabolism (affecting how bilirubin is processed and excreted).
65.Endocrinopathy/endocrinopathies associated with constipation:
A. None of the above
B. Hypercalcemia
C. Hypothyroidism
D. Pregnancy
E. All of the above
E. All of the above
Several endocrinopathies are associated with constipation, including hypothyroidism (reduced thyroid hormone levels slow down many bodily processes, including digestion), hypercalcemia (high calcium levels can reduce motility in the gastrointestinal tract), and pregnancy (hormonal changes and physical pressure from the growing uterus can slow bowel movements).
- Neurologic disease/s commonly associated with chronic constipation:
A. Spinal cord injury
B. Multiple sclerosis
C. Parkinsonism
D. AOTA
D. AOTA
Neurologic diseases such as spinal cord injury, multiple sclerosis, and Parkinsonism are commonly associated with chronic constipation due to their impact on the nervous system’s control over bowel movements.
- Cardiac medication associated with chronic constipation:
A. Angiotensin receptor blockers
B. Calcium channel blockers
C. Nitrates
D. ACE inhibitors
B. Calcium channel blockers
Calcium channel blockers are known to be associated with chronic constipation. They can decrease the contractility of the bowel, leading to slower transit times.
- Generalized muscle disease associated with chronic constipation:
A. Pelvic floor dysfunction
B. Amyloidosis
C. Progressive systemic sclerosis
D. Rectal prolapse
C. Progressive systemic sclerosis (Scleroderma)
Progressive systemic sclerosis (scleroderma) is a generalized muscle disease that can be associated with chronic constipation due to its effects on the smooth muscle of the gastrointestinal tract, leading to decreased motility.
- Which red blood cell indices indicate whether the anemia is normochromic or hypochromic?
A. Mean cell hemoglobin concentration
B. Mean cell volume
C. Reticulocyte count
D. Mean cell hemoglobin
A. Mean cell hemoglobin concentration (MCHC)
MCHC indicates whether the anemia is normochromic or hypochromic. It measures the concentration of hemoglobin in a given volume of packed red blood cells, providing information about the color (chromicity) of the cells.
84.Which red blood indices indicate whether the anemia is microcytic or macrocytic?
A. Mean cell volume
B. Mean cell hemoglobin concentration
C. Reticulocyte count
D. Mean cell hemoglobin
A. Mean cell volume (MCV)
MCV indicates whether the anemia is microcytic (small cells), normocytic (normal-sized cells), or macrocytic (large cells). It measures the average volume of red blood cells.
