Mock 8 Flashcards
72yo man + loose stools over the past 5 weeks + bloody stool + mild generalized abdominal pain most times of the day + T 38.1C + abdominal exam (generalised tenderness WITHOUT palpable masses + unremarkable DRE
Most appropriate INITIAL investigation
Stool microscopy, C/S
***Not colonoscopy. Investigate for infection first
Weakness + Pain + Reflex + Sensory
GI or URTI 3 weeks prior to onset of weakness
Weakness of max severity 2 weeks after initial onset of symptoms; ascending symmetrical weakness
Neuropathic pain in the legs
Decreased tendon reflexes
Paresthesia and sensory loss in the lower extremities
Diagnosis?
Confirmatory?
Mechanism?
Guillain-Barre Syndrome
Nerve Conduction Studies
Autoimmune degeneration of myelinheets of peripheral neurons
It is the proportion of all tested persons who are correctly identified by the test
Accuracy
***Remember that accuracy = a+d/(a+b+c+d)
A = test positive na disease present OR “TRUE POSITIVE”
D = test negative na disease absent OR “TRUE NEGATIVE”
Management of suspected appendicitis?
If male and hemodynamically stable: Straight to OR theatre
If female and hemo stable: Ultrasound first to rule out gyne pathology
If above 50: CT to look for cancer as the cause of pain or perforation
24 y/o + abdominal pain, nausea and vomiting for the past 24 hours + constant pain starting in the RLQ + febrile 37.9C + PE: pain on palpation of right iliac fossa + leukocytosis + elevated CRP + negative pregnancy test + given analgesia, IVF, antibiotics, antiemetics and NPO.
Most appropriate next step in management?
Ultrasound - to rule out gyne pathology
70 y/o + s/p thrombolysis for inferior MI 12 days ago + discharged improved but re-attended the ED with new-onset shortness of breath + bibasal crackles and pansystolic murmur at the ER
Single most appropriate investigation to determine the underlying cause?
Likely diagnosis?
2D echo
Post-MI acute mitral regurgitation
