Q14$

Question 1

Severe constant postprandial epigastric pain with associated n/v with air under diaphragm (crescent shape

NBSIM

Answer 1

Emergent surgical exploration
- perforated peptic ulcer

Question 2

Sjogren has burning sensation in her mouth and is sensitive to acidic and spicy food

NBSIM

Answer 2

KOH preparation of oral scraping
-chronic atrophic candidiasis

Question 3

Pregnant women <6 weeks postpartum with stress incontinence

Management

Answer 3

Observation and reassurance (and do kegels)bc not chronic sui is due to the pregnancy weakening the pfm

Question 4

Man came back from Arkansas without rash but febrile illness and maslos anD AMS. leukopenia and or thrombocytopenia

Treatment

Answer 4

Doxy- Ehrlichiosis (e.chaffeensis and ewingii)

Question 5

Reason for physiological anemia of infancy

Answer 5

Reduced Epo due to increase in tissue oxygenation at birth

Question 6

Microcephalic, wide anterior fonts Elle, cleft palette, hyoplasia of distal phalanges

Reveal history of

Answer 6

Antiepuleptics like phenytoin carbamazepine valproate

Question 7

Difference from athletes heart and hocm

La size
Lv cavity size
Lv wall thickness
Lv diastolic function

Answer 7

Hocm

La size enlarge Normal
Lv cavity size decreased enlarged
Lv wall thickness >15. <
Lv diastolic function impaired Normal

Question 8

39 yo woman gave birth 4 days ago and has 3 other children she’s had chest pain and other mi like symptoms. D dimer and troponins are elevated

Diagnosis
Diagnostic

Answer 8

Coronary artery dissection
- dx: coronary artery angiography

Question 9

Man came from rural area in Guatemala and was a farmer. Now has 10 cm cyst with daughter cysts in the liver

Association with the patients condition

Answer 9

Close contact with dogs
- echo OCP is granulosos- dog tapeworm and you ingested something contaminated with dog feces, rural areas with sheep
- treatment- <5cm albendazole, >5 or separations do Percutaneous therapy

Question 10

Guy works building outdoor fences now he’s peripheral neuropathy, Hyperpigmentation and hypopigmentation areas, pancytopenia and mild transaminases elevation

Diagnosis
Treatment

Answer 10

Arsenic toxicity (wood)
Tx: dimercaprol, dama like succimer

Question 11

RA with pleural effusion s

Answer 11

Low glucose (<50 and very high ldh >700

Question 12

65 yo lady confused , urea>20, RF not>30 BP 110/74 not <90 over <60. Labs show hyponatremia and alveolar infiltrates in right lower lobe

NBSIM

Answer 12

Admit to hospital on Ceft and Azithyromycin (,curb 65 is a 2