A Patient With A history Of Fever and rash....

A 34-yr-old man returns from a journey to West USA with fevers and a rash affecting his hands and feet. He says he was admitted to hospital and has a medical note from the hospital informing you that he was admitted for several days with high fevers and a tachycardia of 105 bpm but that his BP did not drop at any time. After several days of illness, he developed desquamation of his hands and feet. He received some treatment and is now better.
His GP sent some tests that revealed a normal FBC and U&Es. Syphilis serology is negative. What treatment did he most likely receive?
A. IV cefuroxime
B. IV benzylpenicillin
C. Oral doxycycline
D. Oral erythromycin
E. None

Answer:

A 35 Year Old Woman Presents With Fever. Rigors And Diarrhea After Returning From A Journey.

A 35-yr-old woman returns from a journey to Gambia with fevers of 39°C, rigors, vomiting and diarrhoea. She took chloroquine and proguanil prophylaxis. Her oxygen saturations are 90% on air, pulse 120 bpm, BP 80/60 mmHg.
What is the most likely diagnosis?
A. Malaria
B. Typhoid
C. Gastroenteritis GE
D. Atypical pneumonia
E. Pneumococcal pneumonia

Answer:

Antibiotics Most Likely to Cause Pseudomembranous Colitis.

Which one of the following antibiotics is most likely to cause pseudomembranous colitis?

A. Cefaclor
B. Penicillin V
C. Erythromycin
D. Trimethoprim
E. Doxycycline

Answer:

Management Of Pneumonia In A Patient With Cushing Disease.

A 25-yr-old lawyer from Edinburgh was brought into hospital with a 3-day Hx of increasing
shortness of breath and fevers. She recently received a Dx of Cushing’s disease and is awaiting
treatment.
Initial examination revealed a respiratory rate of 20 breaths/min and bilateral sparse crackles, with a characteristic buffalo hump and centripetal obesity.
CXR revealed sparse perihilar shadowing only. She has been on the admission’s ward for 2 days and is being treated with IV cefotaxime and oral clarithromycin. Overnight, she has deteriorated and ABG reveal a p(O2) of 6.5 on 24% oxygen.

What management is most appropriate?
A. Increase the oxygen to 100% and arrange admission to medical HDU for closer monitoring, and change the antibiotics to IV Tazocin
B. Increase the oxygen to 100% and arrange admission to medical HDU, with the addition of IV co-trimoxazole
C. Increase the oxygen to 100% and arrange admission to medical HDU, with the addition of amphotericin iv
D. Increase the oxygen to 100% and arrange admission to medical HDU, with no change in therapy
E. Increase the oxygen to 100% and arrange admission to medical HDU, adding cotrimoxazole, amphotericin and switching to iv Tazocin

Answer:

Management Of Diabetic Neuropathy

A diabetic man is diagnosed as having painful diabetic neuropathy in his feet. He has no other medical history of note. What is the most suitable first-line treatment to relieve his pain?

A. Duloxetine
B. Sodium valproate
C. Carbamazepine
D. Referral to pain management clinic
E. Tramadol

Answer:

Management In A Newly Diagnosed Asthamatic Woman Who Is Pregnant

You are asked to see a newly diagnosed asthmatic woman who is eight weeks’ pregnant. She
is not on any Rx at the moment. Her PEFR diary shows wide diurnal variations and she also gives
a past history of eczema.

Which of the following is true?
A. Short-acting β2-agonists are contraindicated during the first trimester
B. Inhaled steroids are associated with major congenital deformities
C. A leukotriene-receptor antagonist is the first-line Rx
D. Low dose inhaled corticosteroids would be considered acceptable
E. Steroid tablets are teratogenic

Answer:

Valvular Hear Disease - Short Questions

 Regarding Valvular Hear Disease answer the following questions:

1. What is the difference between valvular insufficiency and valvular regurgitation?
2. What types of myocardial hypertrophy can result from valvularabnormalities?
3. What is the most serious long-term consequence of either concentric or eccentric hypertrophy?
4. What is the relationship between the pressure gradient across a stenotic valve, the blood flow across the valve, and the valve area?

Answers:
1. What is the difference between valvular insufficiency and valvular regurgitation?
Regurgitation and insufficiency are interchangeable terms to describe backward flow of blood across a valve at a time in the cardiac cycle when there would be no significant flow across a competent valve.

2. What types of myocardial hypertrophy can result from valvular abnormalities?
When there is a pressure load imposed on the ventricle (such as aortic stenosis for the left ventricle or pulmonic stenosis for the right ventricle), concentric hypertrophy develops. Concentric hypertrophy means that the myocardial wall thickness is increased w ith a normal or decreased internal ventricular diameter. A volume load (such as aortic insufficiency or mitral regurgitation for the left ventricle or tricuspid regurgitation for the right ventricle) results in eccentric hypertrophy; the wall thickness is normal but the internal diameter of the ventricle is increased. Overall, left ventricular mass is increased in both types of hypertrophy.