Which of the following is the best test to help establish the diagnosis of this patient?
Anonymous Quiz
14%
A. Serum gamma-glutamyl transpeptidase
24%
B. Uroporphyrinogen decarboxylase activity
42%
C. Urinary porphobilinogen and total porphyrins
14%
D. Blood lead level, RBC studies, X-ray fluorescence
8%
E. CSF albuminocytological analysis
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⏳ Case-based MCQ | #Case_455
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 56-year-old known hypertensive patient presents to the emergency department with mild dizziness of a day's duration. By careful inquiry it is confirmed that he has vertigo. He has no tinnitus or any other complaint.
Physical examination: heart rate 87 bpm, respiratory rate 18 rpm, blood pressure 138/87 mmHg and body temperature 37.1°C; unidirectional nystagmus that disappeared during visual fixation; rest of physical examination is normal.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 56-year-old known hypertensive patient presents to the emergency department with mild dizziness of a day's duration. By careful inquiry it is confirmed that he has vertigo. He has no tinnitus or any other complaint.
Physical examination: heart rate 87 bpm, respiratory rate 18 rpm, blood pressure 138/87 mmHg and body temperature 37.1°C; unidirectional nystagmus that disappeared during visual fixation; rest of physical examination is normal.
👍6
Which of the following factors favours a peripheral over a central cause of vertigo?
Anonymous Quiz
13%
A. Acute onset of vertigo
8%
B. Mild nature of vertigo
19%
C. Absence of tinnitus
29%
D. Association with unidirectional rather than bidirectional nystagmus
32%
E. Disappearance of nystagmus during visual fixation
👍9🥰4❤3
Forwarded from Medical Mnemonics
🧩 Medical Mnemonics
Virchow’s KISS 💋 will be a memory of Metastatic Gastric Carcinoma forever!
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#cardiology
〰〰〰〰〰〰〰〰〰〰〰
©Medical Mnemonics
Virchow’s KISS 💋 will be a memory of Metastatic Gastric Carcinoma forever!
💻 Join us on the official Instagram page: Online Medical School
#cardiology
〰〰〰〰〰〰〰〰〰〰〰
©Medical Mnemonics
👍5
⏳ Case-based MCQ | #Case_456
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 43-year-old female complaints of flushing, diarrhea, and abdominal pain for the past six weeks. She reports that for few minutes she suddenly feels a warm sensation in her face and neck.
Her vital signs are within normal limits. A pansystolic murmur is heard in the lower left sternal border and increases with inspiration. Proper work-up confirms the diagnosis of metastatic carcinoid syndrome.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 43-year-old female complaints of flushing, diarrhea, and abdominal pain for the past six weeks. She reports that for few minutes she suddenly feels a warm sensation in her face and neck.
Her vital signs are within normal limits. A pansystolic murmur is heard in the lower left sternal border and increases with inspiration. Proper work-up confirms the diagnosis of metastatic carcinoid syndrome.
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Regarding this patient's heart murmur, which of the following statements is most accurate?
Anonymous Quiz
13%
A. It is caused by aortic regurgitation and should be treated with octreotide and lisinopril
39%
B. It is caused by tricuspid regurgitation and should be treated with octreotide and lisinopril
15%
C. It is caused by aortic stenosis and should be treated with lisinopril
22%
D. It is caused by mitral regurgitation and should be treated with lisinopril
11%
E. It is caused by aortic regurgitation and should be treated with somatostatin and amlodipine
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Forwarded from Medical Mnemonics
Hello guys
We just made a group for HCWs who want to Prepare for OET Language Test 🇦🇺 🇨🇦 🏴
We now need an admin or admins with enough information about OET Exam and guide other members.
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We just made a group for HCWs who want to Prepare for OET Language Test 🇦🇺 🇨🇦 🏴
We now need an admin or admins with enough information about OET Exam and guide other members.
Please let us know in the group if you are ready to cooperate.
🔗 https://t.me/OET_Exam_Preparation
Share with your friends ✌
👍11
⏳ Case-based MCQ | #Case_457
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 29-year-old white female is hospitalized following a right middle cerebral artery stroke confirmed by MRI. Her past medical history is remarkable only for a history of an uncomplicated tonsillectomy during childhood and a second-trimester miscarriage three years ago.
The only remarkable finding on physical examination is left hemiplegia. The initial laboratory workup reveals normal hematocrit and hemoglobin levels, a normal prothrombin time, and a platelet count of 200 x 10^9/L. The activated partial thromboplastin time is 95 sec (N 23.6-34.6), and it does not normalize when the patient’s serum is mixed with normal plasma. A serum VDRL is positive, and a serum FTA-ABS is nonreactive.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 29-year-old white female is hospitalized following a right middle cerebral artery stroke confirmed by MRI. Her past medical history is remarkable only for a history of an uncomplicated tonsillectomy during childhood and a second-trimester miscarriage three years ago.
The only remarkable finding on physical examination is left hemiplegia. The initial laboratory workup reveals normal hematocrit and hemoglobin levels, a normal prothrombin time, and a platelet count of 200 x 10^9/L. The activated partial thromboplastin time is 95 sec (N 23.6-34.6), and it does not normalize when the patient’s serum is mixed with normal plasma. A serum VDRL is positive, and a serum FTA-ABS is nonreactive.
👍2❤1
Which one of the following is the most likely diagnosis?
Anonymous Quiz
12%
A. Hemophilia
27%
B. Neurosyphilis
38%
C. Antiphospholipid syndrome
16%
D. Thrombotic thrombocytopenic purpura
7%
E. Protein C deficiency
👍33👏9
Forwarded from Medical Mnemonics
- Do you want to publish your paper in the High Impact journal?
- Would you like your work to be seen in the best journals?
🔷 We will proceed with the journal publishing process with our professional team on MCU RESEARCH COLLABORATION
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- Would you like your work to be seen in the best journals?
🔷 We will proceed with the journal publishing process with our professional team on MCU RESEARCH COLLABORATION
🔻 Feel Free to contact admin 👉 @Mohamm_ADs
👍6
⏳ Case-based MCQ | #Case_458
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 54-year-old female presents to your department with complaints that the left leg has just turned blue, is swollen, and in severe pain. Even though the symptoms became worse an hour ago, 24 hours earlier, she had noticed that the skin of her left leg had whitened and was a bit swollen, she had tried to use compression stockings, but they had not helped. Her past medical history is significant for stasis ulcers, for which compression stocking had been helpful.
On physical examination, left leg edema and cyanosis are noted. The dorsalis pedis pulse is significantly decreased.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 54-year-old female presents to your department with complaints that the left leg has just turned blue, is swollen, and in severe pain. Even though the symptoms became worse an hour ago, 24 hours earlier, she had noticed that the skin of her left leg had whitened and was a bit swollen, she had tried to use compression stockings, but they had not helped. Her past medical history is significant for stasis ulcers, for which compression stocking had been helpful.
On physical examination, left leg edema and cyanosis are noted. The dorsalis pedis pulse is significantly decreased.
👍11
Which of the following is most likely to be associated with this patient's condition?
Anonymous Poll
28%
A. Atherosclerosis
13%
B. Breast cancer
15%
C. Diabetes mellitus
4%
D. Hyperthyroidism
40%
E. Thromboangiitis obliterans
👍15🔥13
⏳ Case-based MCQ | #Case_458 | #answer
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
✅ B
This patient presents with the triad of lower extremity edema, cyanosis, severe pain after 24 hours of experiencing blanching and edema; this is suggestive of the diagnosis of phlegmasia cerulea dolens (PCD), which usually follows phlegmasia alba dolens. This is a rare complication of massive deep vein thrombosis (DVT) that presents suddenly with complete venous occlusion leading to impaired arterial flow. Often the iliofemoral area is affected, and the impaired drainage disorder results in tissue ischemia. This serious condition can lead to venous gangrene of the extremity and compartment syndrome. It is an emergency that requires prompt diagnosis and effective treatment as the mortality rate is between 25% and 40%, while the risk of amputation could be as high as 50%.
The most significant risk factors are malignancy, such as breast cancer (choice B), heart failure, heparin-induced thrombocytopenia, surgery, trauma, and third-trimester pregnancy.
⚠ Atherosclerosis (choice A) is the underlying disease in peripheral arterial disease, which could also lead to decreased dorsalis pedis pulse, but this patient's clinical presentation strongly suggests PCD.
⚠ Diabetes mellitus (choice C) is a risk factor for atherosclerosis, which could lead to decreased lower extremity arterial pulses, but it is not significantly associated with PCD.
⚠ Hyperthyroidism (choice D) is not a risk factor for DVT or PCD.
⚠ Thromboangiitis obliterans (choice E), also known as Buerger's disease, is a vasculitis affecting the lower extremities that has been associated with smoking. Pain, cyanosis, gangrene can all occur, making it similar to the PCD. Patients are usually younger than 45 years, and the blanching that preceded the patient's current condition steers us towards phlegmasia.
🔖 Key point:
A triad of lower extremity edema, cyanosis, severe pain after 24 hours of experiencing blanching and edema is suggestive of the diagnosis of phlegmasia cerulea dolens, a rare complication of massive deep vein thrombosis that presents suddenly with complete venous occlusion leading to impaired arterial flow.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
✅ B
This patient presents with the triad of lower extremity edema, cyanosis, severe pain after 24 hours of experiencing blanching and edema; this is suggestive of the diagnosis of phlegmasia cerulea dolens (PCD), which usually follows phlegmasia alba dolens. This is a rare complication of massive deep vein thrombosis (DVT) that presents suddenly with complete venous occlusion leading to impaired arterial flow. Often the iliofemoral area is affected, and the impaired drainage disorder results in tissue ischemia. This serious condition can lead to venous gangrene of the extremity and compartment syndrome. It is an emergency that requires prompt diagnosis and effective treatment as the mortality rate is between 25% and 40%, while the risk of amputation could be as high as 50%.
The most significant risk factors are malignancy, such as breast cancer (choice B), heart failure, heparin-induced thrombocytopenia, surgery, trauma, and third-trimester pregnancy.
⚠ Atherosclerosis (choice A) is the underlying disease in peripheral arterial disease, which could also lead to decreased dorsalis pedis pulse, but this patient's clinical presentation strongly suggests PCD.
⚠ Diabetes mellitus (choice C) is a risk factor for atherosclerosis, which could lead to decreased lower extremity arterial pulses, but it is not significantly associated with PCD.
⚠ Hyperthyroidism (choice D) is not a risk factor for DVT or PCD.
⚠ Thromboangiitis obliterans (choice E), also known as Buerger's disease, is a vasculitis affecting the lower extremities that has been associated with smoking. Pain, cyanosis, gangrene can all occur, making it similar to the PCD. Patients are usually younger than 45 years, and the blanching that preceded the patient's current condition steers us towards phlegmasia.
🔖 Key point:
A triad of lower extremity edema, cyanosis, severe pain after 24 hours of experiencing blanching and edema is suggestive of the diagnosis of phlegmasia cerulea dolens, a rare complication of massive deep vein thrombosis that presents suddenly with complete venous occlusion leading to impaired arterial flow.
👍30😁5
Forwarded from Medical Mnemonics
🧩 Medical Mnemonics
🧸Thromboangiitis obliterans (Buerger disease) diagnosis is EASY using the mnemonic! 😉
💻 Join us on the official Instagram page: Online Medical School
#surgery
〰〰〰〰〰〰〰〰〰〰〰
©Medical Mnemonics
🧸Thromboangiitis obliterans (Buerger disease) diagnosis is EASY using the mnemonic! 😉
💻 Join us on the official Instagram page: Online Medical School
#surgery
〰〰〰〰〰〰〰〰〰〰〰
©Medical Mnemonics
👍11
⏳ Case-based MCQ | #Case_459
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 41-year-old man presents to the ED with acute onset of a right-sided facial droop. He cannot close his right eye, and he also cannot move the right side of his face when asked to smile. He does admit that he had an upper respiratory infection recently. His speech is not impaired and he has normal motor and sensory exam of his extremities on both sides. His head CT is also normal.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 41-year-old man presents to the ED with acute onset of a right-sided facial droop. He cannot close his right eye, and he also cannot move the right side of his face when asked to smile. He does admit that he had an upper respiratory infection recently. His speech is not impaired and he has normal motor and sensory exam of his extremities on both sides. His head CT is also normal.
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This condition is thought to be most commonly associated with which of the following causative viral organisms?
Anonymous Poll
20%
A. Ebstein barr virus
55%
B. Herpes simplex virus
6%
C. Human immunodeficiency virus
5%
D. Human papillomavirus
14%
E. Respiratory syncytial virus
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⏳ Case-based MCQ | #Case_459 | #answer
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
✅ B
Bell's palsy (idiopathic facial paralysis) is an unexplained weakness or paralysis of the facial nerve, the nerve that controls muscle movement on one side of the face. The condition causes drooping on the affected side, and patients may not be able to close the eye and may experience tearing, drooling and hypersensitive hearing. Although Bell's palsy is unsettling and inconvenient, it is typically not indicative of a serious health problem and in most cases completely resolves itself.
The condition can strike at any age, but young and middle-age adults seem to be the most vulnerable. Pregnant women and individuals with diabetes, influenza, a cold, or an upper respiratory infection seem to be at a greater risk. About eight percent of patients report a family history of Bell's palsy, but it's unclear if the disease has a genetic basis.
While the exact cause of Bell's palsy is not known, many believe that in most cases it is triggered by an infection of the facial nerve by herpes simplex virus (HSV) (choice B). HSV infection has been discovered in up to seventy percent of patients diagnosed with Bell's palsy.
⚠ Other infectious causes of acute peripheral facial palsy include adenovirus, coxsackievirus, cytomegalovirus, Epstein-Barr virus (choice A), influenza B, mumps, and rubella virus.
⚠ Other diseases including Lyme disease and, rarely, HIV (choice C), may also cause sudden facial paralysis. Varicella-zoster virus, a related herpes virus and the cause of chickenpox and shingles, is another cause.
⚠ Human papillomavirus (choice D) and Respiratory syncytial virus (choice E) are not associated with facial palsy.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
✅ B
Bell's palsy (idiopathic facial paralysis) is an unexplained weakness or paralysis of the facial nerve, the nerve that controls muscle movement on one side of the face. The condition causes drooping on the affected side, and patients may not be able to close the eye and may experience tearing, drooling and hypersensitive hearing. Although Bell's palsy is unsettling and inconvenient, it is typically not indicative of a serious health problem and in most cases completely resolves itself.
The condition can strike at any age, but young and middle-age adults seem to be the most vulnerable. Pregnant women and individuals with diabetes, influenza, a cold, or an upper respiratory infection seem to be at a greater risk. About eight percent of patients report a family history of Bell's palsy, but it's unclear if the disease has a genetic basis.
While the exact cause of Bell's palsy is not known, many believe that in most cases it is triggered by an infection of the facial nerve by herpes simplex virus (HSV) (choice B). HSV infection has been discovered in up to seventy percent of patients diagnosed with Bell's palsy.
⚠ Other infectious causes of acute peripheral facial palsy include adenovirus, coxsackievirus, cytomegalovirus, Epstein-Barr virus (choice A), influenza B, mumps, and rubella virus.
⚠ Other diseases including Lyme disease and, rarely, HIV (choice C), may also cause sudden facial paralysis. Varicella-zoster virus, a related herpes virus and the cause of chickenpox and shingles, is another cause.
⚠ Human papillomavirus (choice D) and Respiratory syncytial virus (choice E) are not associated with facial palsy.
👍12❤8
⏳ Case-based MCQ | #Case_460
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 20-year-old female was brought to the ED with confusion. The patient was not oriented in time, place, and person and had Glasgow Coma Score of 14. Pulse rate was weak and regular at 112 bpm, respiration was regular and deep at 30 bpm, blood pressure 105/60 mmHg and her body temperature was 36.9°C.
The diagnosis of diabetic ketoacidosis was established. Treatment was initiated with the infusion of normal saline and then IV insulin and closely monitored. The patient started showing some improvement.
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
A 20-year-old female was brought to the ED with confusion. The patient was not oriented in time, place, and person and had Glasgow Coma Score of 14. Pulse rate was weak and regular at 112 bpm, respiration was regular and deep at 30 bpm, blood pressure 105/60 mmHg and her body temperature was 36.9°C.
The diagnosis of diabetic ketoacidosis was established. Treatment was initiated with the infusion of normal saline and then IV insulin and closely monitored. The patient started showing some improvement.
👍6