heart failure patient on IV furosemide (–1.5 L net) remains oxygen-dependent. VBG shows metabolic alkalosis (pH 7.53, high HCO₃⁻). What is the next step?
Anonymous Quiz
38%
Start acetazolamide
40%
Stop furosemide
7%
Continue same
16%
Add metolazone
💧 Strategies for managing common adverse effects during diuresis include:
- For symptomatic hypotension, consider decreasing the diuretic dose
- For hypokalemia and hypomagnesemia, consider adding a MRA, potassium and magnesium supplement.
- For hyperkalemia due to MRAs, consider decreasing the dose of MRA or discontinuing therapy (based on the potassium level).
- For worsening kidney function consider discontinuing use of thiazide diuretics for patients receiving a combination of a loop and thiazide diuretics.
- For metabolic alkalosis, Consider acetazolamide if the serum creatinine is < 4 mg/dL and the patient is not volume contracted or hypokalemic.
- For symptomatic hypotension, consider decreasing the diuretic dose
- For hypokalemia and hypomagnesemia, consider adding a MRA, potassium and magnesium supplement.
- For hyperkalemia due to MRAs, consider decreasing the dose of MRA or discontinuing therapy (based on the potassium level).
- For worsening kidney function consider discontinuing use of thiazide diuretics for patients receiving a combination of a loop and thiazide diuretics.
- For metabolic alkalosis, Consider acetazolamide if the serum creatinine is < 4 mg/dL and the patient is not volume contracted or hypokalemic.
22-year-old man presents with fever and acute right knee swelling one week after a sore throat. The knee is warm, erythematous, and tender. What is the next best step?
Anonymous Quiz
6%
Throat swab
38%
ASO titer
42%
Arthrocentesis
14%
NSAIDs and observe
🦠 Post-streptococcus complications:
- Otitis media
- Peritonsillar abscess
- Retropharyngeal abscess
- Lemierre syndrome (necrobacillosis)
- Acute rheumatic fever: only after pharyngitis, not streptococcal skin infections
- Poststreptococcal glomerulonephritis: after throat or skin infections
- Streptococcal toxic shock syndrome
- Poststreptococcal reactive arthritis: overlap with ARF
- Otitis media
- Peritonsillar abscess
- Retropharyngeal abscess
- Lemierre syndrome (necrobacillosis)
- Acute rheumatic fever: only after pharyngitis, not streptococcal skin infections
- Poststreptococcal glomerulonephritis: after throat or skin infections
- Streptococcal toxic shock syndrome
- Poststreptococcal reactive arthritis: overlap with ARF
43 year old male felt drowsy while awaiting in the clinic waiting room. His blood sugar was low. What is the best management?
Anonymous Quiz
79%
Fruit juice
13%
Intravenous 5% dextrose
2%
Normal saline
7%
Intramuscular glucagon
What is the most common cause of death in chronic kidney disease?
Anonymous Quiz
77%
Cardiovascular disease
11%
Hyperkalemia
8%
Uremic complications
3%
Coagulation disorder
👍1
adult with asthma exacerbation was given SABA and ICS but did not improve.
IV magnesium sulfate was administered.
Lab results: PCO2 normal, pH 7.29, P02 decreased. Next step?
IV magnesium sulfate was administered.
Lab results: PCO2 normal, pH 7.29, P02 decreased. Next step?
Anonymous Quiz
29%
Non-invasive ventilation
17%
Ipratropium
50%
Mechanical ventilation
4%
IV SABA
❤1👍1
Remember:
Normal/Elevated PaCO₂ with low pH in asthma exacerbation is a red flag, indicating respiratory muscle fatigue and impending respiratory failure 🫁.
Normal/Elevated PaCO₂ with low pH in asthma exacerbation is a red flag, indicating respiratory muscle fatigue and impending respiratory failure 🫁.
❤1
patient diagnosed with TB & started on anti-TB. He presented to the clinic for a follow-up with signs of gout. laboratory investigations showed increased uric acid level. What drug causing this?
Anonymous Quiz
69%
Pyrazinamide
8%
Ethambutol
21%
Isoniazid
3%
Rifampicin
👍1
patient with hepatitis C, cirrhosis, and upper gastrointestinal bleeding (UGIB)
presents to the ER with frothy secretions. What is the most appropriate initial management?
presents to the ER with frothy secretions. What is the most appropriate initial management?
Anonymous Quiz
39%
Endotracheal intubation
19%
Emergency endoscopy
38%
Octreotide
3%
Blood transfusion
👍1
patient is admitted with a diagnosis of lower lobe pneumonia. You are planning to obtain blood cultures. When is the best time to collect them?
Anonymous Quiz
27%
1 hour before event
22%
1 hour after event
48%
During a fever attack
2%
After the seizure
🔥2
⛑️ Barrett’s esophagus surveillance:
- Without dysplasia: EGD every 3-5 years
- Low grade dysplasia: EGD every 12 months
- High grade dysplasia: Endoscopic eradication
- Without dysplasia: EGD every 3-5 years
- Low grade dysplasia: EGD every 12 months
- High grade dysplasia: Endoscopic eradication
👍1
Most common site involves in CD
Anonymous Quiz
3%
Procititis
6%
Small bowel
12%
Colonic
78%
Ileocolonic
40-year-old female with chronic kidney disease comes for a follow-up with no active complaints. Investigations show
Ca 1.7 mmol/L and Phosphate at 1 mmol/L. Next step?
Ca 1.7 mmol/L and Phosphate at 1 mmol/L. Next step?
Anonymous Quiz
11%
Sevelamer
12%
Cinacalcet
42%
Calcitriol
35%
Vitamin D Supplements
patient presented with fever, bony back pain and tenderness by examination. Culture showed gram negative coccobacilli. What is the most likely diagnosis?
Anonymous Quiz
6%
TB
83%
Brucellosis
2%
Schistosomiasis
10%
Staphylococcus aureus
Patient presented with fever headache and myalgia after 1 week returning from umrah with maculopapular rash, neutropenia and thrombocytopenia with picture, what is the likely diagnosis?
Anonymous Quiz
14%
Malaria
7%
TB
75%
Dengue fever
5%
Brucellosis