patient presents with sudden severe chest pain, shortness of breath, a systolic ejection murmur BP 220/100. What is the most appropriate immediate
management?
management?
Anonymous Quiz
30%
Nitroglycerin with esmolol
62%
Labetalol followed by nitroprusside
5%
Nifedipine๏ปฟ๏ปฟ๏ปฟ
3%
Hydralazine
๐1
๐ซ Donโt be tricked:
- in aortic dissection: give BB first then vasodilation (nitroprusside)
- in Pheochromocytoma: give Alpha-blocker then BB
- in Myxedema Coma: give hydrocortisone first then levothyroxine
- in aortic dissection: give BB first then vasodilation (nitroprusside)
- in Pheochromocytoma: give Alpha-blocker then BB
- in Myxedema Coma: give hydrocortisone first then levothyroxine
๐2
43-year-old male presented to the ER with syncope and hypotension. ECG showed supraventricular tachycardia (SVT). What is the best next step?
Anonymous Quiz
46%
IV adenosine
5%
Defibrillation
44%
Cardioversion
5%
IV metoprolol
โค1
30F with RA presents with SOB and dry cough for 3 months
denies fever or weight loss examination: cyanosis, digital clubbing, and bibasilar end-inspiratory crackles (velcro crackle). Likely diagnosis?
denies fever or weight loss examination: cyanosis, digital clubbing, and bibasilar end-inspiratory crackles (velcro crackle). Likely diagnosis?
Anonymous Quiz
2%
Lung abscess
21%
Bronchiectasis
8%
Bronchogenic carcinoma
69%
Interstitial pulmonary fibrosis
๐1
๐ซ Pulmonary manifestations in patients with RA may include:
- Interstitial lung disease
- Pleura inflammation (thickening & effusions)
- Pulmonary hypertension
- Caplan syndrome
- Interstitial lung disease
- Pleura inflammation (thickening & effusions)
- Pulmonary hypertension
- Caplan syndrome
๐1
ู
ุจุฑูู ูุฌู
ูุน ุงูู
ูุจูููู ูุญุธ ุงููุฑ ููุจููุฉ ๐๐ปโค๏ธโค๏ธ
#matching2025
#matching2025
โค4
When should an adult with FSGS be considered glucocorticoid-resistant?
Anonymous Quiz
19%
4 weeks
41%
8 weeks
32%
12 weeks
8%
16 weeks
patient diagnosed with cough variant asthma on albuterol
Initially symptoms improved, but they still complain of cough, need to clear the throat, especially at night & when lying down. Next step?
Initially symptoms improved, but they still complain of cough, need to clear the throat, especially at night & when lying down. Next step?
Anonymous Quiz
12%
Add long-acting beta-agonist
41%
Add inhaled corticosteroid
44%
Add PPI
3%
Add oral steroid
45 woman presents with weight gain, facial rounding and proximal muscle weakness. What is the most appropriate initial investigation to evaluate her condition?
Anonymous Quiz
47%
24-hour urinary free cortisol
27%
Early morning serum cortisol
10%
Plasma ACTH level
16%
Low-dose dexamethasone suppression test
patient with a positive urea breath test, what is your next step?
Anonymous Quiz
68%
Esomeprazole, amoxicillin, clarithromycin for 14 days
3%
Esomeprazole, amoxicillin, clarithromycin for 7 days
26%
Esomeprazole, ciprofloxacin,metronidazole for 14 days
2%
Esomeprazole, ciprofloxacin,metronidazole for 7 days
๐ก Remember:
Avoid clarithromycin and levofloxacin based regimens in the absence of demonstrated antibiotic susceptibility.
First-line eradication regimens for H. pylori infection is optimized bismuth quadruple therapy for 14 days (PPI, bismuth subcitrate, tetracycline and metronidazole)
**Previous question is from an old SMLE Q-bank ๐
Avoid clarithromycin and levofloxacin based regimens in the absence of demonstrated antibiotic susceptibility.
First-line eradication regimens for H. pylori infection is optimized bismuth quadruple therapy for 14 days (PPI, bismuth subcitrate, tetracycline and metronidazole)
**Previous question is from an old SMLE Q-bank ๐
ูู ุงูุชูููู ูุฌููููุฑ ุงูู
ุฏุณู ูู ุงุฎุชุจุงุฑูู
ุงูููู
ูุจูุฑู๐๐ปโค๏ธ
โค1
heart failure patient on IV furosemide (โ1.5 L net) remains oxygen-dependent. VBG shows metabolic alkalosis (pH 7.53, high HCOโโป). What is the next step?
Anonymous Quiz
39%
Start acetazolamide
39%
Stop furosemide
7%
Continue same
16%
Add metolazone
๐ง 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
36%
ASO titer
42%
Arthrocentesis
16%
NSAIDs and observe
โค1
๐ฆ 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
78%
Fruit juice
14%
Intravenous 5% dextrose
1%
Normal saline
6%
Intramuscular glucagon
What is the most common cause of death in chronic kidney disease?
Anonymous Quiz
77%
Cardiovascular disease
11%
Hyperkalemia
9%
Uremic complications
3%
Coagulation disorder
๐1
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
31%
Non-invasive ventilation
17%
Ipratropium
48%
Mechanical ventilation
5%
IV SABA
โค1๐1
Remember:
Normal/Elevated PaCOโ with low pH in asthma exacerbation is a red flag, indicating respiratory muscle fatigue and impending respiratory failure ๐ซ.
Normal/Elevated PaCOโ with low pH in asthma exacerbation is a red flag, indicating respiratory muscle fatigue and impending respiratory failure ๐ซ.
โค1