Internal medicine Lectures, books,Mcqs & usmleπ
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Explanation
Coagulation factors II, V, VII, IX, X, and XI would most likely be deficient. These are some of the factors that are synthesized in the liver. Factors II, VII, IX, and X are the vitamin Kdependent factors, which are also synthesized in the liver. (Lichtman, p. 1953)
Coagulation factors II, V, VII, IX, X, and XI would most likely be deficient. These are some of the factors that are synthesized in the liver. Factors II, VII, IX, and X are the vitamin Kdependent factors, which are also synthesized in the liver. (Lichtman, p. 1953)
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#Note
In asymptomatic individuals, a positive skin or blood test for a particular allergen is not diagnostic of an allergy to that allergen
In asymptomatic individuals, a positive skin or blood test for a particular allergen is not diagnostic of an allergy to that allergen
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#Note
Intranasal steroids are considered the most effective maintenance treatment for persistent allergic rhinitis. Potential adverse effects include nosebleeds and, rarely, septal perforation with long-term use.
Intranasal steroids are considered the most effective maintenance treatment for persistent allergic rhinitis. Potential adverse effects include nosebleeds and, rarely, septal perforation with long-term use.
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#Note
Acute invasive fungal rhinosinusitis is a life-threatening diagnosis with a mortality rate of 50β80%. If suspected, immediately admit the patient and consult ENT.
Acute invasive fungal rhinosinusitis is a life-threatening diagnosis with a mortality rate of 50β80%. If suspected, immediately admit the patient and consult ENT.
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IM volume 4.pdf
121.7 MB
(Hematology-Geriatrics-Infection-Acute medicine-Alternative medicine-Evidence based medicine)
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IM volume 2.pdf
174.8 MB
(Endocrine & metabolism-Nephrology-Genetics-GIT- Hepatology & Pancreas)
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IM volume 1.pdf
115.9 MB
(Ethics-Cardiology-Respiratory)
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18) #caes
A 75-year-old man is brought in by his daughter for progressive mainly unilateral tinnitus, hearing loss, and dizziness for the past year. About 3 weeks ago, he began experiencing unsteadiness and sustained a fall while walking up the stairs. ADDITIONAL HISTORYThe patientβs tinnitus is constant and nonpulsatile and has been interfering with enjoyment of his favorite TV shows. It is low- to moderate-pitched, fairly loud, and occurs mostly on his right side. He has not experienced nausea, headaches, focal weakness, seizures, or constitutional symptoms. In the past, he
worked for many years as an airline mechanic. He reports that
his sense of balance is off and that there is a heaviness or βdeadnessβ in his right ear. During the interview, he asks you to repeat your questions, turning his head to the left to hear you better.
The physical examination is essentially normal, including the cardiac examination. There is no nystagmus. Tympanic membrane appears normal, and you cannot hear any additional sounds. Additional audiologic testing showsmoderate bilateral high-frequency sensorineural hearing loss affecting the right ear much more than the left.
A 75-year-old man is brought in by his daughter for progressive mainly unilateral tinnitus, hearing loss, and dizziness for the past year. About 3 weeks ago, he began experiencing unsteadiness and sustained a fall while walking up the stairs. ADDITIONAL HISTORYThe patientβs tinnitus is constant and nonpulsatile and has been interfering with enjoyment of his favorite TV shows. It is low- to moderate-pitched, fairly loud, and occurs mostly on his right side. He has not experienced nausea, headaches, focal weakness, seizures, or constitutional symptoms. In the past, he
worked for many years as an airline mechanic. He reports that
his sense of balance is off and that there is a heaviness or βdeadnessβ in his right ear. During the interview, he asks you to repeat your questions, turning his head to the left to hear you better.
The physical examination is essentially normal, including the cardiac examination. There is no nystagmus. Tympanic membrane appears normal, and you cannot hear any additional sounds. Additional audiologic testing showsmoderate bilateral high-frequency sensorineural hearing loss affecting the right ear much more than the left.
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Internal medicine Lectures, books,Mcqs & usmleπ
18) #caes A 75-year-old man is brought in by his daughter for progressive mainly unilateral tinnitus, hearing loss, and dizziness for the past year. About 3 weeks ago, he began experiencing unsteadiness and sustained a fall while walking up the stairs. ADDITIONALβ¦
Case 18
Question: What is the most likely
diagnosis?
Question: What is the most likely
diagnosis?
Anonymous Quiz
10%
A. Cerumen impaction
38%
B. Acoustic neuroma
21%
C. Otosclerosis
31%
D. Hearing loss from trauma (airline mechanic
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Internal medicine Lectures, books,Mcqs & usmleπ
Case 18
Question: What is the most likely
diagnosis?
Question: What is the most likely
diagnosis?
Explanation
.
CorrectIanswer:IBI
This 75-year-old man has several reasons to have nonpulsaοΏΎtile tinnitus. He was subjected to chronic noise exposure as
an airline mechanic, which typically causes bilateral highοΏΎfrequency hearing loss and tinnitus. Otosclerosis causes
bilateral tinnitus and progressive conductive hearing loss.
Cerumen impaction is associated with unilateral hearing
loss and tinnitus but would be obvious on physical examiοΏΎnation (eg, wax obscuring the tympanic membrane). In this
case, alarm features include the presence of tinnitus associοΏΎated with progressive unilateral hearing loss. Additionally,
the patient is experiencing disequilibrium and has fallen.
Magnetic resonance imaging of the head revealed an eighth
nerve mass, which on careful resection was a schwannoma,
without invasion. The patientβs hearing improved, and his
tinnitus diminished to tolerable levels.
.
CorrectIanswer:IBI
This 75-year-old man has several reasons to have nonpulsaοΏΎtile tinnitus. He was subjected to chronic noise exposure as
an airline mechanic, which typically causes bilateral highοΏΎfrequency hearing loss and tinnitus. Otosclerosis causes
bilateral tinnitus and progressive conductive hearing loss.
Cerumen impaction is associated with unilateral hearing
loss and tinnitus but would be obvious on physical examiοΏΎnation (eg, wax obscuring the tympanic membrane). In this
case, alarm features include the presence of tinnitus associοΏΎated with progressive unilateral hearing loss. Additionally,
the patient is experiencing disequilibrium and has fallen.
Magnetic resonance imaging of the head revealed an eighth
nerve mass, which on careful resection was a schwannoma,
without invasion. The patientβs hearing improved, and his
tinnitus diminished to tolerable levels.
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A 57-year-old man complains of increased thirstand urination. His examination is normal exceptfor obesity (BMI>30). Which of the following isthe most appropriate initial diagnostic test?
Anonymous Quiz
10%
(A) a urine osmolality
22%
(B) hemoglobin A1C level
34%
(C) a fasting blood sugar (FBS
14%
(D) a glucose tolerance test (GTT
21%
(E) random glucose
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Internal medicine Lectures, books,Mcqs & usmleπ
A 57-year-old man complains of increased thirstand urination. His examination is normal exceptfor obesity (BMI>30). Which of the following isthe most appropriate initial diagnostic test?
Case 19
Explanation
. (C) The gold standard is still a fasting plasmaglucose = 7 mmol/L (126 mg/dL) on two separate occasions. GTTs are rarely required. With typical symptoms even an elevated random
sugar is diagnostic.
Explanation
. (C) The gold standard is still a fasting plasmaglucose = 7 mmol/L (126 mg/dL) on two separate occasions. GTTs are rarely required. With typical symptoms even an elevated random
sugar is diagnostic.
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