Maxemo EMREE 26-27
A patient with eczema reports asthma symptoms 4–5 days/week, nocturnal awakenings 2x/week, and uses a SABA inhaler daily. Which classification of asthma severity is most accurate for this clinical presentation?
💡 EXPLANATION:
This patient has Moderate Persistent asthma based on nocturnal awakenings occurring >1x/week (but not nightly) and daily use of a short-acting beta-agonist (SABA). Mild persistent involves night symptoms 3–4x/month.
A 65 y/o M is admitted with high fever, rust-colored sputum, and RLL consolidation. Vitals are stable. He has no known allergies. What is the most appropriate initial antibiotic regimen?
Anonymous Quiz
9%
Amoxicillin PO
4%
Ciprofloxacin IV
57%
Ceftriaxone + Azithromycin IV
30%
Piperacillin-Tazobactam IV
Maxemo EMREE 26-27
A 65 y/o M is admitted with high fever, rust-colored sputum, and RLL consolidation. Vitals are stable. He has no known allergies. What is the most appropriate initial antibiotic regimen?
💡 EXPLANATION:
Inpatient CAP requires coverage for S. pneumoniae and atypical pathogens. Guidelines recommend a beta-lactam (Ceftriaxone) combined with a macrolide (Azithromycin). Ciprofloxacin is not a respiratory fluoroquinolone.
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A 25 y/o M presents with sudden pleuritic chest pain and dyspnea. A chest X-ray is ordered to confirm a pneumothorax. Which specific radiographic line represents the edge of the collapsed lung?
Anonymous Quiz
32%
Parietal pleural line
14%
Scapular border
0%
Skin fold
55%
Visceral pleural line
Maxemo EMREE 26-27
A 25 y/o M presents with sudden pleuritic chest pain and dyspnea. A chest X-ray is ordered to confirm a pneumothorax. Which specific radiographic line represents the edge of the collapsed lung?
💡 EXPLANATION:
A pneumothorax is defined by air in the pleural space separating the lung from the chest wall. The diagnostic hallmark is the visualization of the visceral pleural line (white line) with an absence of lung markings peripheral to it.
A 45-year-old male presents with chronic sinusitis, recurrent hemoptysis, and elevated creatinine. Urinalysis reveals microscopic hematuria. What is the most likely diagnosis?
Anonymous Quiz
15%
Goodpasture syndrome
8%
Microscopic polyangiitis
65%
Granulomatosis with polyangiitis
12%
Eosinophilic granulomatosis with polyangiitis
Maxemo EMREE 26-27
A 45-year-old male presents with chronic sinusitis, recurrent hemoptysis, and elevated creatinine. Urinalysis reveals microscopic hematuria. What is the most likely diagnosis?
💡 EXPLANATION:
Granulomatosis with polyangiitis (formerly Wegener's) presents with a clinical triad: upper airway disease (sinusitis/saddle nose), lower airway involvement (hemoptysis/cavitation), and glomerulonephritis. c-ANCA is typically positive.
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🔬 Today's Test: ORTHOPEDICS
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Yesterday's Ranks🏆
DERMATOLOGY
1. Reyansh Malhotra
2. Samyak99
3. Rizwan H
4. Shruti p
5. Kabir Reddy
6. Avantika Pillai
7. Sagar
8. Dr.shymaa
9. Aysha
10. Siddharth Sharma
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A patient presents with fever and cough. CXR reveals an opacity in the right lung field obscuring the right heart border. What is the primary radiographic abnormality?
Anonymous Quiz
12%
Pleural effusion
77%
Consolidation
8%
Pneumothorax
4%
Atelectasis
Maxemo EMREE 26-27
A patient presents with fever and cough. CXR reveals an opacity in the right lung field obscuring the right heart border. What is the primary radiographic abnormality?
💡 EXPLANATION:
Airspace opacification that obscures adjacent soft tissue borders (positive silhouette sign) is characteristic of consolidation. This finding is the hallmark of pneumonia, where air in the alveoli is replaced by exudate.
A 32-year-old female non-smoker presents with recurrent spontaneous pneumothorax. Chest HRCT reveals diffuse, round, thin-walled cysts uniformly distributed throughout both lungs. What is the most likely diagnosis?
Anonymous Quiz
29%
Pulmonary Langerhans cell histiocytosis
42%
Lymphangioleiomyomatosis
25%
Birt-Hogg-Dubé syndrome
4%
Lymphocytic interstitial pneumonia
Maxemo EMREE 26-27
A 32-year-old female non-smoker presents with recurrent spontaneous pneumothorax. Chest HRCT reveals diffuse, round, thin-walled cysts uniformly distributed throughout both lungs. What is the most likely diagnosis?
💡 EXPLANATION:
Lymphangioleiomyomatosis (LAM) affects women of childbearing age. It is characterized by recurrent pneumothorax and diffuse, uniform thin-walled cysts on HRCT. PLCH is typically associated with smoking and irregular cysts.
A 6y M presents with fever and headache x3d. O/E: T 38.9°C, +Kernig sign. CSF: WBC 200 (90% lymphs), Glu 3.1 mmol/L (Serum 5.3), Protein 0.6 g/L, Gram stain negative. What is the most likely diagnosis?
Anonymous Quiz
7%
Bacterial meningitis
44%
Viral meningitis
41%
Tuberculous meningitis
7%
Fungal meningitis
Maxemo EMREE 26-27
A 6y M presents with fever and headache x3d. O/E: T 38.9°C, +Kernig sign. CSF: WBC 200 (90% lymphs), Glu 3.1 mmol/L (Serum 5.3), Protein 0.6 g/L, Gram stain negative. What is the most likely diagnosis?
💡 EXPLANATION:
CSF findings of lymphocytic pleocytosis, normal glucose (ratio >0.5), and mild protein elevation are classic for aseptic (viral) meningitis. Bacterial meningitis typically presents with neutrophilic pleocytosis and hypoglycemia.
A 45y M with prior syphilis presents with ataxia, shooting leg pains, and incontinence. O/E: Argyll Robertson pupils. CSF VDRL is positive. What is the most appropriate treatment?
Anonymous Quiz
35%
IM Benzathine Penicillin G 2.4 MU
15%
PO Doxycycline 100 mg BID
42%
IV Aqueous Crystalline Penicillin G
8%
IV Ceftriaxone 2 g daily
Maxemo EMREE 26-27
A 45y M with prior syphilis presents with ataxia, shooting leg pains, and incontinence. O/E: Argyll Robertson pupils. CSF VDRL is positive. What is the most appropriate treatment?
💡 EXPLANATION:
Neurosyphilis (e.g., Tabes Dorsalis) requires IV Aqueous Crystalline Penicillin G (18-24 million units/day) for 10-14 days to ensure adequate CSF penetration. IM Benzathine Penicillin does not achieve therapeutic levels in the CNS.
A 26-year-old G1P0 woman at 14 weeks gestation has asymptomatic bacteriuria (>100,000 CFU/mL E. coli). She denies dysuria. She has no known drug allergies. What is the most appropriate pharmacotherapy?
Anonymous Quiz
28%
Reassurance and observation
55%
Nitrofurantoin
7%
Ciprofloxacin
10%
Doxycycline
Maxemo EMREE 26-27
A 26-year-old G1P0 woman at 14 weeks gestation has asymptomatic bacteriuria (>100,000 CFU/mL E. coli). She denies dysuria. She has no known drug allergies. What is the most appropriate pharmacotherapy?
💡 EXPLANATION:
Asymptomatic bacteriuria in pregnancy requires treatment to prevent pyelonephritis and preterm delivery. Nitrofurantoin is safe in the 2nd trimester. Fluoroquinolones (ciprofloxacin) and tetracyclines (doxycycline) are contraindicated in pregnancy.
A 35 y/o M has these labs: HBsAg (+), HBeAg (-), Anti-HBe (+), Anti-HBc IgG (+). HBV DNA is <2,000 IU/mL with persistently normal ALT. Which phase of chronic Hepatitis B infection does this represent?
Anonymous Quiz
12%
Immune tolerant phase
23%
Immune reactive phase
35%
Inactive carrier phase
31%
HBeAg-negative chronic hepatitis