A 55 y/o healthy postmenopausal F requests osteoporosis screening. She has no history of fractures, steroid use, or smoking. BMI is 24 kg/m2. What is the most appropriate recommendation regarding a DEXA scan?
Anonymous Quiz
12%
Perform DEXA scan immediately
36%
Defer screening until age 65
28%
Defer screening until age 60
24%
Screen only if symptomatic
Maxemo EMREE 26-27
A 55 y/o healthy postmenopausal F requests osteoporosis screening. She has no history of fractures, steroid use, or smoking. BMI is 24 kg/m2. What is the most appropriate recommendation regarding a DEXA scan?
💡 EXPLANATION:
Routine DEXA screening is recommended for women ≥ 65 y/o. Women < 65 require screening only if fracture risk is increased (e.g., low BMI, steroid use, parental hip fracture). Since she has no risk factors, screening is deferred.
A public health study aims to compare the total burden of CVA in the UAE versus Nigeria. The researcher requires a single metric integrating both premature mortality and years lived with disability. Which measure is most appropriate?
Anonymous Quiz
4%
Incidence rate
17%
Case fatality rate
25%
Years of potential life lost
54%
Disability-adjusted life years
❤1
Maxemo EMREE 26-27
A public health study aims to compare the total burden of CVA in the UAE versus Nigeria. The researcher requires a single metric integrating both premature mortality and years lived with disability. Which measure is most appropriate?
💡 EXPLANATION:
Disability-Adjusted Life Years (DALY) is the standard metric for disease burden. It sums Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD), capturing the total health loss better than mortality rates alone.
A 78 y/o M with HTN and T2DM presents with a 6-month history of forgetfulness and repeating questions reported by his son. The patient denies symptoms. Physical exam is unremarkable. What is the most appropriate initial step?
Anonymous Quiz
4%
Reassure and discharge
13%
Order MRI of the brain
79%
Perform Mini-Mental State Examination
4%
Measure serum Vitamin B12
Maxemo EMREE 26-27
A 78 y/o M with HTN and T2DM presents with a 6-month history of forgetfulness and repeating questions reported by his son. The patient denies symptoms. Physical exam is unremarkable. What is the most appropriate initial step?
💡 EXPLANATION:
Subjective cognitive complaints require objective quantification first. Validated screening tools like the Mini-Mental State Examination (MMSE) or MoCA establish a baseline. Labs and imaging are subsequent steps if impairment is confirmed.
A 68 y/o M presents with progressive gait instability and hand clumsiness. O/E: wide-based spastic gait and b/l lower limb hyperreflexia. What is the most likely diagnosis?
Anonymous Quiz
13%
Lumbar spinal stenosis
17%
Normal pressure hydrocephalus
30%
Cervical spondylotic myelopathy
39%
Parkinson's disease
Maxemo EMREE 26-27
A 68 y/o M presents with progressive gait instability and hand clumsiness. O/E: wide-based spastic gait and b/l lower limb hyperreflexia. What is the most likely diagnosis?
💡 EXPLANATION:
UMN signs in legs (spasticity, hyperreflexia) combined with hand clumsiness indicates cervical cord compression. This constellation of findings is classic for Cervical Spondylotic Myelopathy (CSM).
A 47y/o M with HTN and dyslipidemia (LDL 3.8 mmol/L) seeks dietary advice to lower MI risk. BMI is 29 kg/m². Which dietary pattern is most strongly supported by evidence for cardiovascular risk reduction in this patient?
Anonymous Quiz
33%
Strict low-fat diet
67%
Mediterranean diet
0%
Ketogenic diet
0%
Gluten-free diet
Maxemo EMREE 26-27
A 47y/o M with HTN and dyslipidemia (LDL 3.8 mmol/L) seeks dietary advice to lower MI risk. BMI is 29 kg/m². Which dietary pattern is most strongly supported by evidence for cardiovascular risk reduction in this patient?
💡 EXPLANATION:
The Mediterranean diet has the strongest evidence (e.g., PREDIMED study) for reducing major cardiovascular events and improving lipid profiles. It emphasizes vegetables, healthy fats (olive oil), nuts, and whole grains.
A 24 y/o F presents with daily spiking fevers, severe arthralgia, and a transient salmon-colored rash on the trunk. Labs show neutrophilic leukocytosis. ANA and RF are negative. Which additional finding strongly supports the diagnosis?
Anonymous Quiz
21%
Positive anti-dsDNA
46%
Markedly elevated serum ferritin
13%
Low serum complement levels
21%
Positive anti-CCP antibodies
Maxemo EMREE 26-27
A 24 y/o F presents with daily spiking fevers, severe arthralgia, and a transient salmon-colored rash on the trunk. Labs show neutrophilic leukocytosis. ANA and RF are negative. Which additional finding strongly supports the diagnosis?
💡 EXPLANATION:
The clinical picture suggests Adult-Onset Still's Disease (AOSD): quotidian fevers, evanescent salmon-pink rash, and arthralgia. A key diagnostic hallmark is extreme hyperferritinemia (often >1000 ng/mL). Autoantibodies (ANA, RF) are typically negative.
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A 19y/o M presents with fever, severe fatigue, and exudative pharyngitis. O/E: Posterior cervical lymphadenopathy. Monospot test is positive. Regarding primary prevention for this condition, which statement is correct?
Anonymous Quiz
16%
Live attenuated vaccine is effective
36%
Routine childhood vaccination covers it
48%
No licensed vaccine is available
0%
Booster dose is required at age 18
Maxemo EMREE 26-27
A 19y/o M presents with fever, severe fatigue, and exudative pharyngitis. O/E: Posterior cervical lymphadenopathy. Monospot test is positive. Regarding primary prevention for this condition, which statement is correct?
💡 EXPLANATION:
The diagnosis is Infectious Mononucleosis (EBV), indicated by the triad of fever, pharyngitis, and lymphadenopathy with a positive Monospot. Unlike many other viral illnesses, no vaccine is currently licensed for the prevention of EBV.
A 62y/o M with T2DM and prior MI presents for follow-up. HbA1c 7.5%, eGFR 70 mL/min. Empagliflozin is added to his regimen to reduce cardiovascular mortality. Which mechanism primarily mediates this cardioprotective effect?
Anonymous Quiz
14%
Enhancement of insulin sensitivity
18%
Suppression of glucagon secretion
18%
Inhibition of DPP-4 enzyme
50%
Osmotic diuresis via glycosuria