Maxemo EMREE 26-27
A 50 y/o diabetic man presents with a BP of 140/90 mmHg and microalbuminuria (45 mg/day). Which medication is the most appropriate next step to slow the progression of his renal disease?
💡 EXPLANATION:
Lisinopril (an ACE inhibitor) is the drug of choice for diabetic patients with microalbuminuria. It slows nephropathy progression by dilating the efferent arteriole, thereby reducing intraglomerular pressure.
A 62 y/o man presents with acute onset right-sided facial droop, right arm weakness, and expressive aphasia. Which of the following is the most likely occluded vessel?
Anonymous Quiz
67%
Left middle cerebral artery
19%
Right middle cerebral artery
5%
Left anterior cerebral artery
10%
Left posterior cerebral artery
Maxemo EMREE 26-27
A 62 y/o man presents with acute onset right-sided facial droop, right arm weakness, and expressive aphasia. Which of the following is the most likely occluded vessel?
💡 EXPLANATION:
Left MCA occlusion classically presents with contralateral (right-sided) facial and upper extremity weakness, along with expressive (Broca's) aphasia due to involvement of the dominant cerebral hemisphere.
A 40 y/o F presents with a sudden, worst headache of her life during exertion, followed by vomiting. Non-contrast head CT reveals blood in the basal cisterns. What is the most appropriate next step in investigation?
Anonymous Quiz
23%
Lumbar puncture
31%
Magnetic resonance imaging
46%
Computed tomography angiography
0%
Electroencephalogram
Maxemo EMREE 26-27
A 40 y/o F presents with a sudden, worst headache of her life during exertion, followed by vomiting. Non-contrast head CT reveals blood in the basal cisterns. What is the most appropriate next step in investigation?
💡 EXPLANATION:
Non-contrast CT is the initial test for subarachnoid hemorrhage. Once confirmed, computed tomography angiography (CTA) is the immediate next step to identify the source of bleeding (e.g., ruptured aneurysm) prior to surgical intervention.
A 28 y/o F with Myasthenia Gravis presents to the ED with sudden severe respiratory weakness following recent antibiotic use. Pupils are normal. What is the most appropriate next step in management?
Anonymous Quiz
29%
Administer intravenous edrophonium
50%
Perform endotracheal intubation
13%
Administer intravenous immunoglobulin
8%
Increase pyridostigmine dosage
Maxemo EMREE 26-27
A 28 y/o F with Myasthenia Gravis presents to the ED with sudden severe respiratory weakness following recent antibiotic use. Pupils are normal. What is the most appropriate next step in management?
💡 EXPLANATION:
In a myasthenic crisis presenting with severe respiratory weakness, securing the airway via endotracheal intubation is the immediate first priority to prevent respiratory failure.
DAILY FOCUS TEST (DFT)
🔬 Today's Test: BIOSTATISTICS
👉 https://app.maxemo.app/s/dft-emree
Yesterday's Ranks🏆
INTERNAL MEDICINE
1. Reyansh Malhotra
2. Rizwan H
3. Sara
4. Samyak99
5. anjali
6. Silverlin
7. Shruti p
8. Siddharth Sharma
9. Mahmoud_k
10. Ahmed
⏳ Test Ends at 07:00 PM
Join channel 👇
https://t.me/studywithmaxemoemree
🔬 Today's Test: BIOSTATISTICS
👉 https://app.maxemo.app/s/dft-emree
Yesterday's Ranks🏆
INTERNAL MEDICINE
1. Reyansh Malhotra
2. Rizwan H
3. Sara
4. Samyak99
5. anjali
6. Silverlin
7. Shruti p
8. Siddharth Sharma
9. Mahmoud_k
10. Ahmed
⏳ Test Ends at 07:00 PM
Join channel 👇
https://t.me/studywithmaxemoemree
A 68 y/o M presents with a resting tremor, rigidity, bradykinesia, and a shuffling gait. Which of the following is the primary pathophysiological mechanism underlying his condition?
Anonymous Quiz
80%
Decreased dopamine leading to increased acetylcholine tone
8%
Degeneration of upper and lower motor neurons
4%
Autoimmune destruction of acetylcholine receptors
8%
Reduced gamma-aminobutyric acid (GABA) in the striatum
Maxemo EMREE 26-27
A 68 y/o M presents with a resting tremor, rigidity, bradykinesia, and a shuffling gait. Which of the following is the primary pathophysiological mechanism underlying his condition?
💡 EXPLANATION:
Parkinson disease results from dopaminergic neuron loss in the substantia nigra. Decreased dopamine causes a relative increase in acetylcholine tone, leading to motor inhibition and the classic triad of tremor, rigidity, and bradykinesia.
A 22 y/o man presents with ascending weakness and absent reflexes 1 week after a diarrheal illness. CSF analysis shows high protein with normal WBC count. Which of the following best describes the underlying pathology?
Anonymous Quiz
4%
Degeneration of motor neurons in the anterior horn
50%
Autoimmune demyelination of peripheral nerves
29%
Autoimmune demyelination of central nervous system
17%
Antibody-mediated blockade of acetylcholine receptors
Maxemo EMREE 26-27
A 22 y/o man presents with ascending weakness and absent reflexes 1 week after a diarrheal illness. CSF analysis shows high protein with normal WBC count. Which of the following best describes the underlying pathology?
💡 EXPLANATION:
Guillain-Barré syndrome is a post-infectious autoimmune condition causing demyelination of peripheral nerves. Diagnosis is supported by albuminocytologic dissociation (elevated protein with normal WBC) on CSF analysis.
A 4 y/o boy presents with a 2/6 systolic murmur at the left lower sternal border. The murmur intensity decreases upon standing and increases when lying supine. He is otherwise asymptomatic. What is the most likely diagnosis?
Anonymous Quiz
17%
Ventricular septal defect
21%
Atrial septal defect
25%
Innocent murmur
38%
Mitral valve prolapse
A 9 y/o girl presents with migratory polyarthritis and painless subcutaneous nodules. Which laboratory test provides the essential evidence to confirm the underlying diagnosis?
Anonymous Quiz
22%
Rheumatoid factor level
9%
Antinuclear antibody (ANA)
70%
Anti-streptolysin O (ASO) titer
0%
Erythrocyte sedimentation rate (ESR)
Maxemo EMREE 26-27
A 9 y/o girl presents with migratory polyarthritis and painless subcutaneous nodules. Which laboratory test provides the essential evidence to confirm the underlying diagnosis?
💡 EXPLANATION:
The clinical presentation suggests acute rheumatic fever. To fulfill the Jones criteria, evidence of a preceding Group A Streptococcal infection is required, typically confirmed by an elevated Anti-streptolysin O (ASO) titer.
A 9-mo infant presents with 10% dehydration, doughy skin, and a high-pitched cry. Labs reveal Na 155 mmol/L and K 2.3 mmol/L. What is the most likely diagnosis?
Anonymous Quiz
90%
Hypernatremic dehydration
5%
Hyponatremic dehydration
0%
Isotonic dehydration
5%
Hypokalemic alkalosis
Maxemo EMREE 26-27
A 9-mo infant presents with 10% dehydration, doughy skin, and a high-pitched cry. Labs reveal Na 155 mmol/L and K 2.3 mmol/L. What is the most likely diagnosis?
💡 EXPLANATION:
Doughy skin, high-pitched cry, and Na > 150 mmol/L indicate hypernatremic dehydration. This occurs when water loss exceeds sodium loss, leading to a concentrated extracellular compartment.
A macrosomic neonate born to a diabetic mother is found to have a blood glucose level of 2.2 mmol/L. What is the most appropriate next step in management?
Anonymous Quiz
25%
Reassure and observe the neonate
45%
Initiate enteral feeding and recheck
25%
Administer intravenous 50% dextrose
5%
Administer intramuscular glucagon
Maxemo EMREE 26-27
A macrosomic neonate born to a diabetic mother is found to have a blood glucose level of 2.2 mmol/L. What is the most appropriate next step in management?
💡 EXPLANATION:
Neonatal hypoglycemia (glucose < 2.6 mmol/L) in infants of diabetic mothers requires immediate intervention to prevent brain injury. Enteral feeding is the appropriate first step for asymptomatic neonates, followed by rechecking.