Maxemo EMREE 26-27
A 10-month-old infant presents after a 3-minute generalized tonic-clonic seizure associated with a fever of 39°C. The child is currently alert and neurologically intact. What is the most appropriate management?
💡 EXPLANATION:
This is a simple febrile seizure (generalized, <15 mins, no recurrence in 24h). Since the infant is neurologically normal, routine EEG, lumbar puncture, or daily antiepileptic prophylaxis are not indicated. Reassurance is the best step.
A 7 y/o boy presents with brief staring spells lasting 10 seconds. He resumes normal activity immediately with no postictal confusion. What is the most likely diagnosis?
Anonymous Quiz
5%
Focal impaired awareness seizure
80%
Absence seizure
5%
Juvenile myoclonic epilepsy
10%
Lennox-Gastaut syndrome
Maxemo EMREE 26-27
A 7 y/o boy presents with brief staring spells lasting 10 seconds. He resumes normal activity immediately with no postictal confusion. What is the most likely diagnosis?
💡 EXPLANATION:
Absence seizures present with brief staring spells and no postictal confusion. Typical EEG shows a 3 Hz spike-and-wave pattern. First-line treatment is ethosuximide.
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🔬 Today's Test: CARDIOLOGY
👉 https://app.maxemo.app/s/dft-emree
Yesterday's Ranks🏆
BIOSTATISTICS
1. Reyansh Malhotra
2. Samer
3. Mohammed Aramin
4. anjali
5. rky_07
6. Faizan
7. Silverlin
8. Rahul_md
9. Cipher_
10. Samyak99
⏳ Test Ends at 07:00 PM
Join channel 👇
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❤2
A 6 y/o boy presents with progressive proximal muscle weakness, difficulty rising from the floor (Gowers sign), and calf pseudohypertrophy. Which of the following proteins is most likely defective in this condition?
Anonymous Quiz
89%
Dystrophin
6%
Fibrillin-1
6%
Type I collagen
0%
Alpha-dystroglycan
Maxemo EMREE 26-27
A 6 y/o boy presents with progressive proximal muscle weakness, difficulty rising from the floor (Gowers sign), and calf pseudohypertrophy. Which of the following proteins is most likely defective in this condition?
💡 EXPLANATION:
The child has Duchenne muscular dystrophy, an X-linked recessive disorder caused by a frameshift mutation in the dystrophin gene. The absent dystrophin leads to progressive myonecrosis, proximal weakness, and elevated CK levels.
A 10-month-old infant presents with fever, cough, coryza, and conjunctivitis. Examination reveals small white spots on the buccal mucosa and a maculopapular rash starting on the face. What is the most likely diagnosis?
Anonymous Quiz
11%
Rubella
78%
Measles
11%
Roseola infantum
0%
Erythema infectiosum
Maxemo EMREE 26-27
A 10-month-old infant presents with fever, cough, coryza, and conjunctivitis. Examination reveals small white spots on the buccal mucosa and a maculopapular rash starting on the face. What is the most likely diagnosis?
💡 EXPLANATION:
The presentation of fever, cough, coryza, conjunctivitis (3 Cs), and pathognomonic Koplik spots strongly indicates measles. Management is supportive and includes Vitamin A supplementation.
A 32 y/o F with Graves disease on methimazole presents with fever (40.8 C) and sore throat. Labs show WBC 3.2 x 10^9/L with 8% neutrophils. What is the most appropriate immediate next step in management?
Anonymous Quiz
13%
Start empirical oral antibiotics
13%
Decrease the methimazole dose
31%
Switch to propylthiouracil
44%
Discontinue methimazole
Maxemo EMREE 26-27
A 32 y/o F with Graves disease on methimazole presents with fever (40.8 C) and sore throat. Labs show WBC 3.2 x 10^9/L with 8% neutrophils. What is the most appropriate immediate next step in management?
💡 EXPLANATION:
Fever and sore throat in a patient on methimazole with severe neutropenia indicates drug-induced agranulocytosis. The immediate management requires stopping the offending medication to prevent fatal immunosuppression.
A 20 y/o F with Type 1 diabetes presents with altered mental status. Labs: glucose 66.6 mmol/L, HCO3 2 mmol/L, K 5.0 mmol/L. She is on trimethoprim-sulfamethoxazole for a UTI. What best explains her serum potassium level?
Anonymous Quiz
8%
Decreased renal excretion from trimethoprim
85%
Extracellular shift due to insulin deficiency
8%
True total body potassium excess
0%
Cellular release secondary to hemolysis
Maxemo EMREE 26-27
A 20 y/o F with Type 1 diabetes presents with altered mental status. Labs: glucose 66.6 mmol/L, HCO3 2 mmol/L, K 5.0 mmol/L. She is on trimethoprim-sulfamethoxazole for a UTI. What best explains her serum potassium level?
💡 EXPLANATION:
In DKA, profound insulin deficiency and acidosis cause potassium to shift extracellularly, resulting in normal or high serum potassium despite severe total-body potassium depletion from osmotic diuresis.
A 46 y/o F presents with hypertension and recurrent kidney stones. Labs: Calcium 2.8 mmol/L, Phosphorus 0.7 mmol/L, PTH 890 pg/mL. Urine calcium is high. What is the most appropriate next step in management?
Anonymous Quiz
25%
Start oral bisphosphonates
25%
Prescribe thiazide diuretics
42%
Schedule parathyroidectomy
8%
Recommend calcium restriction
Maxemo EMREE 26-27
A 46 y/o F presents with hypertension and recurrent kidney stones. Labs: Calcium 2.8 mmol/L, Phosphorus 0.7 mmol/L, PTH 890 pg/mL. Urine calcium is high. What is the most appropriate next step in management?
💡 EXPLANATION:
Primary hyperparathyroidism (hypercalcemia, hypophosphatemia, elevated PTH) presenting with symptomatic kidney stones is a clear clinical indication for definitive surgical treatment with a parathyroidectomy.
A 40 y/o woman has a seizure 2 days after severe postpartum hemorrhage. She cannot lactate. BP 101/61 mmHg, glucose 2.0 mmol/L. What is the most likely underlying mechanism?
Anonymous Quiz
13%
Autoimmune destruction of the pituitary
31%
Hemorrhagic infarction of an adenoma
6%
Metastatic infiltration of the gland
50%
Ischemic necrosis of the pituitary gland
Maxemo EMREE 26-27
A 40 y/o woman has a seizure 2 days after severe postpartum hemorrhage. She cannot lactate. BP 101/61 mmHg, glucose 2.0 mmol/L. What is the most likely underlying mechanism?
💡 EXPLANATION:
Sheehan syndrome occurs due to severe postpartum hemorrhage causing hypoperfusion and ischemic necrosis of the pituitary gland. This panhypopituitarism presents with failure to lactate and secondary adrenal insufficiency (hypoglycemia, hypotension).
A 57 y/o F with a history of IV drug use presents with a DVT. Labs show elevated creatinine (150 µmol/L) and low total calcium (1.4 mmol/L). What is the most likely underlying mechanism for her hypercoagulable state?
Anonymous Quiz
13%
Factor V Leiden mutation
7%
Antiphospholipid antibodies
20%
Decreased hepatic synthesis of Protein C
60%
Urinary loss of antithrombin III
Maxemo EMREE 26-27
A 57 y/o F with a history of IV drug use presents with a DVT. Labs show elevated creatinine (150 µmol/L) and low total calcium (1.4 mmol/L). What is the most likely underlying mechanism for her hypercoagulable state?
💡 EXPLANATION:
IV drug use can cause nephropathy. The low total calcium reflects severe hypoalbuminemia seen in nephrotic syndrome. The hypercoagulable state is driven by excessive urinary loss of anticoagulant proteins, specifically antithrombin III.
A 17 y/o F weightlifter presents with primary amenorrhea. She has new unilateral pulsating headaches and nausea. Exam shows normal breast/pubic hair and normal pelvis. BP 137/90 mmHg, HR 98/min. Urine hCG is negative. Most likely diagnosis?
Anonymous Quiz
6%
Prolactinoma
6%
Mullerian agenesis
0%
Polycystic ovary syndrome
89%
Functional hypothalamic amenorrhea