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
Maxemo EMREE 26-27
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?
💡 EXPLANATION:
Functional hypothalamic amenorrhea results from excessive physical stress (intense exercise) suppressing the HPO axis. This causes anovulation and presents as primary or secondary amenorrhea in competitive female athletes.
28 y/o F with Crohn's and BMI 33 presents with tender, discharging nodules and fistulas in the right inframammary fold for 2 months. She has a history of axillary lesions that healed with scarring. What is the most likely diagnosis?
Anonymous Quiz
12%
Furunculosis
0%
Acne conglobata
65%
Hidradenitis suppurativa
24%
Cutaneous Crohn's disease
Maxemo EMREE 26-27
28 y/o F with Crohn's and BMI 33 presents with tender, discharging nodules and fistulas in the right inframammary fold for 2 months. She has a history of axillary lesions that healed with scarring. What is the most likely diagnosis?
💡 EXPLANATION:
Hidradenitis suppurativa is a chronic inflammatory disease causing recurrent nodules, abscesses, and fistulas in intertriginous zones. It heals with scarring and is strongly associated with obesity, insulin resistance, and Crohn's disease.
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🔬 Today's Test: EMERGENCY MEDICINE
👉 https://app.maxemo.app/s/dft-emree
Yesterday's Ranks🏆
CARDIOLOGY
1. Mohammed Aramin
2. UNBOTHERED SOUL
3. Samyak99
4. Aisha
5. Shruti p
6. Silverlin
7. Cipher_
8. Reyansh Malhotra
9. Samer
10. Aysha
⏳ Test Ends at 07:00 PM
Join channel 👇
https://t.me/studywithmaxemoemree
A 37 y/o M with HIV on ART presents with progressive gynecomastia, a buffalo hump, hollowed cheeks, and dyslipidemia. The medication class responsible for this syndrome is most known to induce which metabolic abnormality?
Anonymous Quiz
6%
Hypocalcemia
81%
Insulin resistance
6%
Hyperuricemia
6%
Hypothyroidism
Maxemo EMREE 26-27
A 37 y/o M with HIV on ART presents with progressive gynecomastia, a buffalo hump, hollowed cheeks, and dyslipidemia. The medication class responsible for this syndrome is most known to induce which metabolic abnormality?
💡 EXPLANATION:
Protease inhibitors can cause lipodystrophy syndrome, altering adipocyte function and glucose transporters. This leads to peripheral insulin resistance, hyperglycemia, dyslipidemia, and characteristic fat redistribution.
A 68 y/o M presents with worsening confusion, polyuria, and 7 kg weight loss over 3 weeks. Labs show severe hypercalcemia (Ca2+ 3.05 mmol/L) and a suppressed PTH level (8 pg/mL). What is the most likely cause of his presentation?
Anonymous Quiz
18%
Primary hyperparathyroidism
76%
Occult malignancy
6%
Vitamin D toxicity
0%
Thiazide-induced hypercalcemia