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
13%
Furunculosis
0%
Acne conglobata
69%
Hidradenitis suppurativa
19%
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 👇
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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
7%
Hypocalcemia
87%
Insulin resistance
7%
Hyperuricemia
0%
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
19%
Primary hyperparathyroidism
75%
Occult malignancy
6%
Vitamin D toxicity
0%
Thiazide-induced hypercalcemia
Maxemo EMREE 26-27
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?
💡 EXPLANATION:
Severe hypercalcemia with suppressed PTH and significant weight loss in an elderly patient strongly indicates a PTH-independent cause, most commonly an occult malignancy producing PTH-related peptide (PTHrP).
A 65M with diaphoresis presents with 2 hours of substernal chest pain. His ECG shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis?
Anonymous Quiz
11%
Anterior wall myocardial infarction
89%
Inferior wall myocardial infarction
0%
Lateral wall myocardial infarction
0%
Acute pericarditis
Maxemo EMREE 26-27
A 65M with diaphoresis presents with 2 hours of substernal chest pain. His ECG shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis?
💡 EXPLANATION:
ST elevation in leads II, III, and aVF localizes the infarct to the inferior wall of the heart. Anterior MI involves V1 to V4, lateral MI involves leads I, aVL, V5, and V6, and acute pericarditis typically causes diffuse ST elevation.
A child presents with a bright red rash on both cheeks giving a classic slapped cheek appearance. What is the most likely diagnosis?
Anonymous Quiz
62%
Erythema infectiosum
33%
Scarlet fever
5%
Measles
0%
Rubella
Maxemo EMREE 26-27
A child presents with a bright red rash on both cheeks giving a classic slapped cheek appearance. What is the most likely diagnosis?
💡 EXPLANATION:
Erythema infectiosum, also called fifth disease, is caused by parvovirus B19. The characteristic slapped cheek rash is pathognomonic.
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Labs show TSH 14 mIU per L and free T4 0.5 ng per dL. No goiter is palpated. What is the most appropriate next step?
Anonymous Quiz
47%
Start levothyroxine therapy
16%
Repeat TSH and free T4 in 4 weeks
11%
Order a thyroid ultrasound
26%
Check for anti TPO antibodies
Maxemo EMREE 26-27
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Labs show TSH 14 mIU per L and free T4 0.5 ng per dL. No goiter is palpated. What is the most appropriate next step?
💡 EXPLANATION:
The patient has overt primary hypothyroidism with both clinical features and biochemical confirmation. Immediate treatment with levothyroxine is indicated. Further testing can be done later but should not delay therapy.
Postoperative fever and confusion in an elderly patient with an indwelling urinary catheter is most indicative of which condition?
Anonymous Quiz
11%
Atelectasis
84%
Urosepsis
5%
Surgical site infection
0%
Anastomotic leak
Maxemo EMREE 26-27
Postoperative fever and confusion in an elderly patient with an indwelling urinary catheter is most indicative of which condition?
💡 EXPLANATION:
In an elderly catheterized patient, fever with delirium strongly suggests urinary tract infection progressing to urosepsis. This corresponds to the water category in postoperative fever causes.
What is the primary mechanism of action of spironolactone?
Anonymous Quiz
5%
Beta adrenergic receptor blockade
25%
Inhibition of the sodium potassium chloride symporter
70%
Aldosterone receptor antagonism in the collecting ducts
0%
Angiotensin converting enzyme inhibition
Maxemo EMREE 26-27
What is the primary mechanism of action of spironolactone?
💡 EXPLANATION:
Spironolactone is a potassium sparing diuretic that competitively antagonizes aldosterone receptors in the distal nephron, reducing sodium reabsorption and potassium excretion.
A 55M with resistant hypertension, carotid bruits, and peripheral artery disease has hypokalemia and elevated plasma renin activity. These findings are most consistent with which condition?
Anonymous Quiz
30%
Primary aldosteronism
50%
Renovascular hypertension
5%
Cushing syndrome
15%
Pheochromocytoma
Maxemo EMREE 26-27
A 55M with resistant hypertension, carotid bruits, and peripheral artery disease has hypokalemia and elevated plasma renin activity. These findings are most consistent with which condition?
💡 EXPLANATION:
Widespread atherosclerosis with resistant hypertension and high renin levels suggests renal artery stenosis causing renovascular hypertension. Primary aldosteronism typically suppresses renin.
The underlying pathophysiology of iron deficiency anemia involves:
Anonymous Quiz
30%
Hepcidin mediated block of iron release from macrophages
4%
Reduced globin chain synthesis
0%
Defective DNA synthesis in erythroblasts
65%
Impaired heme synthesis due to lack of iron