A patient with Graves disease develops a subtle high frequency tremor of the outstretched hands. This finding represents which complication?
Anonymous Quiz
13%
Coarse tremor
0%
Pretibial myxedema
22%
Exophthalmos
65%
Fine tremor
👍2
Maxemo EMREE 26-27
A patient with Graves disease develops a subtle high frequency tremor of the outstretched hands. This finding represents which complication?
💡 EXPLANATION:
Hyperthyroidism produces an adrenergic state leading to a high frequency low amplitude fine tremor, best seen with hands outstretched.
A patient with an inferior STEMI develops hypotension after nitrates with clear lung fields. What is the most likely cause?
Anonymous Quiz
10%
Papillary muscle rupture
45%
Right ventricular infarction
3%
Ventricular free wall rupture
42%
Cardiogenic shock from left ventricular failure
👍1
Maxemo EMREE 26-27
A patient with an inferior STEMI develops hypotension after nitrates with clear lung fields. What is the most likely cause?
💡 EXPLANATION:
Inferior STEMI may involve the right ventricle. Nitrates reduce preload and can precipitate hypotension in right ventricular infarction. Clear lungs argue against left ventricular failure.
A 45-year-old manager newly diagnosed with diabetes on metformin has persistent polyuria. Labs show absent C-peptide and positive GAD antibodies. What is the most appropriate initial step?
Anonymous Quiz
11%
Add an SGLT2 inhibitor
5%
Increase metformin dose
84%
Stop metformin and initiate insulin therapy
0%
Order abdominal CT scan
Maxemo EMREE 26-27
A 45-year-old manager newly diagnosed with diabetes on metformin has persistent polyuria. Labs show absent C-peptide and positive GAD antibodies. What is the most appropriate initial step?
💡 EXPLANATION:
Absent C-peptide and positive autoantibodies indicate autoimmune diabetes (LADA/type 1). Insulin therapy is mandatory; oral agents are ineffective.
A strong family history of which condition is associated with the highest increased risk for ovarian cancer?
Anonymous Quiz
9%
Cervical cancer
30%
Endometrial cancer
61%
Breast cancer
0%
Uterine fibroids
Maxemo EMREE 26-27
A strong family history of which condition is associated with the highest increased risk for ovarian cancer?
💡 EXPLANATION:
BRCA1 and BRCA2 mutations significantly increase the risk of both breast and ovarian cancers.
What is the primary mechanism of action of eluxadoline?
Anonymous Quiz
15%
Selective 5-HT3 receptor antagonism
46%
Peripheral mu-opioid receptor agonism
0%
Anticholinergic muscarinic blockade
38%
Mixed mu-opioid agonist and delta-opioid antagonist
Maxemo EMREE 26-27
What is the primary mechanism of action of eluxadoline?
💡 EXPLANATION:
Eluxadoline treats IBS-D by reducing gut motility via mu-opioid agonism while limiting adverse effects through delta-opioid antagonism.
An elderly patient presents with splenomegaly, anemia, thrombocytopenia, low alkaline phosphatase, and a blood film showing granulocytes at all stages of maturation. This is most consistent with:
Anonymous Quiz
12%
Acute myeloid leukemia
6%
Leukemoid reaction
71%
Chronic myeloid leukemia
12%
Acute lymphoblastic leukemia
Maxemo EMREE 26-27
An elderly patient presents with splenomegaly, anemia, thrombocytopenia, low alkaline phosphatase, and a blood film showing granulocytes at all stages of maturation. This is most consistent with:
💡 EXPLANATION:
Granulocytes at all stages with splenomegaly and low LAP score are classic for chronic myeloid leukemia.
The underlying pathophysiology of systemic lupus erythematosus involves:
Anonymous Quiz
0%
Fibroblast activation and fibrosis
11%
Anti-CCP antibodies and synovial pannus
89%
Anti-nuclear antibodies and immune complex deposition
0%
IL-23 and IL-17 driven inflammation
Maxemo EMREE 26-27
The underlying pathophysiology of systemic lupus erythematosus involves:
💡 EXPLANATION:
SLE is a type III hypersensitivity disorder characterized by immune complex deposition from anti-nuclear antibodies.
What is the first-line treatment for a healthy 1-year-old with uncomplicated community-acquired pneumonia due to suspected Streptococcus pneumoniae?
Anonymous Quiz
27%
Azithromycin
50%
Amoxicillin
23%
Ceftriaxone
0%
Vancomycin
Maxemo EMREE 26-27
What is the first-line treatment for a healthy 1-year-old with uncomplicated community-acquired pneumonia due to suspected Streptococcus pneumoniae?
💡 EXPLANATION:
High-dose amoxicillin is the first-line treatment for uncomplicated pediatric CAP due to Streptococcus pneumoniae.
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ENDOCRINOLOGY
1. Samira
2. Mohammed Aramin
3. Vivaan Vasudevan
4. Reyansh Malhotra
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A 58-year-old man with long-standing diabetes reports early satiety and vomiting of undigested food hours after meals. This is most likely due to:
Anonymous Quiz
0%
Nephropathy
90%
Gastroparesis
10%
Peripheral neuropathy
0%
Retinopathy
Maxemo EMREE 26-27
A 58-year-old man with long-standing diabetes reports early satiety and vomiting of undigested food hours after meals. This is most likely due to:
💡 EXPLANATION:
Autonomic neuropathy affecting the vagus nerve leads to delayed gastric emptying, known as diabetic gastroparesis.
A 58-year-old man presents with crushing chest pain and ECG shows ST elevation in leads V2 to V4. What is the most critical immediate medication?
Anonymous Quiz
13%
Intravenous nitroglycerin
80%
Chewed aspirin 325 mg
0%
Intravenous metoprolol
7%
Unfractionated heparin bolus