Maxemo EMREE 26-27
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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
17%
Primary aldosteronism
50%
Renovascular hypertension
8%
Cushing syndrome
25%
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.
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Maxemo EMREE 26-27
The underlying pathophysiology of iron deficiency anemia involves:
💡 EXPLANATION:
Iron is essential for heme synthesis. Deficiency leads to reduced hemoglobin production and microcytic hypochromic red blood cells.
A stable 30-year-old woman with pain and bleeding at 8 weeks amenorrhea has ultrasound evidence of a right adnexal mass and no intrauterine pregnancy. Beta hCG is 1200. What is the most appropriate management?
Anonymous Quiz
33%
Administer methotrexate
67%
Repeat beta hCG in 48 hours
0%
Laparoscopic salpingectomy
0%
Expectant management
Maxemo EMREE 26-27
A stable 30-year-old woman with pain and bleeding at 8 weeks amenorrhea has ultrasound evidence of a right adnexal mass and no intrauterine pregnancy. Beta hCG is 1200. What is the most appropriate management?
💡 EXPLANATION:
This is a confirmed ectopic pregnancy meeting criteria for medical management with methotrexate due to hemodynamic stability, low beta hCG level, and small adnexal mass.
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A patient with Graves disease develops a subtle high frequency tremor of the outstretched hands. This finding represents which complication?
Anonymous Quiz
29%
Coarse tremor
14%
Pretibial myxedema
14%
Exophthalmos
43%
Fine tremor
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
0%
Papillary muscle rupture
40%
Right ventricular infarction
0%
Ventricular free wall rupture
60%
Cardiogenic shock from left ventricular failure
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.