MDS PREP
Which of the following is a characteristic of pulmonary embolism?
1) Absent breath sounds
2) Hyperinflated lungs
3) Pleural friction rub
4) Wheezing
Pulmonary embolism is often associated with the sudden onset of absent or diminished breath sounds on the affected side of the chest due to the obstruction of a pulmonary artery by a blood clot.
What is the primary prevention strategy for pulmonary embolism in patients with heart failure and atrial fibrillation?
(1) Antiplatelet therapy
(2) Anticoagulation therapy with warfarin
(3) Physical prophylaxis with compression stockings
(4) Thrombolytic therapy
Patients with heart failure and atrial fibrillation are at high risk for pulmonary embolism due to venous thrombosis and intra-cardiac thrombus formation. The primary prevention strategy for these patients is anticoagulation therapy with warfarin, as it reduces the risk of thrombus formation and embolization. Warfarin is effective in preventing stroke and systemic embolism in patients with non-valvular atrial fibrillation and is also beneficial in the context of heart failure.
What is the typical age of onset for the increased risk of coronary heart disease in men?
1) ? 45 years
2) ? 55 years
3) ? 65 years
4) ? 75 years
Men generally have an earlier onset of coronary heart disease compared to women, and the risk increases significantly after the age of 45.
A 35-year-old male comes to the clinic complaining of fever and malaise. Blood tests reveal a positive reaction to a tuberculin skin test. What is the most likely diagnosis?
(1) Active tuberculosis (TB)
(2) Latent TB infection
(3) BCG vaccine failure
(4) TB meningitis
A positive tuberculin skin test indicates a past exposure to TB bacteria, which has led to the development of an immune response. Latent TB infection is asymptomatic and does not imply active disease. Further tests are needed to rule out active TB.
A patient presents with symptoms of chronic obstructive pulmonary disease (COPD). The physician suspects the presence of emphysema.
Which of the following conditions is likely to cause pulsus paradoxus in this patient?
(1) Pneumothorax
(2) Pleural effusion
(3) Emphysema/Asthma
(4) Cor pulmonale
Pulsus paradoxus is an exaggerated decrease in systolic blood pressure during inspiration, which can occur in patients with airflow obstruction conditions such as emphysema and asthma. These conditions can lead to increased intrathoracic pressure swings during respiration, which affects the cardiac output and arterial pulse amplitude.
A patient with severe nausea and vomiting is prescribed metoclopramide. What is the primary mechanism of action of metoclopramide?
(1) Antihistaminic action
(2) Dopamine antagonism in the CNS
(3) Muscarinic receptor antagonism
(4) 5-HT3 receptor antagonism
Metoclopramide acts primarily as a dopamine D2 receptor antagonist in the chemoreceptive trigger zone in the brain and in the gastrointestinal tract, which helps to reduce nausea and vomiting by decreasing gastric emptying and increasing gastric tone.
A patient with type 2 diabetes mellitus is prescribed glimepiride. What is the primary mechanism of action of glimepiride?
(1) Stimulation of insulin secretion
(2) Inhibition of insulin secretion
(3) Increased peripheral glucose utilization
(4) Inhibition of gluconeogenesis
Glimepiride is a sulfonylurea medication that stimulates insulin secretion from pancreatic beta cells by closing ATP-sensitive potassium channels and causing depolarization, leading to calcium influx and insulin release.
What is the common mode of action of antifungal agents like nystatin and clotrimazole in treating oral candidiasis?
(1) Binding to bacterial cell walls
(2) Inhibition of bacterial protein synthesis
(3) Inhibition of fungal ergosterol synthesis
(4) Inhibition of fungal DNA synthesis
Nystatin and clotrimazole work by binding to ergosterol in the fungal cell membrane, increasing permeability and allowing the leakage of intracellular components. This leads to the death of the affected fungal cell.