MDS PREP
A patient with known sickle cell anemia presents with severe pain in the left upper quadrant of the abdomen. His white blood cell count is elevated, and his ultrasound shows a dilated gallbladder with multiple gallstones. Which of the following is the most appropriate initial treatment?
1) Antibiotics
2) Hydration and analgesics
3) Surgical cholecystectomy
4) Endoscopic retrograde cholangiopancreatography (ERCP)
In a patient with sickle cell anemia and symptoms of biliary colic, the most likely diagnosis is cholelithiasis due to the increased incidence of gallstone formation in this population. Initial management should focus on hydration and pain relief with analgesics, as surgery is typically reserved for cases of cholecystitis or pancreatitis.
What is the most common site for hydatid cyst formation in humans?
1) Brain
2) Lung
3) Liver
4) Spleen
Hydatid disease, caused by Echinococcus granulosus, primarily affects the liver in approximately 70% of cases. This is because the ova ingested by humans are carried to the liver via the portal venous system, where they are trapped and develop into cysts.
A patient with a history of liver cirrhosis develops a hemorrhagic tendency. Which coagulation factor is likely to be deficient?
1) Factor I (Fibrinogen)
2) Factor II (Prothrombin)
3) Factor V
4) Factor VIII
In liver disease, especially cirrhosis, there is a decrease in hepatic synthesis of clotting factors, particularly factor II (prothrombin). Vitamin K deficiency is also common in liver disease, which further contributes to hypoprothrombinemia. The deficiency of fibrinogen (factor I) would also result in a bleeding diathesis but is less common in liver disease. Factors V and VIII are also synthesized in the liver but are less frequently affected than factor II in such cases.
A 60-year-old male with a history of hypertension and diabetes mellitus presents with sudden onset of severe headache, neck stiffness, and photophobia. His CSF analysis shows a high white blood cell count with a predominance of neutrophils and a low glucose level. Which of the following is the most likely diagnosis?
1) Bacterial meningitis
2) Viral meningitis
3) Tuberculous meningitis
4) Fungal meningitis
The sudden onset of symptoms, along with neck stiffness and photophobia, suggests meningitis. The CSF findings of a high white blood cell count with a predominance of neutrophils and low glucose are more indicative of bacterial meningitis, as this pattern is less common in viral or fungal meningitis.
A 20-year-old female presents with a two-day history of fever, sore throat, and a fine, macular rash that appears more prominent on her palms and soles. Which of the following is the most likely diagnosis?
1) Measles
2) Scarlet fever
3) Rubella
4) Mononucleosis
The combination of fever, sore throat, and a fine, macular rash that is more prominent on the palms and soles is characteristic of scarlet fever.
Most common symptom of pulmonary embolism
1) Chest pain
2) Dyspnoea
3) Haemoptysis
4) Cough
General Medicine
Answer: 2
The most common symptom of pulmonary embolism is dyspnoea
A patient with chronic kidney disease is found to have a serum uric acid level of 8.0 mg/dL. This is most likely due to:
1) Excessive dietary purine intake
2) Decreased glomerular filtration rate
3) Excessive lactate production
4) Impaired tubular secretion of uric acid
Chronic kidney disease can lead to hyperuricemia due to decreased glomerular filtration rate, resulting in decreased excretion of uric acid by the kidneys.
What is the most common non-CNS manifestation of Wilson’s disease?
1) Hepatic cirrhosis
2) Cardiac dysfunction
3) Pancreatitis
4) Arthritis
While CNS manifestations are prominent in Wilson’s disease, hepatic cirrhosis is the most common non-CNS manifestation. It occurs due to the deposition of copper in the liver, leading to chronic liver damage.