MDS PREP
A 50-year-old male with a history of type 2 diabetes mellitus presents with sudden onset of severe, painful, and reddened skin on the dorsum of his foot. His blood glucose is 350 mg/dL. Which of the following is the most likely diagnosis?
1) Cellulitis
2) Diabetic neuropathic ulcer
3) Pyoderma gangrenosum
4) Erythema multiforme
The sudden onset of pain, redness, and swelling of the skin, particularly in a patient with poorly controlled diabetes, suggests a bacterial infection such as cellulitis.
A 45-year-old male presents with sudden onset of severe abdominal pain, distension, and constipation. His abdomen is rigid and tender, with hypoactive bowel sounds. An abdominal X-ray shows dilated loops of bowel with air-fluid levels. Which of the following is the most likely diagnosis?
1) Small bowel obstruction
2) Large bowel obstruction
3) Paralytic ileus
4) Mesenteric ischemia
The sudden onset of pain, abdominal distension, and constipation with the presence of dilated loops of bowel and air-fluid levels on X-ray are indicative of small bowel obstruction.
What is the primary treatment for hypertension in the nephrotic syndrome?
1) Diuretics
2) Corticosteroids
3) Angiotensin-converting enzyme (ACE) inhibitors
4) Antihypertensive medications
ACE inhibitors are the primary treatment for hypertension in the nephrotic syndrome as they help reduce proteinuria, decrease intraglomerular pressure, and preserve renal function by blocking the angiotensin-aldosterone system.
A 55-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents with increasing shortness of breath and cough with greenish sputum. His chest X-ray shows consolidation in the right middle lobe. Which of the following is the most likely pathogen?
1) Streptococcus pneumoniae
2) Haemophilus influenzae
3) Mycoplasma pneumoniae
4) Legionella pneumophila
In a patient with COPD presenting with community-acquired pneumonia, the most common bacterial pathogen is Streptococcus pneumoniae. The consolidation on chest X-ray and the presence of purulent sputum are characteristic features of bacterial pneumonia.
A patient with a deficiency of which coagulation factor will have a prolonged PT and a normal aPTT?
1) Factor II
2) Factor V
3) Factor X
4) Factor XII
Factor II (prothrombin) deficiency leads to a prolonged PT (Prothrombin Time) because it is involved in the extrinsic pathway of the coagulation cascade, which is assessed by the PT test. The aPTT (activated Partial Thromboplastin Time) is normal because the intrinsic pathway is not affected.
In a patient with hyperparathyroidism, which of the following is NOT a feature of osteoporosis?
1) Decreased bone density
2) Increased bone turnover
3) Increased risk of fractures
4) Decreased bone resorption
Hyperparathyroidism typically leads to increased bone resorption due to the actions of PTH, which can result in osteoporosis characterized by decreased bone density and increased risk of fractures despite increased bone turnover.
Which of the following is true regarding the Glasgow Coma Scale (GCS)?
1) It is used primarily to assess the severity of spinal injuries.
2) It assesses only motor function.
3) It is not applicable in patients with head injuries.
4) It evaluates eye opening, verbal response, and motor activity.
The Glasgow Coma Scale (GCS) is widely used to assess the severity of coma or impaired consciousness, particularly in patients with head injuries.
In which of the following conditions is nephrotic syndrome characterized by the presence of fibrin in the glomerulus?
1) Membranoproliferative glomerulonephritis
2) Minimal-change disease
3) Focal segmental glomerulosclerosis
4) Membranous nephropathy
Membranoproliferative glomerulonephritis is characterized by the deposition of immune complexes in the glomerular basement membrane and mesangium, leading to proliferation of mesangial cells and the formation of a dense, double-contour appearance. This can result in the deposition of fibrin in the glomerulus.