MDS PREP
What is the primary mechanism of action of the heat-stable toxin produced by ETEC?
1) Increases intracellular cAMP
2) Increases intracellular cGMP
3) Induces lipid peroxidation
4) Inhibits DNA synthesis
The heat-stable toxin (ST) of ETEC increases intracellular cGMP, leading to increased fluid and electrolyte secretion into the gut lumen, contributing to the diarrheal illness.
Which of the following is NOT a component of the nephrotic syndrome?
1) Massive proteinuria
2) Hypoalbuminemia
3) Lipiduria
4) Neutrophiluria
The nephrotic syndrome includes massive proteinuria, hypoalbuminemia, generalized edema, and hyperlipidemia with lipiduria. Neutrophiluria, the presence of neutrophils in the urine, is not a typical feature of the nephrotic syndrome and is more associated with conditions like acute glomerulonephritis or pyelonephritis.
Lung involvement in chronic bronchitis is
1) Bilateral
2) Segmental
3) Lobar
4) Unilateral
General Medicine
Answer: 1
Lung involvement in chronic bronchitis is bilateral
Pulsus alternans is
1) An innocuous feature
2) Denotes severe cardiac decompensation
3) Sign of digoxin toxicity
4) Sign of mitral imcompetence
General Medicine
Answer: 4
Pulsus alternans is characterized by alternating strong and weak heartbeats
and is often associated with severe heart conditions, including mitral
incompetence. It indicates significant cardiac dysfunction.
Signs of Pulsus Alternans
Alternating Pulse Amplitude:
The most defining characteristic of pulsus alternans is the
alternating pattern of pulse strength. When palpating the radial pulse,
a healthcare provider will notice that one beat is strong (high
amplitude) and the next is weak (low amplitude).
Irregular Pulse Rhythm:
While the rhythm may appear regular, the variation in amplitude can
create an irregular sensation when palpating the pulse.
Blood Pressure Variability:
Blood pressure readings may also show variability, with alternating
high and low readings corresponding to the strong and weak beats.
Heart Sounds:
On auscultation, the heart sounds may also reflect this alternation,
with variations in the intensity of the heart sounds corresponding to
the pulse amplitude.
Symptoms Associated with Pulsus Alternans
Pulsus alternans itself is a sign rather than a symptom, but it is often
associated with symptoms of underlying cardiac dysfunction, including:
Shortness of Breath (Dyspnea):
Fatigue:
Palpitations:
Patients may report feeling their heart racing or irregular
heartbeats, which can be distressing.
Edema:
Swelling in the legs, ankles, or abdomen may occur due to fluid
retention associated with heart failure.
Chest Pain or Discomfort:
Some patients may experience chest pain or discomfort, particularly
if there is underlying ischemic heart disease.
Cough:
A persistent cough, especially when lying down, may occur due to
pulmonary congestion.
Dizziness or Lightheadedness:
Patients may feel dizzy or lightheaded, particularly when standing
up (orthostatic hypotension) due to fluctuating blood pressure.
What is the most common neurological manifestation of Wilson’s disease?
1) Movement disorders
2) Cognitive impairment
3) Seizures
4) Peripheral neuropathy
Movement disorders, particularly those associated with basal ganglia dysfunction such as dystonia and chorea, are the most common neurological manifestations of Wilson’s disease due to the primary toxic effect on the basal ganglia from copper deposition.
In emphysema, the dilatation occurs
1) Beyond major bronchus
2) In alveolar region
3) Beyond terminal bronchioles
4) Beyond minor bronchus
General Medicine
Answer: 3
In emphysema, the dilatation occurs beyond terminal bronchioles
The most important aspect in treating Disseminated intravascular Coagulation (DIC) is to
1) Administer heparin
2) Administer platelets
3) Treat the underlying disease process
4) Achieve normal levels of fibrinogen
General Medicine
Answer: 3
DIC is a serious condition characterized by the widespread activation of the coagulation cascade, leading to the formation of blood clots throughout the small blood vessels. This can result in organ dysfunction and bleeding. The most critical step in managing DIC is to identify and treat the underlying cause (such as infection, trauma, or malignancy) because addressing the root issue can help resolve the coagulation abnormalities.
What is the primary function of transferrin in the body?
1) Transport of iron
2) Transport of copper
3) Binding and transport of thyroid hormones
4) Lipoprotein assembly
Transferrin is a glycoprotein synthesized by the liver that acts as the primary iron-transport protein in the blood. It binds to iron and transfers it to cells that require it, such as erythrocytes for hemoglobin synthesis.