MDS PREP
What is the most common cause of primary adrenal insufficiency (Addison's disease) in developing countries?
1) Tuberculosis
2) Autoimmune diseases
3) Adrenal hemorrhage
4) Adrenal cancer
In developing countries, the most common cause of primary adrenal insufficiency is tuberculosis, due to its higher prevalence and ability to spread to various organs, including the adrenal glands.
What is the primary mechanism of action of antihistamines in the management of anaphylaxis?
1) Blocking the release of mediators from mast cells
2) Directly counteracting the effects of histamine on H1 receptors
3) Acting on beta-2 adrenergic receptors to dilate bronchioles
4) Inhibiting the production of leukotrienes and prostaglandins
Antihistamines, particularly H1 blockers, are used to counteract the vasodilatory and bronchoconstrictive effects of histamine in anaphylaxis.
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.
Which of the following is NOT a complication of chronic kidney disease?
1) Hypertension
2) Anemia
3) Hyperkalemia
4) Hypernatremia
Chronic kidney disease can lead to hypertension, anemia, and hyperkalemia due to impaired renal function. However, hypernatremia is typically associated with decreased water intake or increased water loss, not increased sodium levels.
Alpha antitrypism deficiency causes
1) Centrilobular emphysema
2) Panacinar emphysema
3) Lung cysts
4) Bronchiectasis
General Medicine
Answer: 2
Alpha antitrypism deficiency causes panacinar emphysema
What is the most common serotype of Enterohemorrhagic E. coli (EHEC) associated with outbreaks in developed countries?
1) O157:H7
2) O104:H4
3) O26:H11
4) O111:H8
E. coli O157:H7 is the most commonly identified serotype of EHEC and is associated with outbreaks related to the consumption of inadequately cooked ground beef, milk, and vegetables. It produces Shiga-like toxins, which can cause hemolytic uremic syndrome.
What gene is commonly associated with Peutz-Jeghers syndrome?
1) APC
2) LKB1/STK11
3) MUTYH
4) TP53
Peutz-Jeghers syndrome is associated with mutations in the LKB1/STK11 gene. This autosomal dominant disorder is characterized by gastrointestinal hamartomatous polyps and mucocutaneous hyperpigmentation, and it increases the risk of various malignancies.
What is the primary diagnostic difference between constitutional delay of growth and growth hormone deficiency?
1) Family history
2) Epiphyseal development
3) Birth weight and height
4) GH receptor sensitivity
Constitutional delay of growth is characterized by a positive family history of late maturation, while growth hormone deficiency typically is not associated with such a family pattern.