MDS PREP
What is the typical age of onset for Huntington's disease?
(1) Childhood
(2) Fourth or fifth decade
(3) Seventh or eighth decade
(4) Second or third decade
Huntington's disease typically begins in the fourth or fifth decade of life. It is an autosomal dominant disorder that affects both men and women, and the symptoms include chorea, behavioral disturbances, and cognitive decline. While there is a wide range in age of onset, the average age of symptom manifestation is around 30 to 50 years.
What is the typical age of onset for increased risk of coronary heart disease in women?
1) ? 45 years
2) ? 55 years
3) ? 65 years
4) ? 75 years
Women are generally protected from coronary heart disease by estrogen before menopause, which is why the increased risk typically starts later at the age of 55 years.
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.
What is the most commonly damaged heart valve in rheumatic heart disease?
1) Aortic valve
2) Mitral valve
3) Tricuspid valve
4) Pulmonary valve
Rheumatic heart disease is most commonly associated with damage to the mitral valve, which is situated between the left atrium and left ventricle of the heart.
A patient with a history of heart failure is prescribed digoxin. Which of the following is a common side effect of digoxin therapy?
(1) Hypertension
(2) Hyperkalemia
(3) Hypokalemia
(4) Hypercalcemia
Digoxin can cause hyperkalemia due to its effect on sodium-potassium ATPase pumps in cardiac cells, leading to increased intracellular sodium and decreased intracellular potassium. However, it is important to note that digoxin can also cause arrhythmias in the presence of high serum potassium levels.
The drug of choice for the treatment of tuberculous meningitis is:
1) Rifampicin
2) Isoniazid
3) Streptomycin
4) Gentamicin
Rifampicin is a first-line drug for the treatment of tuberculous meningitis. It has excellent penetration into the cerebrospinal fluid and is bactericidal. Isoniazid and ethambutol are also commonly used as part of a multi-drug regimen, but rifampicin is particularly important due to its ability to cross the blood-brain barrier effectively and its rapid bactericidal activity against Mycobacterium tuberculosis.
A 65-year-old male with a history of hypertension is admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD). His current medication includes metoprolol. Which of the following is a possible adverse effect of metoprolol that could be relevant to his condition?
(1) Bronchospasm
(2) Peripheral edema
(3) Bradycardia
(4) Tachycardia
Metoprolol is a beta-blocker, which can cause bronchospasm as a side effect, particularly in patients with a history of respiratory conditions like asthma or COPD. It is important to monitor patients with respiratory diseases closely for signs of bronchospasm when prescribing beta-blockers.
A 50-year-old male patient with a history of type 2 diabetes mellitus presents to the emergency department with severe abdominal pain and altered mental status. His blood glucose level is 30 mg/dL. What is the most appropriate initial treatment for his hypoglycemia?
(1) 1 mg glucagon IM
(2) 50 ml of 50% glucose solution IV
(3) 100 ml of 5% dextrose solution IV
(4) 500 ml of normal saline IV
In an unconscious patient, it is best to administer glucagon IM which can quickly raise blood glucose levels by mobilizing glycogen stores in the liver. Oral glucose cannot be given due to the patient's altered mental state.