MDS PREP
A 30-year-old male presents with a history of recurrent fever, chills, and pain in the right iliac fossa. His urinalysis is normal. His blood tests reveal leukocytosis and an elevated ESR. An ultrasound shows a right sided mass. Which of the following is the most likely diagnosis?
1) Pyelonephritis
2) Crohn's disease
3) Tubo-ovarian abscess
4) Appendicitis
The combination of fever, chills, and right iliac fossa pain with a pelvic mass and leukocytosis is most indicative of a tubo-ovarian abscess. This condition is often a complication of pelvic inflammatory disease, which can be caused by a variety of bacterial pathogens including sexually transmitted infections.
What is the principal cause of megaloblastic anemia other than vitamin B12 deficiency?
1) Folate deficiency
2) Iron deficiency
3) Vitamin A deficiency
4) Vitamin C deficiency
Megaloblastic anemia can be caused by either folate or vitamin B12 deficiency. Both of these nutrients are essential for DNA synthesis and cell division in the bone marrow.
What is the first step in the activation of vitamin D3 in the body?
1) Liver hydroxylation to calcidiol
2) Kidney hydroxylation to calcitriol
3) Skin synthesis from 7-dehydrocholesterol
4) Intestinal absorption with bile salts
The initial activation of vitamin D3 begins with its synthesis from 7-dehydrocholesterol in the skin when exposed to UV light.
What is the typical serum albumin level seen in the nephrotic syndrome?
1) > 4 g/dL
2) 3.0-3.5 g/dL
3) < 3.0 g/dL
4) 2.0-2.5 g/dL
The nephrotic syndrome is characterized by hypoalbuminemia, with serum albumin levels typically less than 3 g/dL due to the loss of albumin in the urine.
In a patient with hyperparathyroidism, which of the following is a late and irreversible complication of hypercalcemia?
1) Renal calculi
2) Nephrogenic diabetes insipidus
3) Osteoporosis
4) Cardiac arrhythmias
While hypercalcemia can cause nephrogenic diabetes insipidus and cardiac arrhythmias, these are usually reversible with correction of calcium levels. Osteoporosis, on the other hand, is a late complication resulting from long-standing increased bone resorption and decreased bone density.
Bronchiectasis is most common in which lobe
1) Right upper lobe
2) Right middle lobe
3) Left upper lobe
4) Left lower lobe
General Medicine
Answer: 4
Bronchiectasis is most common in the left lower lobe
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 primary mechanism of action of nitroglycerin in the treatment of angina pectoris is:
1) Dilatation of coronary arteries
2) Decreased cardiac contractility
3) Increased cardiac output
4) Decreased systemic vascular resistance
Nitroglycerin is a vasodilator that primarily acts by relaxing vascular smooth muscles, which leads to dilatation of coronary arteries.