This document contains a series of clinical case summaries presented by Dr. Juan Carlos Díaz Torre. Each case includes background information on a patient's presentation, relevant examination findings, and multiple choice questions related to evaluation and management. The cases cover topics in various medical specialties including pediatrics, internal medicine, neurology, infectious diseases, and surgery.
This document contains a series of multiple choice questions and answers related to an MD entrance exam paper. Some key points covered include:
- Question 1 asks about Thromboxane A2 and the correct answer is that it is not secreted by WBC.
- Question 2 presents a scenario of a car accident survivor developing post-traumatic stress disorder.
- Question 3 indicates that neurocysticercosis usually presents with seizure resistant to antiepileptic drugs.
- Question 4 states that free radicals in the brain are detoxified by superoxide dismutase.
- Question 5 suggests atherosclerosis as the likely cause for fusiform dilatation of the descending aorta in an
This document provides answers and explanations for the AIIMS November 2004 exam. It discusses 24 answers provided for the exam, with 2-4 answers noted as either not marked or doubtful. Readers are encouraged to discuss the answers on online forums. Some answers are still pending updates. The document then provides answers for 33 multiple choice questions related to topics in microbiology, pathology, and other medical subjects, with brief explanations for each answer.
This document contains several clinical case summaries presented as questions with multiple choice answers. The cases cover topics including a patient presenting with hives, a post-surgery complication, a patient with joint swelling and chronic gout, and a pregnant patient with SLE and high blood pressure. For each case, the correct answer is provided to identify the underlying mechanism, appropriate treatment, most likely diagnosis, or best next test.
This document provides the questions and answers from the AIIMS May 11 paper along with some explanations. It contains 43 multiple choice questions from various subject areas related to medicine. For some questions, the document indicates the answer may be doubtful or missing. It also provides additional context and details for some questions to explain the reasoning behind the correct answers.
This document contains 26 multiple choice questions about physiology from an exam. It includes questions about the visual pathway, lateral geniculate nucleus, endothelial cells, pacemaker cells of the heart, temperature regulation, blood flow regulation, oxygen levels during exercise, nerve injury, motor neuron lesions, medical terms, hormone functions, alcohol withdrawal symptoms, thiamine deficiency, and more. The questions are from a review of physiology textbook and include the answers and brief explanations.
This document contains a series of stations from an OSCE (Objective Structured Clinical Examination) in pediatrics. It includes 23 stations testing knowledge of various pediatric conditions through patient scenarios, investigations, images, and smears. For each station, the examinee is asked to identify findings, diagnoses, appropriate tests or management. The stations cover topics like congenital heart disease, meningitis, nephrotic syndrome, diabetes insipidus, Stevens-Johnson syndrome, and various hematologic conditions discernible from blood smears.
This document summarizes a debate between David Baker-For and Heinz Weindl-Against on whether B cells or T cells are the key pathogenic cell in multiple sclerosis (MS). It provides evidence from animal models, response to various MS therapies, and B cell and T cell biology to argue that memory B cells, not T cells, are the primary driver of MS pathology. Graphics show that treatments which reduce memory B cells in the blood correlate with decreased relapse rates and lesions in MS patients. The document concludes that while T cells may facilitate the disease, memory B cells are the main culprit in destroying myelin in MS.
A patient was diagnosed with amebic dysentery based on laboratory analyses showing they had abdominal pain, diarrhea, and a fever after drinking from an open water reservoir in a forest. Metronidazole is the drug of choice for treating amebic dysentery. A woman with seasonal rhinitis was prescribed an antihistamine with no effect on the central nervous system, such as loratadine. Prolonged relaxation of skeletal muscles and inhibited respiration in a patient after receiving the muscle relaxant dithylinum was caused by a lack of butyrylcholinesterase in the blood serum.
This document contains a series of multiple choice questions and answers related to an MD entrance exam paper. Some key points covered include:
- Question 1 asks about Thromboxane A2 and the correct answer is that it is not secreted by WBC.
- Question 2 presents a scenario of a car accident survivor developing post-traumatic stress disorder.
- Question 3 indicates that neurocysticercosis usually presents with seizure resistant to antiepileptic drugs.
- Question 4 states that free radicals in the brain are detoxified by superoxide dismutase.
- Question 5 suggests atherosclerosis as the likely cause for fusiform dilatation of the descending aorta in an
This document provides answers and explanations for the AIIMS November 2004 exam. It discusses 24 answers provided for the exam, with 2-4 answers noted as either not marked or doubtful. Readers are encouraged to discuss the answers on online forums. Some answers are still pending updates. The document then provides answers for 33 multiple choice questions related to topics in microbiology, pathology, and other medical subjects, with brief explanations for each answer.
This document contains several clinical case summaries presented as questions with multiple choice answers. The cases cover topics including a patient presenting with hives, a post-surgery complication, a patient with joint swelling and chronic gout, and a pregnant patient with SLE and high blood pressure. For each case, the correct answer is provided to identify the underlying mechanism, appropriate treatment, most likely diagnosis, or best next test.
This document provides the questions and answers from the AIIMS May 11 paper along with some explanations. It contains 43 multiple choice questions from various subject areas related to medicine. For some questions, the document indicates the answer may be doubtful or missing. It also provides additional context and details for some questions to explain the reasoning behind the correct answers.
This document contains 26 multiple choice questions about physiology from an exam. It includes questions about the visual pathway, lateral geniculate nucleus, endothelial cells, pacemaker cells of the heart, temperature regulation, blood flow regulation, oxygen levels during exercise, nerve injury, motor neuron lesions, medical terms, hormone functions, alcohol withdrawal symptoms, thiamine deficiency, and more. The questions are from a review of physiology textbook and include the answers and brief explanations.
This document contains a series of stations from an OSCE (Objective Structured Clinical Examination) in pediatrics. It includes 23 stations testing knowledge of various pediatric conditions through patient scenarios, investigations, images, and smears. For each station, the examinee is asked to identify findings, diagnoses, appropriate tests or management. The stations cover topics like congenital heart disease, meningitis, nephrotic syndrome, diabetes insipidus, Stevens-Johnson syndrome, and various hematologic conditions discernible from blood smears.
This document summarizes a debate between David Baker-For and Heinz Weindl-Against on whether B cells or T cells are the key pathogenic cell in multiple sclerosis (MS). It provides evidence from animal models, response to various MS therapies, and B cell and T cell biology to argue that memory B cells, not T cells, are the primary driver of MS pathology. Graphics show that treatments which reduce memory B cells in the blood correlate with decreased relapse rates and lesions in MS patients. The document concludes that while T cells may facilitate the disease, memory B cells are the main culprit in destroying myelin in MS.
A patient was diagnosed with amebic dysentery based on laboratory analyses showing they had abdominal pain, diarrhea, and a fever after drinking from an open water reservoir in a forest. Metronidazole is the drug of choice for treating amebic dysentery. A woman with seasonal rhinitis was prescribed an antihistamine with no effect on the central nervous system, such as loratadine. Prolonged relaxation of skeletal muscles and inhibited respiration in a patient after receiving the muscle relaxant dithylinum was caused by a lack of butyrylcholinesterase in the blood serum.
This document summarizes a debate about whether B cells or T cells are the key pathogenic cell in multiple sclerosis (MS). It provides evidence from MS therapies, animal models, and human data that memory B cells may drive MS pathology. Studies show that effective MS treatments like alemtuzumab, rituximab, and ocrelizumab strongly deplete memory B cells and reduce relapse rates. Memory B cell levels are also higher in the cerebrospinal fluid of patients during MS relapses. While T cells outnumber B cells in MS lesions, B cells may have an important role in antigen presentation and driving inflammation. Genetic studies also link MS risk genes to B cell functions. Overall, the document argues that
This document outlines 20 stations for a pediatric OSCE exam, including questions on resuscitation, physical exams, teaching a mother about insulin administration, history taking, reviewing videos, x-rays, EEGs, growth charts, hematology slides, reflex exams, and more. Exam topics assess candidates' abilities in areas such as diagnosis, treatment, clinical findings, drug choices and contraindications, inheritance patterns, and statistical analyses. Stations involve written questions, photographs, videos, and physical exams to comprehensively evaluate pediatric medical knowledge and skills.
This document provides information on organ donation and transplantation. It discusses:
- The history of organ transplantation, including the first successful kidney transplant in 1954 and establishment of organ procurement organizations.
- Types of organ transplants including living donor transplants, deceased donor transplants, and the potential future of xenotransplantation using animal organs.
- The process of organ transplantation including donor and recipient evaluation and screening, surgical procedures, post-operative care, immunosuppression regimens, and complications.
- Key terms related to organ transplantation and the Transplantation of Human Organs Act which regulates organ donation in India.
This document summarizes extrahepatic manifestations that can occur due to hepatitis C virus infection. Some of the most common manifestations mentioned include vasculitis, fatigue, arthralgia-myalgia, and sicca syndrome. The document discusses how HCV can affect multiple organ systems like the skin, nerves, blood cells, and kidneys. It also explores the pathogenesis of conditions like cryoglobulinemia and suggests immune-mediated mechanisms involving B cells, T cells, and cytokines may play a role in extrahepatic disease manifestations from HCV.
Edward R. Cachay, MD, MAS of UC San Diego Owen Clinic presents "When to Consider Neurosurgical Interventions for the Management of Complicated Cryptococcal Meningitis"
Krok 1 - 2015 Question Paper (General medicine)Eneutron
1. The document contains 30 multiple choice questions about various topics in medicine. The questions cover topics like diseases, anatomy, physiology, biochemistry, and microbiology.
2. Many of the questions test knowledge of specific diseases, organs, cells or biological processes. For example, there are questions about glycogen storage diseases, kidney anatomy, muscular dystrophy, auditory system structures, protein biosynthesis, and tuberculosis diagnosis.
3. The questions also cover broader topics like biochemical pathways, hormones, blood components, chromosome abnormalities, infectious diseases, and autopsy findings. Multiple choices are provided for each question.
Cacoub p hcv ehm & inflam pr cacoub du 15 01 15 odeckmyn
This document discusses extrahepatic manifestations associated with chronic hepatitis C virus (HCV) infection. It finds that:
1. Extrahepatic manifestations like vasculitis, arthralgia/myalgia, and autoimmune disorders are a major problem in chronic HCV infection, affecting 5-40%, 25-35%, and 10-40% of patients respectively.
2. Fatigue, depression, and cognitive impairment from HCV infection are also significant, with 50-67% of patients experiencing fatigue and 28% experiencing depression prior to therapy. Sustained virological response is associated with decreased rates of fatigue.
3. Autoimmune disorders are thought to arise from polyclonal or oligoclonal B
The document discusses complement activation and traumatic brain injury. It summarizes several studies that show:
1. Complement proteins like C3 and the membrane attack complex C5b-9 are activated in the border zone of brain contusions in rats and humans following traumatic brain injury.
2. There is local synthesis of complement proteins like C3, and upregulation of the regulator clusterin in response to complement attack on neurons and astroglia.
3. Complement activation occurs endogenously in the injured brain without circulating blood components, as shown in studies using brain slice cultures.
4. Genetic factors influence the inflammatory response and complement activation following TBI, with more pronounced immune reactivity linked
1. Findings in this x-ray: Bilateral coalesced opacities in upper and mid zones.
2. Two important conditions which produce similar findings: Pulmonary tuberculosis, pneumonia.
3. To differentiate radiologically: In tuberculosis, opacities are more dense and cavitation is seen. In pneumonia, opacities are less dense and consolidation is seen.
4. Hematological problems that can occur: Anemia due to chronic disease, thrombocytopenia.
This document summarizes a new protocol for ABO-incompatible kidney transplantation in children that was designed to expand the donor pool. The key aspects of the new protocol are:
1) It utilizes antigen-specific immunoadsorption rather than plasma exchange to remove existing anti-A/B antibodies pre-operatively.
2) It uses rituximab rather than splenectomy to prevent antibody rebound.
3) Ten pediatric patients have been successfully transplanted using this protocol so far with results comparable to ABO-compatible transplants in terms of graft function and adverse events.
Krok 1 - 2008 Question Paper (General medicine)Eneutron
This document contains 31 multiple choice questions related to medicine. The questions cover topics such as: symptoms of different digestive disorders; acid-base balance disorders in infants; complications of medications like aspirin and phenobarbital; laboratory tests and their implications for diseases like diabetes and rheumatism; anatomy and functions of the auditory system; stages of protein biosynthesis; reflexes; and more. The correct answer is listed for each multiple choice question.
The document contains several clinical case summaries presented as questions with multiple choice answers. It discusses cases involving issues like knee pain, respiratory acidosis, Huntington's disease, lupus, lower back pain, and hydronephrosis during pregnancy. For each case, a question is asked to test the reader's knowledge and the most appropriate answer is provided.
Hepatitis C virus (HCV) can cause a variety of extrahepatic manifestations beyond liver disease, including vasculitis, fatigue, arthralgia, sicca syndrome, and autoantibody production. HCV infection of lymphocytes and hepatocytes leads to polyclonal and monoclonal B cell proliferation and autoantibody secretion, resulting in mixed cryoglobulinemia and associated conditions in 5-40% of cases. Treatment with pegylated interferon and ribavirin can improve outcomes of HCV-associated vasculitis by reducing viral load, B cell populations, and increasing regulatory T cells, with rituximab also effective for refractory cases. Liver fibrosis severity and other clinical factors predict prognosis,
This document discusses hepatitis C virus (HCV)-related vasculitis. It begins by noting an abnormal T lymphocyte distribution and Th1 cytokine profile in vasculitis lesions, as well as a deficit in regulatory T lymphocytes. A genome-wide association study found an association between HLA-DRB1/DQA1 and HCV-related vasculitis. Treatment of HCV-vasculitis includes antiviral therapy to achieve sustained virological response, as well as immunosuppressants. Complete clinical response is associated with increased levels of regulatory T cells. Rituximab and low-dose interleukin-2 may also be effective treatments.
A woman is concerned about the risk of her son inheriting haemophilia, as her husband has the disease. The disease is inherited through the X chromosome. As the mother does not have the disease, the risk to sons is 25% of inheriting it, while daughters would be carriers but not affected.
1) Chronic hepatitis C virus infection can cause a variety of extrahepatic manifestations including mixed cryoglobulinemia, a condition where low levels of cryoglobulins in the blood vessel can lead to inflammation.
2) Rituximab, a monoclonal antibody targeting CD20 found on B cells, has shown effectiveness in treating the symptoms of mixed cryoglobulinemia, particularly rashes and kidney involvement.
3) Combining rituximab treatment with pegylated interferon and ribavirin therapy may provide the best chance of achieving both clinical response and viral clearance for patients with mixed cryoglobulinemia caused by chronic hepatitis C infection.
1. The document describes a series of biology questions and multiple choice answers. It includes questions about inheritance patterns, protein synthesis, infectious diseases, and other biology topics.
2. Specific questions addressed include inheritance of a hereditary disease, types of hemophilia inheritance, phenylketonuria genotypes, stages of protein synthesis, malaria-carrying mosquitoes, sickle cell anemia causation, intestinal parasites, and karyotypes associated with medical conditions.
3. The questions cover a wide range of biology subject areas including genetics, infectious diseases, protein synthesis, cell structure and function, and more. The multiple choice answers would allow someone to self-test their knowledge on these topics.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
The document discusses the need for a new sustainable economic model based on collaborative and systemic growth for future generations. It highlights several challenges facing the current economic system such as climate change, resource depletion, and social issues. The author proposes nature-inspired solutions like biomimicry, circular economy models, and tapping into underutilized resources. The key is shifting from individualistic to collaborative intentions and prioritizing immaterial and human values over just material growth.
Este documento describe la práctica 3 que trata de agregar botones de acción en las diapositivas. El documento menciona que la práctica 3 se enfoca en agregar botones de acción en las diapositivas y proporciona el nombre del estudiante que realizó la práctica.
This document summarizes a debate about whether B cells or T cells are the key pathogenic cell in multiple sclerosis (MS). It provides evidence from MS therapies, animal models, and human data that memory B cells may drive MS pathology. Studies show that effective MS treatments like alemtuzumab, rituximab, and ocrelizumab strongly deplete memory B cells and reduce relapse rates. Memory B cell levels are also higher in the cerebrospinal fluid of patients during MS relapses. While T cells outnumber B cells in MS lesions, B cells may have an important role in antigen presentation and driving inflammation. Genetic studies also link MS risk genes to B cell functions. Overall, the document argues that
This document outlines 20 stations for a pediatric OSCE exam, including questions on resuscitation, physical exams, teaching a mother about insulin administration, history taking, reviewing videos, x-rays, EEGs, growth charts, hematology slides, reflex exams, and more. Exam topics assess candidates' abilities in areas such as diagnosis, treatment, clinical findings, drug choices and contraindications, inheritance patterns, and statistical analyses. Stations involve written questions, photographs, videos, and physical exams to comprehensively evaluate pediatric medical knowledge and skills.
This document provides information on organ donation and transplantation. It discusses:
- The history of organ transplantation, including the first successful kidney transplant in 1954 and establishment of organ procurement organizations.
- Types of organ transplants including living donor transplants, deceased donor transplants, and the potential future of xenotransplantation using animal organs.
- The process of organ transplantation including donor and recipient evaluation and screening, surgical procedures, post-operative care, immunosuppression regimens, and complications.
- Key terms related to organ transplantation and the Transplantation of Human Organs Act which regulates organ donation in India.
This document summarizes extrahepatic manifestations that can occur due to hepatitis C virus infection. Some of the most common manifestations mentioned include vasculitis, fatigue, arthralgia-myalgia, and sicca syndrome. The document discusses how HCV can affect multiple organ systems like the skin, nerves, blood cells, and kidneys. It also explores the pathogenesis of conditions like cryoglobulinemia and suggests immune-mediated mechanisms involving B cells, T cells, and cytokines may play a role in extrahepatic disease manifestations from HCV.
Edward R. Cachay, MD, MAS of UC San Diego Owen Clinic presents "When to Consider Neurosurgical Interventions for the Management of Complicated Cryptococcal Meningitis"
Krok 1 - 2015 Question Paper (General medicine)Eneutron
1. The document contains 30 multiple choice questions about various topics in medicine. The questions cover topics like diseases, anatomy, physiology, biochemistry, and microbiology.
2. Many of the questions test knowledge of specific diseases, organs, cells or biological processes. For example, there are questions about glycogen storage diseases, kidney anatomy, muscular dystrophy, auditory system structures, protein biosynthesis, and tuberculosis diagnosis.
3. The questions also cover broader topics like biochemical pathways, hormones, blood components, chromosome abnormalities, infectious diseases, and autopsy findings. Multiple choices are provided for each question.
Cacoub p hcv ehm & inflam pr cacoub du 15 01 15 odeckmyn
This document discusses extrahepatic manifestations associated with chronic hepatitis C virus (HCV) infection. It finds that:
1. Extrahepatic manifestations like vasculitis, arthralgia/myalgia, and autoimmune disorders are a major problem in chronic HCV infection, affecting 5-40%, 25-35%, and 10-40% of patients respectively.
2. Fatigue, depression, and cognitive impairment from HCV infection are also significant, with 50-67% of patients experiencing fatigue and 28% experiencing depression prior to therapy. Sustained virological response is associated with decreased rates of fatigue.
3. Autoimmune disorders are thought to arise from polyclonal or oligoclonal B
The document discusses complement activation and traumatic brain injury. It summarizes several studies that show:
1. Complement proteins like C3 and the membrane attack complex C5b-9 are activated in the border zone of brain contusions in rats and humans following traumatic brain injury.
2. There is local synthesis of complement proteins like C3, and upregulation of the regulator clusterin in response to complement attack on neurons and astroglia.
3. Complement activation occurs endogenously in the injured brain without circulating blood components, as shown in studies using brain slice cultures.
4. Genetic factors influence the inflammatory response and complement activation following TBI, with more pronounced immune reactivity linked
1. Findings in this x-ray: Bilateral coalesced opacities in upper and mid zones.
2. Two important conditions which produce similar findings: Pulmonary tuberculosis, pneumonia.
3. To differentiate radiologically: In tuberculosis, opacities are more dense and cavitation is seen. In pneumonia, opacities are less dense and consolidation is seen.
4. Hematological problems that can occur: Anemia due to chronic disease, thrombocytopenia.
This document summarizes a new protocol for ABO-incompatible kidney transplantation in children that was designed to expand the donor pool. The key aspects of the new protocol are:
1) It utilizes antigen-specific immunoadsorption rather than plasma exchange to remove existing anti-A/B antibodies pre-operatively.
2) It uses rituximab rather than splenectomy to prevent antibody rebound.
3) Ten pediatric patients have been successfully transplanted using this protocol so far with results comparable to ABO-compatible transplants in terms of graft function and adverse events.
Krok 1 - 2008 Question Paper (General medicine)Eneutron
This document contains 31 multiple choice questions related to medicine. The questions cover topics such as: symptoms of different digestive disorders; acid-base balance disorders in infants; complications of medications like aspirin and phenobarbital; laboratory tests and their implications for diseases like diabetes and rheumatism; anatomy and functions of the auditory system; stages of protein biosynthesis; reflexes; and more. The correct answer is listed for each multiple choice question.
The document contains several clinical case summaries presented as questions with multiple choice answers. It discusses cases involving issues like knee pain, respiratory acidosis, Huntington's disease, lupus, lower back pain, and hydronephrosis during pregnancy. For each case, a question is asked to test the reader's knowledge and the most appropriate answer is provided.
Hepatitis C virus (HCV) can cause a variety of extrahepatic manifestations beyond liver disease, including vasculitis, fatigue, arthralgia, sicca syndrome, and autoantibody production. HCV infection of lymphocytes and hepatocytes leads to polyclonal and monoclonal B cell proliferation and autoantibody secretion, resulting in mixed cryoglobulinemia and associated conditions in 5-40% of cases. Treatment with pegylated interferon and ribavirin can improve outcomes of HCV-associated vasculitis by reducing viral load, B cell populations, and increasing regulatory T cells, with rituximab also effective for refractory cases. Liver fibrosis severity and other clinical factors predict prognosis,
This document discusses hepatitis C virus (HCV)-related vasculitis. It begins by noting an abnormal T lymphocyte distribution and Th1 cytokine profile in vasculitis lesions, as well as a deficit in regulatory T lymphocytes. A genome-wide association study found an association between HLA-DRB1/DQA1 and HCV-related vasculitis. Treatment of HCV-vasculitis includes antiviral therapy to achieve sustained virological response, as well as immunosuppressants. Complete clinical response is associated with increased levels of regulatory T cells. Rituximab and low-dose interleukin-2 may also be effective treatments.
A woman is concerned about the risk of her son inheriting haemophilia, as her husband has the disease. The disease is inherited through the X chromosome. As the mother does not have the disease, the risk to sons is 25% of inheriting it, while daughters would be carriers but not affected.
1) Chronic hepatitis C virus infection can cause a variety of extrahepatic manifestations including mixed cryoglobulinemia, a condition where low levels of cryoglobulins in the blood vessel can lead to inflammation.
2) Rituximab, a monoclonal antibody targeting CD20 found on B cells, has shown effectiveness in treating the symptoms of mixed cryoglobulinemia, particularly rashes and kidney involvement.
3) Combining rituximab treatment with pegylated interferon and ribavirin therapy may provide the best chance of achieving both clinical response and viral clearance for patients with mixed cryoglobulinemia caused by chronic hepatitis C infection.
1. The document describes a series of biology questions and multiple choice answers. It includes questions about inheritance patterns, protein synthesis, infectious diseases, and other biology topics.
2. Specific questions addressed include inheritance of a hereditary disease, types of hemophilia inheritance, phenylketonuria genotypes, stages of protein synthesis, malaria-carrying mosquitoes, sickle cell anemia causation, intestinal parasites, and karyotypes associated with medical conditions.
3. The questions cover a wide range of biology subject areas including genetics, infectious diseases, protein synthesis, cell structure and function, and more. The multiple choice answers would allow someone to self-test their knowledge on these topics.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
The document discusses the need for a new sustainable economic model based on collaborative and systemic growth for future generations. It highlights several challenges facing the current economic system such as climate change, resource depletion, and social issues. The author proposes nature-inspired solutions like biomimicry, circular economy models, and tapping into underutilized resources. The key is shifting from individualistic to collaborative intentions and prioritizing immaterial and human values over just material growth.
Este documento describe la práctica 3 que trata de agregar botones de acción en las diapositivas. El documento menciona que la práctica 3 se enfoca en agregar botones de acción en las diapositivas y proporciona el nombre del estudiante que realizó la práctica.
The document discusses the results of a study on the impact of climate change on global wheat production. Researchers found that rising temperatures will significantly reduce wheat yields across different regions of the world by the end of the century. Under a high emissions scenario, the study projects a global average decrease in wheat production of around 7.4% with reductions as high as 25% in Central Asia and West Africa.
El documento trata sobre la política energética de un país. Propone aumentar la inversión en energías renovables como la solar y eólica para reducir la dependencia de los combustibles fósiles y alcanzar las metas de descarbonización. También recomienda mejorar la eficiencia energética en edificios e industrias para disminuir el consumo de energía.
The document describes symptoms and signs in medical examinations. Symptoms are problems reported by patients, like pain, while signs are found by doctors during examinations, such as high blood pressure. Patients present to doctors with their presenting symptom or complaint. Common symptoms discussed include tiredness, weight changes, and digestive issues. The document provides examples of medical terminology and phrases used to describe symptoms in patient reports and examinations.
This document contains a series of clinical case studies presented by Dr. Juan Carlos Díaz Torre. Each case presents a patient scenario, possible diagnoses or treatment options, and questions for the reader to answer. The cases cover topics like depression, frostbite treatment, preterm labor prevention, and corneal abrasion management. The document is intended as a teaching tool using brief real-world medical scenarios.
This document contains 120 clinical cases presented by Dr. Juan Carlos Díaz Torre, a pediatric neonatologist. Each case presents a patient scenario or medical issue and asks the reader to choose the most appropriate response from a list of options. The cases cover a wide range of topics in pediatrics, obstetrics/gynecology, family medicine and internal medicine.
The document contains 20 brief clinical cases presented by Dr. Juan Carlos Díaz Torre, a pediatric neonatologist. Each case presents a medical scenario and potential answers for the appropriate next step. The cases cover topics in obstetrics, psychiatry, dermatology, emergency medicine, and oncology. Screening for melanoma is discussed in the final case, noting that screening is not clinically proven to reduce mortality from the disease.
This document provides instructions for participants taking a simulated exam for a medical licensing exam. It explains that the exam will take place over two sessions, from 8am to 2pm for the first part and 4pm to 8pm for the second part. It provides an example case study and question to demonstrate the exam format. It also includes a response sheet for participants to record their answers. The document aims to clearly explain the format, timing and expectations for the simulated exam.
This document contains a series of clinical cases and questions related to various medical conditions. Each case provides brief details about a patient and their symptoms, and is followed by multiple choice questions testing knowledge of the case. The cases cover topics like premenstrual syndrome, diabetes, blood typing in pregnancy, sleep disorders, bullying, prostate exams, skin infections, urinary tract infections, gastrointestinal issues, and COPD.
The document contains several clinical cases presented as short paragraphs with multiple choice questions. It discusses cases involving a man with hives, a woman who underwent fundoplication surgery, a man with gout and kidney disease, a man with hemoptysis and kidney problems, a man with ulcerative colitis, a woman with asthma, a woman with sudden vision loss, a man with HIV and brain lesions, a man with sepsis and kidney injury, and a pregnant woman with lupus and hypertension. Each case is followed by a question testing the reader's knowledge of diagnosis or treatment.
The document is the question booklet for a postgraduate medical entrance exam containing 45 multiple choice questions. It provides instructions to candidates to verify their hall ticket number and read instructions on the answer sheet carefully before answering the questions by darkening the appropriate oval on the answer sheet. Candidates are instructed to return the question booklet along with their answered answer sheet.
These clinical cases provide brief summaries of patient presentations and questions about appropriate diagnosis or treatment. The document contains 159 cases presented over 48 pages covering various medical topics including dermatology, gynecology, pediatrics, cardiology, infectious diseases, and oncology. Each case is a few paragraphs with a multiple choice question to test clinical decision making.
This document contains 80 clinical case summaries presented by Dr. Juan Carlos Díaz Torre, a pediatric neonatologist. Each case presents a brief medical scenario or patient information and asks the reader to choose the most appropriate diagnosis, treatment, or next step. The cases cover a range of topics in pediatrics, internal medicine, obstetrics/gynecology, and other clinical fields. Contact information is provided for Dr. Díaz Torre at the beginning and end of the document.
1) The document appears to be an exam question booklet for a postgraduate medical entrance exam containing multiple choice questions.
2) It provides instructions for exam takers and details 40 questions covering various topics in medicine.
3) The questions assess knowledge of topics like pharmacology, microbiology, pathology and clinical presentations of diseases.
Golden book for Medicine OSCE: First ViewMan B Paudyal
This document provides summaries of various medical cases and images in the form of questions and answers. It covers topics like Peutz-Jeghers syndrome, Bell's palsy, cirrhosis, clubbing, multiple myeloma, Cushing's syndrome, Graves' disease, scleroderma, rheumatoid arthritis, hyperthyroidism, brain abscess, empyema, G6PD deficiency, megaloblastic anemia, Charcot-Marie-Tooth disease, Ataxia telangiectasia, infective endocarditis, and more. For each case, it provides the diagnosis, relevant physical findings, investigations, management, and complications.
This document contains 27 multiple choice questions that appear to be from a medical licensing exam known as KROK-2. The questions cover a range of medical topics and scenarios involving diagnosis and treatment. Some example questions include one about diagnosing a patient presenting with eye, skin and gastrointestinal symptoms, one about complications of hepatic cirrhosis in a 17-year-old girl, and one about appropriate secondary prevention drugs for a patient with atrial fibrillation after experiencing an ischemic stroke from cardiac embolism. The document provides the questions and answer options to test medical knowledge.
This document contains 29 multiple choice questions related to medical microbiology and virology. The questions cover topics such as gram-positive bacterial cell walls, influenza virus antigenic shift, fungal and bacterial infections, antibiotic modes of action, viral hepatitis, HIV and other blood-borne pathogens, tuberculosis drug interactions, and laboratory tests for various microorganisms.
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
The document contains 155 multiple choice questions about trauma, medical assessment, cardiac care, and anatomy. Some sample questions assess signs of head injuries, appropriate triage of motor vehicle accident patients, medications like nitroglycerin and Ativan, and identification of heart structures. The questions cover topics relevant to EMT assessment and management of trauma and cardiac patients.
This document contains 63 multiple choice questions about general epidemiology. The questions cover a range of epidemiological topics including levels of prevention (primordial, primary, secondary, tertiary), disease transmission and distribution, outbreak investigation, and risk factors. Correct answers are provided for each question.
This document contains 25 multiple choice questions about the thyroid gland. The questions cover topics like the arterial supply of the thyroid, signs of a toxic thyroid, management of hyperthyroidism in pregnancy, treatments for Graves' disease, complications of thyroidectomy, and causes of thyrotoxicosis. The questions are part of a thyroid MCQ revision for a surgical resident by Dr. Mohamed Elmatary and Omar Ayman.
A 3-year-old boy presents with a high fever for the past few days. On examination, he has bilateral conjunctival injection without exudate. This is likely due to an adenoviral conjunctivitis, which commonly causes pink eye in children. Supportive care with cool compresses is the appropriate initial treatment. Close follow-up is needed in case the infection spreads or complications arise.
This document contains 140 clinical case summaries presented by Dr. Juan Carlos Díaz Torre. Each case presents brief patient information and a multiple choice question related to diagnosis, treatment, or management. The cases cover a wide range of medical topics including infectious diseases, obstetrics, psychiatry, surgery, and more.
Este documento resume la varicela, causada por el virus varicela-zóster. Describe que el 90-95% de las personas la adquieren en la niñez y se transmite por vía aérea o contacto. Tras una incubación de 14-16 días, aparecen lesiones dérmicas (máculas, pápulas y vesículas) que siguen un curso centrípeto. Las complicaciones más comunes son infecciones bacterianas secundarias, neumonía y encefalitis. El tratamiento incluye control de síntomas y
El sarampión es una enfermedad viral altamente contagiosa causada por un virus paramixovirus que se transmite por vía aérea. Se caracteriza por tres fases: una fase prodrómica con fiebre y síntomas respiratorios, una fase exantemática con erupción cutánea y una fase de convalecencia con descamación. Puede causar complicaciones graves como neumonía, encefalitis y diarrea. El tratamiento incluye vitamina A para reducir la gravedad y mortalidad.
El documento proporciona información sobre varias enfermedades infecciosas, incluido su agente causal, síntomas, periodo de incubación y contagio. Describe las características del eritema infeccioso, la exantema súbita, el síndrome mano-pie-boca, el síndrome de Gianotti-Crosti y la rubeola, así como los diferentes tipos de exantemas. También correlaciona diferentes enfermedades con sus respectivos periodos de incubación.
El documento proporciona información sobre quemaduras. Las quemaduras afectan principalmente a niños pequeños y las quemaduras severas ocurren más comúnmente en niños menores de 5 años. En México, la mayoría de las quemaduras son causadas por fuego o escaldadura. El documento describe los grados de quemadura, el tratamiento, y los criterios para referencia a un centro especializado.
Este documento describe la parotiditis, una virosis glandular altamente contagiosa que causa la inflamación de las glándulas salivales, especialmente las parótidas. Afecta principalmente a niños entre 5 y 15 años e incide más en invierno y primavera. Se transmite por contacto directo con la saliva de personas infectadas. Sus síntomas incluyen fiebre, dolor e hinchazón de las glándulas parótidas que puede durar hasta dos semanas. El diagnóstico se confirma mediante pruebas serológic
La adolescente presentó cuadro de meningitis bacteriana aguda con alteración del estado de conciencia y signos meníngeos negativos. El líquido cefalorraquídeo mostró niveles elevados de proteínas y glucosa disminuida, lo que es compatible con una etiología bacteriana. Se requiere tratamiento antibiótico empírico de amplio espectro y monitorización estrecha dado el riesgo de complicaciones asociadas a la gravedad del cuadro clínico.
Este documento describe la leucemia, en particular la leucemia linfoblástica aguda. Define la leucemia como una enfermedad caracterizada por la proliferación no controlada de células precursoras linfoides en la médula ósea. Explica la epidemiología, etiología, síntomas, diagnóstico y tratamiento de la leucemia linfoblástica aguda, que es el tipo más común de leucemia en niños. También resume brevemente la leucemia mieloide aguda.
La influenza es una infección viral aguda de las vías respiratorias causada principalmente por los virus de la influenza A y B. Los síntomas son similares a un resfriado común pero más graves e incluyen fiebre, tos, dolor de garganta y cuerpo. Los grupos de alto riesgo incluyen ancianos, niños pequeños, embarazadas y personas con enfermedades crónicas. El tratamiento se enfoca en aliviar los síntomas y la terapia antiviral puede prevenir complicaciones en grupos de alto riesgo. La vacuna
La faringoamigdalitis es más frecuente en niños menores de 3 años, siendo causada principalmente por bacterias como el estreptococo hemolítico del grupo A o virus. Presenta signos como dolor faríngeo, fiebre y exudado amigdalar. Su tratamiento incluye antibióticos como penicilina o eritromicina para prevenir complicaciones como la fiebre reumática. Las otitis medias también son comunes en niños pequeños y su tratamiento es con antibióticos como amoxicilina.
Este documento describe las neumonías, definiéndolas como un proceso inflamatorio e infeccioso del parénquima pulmonar causado por varios microorganismos. Explica que existen neumonías adquiridas en la comunidad y clasificadas como típicas o atípicas. Finalmente, cubre factores de riesgo, etiología, diagnóstico, tratamiento y más detalles sobre las neumonías.
Este documento proporciona información sobre la hepatitis A. Resume que la hepatitis A es una infección viral aguda transmitida oral-fecalmente, con un periodo de incubación promedio de 30 días. Los síntomas incluyen ictericia, fiebre, dolor abdominal y elevación de las enzimas hepáticas. La infección es muy común en México en niños menores de un año. No causa secuelas crónicas.
Este documento describe la escarlatina, una enfermedad estreptocócica que causa faringoamigdalitis, exantema, fiebre y descamación. Se presenta típicamente en niños de 3 a 15 años en invierno y primavera. El agente causal es el estreptococo beta hemolítico del grupo A. El cuadro clínico incluye fiebre alta, exantema en la piel y enantema (manchas) en la boca. El tratamiento de elección es la penicilina.
Este documento describe las características de las mordeduras de serpientes venenosas en México. Existen dos especies venenosas principales, la familia Viperidae, responsable del 90% de los accidentes ofídicos, y la familia Elapidae. La gravedad del envenenamiento se clasifica dependiendo del grado de edema y los síntomas pueden incluir dolor, hinchazón, náuseas y vómitos. El tratamiento incluye la administración de antiveneno según la gravedad del caso y la monitorización de parámetros como
Este documento describe las picaduras de arañas como un problema importante de salud pública, enfocándose en las arañas Latrodectus (viuda negra) y Loxosceles (araña violinista) encontradas en México. Explica sus características, síntomas de las picaduras y tratamientos recomendados que incluyen analgésicos, antivenenos y esteroides para prevenir daños mayores.
Este documento describe la intoxicación por veneno de alacrán en México. Explica que la costa del Pacífico y el centro-oeste de México son zonas alacranógenas, con más de 200,000 accidentes por picadura de alacrán cada año. Detalla los síntomas de intoxicaciones leves, moderadas y severas, así como el tratamiento específico requerido en cada caso.
Este documento resume varios casos clínicos de parasitosis comunes en México, incluyendo información sobre el agente causal, ciclo de vida, síntomas, diagnóstico y tratamiento. Se describen casos de necatoriasis, triquinosis, giardiasis, enterobiasis, himenolepiasis, trichuriasis, teniasis, ascariasis, estrongiloidosis y amibiasis. Para cada caso, se identifica el parásito responsable, sus características, y los métodos para diagnosticar y tratar la infección.
Este documento describe la diarrea en niños de 2 meses a 5 años. Define diarrea aguda, crónica y prolongada. Explica los factores de riesgo para diarrea persistente y deshidratación. Detalla las principales causas bacterianas y virales de diarrea como rotavirus, E. coli, Shigella, Salmonella y Campylobacter. Incluye información sobre diagnóstico, tratamiento y prevención, resaltando la importancia de la hidratación y la promoción de la salud a través de buena higiene.
La paciente es una mujer de 44 años que presenta síntomas de mareo, astenia y adinamia progresivos. Las pruebas de laboratorio muestran linfopenia, anemia y resultados repetidamente reactivos para VIH. El diagnóstico es infección por VIH manifestando un síndrome agudo. Durante la hospitalización se diagnostica una infección oportunista, posiblemente neumocystis, la cual mejora con el tratamiento recibido.
Este documento resume información sobre tres enfermedades infecciosas: paludismo, tuberculosis y dengue. Describe la epidemiología, etiología, manifestaciones clínicas, complicaciones y tratamiento del paludismo, causado por parásitos del género Plasmodium y transmitido por mosquitos. También resume brevemente la tuberculosis, enfermedad causada por bacterias del complejo Mycobacterium tuberculosis, y su transmisión. No incluye detalles sobre dengue.
Este documento resume dos tipos de vasculitis: la arteritis de células gigantes y la arteritis de Takayasu. La arteritis de células gigantes involucra las arterias carótidas y causa cefalea, disminución de pulsos y pérdida de visión. Se diagnostica con biopsia y se trata con corticoesteroides. La arteritis de Takayasu afecta la aorta y sus ramas principales y causa disminución de pulsos, soplos y claudicación. Su diagnóstico incluye arteriografía
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Clinical cases (1) june 30, 13
1. CURSO DE INGLÉS
ENGLISH COURSE
Dr. Juan Carlos Díaz Torre
Pediatra Neonatólogo
dr_diaz_torre@hotmail.com
(779) 100 - 40 - 26
DR.JCDT
1
2. BRIEF CLINICAL CASES
CASOS CLÍNICOS BREVES
(13)
Dr. Juan Carlos Díaz Torre
Pediatra Neonatólogo
dr_diaz_torre@hotmail.com
(779) 100 - 40 - 26
DR.JCDT
2
3. DR.JCDT
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Case # 161
A 58-year-old male who works with
heavy machinery at a local factory
presents to your office for evaluation of
hearing loss of several years’
progression. He notes that the loss is
mainly in the left ear and he also has
mild tinnitus. He has had no trauma to
his head, and he has no history of ear
infections.
4. DR.JCDT
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Examination of the ears reveals normal
tympanic membranes and a neurologic
examination is negative. When a tuning
fork is placed in the center of his
forehead, he says the sound is much
louder on the right side (Weber test).
Comparing sound in front of the ear to
the sound when the tuning fork is placed
on the mastoid (the Rinne test) reveals
that air conduction is better than bone
conduction in the left ear.
5. DR.JCDT
5
Which one of the following is true
regarding further evaluation and
management? :
a) Carotid ultrasonography should be
ordered
b) No treatment or further diagnostic
studies are indicated
6. DR.JCDT
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c) A hearing aid plus better hearing
protection is all that is needed
d) Audiometry is the best initial
screening test
e) A tympanogram is indicated
7. DR.JCDT
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Case # 162
A 6-year-old male is brought to your
office 10 days after the onset of a cough
and low-grade fever.
On examination, his temperature is
37.9° C (100.2° F), pulse 100 beats/min,
respirations 22/min, and O2 saturation
94%. He has diffuse wheezes on
auscultation of his chest.
8. DR.JCDT
8
His WBC count is 9800/mm (N 4,500 –
11,000) with a slight left shift. His C-
reactive protein level is mildly elevated
and a chest radiograph reveals an
interstitial infiltrate.
Which one of the following would be the
most appropriate initial therapy?:
10. DR.JCDT
10
Case # 163
A 75-year-old male is brought in by his
family due to concerns about memory
loss.
Which one of the following is best for
determining whether or not he has
dementia? :
11. DR.JCDT
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a) A Mini-Mental State Examination
(MMSE)
b) Non–contrast-enhanced CT of the
head
c) An electroencephalogram
d) A lumbar puncture
e) MRI of the head
12. DR.JCDT
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Case # 164
Of the following, which one has the
greatest potential to spread via human-
to-human transmission?:
14. DR.JCDT
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Case # 165
The mother of a 3-year-old male is
concerned that he doesn’t like being
held, doesn’t interact much with other
children, and rarely smiles.
Of the following, which feature would be
most helpful in distinguishing Asperger’s
syndrome from autism in this patient?
15. DR.JCDT
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a) Repetitive fine motor mannerisms
b) Delayed gross motor development
c) Normal language development
d) Preoccupation with parts of objects
e) Focused patterns of intense interest
16. DR.JCDT
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Case # 166
A 76-year-old male is brought to your
office by his son. The patient complains
of dizziness that has slowly been
worsening over the past year. His
description is vague, but he says that he
notices the dizziness when he tries to
walk.
17. DR.JCDT
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The review of systems is normal, except
for increasing problems with his
“prostate” in the last 6 months, with
dribbling and accidents at times.
His Mini-Mental State Examination
(MMSE) score is 22 out of 30. No tremor
is noted. A CBC, creatinine level, TSH
level, vitamin B 12 level, and VDRL are all
normal. Which one of the following
should you do next?:
18. DR.JCDT
18
a) Order a brainstem auditory evoked
potential
b) Prescribe sertraline (Zoloft)
c) Order physical therapy
d) Order a brain MRI
e) Prescribe carbidopa/levodopa
(Sinemet)
19. DR.JCDT
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Case # 167
The most appropriate initial
pharmacologic treatment of panic
disorder is:
a) Valproic acid (Depakene)
b) Lithium
c) An SSRI
d) A tricyclic antidepressant
20. DR.JCDT
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Case # 168
A 24-year-old worker at a local day-care
center has not had a menstrual period in
over 2 months. A home pregnancy test is
positive and is confirmed in your office.
She is concerned because she was
recently exposed to a child who was
diagnosed with rubella. A serum rubella
IgG antibody test is negative.
21. DR.JCDT
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Which one of the following would be
the best course of action?
a) Order level III ultrasonography to
screen for congenital anomalies
b) Repeat the serologic testing in 2–3
weeks
22. DR.JCDT
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c) Administer rubella immune globulin
d) Tell the patient she is immune to
rubella and is not at risk
e) Administer live-virus rubella vaccine
23. DR.JCDT
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Case # 169
A 23-year-old male with Down syndrome
is brought to your office by his parents.
The patient has had a low-grade fever
(approximately 100° F) for 7 days. The
fever is not associated with rhinorrhea,
sore throat, cough, dysuria, or shortness
of breath. The parents note that their
son has complained of aches in various
places, and has not been eating well for
several weeks.
24. DR.JCDT
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The physical examination is remarkable
for swollen lymph glands in multiple
places, pale conjunctivae, and an 8-lb
weight loss since his last visit 1 month
ago.
Which one of the following is most
consistent with this patient’s symptoms?
25. DR.JCDT
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a) Urinary tract infection
b) Atypical pneumonia
c) Acute myeloid leukemia
d) Hodgkin’s lymphoma
e) Myocarditis
26. DR.JCDT
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Case # 170
Which one of the following is true
regarding Osgood-Schlatter disease?
a) Complete symptom resolution
usually occurs in 18–24 months
b) Effusions are often present on
examination and knee range of
motion is limited
27. DR.JCDT
27
c) Most cases are triggered by a single
traumatic event
d) Pain is localized to the inferior
patellar pole at the origin of the
patellar tendon
e) Pain usually begins at 20°– 30° of
flexion
28. DR.JCDT
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Case # 171
You see a 9-month-old white male for a
routine examination. He was seen at 2
months and 4 months for routine care
and immunizations, but was not brought
back at 6 months. The mother states that
he has an excellent appetite. She
expresses no concerns except that the
baby "seems cranky”.
29. DR.JCDT
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The child is somewhat obese and pale,
but the rest of the physical examination
is unremarkable. A heel stick hematocrit
done in your office is 26%
Known risk factors for iron deficiency at
this age include:
30. DR.JCDT
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a) Maternal iron deficiency without
anemia during pregnancy
( ) True ( ) False
b) Mild maternal anemia during
pregnancy
( ) True ( ) False
c) Excessive blood loss during delivery
( ) True ( ) False
32. DR.JCDT
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Case # 172
You learn that the child drinks 1.5 quarts
of whole cow's milk per day, with a daily
dose of iron mixed into the milk.
Therapeutic interventions could include
a) Dietary instruction regarding
overfeeding
( ) True ( ) False
33. DR.JCDT
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b) Limiting cow's milk to 1 pint a day or
less
( ) True ( ) False
c) Blood transfusion
( ) True ( ) False
d) Continuing oral iron therapy, and
advising the mother to avoid mixing
it in the milk
( ) True ( ) False
35. DR.JCDT
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Case # 173
A 42-year-old white male wants a dark
mole removed from his thigh because he
is afraid it is a melanoma.
a) A biopsy is indicated if the lesion has
increased in size recently.
( ) True ( ) False
36. DR.JCDT
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b) Has an irregular, notched border
( ) True ( ) False
c) Is mixed reddish-blue in color
( ) True ( ) False
d) Is pruritic
( ) True ( ) False
37. DR.JCDT
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Case # 174
A biopsy confirms malignant melanoma
in the superficial 0. 7 mm of the tissue
submitted. Initial treatment should
include:
a) Wide local excision
( ) True ( ) False
38. DR.JCDT
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b) 8,000 rad local radiation
( ) True ( ) False
c) Regional node dissection
( ) True ( ) False
d) Fluoxymesterone (Halotestin), 10 mg
orally
( ) True ( ) False
39. DR.JCDT
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Case # 175
A 56-year-old white female complains of
painful, burning dysesthesias in her
hands and feet. Her past history is
positive for cancer of the ovary treated
with chemotherapy. Physical
examination is normal except for
evidence of a purely sensory peripheral
neuropathy.
40. DR.JCDT
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The etiology of peripheral neuropathy
includes
a) Toxic effects of antineoplastic
medications
( ) True ( ) False
b) Paraneoplastic syndrome
( ) True ( ) False
42. DR.JCDT
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Treatment options include
a) Chelation therapy
( ) True ( ) False
b) Carbamazepine (Tegretol)
( ) True ( ) False
c) Tricyclic antidepressants such as
amitriptyline (Elavil)
( ) True ( ) False
43. DR.JCDT
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Case # 176
A 60-year-old white male has pain that
starts in the hypogastric area that
subsequently localizes in the left
lower quadrant. His maximum
temperature is 38.5 ° C ( 101.3 ° F) and he
is able to take oral fluids without
difficulty .He is mildly tender in the left
lower quadrant on examination and has
no rebound tenderness.
44. DR.JCDT
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Appropriate management at this time
would include
a) Emergency surgical consultation
( ) True ( ) False
b) CBC
( ) True ( ) False
c) Urinalysis
( ) True ( ) False
46. DR.JCDT
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In 10 days the patient is reevaluated.
His abdominal pain has resolved and he
is afebrile. Appropriate measures would
now include
a) A low-residue diet
( ) True ( ) False
b) Colonoscopy
( ) True ( ) False
47. DR.JCDT
47
Case # 177
He follows your recommendations and
does well until 2 years later when the
symptoms recur. He has delayed seeing
you because he thought the symptoms
would go away. Examination shows him
to be extremely uncomfortable, with a
temperature of 38.8° C (102.0° F), and
tenderness in the left lower quadrant.
48. DR.JCDT
48
On palpation, you suspect there may be a
left lower quadrant mass. His abdomen is
moderately distended with decreased
bowel sounds.
Appropriate measures at this time would
include
a) A barium enema
( ) True ( ) False
49. DR.JCDT
49
b) A CT scan of the abdomen
( ) True ( ) False
c) A full liquid diet
( ) True ( ) False
d) Parenteral narcotics as needed
( ) True ( ) False
e) Broad-spectrum antibiotics
( ) True ( ) False
50. DR.JCDT
50
Case # 178
You are covering the emergency
department at your local community
hospital. A 24-year-old previously
healthy white female presents with
complaints of dry mouth and blurred
vision associated with nausea, malaise,
and the recent onset of diplopia. You
learn that 2 days ago she enjoyed home-
canned foods at a friend's house.
51. DR.JCDT
51
On examination you note a slight but
definite ptosis and a slightly
disconjugate gaze. Her examination is
otherwise unremarkable and
comprehensive blood chemistries are
normal.
You decide which of the following tests
might be diagnostic? :
52. DR.JCDT
52
a) An MRI to rule out Guillain-Barre
syndrome
( ) True ( ) False
b) A lumbar puncture to rule out a
cerebrovascular accident
( ) True ( ) False
53. DR.JCDT
53
c) A doxycyline challenge for tick
paralysis
( ) True ( ) False
d) A psychiatric consultation for
hysteria
( ) True ( ) False
54. DR.JCDT
54
Results of appropriate testing are
normal. The patient complains that she is
getting weaker and notes a feeling of
dyspnea.
Appropriate actions at this time would
include which of the following?:
a) Admit the patient to the intensive-
care unit
( ) True ( ) False
55. DR.JCDT
55
b) Obtain psychiatric consultation
( ) True ( ) False
c) Begin intravenous ciprofloxacin
(Cipro)
( ) True ( ) False
d) Monitor respiratory status closely
( ) True ( ) False
56. DR.JCDT
56
Case # 179
An obese 51-year-o1d white female
consults you about her menstrual
periods. For the past 6 months her
menses have been irregular, spaced
anywhere from 3-6 weeks apart. In
addition, the flow has been considerably
heavier and more prolonged than in the
past. The only medication she is taking is
a ginseng extract. She is not sexually
active. Pelvic examination is normal.
57. DR.JCDT
57
Appropriate diagnostic studies at this
time include which of the following?
a) Thyroid-stimulating hormone (TSH)
level
( ) True ( ) False
b) CBC
( ) True ( ) False
59. DR.JCDT
59
All laboratory tests ordered reveal
normal results. The best approach to
management at this time would include
a) Discontinuing ginseng
( ) True ( ) False
b) Dilatation and curettage
( ) True ( ) False
60. DR.JCDT
60
c) Endometrial ablation
( ) True ( ) False
d) Medroxyprogesterone acetate
(Provera), 5-10 mg daily 10 days of
each month
( ) True ( ) False
61. DR.JCDT
61
Within 8 months, she has no further
bleeding but reports hot flushes. After
discussion with the patient, appropriate
therapeutic options include which of the
following?:
a) Prescribe conjugated estrogen
supplementation
( ) True ( ) False
62. DR.JCDT
62
b) Prescribe combined estrogen and
progesterone therapy
( ) True ( ) False
c) Recommend dilatation and
curettage
( ) True ( ) False
d) Begin therapy with danazol
(Danocrine)
( ) True ( ) False
63. DR.JCDT
63
Case # 180
An 84-year-old white male with a 5-year
history of Alzheimer's disease is admitted
to the nursing home because his family is
having difficulty caring for him at home,
due to increased confusion, incontinence,
and combativeness. For the last week he
has been having visual hallucinations.
64. DR.JCDT
64
On admission to the nursing home he
remains combative, striking out at staff
and other residents, and is resistive to
care. He is inattentive and distractible,
and resists attempts at physical
examination. His vital signs are stable,
and a physical examination and
laboratory workup fail to reveal any
acute infections or other significant
changes.
65. DR.JCDT
65
Current medications likely contributing
to his altered mental state include which
of the following?
a) Lisinopril (Zestril)
( ) True ( ) False
b) Cimetidine (Tagamet)
( ) True ( ) False
67. DR.JCDT
67
Which of the following historical features
would suggest delirium, rather than
progressive dementia, as a cause of his
worsening condition?
a) Altered level of consciousness
( ) True ( ) False
b) Visual hallucinations for 1 week
( ) True ( ) False
69. DR.JCDT
69
He improves with behavioral
management and medication changes,
but remains combative and exhibits
delusional and paranoid ideation. Which
of the following neuroleptics could help
control these problems with a relatively
low risk of sedation and extrapyramidal
side effects?
a) Olanzapine (Zyprexa)
( ) True ( ) False