MDS PREP
A 20-year-old female presents with a two-day history of fever, sore throat, and a fine, macular rash that appears more prominent on her palms and soles. Which of the following is the most likely diagnosis?
1) Measles
2) Scarlet fever
3) Rubella
4) Mononucleosis
The combination of fever, sore throat, and a fine, macular rash that is more prominent on the palms and soles is characteristic of scarlet fever.
What is the primary target of the immune response in Celiac disease?
1) Glia cells in the intestinal mucosa
2) Gluten proteins
3) Enterocytes in the intestinal villi
4) Pancreatic cells
Celiac disease is an autoimmune response to gluten proteins found in wheat, barley, rye, and possibly other grains, which leads to inflammation and damage in the small intestine.
Which of the following is NOT a manifestation of CNS involvement in Wilson’s disease?
1) Dystonia
2) Incoordination
3) Sensory abnormalities
4) Chorea
The toxic injury in Wilson’s disease primarily affects the basal ganglia, leading to extrapyramidal symptoms such as dystonia, incoordination, tremor, dysphagia, dysarthria, memory loss, and seizures. However, sensory abnormalities and muscular weakness are not typical features of the disease.
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.
A patient with a deficiency of which coagulation factor will have a prolonged PT and a normal aPTT?
1) Factor II
2) Factor V
3) Factor X
4) Factor XII
Factor II (prothrombin) deficiency leads to a prolonged PT (Prothrombin Time) because it is involved in the extrinsic pathway of the coagulation cascade, which is assessed by the PT test. The aPTT (activated Partial Thromboplastin Time) is normal because the intrinsic pathway is not affected.
What is the treatment of choice for iron removal in hemochromatosis?
1) Iron supplements
2) Chelation therapy
3) Phlebotomy
4) Dietary restriction of iron
The treatment of choice for hemochromatosis is phlebotomy, which involves the regular removal of blood to reduce iron levels in the body. This method is more effective and safer for most patients compared to chelating agents, which are reserved for cases where phlebotomy is not feasible or when there is severe anemia or hypoproteinemia.
A patient with diabetes mellitus presents with a non-healing foot ulcer. Which of the following is NOT a component of the comprehensive management of the ulcer?
1) Infection control
2) Daily wound dressing changes
3) Blood glucose management
4) Revascularization if indicated
While daily wound dressing changes are a part of ulcer care, the other options are more critical in the comprehensive management of diabetic foot ulcers.
The most frequent source of pulmonary embolism is
1) Leg veins
2) Heart
3) Arm veins
4) Splenic vein
General Medicine
Answer: 1
The most frequent source of pulmonary embolism is leg veins