MDS PREP
CPR should have a ratio of chest compression to mouth breathing of
1) 1:4
2) 4:1
3) 2:3
4) 3:2
General Medicine
Answer: 2
CPR should have a ratio of chest compression to mouth breathing of 4:1
A 55-year-old male with a history of alcoholism presents with a chronic non-healing ulcer on his lower leg. The ulcer has a necrotic center surrounded by erythematous tissue. Which of the following is the most likely diagnosis?
1) Arterial ulcer
2) Venous stasis ulcer
3) Pressure ulcer
4) Neuropathic ulcer
The chronic non-healing nature of the ulcer and its location on the lower leg in an individual with a history of alcoholism are more consistent with a neuropathic ulcer. Neuropathy due to chronic alcohol use can lead to loss of protective sensation and poor blood supply, resulting in these types of ulcers.
What is the primary mechanism of action of Shiga-like toxins produced by EHEC?
1) Inhibits protein synthesis by binding to ribosomes
2) Induces lipid peroxidation in cell membranes
3) Increases intracellular cAMP
4) Induces endothelial cell damage
Shiga-like toxins produced by EHEC bind to ribosomes in target cells, particularly endothelial cells, and inhibit protein synthesis. This leads to cell damage and contributes to the development of hemolytic uremic syndrome.
A patient with known sickle cell anemia presents with severe pain in the left upper quadrant of the abdomen. His white blood cell count is elevated, and his ultrasound shows a dilated gallbladder with multiple gallstones. Which of the following is the most appropriate initial treatment?
1) Antibiotics
2) Hydration and analgesics
3) Surgical cholecystectomy
4) Endoscopic retrograde cholangiopancreatography (ERCP)
In a patient with sickle cell anemia and symptoms of biliary colic, the most likely diagnosis is cholelithiasis due to the increased incidence of gallstone formation in this population. Initial management should focus on hydration and pain relief with analgesics, as surgery is typically reserved for cases of cholecystitis or pancreatitis.
Drug of choice in chronic lymphatic leukaemia is
1) Busulphan
2) Vincristine
3) Chlorambucil
4) Mercaptopurine
General Medicine
Answer: 3
Chlorambucil is an alkylating agent that is commonly used as the first-line treatment for chronic lymphocytic leukemia (CLL). It is effective in managing the disease and is preferred due to its favorable side effect profile compared to other chemotherapeutic agents.
What is the typical clinical presentation of acute alcoholic hepatitis?
1) Asymptomatic, with mild transaminitis
2) Fever, jaundice, and abdominal pain
3) Diarrhea and vomiting
4) Generalized edema
Acute alcoholic hepatitis typically presents with fever, jaundice, and right upper quadrant abdominal pain. It is characterized by hepatocellular necrosis and inflammation.
Which of the following HLA types is most strongly associated with Celiac disease?
1) HLA-DQ2
2) HLA-DQ8
3) HLA-B8
4) HLA-DR3
The strongest genetic association with Celiac disease is with the HLA-DQ2 haplotype, which is found in the majority of patients with the condition.
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.