MDS PREP
In a patient with a history of chronic obstructive pulmonary disease (COPD), which of the following is NOT a common side effect of long-term inhaled corticosteroid therapy?
1) Oral thrush
2) Pneumonia
3) Osteoporosis
4) Tachycardia
Long-term inhaled corticosteroid therapy is commonly used in COPD management to reduce inflammation and exacerbations. Common side effects include oral thrush, pneumonia due to immunocompromise, and osteoporosis due to steroid-induced bone loss. Tachycardia is not a typical side effect of inhaled corticosteroids.
A 2-year-old child is brought to the emergency department with fever and seizures. The child's mother reports that the child has been vomiting and has had diarrhea for the past 24 hours. What is the most likely diagnosis?
(1) Diabetic ketoacidosis
(2) Meningitis
(3) Sepsis
(4) Gastroenteritis
The combination of fever, vomiting, and diarrhea with seizures in a young child is more indicative of gastroenteritis, which can cause dehydration and electrolyte imbalances leading to seizures, rather than the other options listed.
Which of the following is NOT a common symptom of valvular heart disease?
1) Shortness of breath
2) Rapid heartbeat
3) Chest discomfort
4) Abnormal body temperature
Valvular heart disease symptoms typically include weakness on exertion, rapid heartbeat, chest discomfort, and fainting spells. However, an abnormal body temperature is not a common symptom associated with valvular heart disease.
What is the primary prevention strategy for pulmonary embolism in patients with heart failure and atrial fibrillation?
(1) Antiplatelet therapy
(2) Anticoagulation therapy with warfarin
(3) Physical prophylaxis with compression stockings
(4) Thrombolytic therapy
Patients with heart failure and atrial fibrillation are at high risk for pulmonary embolism due to venous thrombosis and intra-cardiac thrombus formation. The primary prevention strategy for these patients is anticoagulation therapy with warfarin, as it reduces the risk of thrombus formation and embolization. Warfarin is effective in preventing stroke and systemic embolism in patients with non-valvular atrial fibrillation and is also beneficial in the context of heart failure.
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.
What is the primary mechanism of action of antiphospholipid syndrome in promoting thrombosis?
1) Inhibition of protein C and protein S
2) Activation of platelets
3) Enhancement of fibrinolysis
4) Induction of antibodies against phospholipids
Antiphospholipid syndrome is an autoimmune disorder characterized by the presence of antiphospholipid antibodies. These antibodies can bind to phospholipids in cell membranes, leading to a prothrombotic state and an increased risk of thrombosis. The exact mechanism by which these antibodies induce thrombosis is complex and may involve interference with anticoagulant proteins like protein C and protein S, as well as platelet activation and endothelial damage. However, the primary mechanism is the presence of these autoantibodies.
In a patient with nephrotic syndrome, which of the following is true regarding plasma cholesterol levels?
(1) Plasma cholesterol levels are decreased due to increased LDL receptors in the liver.
(2) Plasma cholesterol levels are increased due to the loss of cholesterol in urine.
(3) Plasma cholesterol levels are normal as the condition is unrelated to lipid metabolism.
(4) Plasma cholesterol levels are decreased due to increased hepatic synthesis of bile salts.
Nephrotic syndrome is associated with hyperlipidemia, particularly increased levels of LDL and cholesterol. The underlying mechanism involves the loss of albumin in the urine, which leads to hypoalbuminemia. This causes an increased synthesis of very low-density lipoproteins (VLDL) by the liver to compensate for the loss of oncotic pressure. Additionally, the loss of proteins that normally bind to cholesterol in the blood, such as lipoproteins, results in decreased clearance of LDL.
What is the primary defect in familial hypokalemic periodic paralysis?
1) Marked increase in muscle potassium permeability
2) Marked decrease in muscle sodium permeability
3) Marked decrease in muscle potassium permeability
4) Impaired sodium-potassium pump function
In familial hypokalemic periodic paralysis, the primary defect is a decrease in muscle potassium permeability, leading to a reduced efflux of potassium from muscle cells.