MDS PREP
A patient presents with symptoms of chronic obstructive pulmonary disease (COPD). The physician suspects the presence of emphysema.
Which of the following conditions is likely to cause pulsus paradoxus in this patient?
(1) Pneumothorax
(2) Pleural effusion
(3) Emphysema/Asthma
(4) Cor pulmonale
Pulsus paradoxus is an exaggerated decrease in systolic blood pressure during inspiration, which can occur in patients with airflow obstruction conditions such as emphysema and asthma. These conditions can lead to increased intrathoracic pressure swings during respiration, which affects the cardiac output and arterial pulse amplitude.
A patient with type 2 diabetes mellitus is prescribed glimepiride. What is the primary mechanism of action of glimepiride?
(1) Stimulation of insulin secretion
(2) Inhibition of insulin secretion
(3) Increased peripheral glucose utilization
(4) Inhibition of gluconeogenesis
Glimepiride is a sulfonylurea medication that stimulates insulin secretion from pancreatic beta cells by closing ATP-sensitive potassium channels and causing depolarization, leading to calcium influx and insulin release.
A patient with diabetes mellitus and chronic kidney disease is prescribed chloramphenicol for a bacterial infection. What is a potential adverse effect of this medication that requires careful monitoring in this patient population?
(1) Nephrotoxicity
(2) Hepatotoxicity
(3) Ototoxicity
(4) Neutropenia
Chloramphenicol is known to have nephrotoxic effects and can exacerbate pre-existing kidney damage. It is essential to monitor renal function closely in patients with diabetes and chronic kidney disease when administering this antibiotic.
A patient presents with oral lesions and is diagnosed with secondary syphilis. Which of the following is a characteristic feature of this stage?
(1) Condylomata lata
(2) Lues maligna
(3) Mucous patches
(4) Necrotizing ulcerative periodontitis
Secondary syphilis is characterized by the development of mucocutaneous lesions, including mucous patches, which are painless, erythematous ulcers with a smooth, moist, and glistening appearance, often found on the oral mucosa. These lesions can occur anywhere in the oral cavity but are particularly common on the tongue, palate, and buccal mucosa.
In which condition is the plasma cholesterol level increased?
1) Hyperthyroidism
2) Obstructive jaundice
3) Nephrotic syndrome
4) Diabetes mellitus
Obstructive jaundice is associated with increased cholesterol levels due to impaired cholesterol metabolism.
What is the primary treatment for a pneumothorax?
(1) Inhalation of oxygen
(2) Chest tube placement
(3) Pleural fluid drainage
(4) Anti-inflammatory medication
The definitive treatment for a pneumothorax is the insertion of a chest tube, which allows the evacuation of air or gas from the pleural space and the re-expansion of the lung. This is crucial for alleviating the symptoms and preventing the condition from progressing to a tension pneumothorax, which can be life-threatening. Other treatments may include oxygen therapy and pain management.
In Paget's disease of bone, which of the following is a characteristic finding in serum biochemistry?
(1) High serum alkaline phosphatase levels
(2) High serum calcium levels
(3) Low serum phosphorus levels
(4) High serum PTH levels
Paget's disease is characterized by excessive and abnormal bone remodeling, which results in increased bone turnover. This increased turnover is reflected in the serum by high levels of alkaline phosphatase, an enzyme involved in bone formation. While calcium and phosphorus levels may be affected in some cases, the hallmark biochemical abnormality in Paget's disease is elevated alkaline phosphatase.
What is the primary function of the aortic valve?
(1) To prevent backflow of blood from the aorta into the left ventricle during diastole
(2) To prevent backflow of blood from the pulmonary artery into the right ventricle during diastole
(3) To prevent backflow of blood from the pulmonary vein into the left atrium during systole
(4) To prevent backflow of blood from the left ventricle into the left atrium during systole
The aortic valve is located between the left ventricle and the aorta and is responsible for preventing the backflow of blood into the left ventricle during systole, ensuring that blood is efficiently pumped out of the heart into the systemic circulation.