MDS PREP
In emphysema, the dilatation occurs
1) Beyond major bronchus
2) In alveolar region
3) Beyond terminal bronchioles
4) Beyond minor bronchus
General Medicine
Answer: 3
In emphysema, the dilatation occurs beyond terminal bronchioles
In a patient with a pulmonary embolism, which of the following is the most sensitive diagnostic test?
1) Chest X-ray
2) D-dimer assay
3) Computed tomography pulmonary angiogram (CTPA)
4) Ventilation-perfusion (V/Q) scan
CTPA is the most sensitive diagnostic test for pulmonary embolism, as it directly visualizes the emboli in the pulmonary arteries.
The first line treatment for anaphylactic shock includes:
1) Intramuscular epinephrine (adrenaline)
2) Intravenous antihistamines
3) Intravenous corticosteroids
4) Intramuscular corticosteroids
Adrenaline is the drug of choice in anaphylactic shock as it acts rapidly to counteract the effects of histamine by causing vasoconstriction and bronchodilation. It is administered intramuscularly to ensure quick absorption and action.
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.
What is the primary function of alpha-2-macroglobulin in the body?
1) Inhibition of serum proteases
2) Osmotic regulation
3) Transport of copper
4) Blood clot dissolution
Alpha-2-macroglobulin is a plasma protein that functions as an inhibitor of serum proteases, including thrombin and other proteolytic enzymes. It is involved in the regulation of extracellular proteolytic activity and the prevention of tissue damage.
Which of the following is NOT a component of the intrinsic pathway of the coagulation cascade?
1) Factor XII
2) Factor XI
3) Tissue factor
4) Factor X
Tissue factor is actually a component of the extrinsic pathway of the coagulation cascade. The intrinsic pathway involves factors XII, XI, prekallikrein, high molecular weight kininogen, and factors VIII, IX, and X.
What is the typical location of involvement in Crohn's disease?
1) Proximal small intestine
2) Distal small intestine
3) Large intestine
4) Both small and large intestines
Crohn's disease most commonly affects the distal ileum, which is the last part of the small intestine that connects to the large intestine.
Heimlich manoeuver is carried out in
1) Syncope
2) Airway obstruction
3) Carotid blow out
4) Cardiac arrest
General Medicine
Answer: 2
Heimlich manoeuver is carried out in airway obstruction