Case-based MCQ

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Repost from Mediccount - Medical accounts

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Repost from Mediccount - Medical accounts

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18 480

Repost from Backup Channel

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18 480

Repost from Mediccount - Medical accounts

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Repost from Backup Channel

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18 480

Repost from Mediccount - Medical accounts

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👍Correct Answer Is A Correct – This patient, who was recently started on empagliflozin, likely has euglycemic diabetic ketoacidosis (DKA), as evidenced by his calculated anion gap of 22 mEq/L, low bicarbonate, and ketonuria despite normal glucose levels. The deep, rapid breathing represents respiratory compensation for metabolic acidosis. Initial management of DKA includes intravenous fluid resuscitation to correct dehydration and insulin therapy to halt ketogenesis and correct the metabolic acidosis. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors such as empagliflozin are a recognized cause of euglycemic DKA

18 480

Repost from Mediccount - Medical accounts

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A 65-year-old man presents to the emergency department with a 2-day history of progressive dyspnea and fatigue. His medical history includes hypertension, type 2 diabetes, COPD, and heart failure with reduced ejection fraction. Routine echocardiography 3 months ago showed an ejection fraction of 45%. HbA1c was 7.9% 2 months ago. His regular medications include carvedilol, valsartan, spironolactone, metformin, and a combination LABA/LAMA inhaler. In addition to these, empagliflozin was started 2 months ago. He reports nausea but denies chest pain, orthopnea, or paroxysmal nocturnal dyspnea. Vital signs are BP, 105/65; P, 108; R, 28; T, 36.9°C (98.4°F); O2 saturation 98% on room air. Physical examination shows an alert patient with deep, rapid respirations. The cardiovascular exam shows a regular rhythm without murmurs, no jugular venous distension, and minimal bilateral pretibial edema. Lungs are clear to auscultation bilaterally. Laboratory results: WBC 8,200/μL, Hgb 13.2 g/dL, platelets 245,000/μL, sodium 140 mEq/L, potassium 4.2 mEq/L, chloride 106 mEq/L, bicarbonate 12 mEq/L, BUN 32 mg/dL, creatinine 1.2 mg/dL, glucose 180 mg/dL. Urinalysis shows +2 ketones. Which of the following is the most appropriate next step in management for this patient? A. Intravenous fluids and insulin therapy B. CT pulmonary angiogram C. ECG and troponin levels D. Intravenous furosemide E. Bronchodilators and systemic corticosteroids

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Correct Answer Is C This patient demonstrates red flags requiring urology referral including recurrent UTIs and persistent hematuria. Recurrent infections in the setting of incontinence may indicate underlying anatomical abnormalities or incomplete bladder emptying, while persistent hematuria warrants specialist evaluation with advanced diagnostic studies such as cystoscopy

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A 62-year-old woman presents to the emergency department with worsening urinary incontinence over the past month. She reports involuntary urine leakage that occurs both with coughing and with sudden urges to urinate. She has had three urinary tract infections treated by her primary care physician in the past 4 months, with the most recent one finishing antibiotic treatment 2 weeks ago. Physical examination reveals mild suprapubic tenderness. Urinalysis shows microscopic hematuria. Including discharge, which of the following is the most appropriate disposition? A. Primary care follow-up B. Home bladder training C. Urology referral D. Prescription for anticholinergic medication E. Referral for pelvic floor physical therapy

18 480

Repost from Medical Mnemonics

🧩 Medical Mnemonics 📌 Conus 🆚 Cauda — Easy to remember 🧠 Conus Medullaris = 4S ✖ Sudden onset ✖ Symmetric deficits ✖ Saddle anesthesia ✖ Sphincters early 🐎 Cauda Equina = 4P ✖ Pain (radicular, severe) ✖ Patchy deficits (asymmetric) ✖ Progressive onset ✖ Pee late #neurology 〰〰〰〰〰〰〰〰〰〰〰 ©Medical Mnemonics

18 480

Repost from Mediccount - Medical accounts

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18 480

Repost from Mediccount - Medical accounts

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Repost from Mediccount - Medical accounts

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Repost from Mediccount - Medical accounts

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18 480

Repost from Residency in Germany

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