MedRevisions
Open in Telegram
MedRevisions is a pioneer in providing a question bank consisting of 4400+ exam-style clinical questions, 24+ mock exams and High Yield clinical notes solely for the PLAB Part 1 exam. Find out more: https://www.medrevisions.com/
Show moreThe country is not specifiedThe category is not specified
1 323
Subscribers
No data24 hours
No data7 days
No data30 days
Data loading in progress...
Similar Channels
No data
Any problems? Please refresh the page or contact our support manager.
Tags Cloud
No data
Any problems? Please refresh the page or contact our support manager.
Incoming and Outgoing Mentions
---
---
---
---
---
---
Attracting Subscribers
February '24
February '24
+96
in 0 channels
January '240
in 0 channels
Get PRO
December '23
+1 250
in 0 channels
| Date | Subscriber Growth | Mentions | Channels | |
| 16 February | 0 | |||
| 15 February | 0 | |||
| 14 February | +3 | |||
| 13 February | 0 | |||
| 12 February | +1 | |||
| 11 February | +1 | |||
| 10 February | +1 | |||
| 09 February | +3 | |||
| 08 February | +4 | |||
| 07 February | +2 | |||
| 06 February | +4 | |||
| 05 February | +1 | |||
| 04 February | 0 | |||
| 03 February | +3 |
Channel Posts
A 72-year-old retired school teacher presents to the clinic complaining of episodes of dizziness and one episode of syncope while climbing a flight of stairs at his home. He describes associated shortness of breath and a mild, central chest discomfort on moderate exertion. He denies any palpitations or nocturnal symptoms. On examination, you notice that his pulse is regular, blood pressure is 115/75 mmHg, and respiratory rate is 18 breaths per minute. His jugular venous pressure is not elevated. On cardiac auscultation, you notice an ejection systolic murmur best heard in the aortic area, radiating to the carotids. Given his clinical presentation, what would be the SINGLE most definitive investigation to confirm the diagnosis?
A. ECG
B. Echocardiogram
C. Ambulatory blood pressure monitoring
D. Holter ECG
E. CT head
| 2 | https://youtu.be/F7wNKwGYmKY | 1 495 |
| 3 | https://youtu.be/oc_KE2qXSfc | 1 939 |
| 4 | The correct answer is Aortic stenosis
Aortic stenosis is a common valvular heart disease in older patients. It is often associated with reduced exercise tolerance, fatigue, and in severe cases, chest pain, shortness of breath, and syncope. This patient's age, history of hypertension, and hyperlipidemia put her at risk for developing aortic stenosis. Aortic stenosis is characterised by a late peaking ejection systolic murmur with a harsh quality, loudest at the second right intercostal space, and radiating to the carotid arteries. The murmur becoming softer with the Valsalva manoeuvre further supports this diagnosis.
Aortic regurgitation typically presents with an early diastolic murmur, heard best at the left sternal border, and is inconsistent with this patient's presentation.
Mitral stenosis presents with a low-pitched, rumbling, mid-diastolic murmur, heard best at the apex in the left lateral decubitus position, which is inconsistent with this patient's presentation.
Mitral regurgitation presents with a holosystolic murmur, heard best at the apex and radiating to the left axilla, which is inconsistent with this patient's presentation.
Tricuspid regurgitation presents with a holosystolic murmur, heard best at the left lower sternal border and increasing with inspiration, which is inconsistent with this patient's presentation. | 2 113 |
| 5 | A 68-year-old woman with a history of hypertension and hyperlipidemia presents to the clinic with increasing fatigue and reduced exercise tolerance over the past six months. She denies chest pain, shortness of breath, and syncope. On physical examination, her blood pressure is 145/90 mmHg, heart rate is 70 beats per minute, and respiratory rate is 16 breaths per minute. Auscultation of the heart reveals a late peaking ejection systolic murmur with a harsh quality, heard loudest at the second right intercostal space and radiating to the carotid arteries. The murmur becomes softer when the patient performs a Valsalva maneuver. Which of the following is the SINGLE most likely diagnosis for this patient?
A. Aortic regurgitation
B. Aortic stenosis
C. Mitral regurgitation
D. Mitral stenosis
E. Tricuspid regurgitation | 2 099 |
| 6 | A 7-year-old girl is brought to the pediatrician by her parents who are worried about her developing secondary sexual characteristics earlier than her peers. They report that she has been having noticeable breast development and the growth of pubic hair. The patient also has recently experienced a rapid increase in her height. The child's mother mentions that she herself had an early menarche, around the age of 10. On examination, Tanner Stage III breast and pubic hair development is noted. There is no axillary hair, acne, or hirsutism, and her bone age, assessed by a left hand and wrist x-ray, corresponds to a chronological age of 10 years. She is otherwise healthy and takes no medication.
Which of the following is the most likely diagnosis?
A. Premature adrenarche
B. Premature thelarche
C. McCune-Albright syndrome
D. Central precocious puberty
E. Hyperthyroidism | 2 289 |
| 7 | Laryngeal carcinoma often presents with persistent hoarseness and may be associated with other symptoms such as ear pain, difficulty swallowing (dysphagia), and weight loss. The risk factors for laryngeal cancer include tobacco and alcohol use, and exposure to certain chemicals and substances such as asbestos and coal dust. In this patient, the significant smoking history and the findings on physical examination strongly point towards a diagnosis of laryngeal carcinoma.
Laryngeal papillomatosis (Option B) is a disease characterized by the development of benign tumors (papillomas) on the surface of the larynx. It is typically seen in children and is caused by the human papillomavirus (HPV). It does not typically present with a neck mass.
Vocal cord nodules (Option C) are benign growths on both vocal cords that are caused by vocal abuse or misuse. The patient's history of smoking and the presence of a neck mass do not support this diagnosis.
Parotid gland tumors (Option D) can cause ear pain and neck masses, but they would not typically cause hoarseness or an ulcerative lesion on the vocal cord. Most parotid gland tumors are also benign.
Sialolithiasis (Option E) involves the formation of a stone within a salivary gland, usually the submandibular gland. This can cause pain and swelling in the neck, especially during meals. However, it wouldn't typically cause hoarseness or dysphagia.
Thus, the clinical picture given in the question is most suggestive of laryngeal carcinoma. It's crucial to remember that hoarseness lasting more than two weeks, especially in the context of risk factors like smoking and alcohol use, necessitates further investigation to rule out a laryngeal carcinoma. This is especially true if other symptoms, such as weight loss, dysphagia, and otalgia (ear pain), are present. | 1 706 |
| 8 | A 72-year-old man, with a 50 pack-year smoking history and a recent diagnosis of atrial fibrillation, presents to your clinic complaining of a two-month history of persistent hoarseness, difficulty swallowing, and a noticeable weight loss. He denies having a fever or cough but reports a chronic, dull ache in his left ear. On examination, you note a firm, non-tender, immobile mass on the left side of his neck, and fiberoptic laryngoscopy reveals an ulcerative lesion involving the left true vocal cord. What is the SINGLE most likely diagnosis?
A. Laryngeal carcinoma
B. Laryngeal papillomatosis
C. Vocal cord nodule
D. Parotid gland tumor
E. Sialolithiasis | 2 028 |
| 9 | A. Meniscal tear is the most likely diagnosis in this case, as the patient's symptoms of knee locking and inability to fully extend the knee are characteristic features of a torn meniscus. Meniscal injuries can occur concurrently with ACL injuries and may not be evident immediately after surgery.
B. Patellar dislocation usually presents with a history of a sudden twisting injury, with the patient experiencing severe pain, swelling, and an obvious deformity of the knee. This diagnosis is less likely given the patient's clinical presentation.
C. Quadriceps tendon rupture typically presents with an inability to actively extend the knee and a palpable gap above the patella. This diagnosis is less likely given the patient's clinical presentation.
D. Patellar tendon rupture presents with an inability to actively extend the knee and a palpable gap below the patella. This diagnosis is less likely given the patient's clinical presentation.
E. Posterior cruciate ligament (PCL) injury presents with pain, swelling, and posterior instability of the knee joint. This diagnosis is less likely given the patient's clinical presentation. | 1 608 |
| 10 | A 28-year-old woman underwent an arthroscopic knee surgery to repair her anterior cruciate ligament (ACL) after a skiing accident. After a few weeks of immobilization in a knee brace, she started physical therapy. During her rehabilitation, she noticed that she could not fully extend her knee, and she experienced a feeling of "locking" in her knee joint. What is the SINGLE most likely diagnosis?
A. Meniscal tear
B. Patellar dislocation
C. Quadriceps tendon rupture
D. Patellar tendon rupture
E. Posterior cruciate ligament (PCL) injury | 1 979 |
| 11 | When prescribing medications for a breastfeeding mother, it is essential to consider both the mother's health and the potential risk for the baby.
A. Tetracycline: Tetracyclines, including doxycycline, can affect bone and teeth development in infants. They can bind to calcium in the infant's body, leading to staining of teeth and potential growth restriction of long bones. Therefore, tetracycline and other drugs of this class are generally avoided in breastfeeding mothers.
B. Ciprofloxacin: Ciprofloxacin is a fluoroquinolone antibiotic. While it is not strictly contraindicated, it is not usually the first choice for breastfeeding women due to theoretical concerns about effects on the infant's developing joints.
C. Chloramphenicol: Chloramphenicol can cause gray baby syndrome, a condition characterized by poor feeding, abdominal distension, and a grayish color of the skin, particularly in premature infants and newborns. Therefore, it is generally avoided in breastfeeding mothers.
D. Doxycycline: Doxycycline is a tetracycline antibiotic, and like tetracycline, it can affect bone and teeth development in infants. Therefore, it is generally avoided in breastfeeding mothers.
E. Ceftriaxone: Ceftriaxone is a third-generation cephalosporin antibiotic. It is generally considered safe to use during breastfeeding as it has a low level of excretion into breast milk and is poorly absorbed from the gut, minimizing the risk to the infant.
So, among the given options, ceftriaxone (option E) is not contraindicated while breastfeeding and can be safely used to treat the mother's pneumonia. Always remember that it's crucial to weigh the benefits of the medication for the mother against the potential risks for the baby. | 1 796 |
| 12 | You are seeing a 32-year-old woman in the postnatal clinic who is currently breastfeeding her 6-week-old baby. She presents with a high-grade fever, productive cough, and pleuritic chest pain. After examination and investigation, you diagnose her with community-acquired pneumonia. You need to decide on the appropriate antibiotic therapy considering that she is breastfeeding. Which of the following antibiotics is not contraindicated while breastfeeding?
A. Tetracycline
B. Ciprofloxacin
C. Chloramphenicol
D. Doxycycline
E. Ceftriaxone | 1 523 |
| 13 | The correct answer is C.
The combined oral contraceptive pill (COCP) is a widely used method of contraception containing both estrogen and progestogen. While it is an effective and convenient method, it also has various health effects that can influence a woman's risk of developing certain types of cancer.
In the context of this question, the COCP has been shown to have a protective effect against ovarian cancer (Option C). This effect is thought to be due to the suppression of ovulation, which reduces the number of times the ovarian epithelium is disrupted and repaired. The protective effect increases with the duration of use and persists for many years after discontinuation of the COCP.
It is essential to note that the COCP has other effects on cancer risk:
Increased risk of breast and cervical cancer: Women who take the COCP have a slightly increased risk of developing breast cancer and cervical cancer compared to those who do not. The risk of breast cancer decreases over time after stopping the pill, while the risk of cervical cancer is related to the duration of use.
Protective against endometrial cancer: Similar to its protective effect on ovarian cancer, the COCP also reduces the risk of endometrial cancer. This is likely due to the progestogen component, which opposes the proliferative effects of estrogen on the endometrium.
In summary, the COCP has a complex impact on a woman's risk of developing certain types of cancer. It is essential to counsel patients on these potential risks and benefits and help them make an informed decision about their contraceptive options. | 1 552 |
| 14 | A 25-year-old woman comes to your clinic seeking advice on the potential long-term effects of the combined oral contraceptive pill (COCP) on her health. Which of the following types of cancer has a reduced incidence in women taking the COCP?
A. Breast cancer
B. Cervical cancer
C. Ovarian cancer
D. Lung cancer
E. Pancreatic cancer | 1 787 |
| 15 | Correct answer is D
Dexamethasone is a potent glucocorticoid steroid used to treat vasogenic edema that occurs due to the breakdown of the blood-brain barrier, as is commonly seen in patients with brain tumors. Its use is essential in managing cerebral edema in patients with glioblastoma.
However, dexamethasone therapy is associated with several side effects, one of which is immunosuppression (option D). Glucocorticoids, such as dexamethasone, can suppress the immune response, making patients more susceptible to infections. This effect is especially relevant for patients undergoing surgery or other invasive procedures, as well as those receiving concomitant immunosuppressive treatments, such as chemotherapy.
Hypoglycemia (option A) is not a typical side effect of dexamethasone therapy; in fact, glucocorticoids may cause hyperglycemia by increasing gluconeogenesis and insulin resistance.
Bradycardia (option B) is not typically associated with dexamethasone use. Glucocorticoids can cause fluid retention and hypertension but do not directly affect heart rate.
Hyperkalemia (option C) is not a side effect of dexamethasone therapy. Glucocorticoids can cause hypokalemia due to their mineralocorticoid effects, promoting potassium excretion in the kidneys.
Hyponatremia (option E) is not a typical side effect of dexamethasone. Glucocorticoids can cause fluid retention, which may lead to dilutional hyponatremia in some cases, but this is not a direct effect of the drug on sodium levels. | 1 585 |
| 16 | A 61-year-old woman presents to the emergency department with morning headaches, nausea, and vomiting. An urgent CT head reveals a mass within the right frontal lobe, and a subsequent MRI head confirms a glioblastoma surrounded by edema. The patient is started on dexamethasone for the cerebral edema. Which of the following is a potential side effect of dexamethasone therapy in this patient?
A. Hypoglycemia
B. Bradycardia
C. Hyperkalemia
D. Immunosuppression
E. Hyponatremia | 1 649 |
| 17 | Correct answer is D
The most likely underlying diagnosis in this case is dehydration. The patient's blood results show a proportionally higher rise in urea (16 mmol/L) than creatinine (110 µmol/L), which is characteristic of dehydration. The mild hypernatremia (146 mmol/L) can also be explained by the patient being dehydrated. The reduced urine output is likely a consequence of having a negative fluid balance overall.
Given the patient's clinical and laboratory findings, the most appropriate next step in management is to administer intravenous (IV) fluids (option D) to correct the dehydration. IV fluids will help restore the patient's fluid balance, improve urine output, and potentially correct the electrolyte abnormalities.
Starting continuous renal replacement therapy (CRRT) (option A) is not appropriate, as the patient does not have acute kidney injury (AKI). AKI would present with a proportionally greater rise in creatinine than urea, and the rise in creatinine would be much higher.
Administering furosemide (option B) is not warranted, as it is a diuretic and would likely exacerbate the patient's dehydration.
Ordering a renal ultrasound (option C) may be useful in assessing for other potential causes of reduced urine output, but it does not address the underlying dehydration, which should be managed first.
Increasing the dose of IV antibiotics (option E) is not necessary, as there is no indication that the chest infection is worsening, and the patient's CURB-65 score is only 1. | 1 861 |
| 18 | A 64-year-old in-patient with a history of surgical removal of kidney stones is being seen by a urology registrar due to concerns about reduced urine output over the past 2 days. The patient's catheter was accidentally removed, and there is no record of urine output. They have been kept in the hospital due to a chest infection and have been treated with IV antibiotics. The patient denies pain and does not appear confused. Basic observations and blood results are as follows:
Respiratory rate: 14 breaths/min
Heart rate: 82 bpm
Blood pressure: 109/62 mmHg
Sodium: 146 mmol/L
Potassium: 4.1 mmol/L
Urea: 16 mmol/L
Creatinine: 110 µmol/L
Considering the patient's clinical and laboratory findings, what is the most appropriate next step in management?
A. Start continuous renal replacement therapy (CRRT)
B. Administer furosemide
C. Order a renal ultrasound
D. Administer intravenous (IV) fluids
E. Increase the dose of IV antibiotics | 1 701 |
| 19 | Correct answer is B
In patients with glioblastoma or other brain tumors, preoperative management with dexamethasone (option B) is often employed to reduce cerebral edema and the associated mass effect, helping to minimize the risk of complications during surgery. Dexamethasone is a potent glucocorticoid steroid that effectively treats vasogenic edema by reducing the breakdown of the blood-brain barrier.
Preoperative administration of hypertonic saline (option A) is not the standard approach for reducing cerebral edema in brain tumor patients. Hypertonic saline may be used in the context of acute neurological emergencies to decrease intracranial pressure rapidly but is not the preferred choice in this scenario.
Mannitol (option C) is an osmotic diuretic commonly used to treat elevated intracranial pressure in acute settings, such as traumatic brain injury. However, in the context of preoperative management for brain tumors, dexamethasone is preferred due to its specific effects on vasogenic edema.
Immediate administration of chemotherapy (option D) is not appropriate for preoperative management of glioblastoma. Chemotherapy is typically administered postoperatively, sometimes in conjunction with radiation therapy, as part of a multimodal treatment approach.
Furosemide (option E) is a loop diuretic that is not routinely used to treat cerebral edema in brain tumor patients. While it can be helpful in managing fluid overload, it does not specifically target vasogenic edema associated with brain tumors, making dexamethasone a more appropriate choice. | 1 348 |
| 20 | A 61-year-old woman presents to the emergency department with morning headaches, nausea, and vomiting. An urgent CT head reveals a mass within the right frontal lobe, and an MRI head confirms the presence of a glioblastoma surrounded by edema. The neurosurgery team is consulted, and the patient is scheduled for surgical intervention. Which of the following management strategies is most appropriate to help prevent complications during surgery?
A. Preoperative administration of hypertonic saline
B. Preoperative initiation of dexamethasone therapy
C. Preoperative administration of mannitol
D. Immediate administration of chemotherapy
E. Preoperative administration of furosemide | 1 545 |
