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Enhance Your Medical Expertise with Case Based MCQ – Your Go-To Telegram Channel for Challenging, Real-World MCQs and Continuous Learning. Admin: @Mohamm_ADs
Mostrar más📈 Análisis del canal de Telegram Case-based MCQ
El canal Case-based MCQ (@casebasedmcq) en el segmento lingüístico de Inglés es un actor destacado. Actualmente la comunidad reúne a 19 220 suscriptores, ocupando la posición 1 206 en la categoría Medicina y el puesto 22 541 en la región India.
📊 Métricas de audiencia y dinámica
Desde su creación el невідомо, el proyecto ha mostrado un crecimiento acelerado, reuniendo a 19 220 suscriptores.
Según los últimos datos del 21 junio, 2026, el canal mantiene una actividad estable. En los últimos 30 días la variación de miembros fue de -194, y en las últimas 24 horas de -7, conservando un alto alcance.
- Estado de verificación: No verificado
- Tasa de interacción (ER): El promedio de interacción de la audiencia es 2.19%. Durante las primeras 24 horas tras publicar, el contenido suele obtener 0.71% de reacciones respecto al total de suscriptores.
- Alcance de las publicaciones: Cada publicación recibe en promedio 421 visualizaciones. En el primer día suele acumular 137 visualizaciones.
- Reacciones e interacción: La audiencia responde de forma activa: el promedio de reacciones por publicación es 1.
- Intereses temáticos: El contenido se centra en temas clave como boardvital, bmj, journal, usmle, drug.
📝 Descripción y política de contenido
El autor describe el recurso como un espacio para expresar opiniones subjetivas:
“Enhance Your Medical Expertise with Case Based MCQ – Your Go-To Telegram Channel for Challenging, Real-World MCQs and Continuous Learning.
Admin: @Mohamm_ADs”
Gracias a la alta frecuencia de actualizaciones (últimos datos recibidos el 22 junio, 2026), el canal mantiene la vigencia y un amplio alcance. La analítica demuestra que la audiencia interactúa activamente con el contenido, lo que lo convierte en un punto de referencia dentro de la categoría Medicina.
19 220
Suscriptores
-724 horas
-437 días
-19430 días
Archivo de publicaciones
19 220
🇨🇦 MCCQE1,2 | #Case_107
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A 15-year-old white male is brought to your department by his mother because he has been waking up at night "drenched in sweat". This usually occurs between midnight and 1 am and he goes to bed at 10 pm every night. He also reports that his pre-breakfast blood glucose (at 6 am) is 12.2 mmol/L (220 mg/dL). He was diagnosed with type 1 diabetes mellitus and it is treated with insulin. He takes his insulin therapy as prescribed. An hour or so before bedtime he takes 100 units of insulin, (70 units NPH insulin and 30 units of insulin aspart). What is the best recommendation to manage this patient’s condition?
a) Nocturnal hormonal measurements
b) Reduce the evening dose of insulin by half
c) Replace NPH and insulin aspart with glargine
d) Double the dose of NPH and insulin aspart
e) No change in treatment, eat some sugar if sweating develops in the night
19 220
🇨🇦 MCCQE1,2 | #Case_107 | #answer
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✅ E
🔎 Explanation
Hyperglycemia is common after a major surgery due to release of counter-regulatory hormones. It has negative effect on morbidity and mortality in post-operative period. Randomized clinical trials have shown that tight control of blood glucose in surgical intensive care units improve outcomes, independent of whether the patient has history of diabetes or not. For this reason, hyperglycemia should be aggressively treated in intensive care setting with insulin infusion (choice
E) to maintain blood sugar levels between 7.7 mmol/L and 10 mmol/L. The patient described in the stem is not diabetic but has manifested stress induced hyperglycemia. Glycemic control in this case should be achieved with standard insulin infusion; which is 100 units of insulin in 100ml of 0.9% NaCl. Regular insulin, insulin aspart and insulin glulisine are approved for intravenous use. The rate of insulin infusion is 2 units/hour, for blood glucose in the range of 10-11.1 mmol/L, which is reduced to 1.5 unit/hour when the blood glucose is below 10mmol/L and, 1unit/hour when it is below 8.3 mmol/L.
⚠ Observation and monitoring (choice A) is not appropriate for this situation as the patient’s blood glucose level is high and should be treated.
⚠ Sliding scale regime (choice B), in which dose of subcutaneous regular insulin is adjusted based on intermittent capillary sugar values is not suitable in intensive care setting. Insulin absorption from subcutaneous tissue is unpredictable because of circulatory changes and drugs administered in intensive care.
⚠ Glargine is a long-acting insulin and provides basal insulin requirement. It is not suitable in intensive care setting as it does not treat hyperglycaemic surges, which are common in the setting. Dosing regimen of 12 hours (choice D) or 24 hours (choice C) are both unsuitable.
🔖 Key point:
Tight control of blood glucose in surgical intensive care units improve outcomes, independent of whether the patient has history of diabetes or not. For this reason, hyperglycemia should be aggressively treated in intensive care setting with insulin infusion
19 220
🇨🇦 MCCQE1,2 | #Case_107
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A 62-year-old man underwent coronary artery bypass grafting surgery for triple vessel disease. His past medical history is significant for hypertension for which he receives amlodipine and ramipril. He is not diabetic. His pre-operative glycated haemoglobin was 5.8%. Following the surgery he is shifted to the surgical intensive care unit, where his blood glucose is tested 6-hourly. The second spot sample tested 12 hours postoperatively is 10.4 mmol/L. Which one of the following is the most appropriate management of this patient’s glucose levels?
a) Observation and 2 hourly blood sugar monitoring
b) Sliding scale regular insulin
c) Insulin glargine once in a day
d) Insulin glargine 12 hourly
e) Insulin infusion
19 220
🇨🇦 MCCQE1,2 | #Case_106 | #answer
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✅ E
🔎 Explanation
The patient has acute suppurative sialadenitis which is caused by coagulase-positive Staphylococcus aureus, Streptococcus pneumoniae, and other bacteria. Sialadenitis creates a painful lump in the gland, and foul-tasting pus drains into the mouth. The patient needs treatment with antibiotics (choice E).
⚠ The patient needs to be treated and observation only (choice A) would be considered negligence.
⚠ Cat scratch disease (choice B) involves the lymph glands, not the salivary glands.
⚠ Tuberculosis (choice C) is a rare cause.
⚠ A CT scan (choice E) may be indicated if there is no improvement, or if a tumor is suspected.
19 220
🇨🇦 MCCQE1,2 | #Case_106
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A 39-year-old white male is seen in your office with a history of sudden painful swelling of the right parotid gland. He also reports occasional foul taste in the mouth. The patient has a temperature of 38.2°C (100.8°F). The parotid gland is tender on examination. Which one of the following would be most appropriate at this point?
a) Observation only
b) Asking about pets in the household
c) Tuberculin test
d) A CT scan
e) Antibiotics
19 220
🇨🇦 MCCQE1,2 | #Case_105 | #answer
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✅ C
🔎 Explanation
Chronic radiation proctitis develops months to years after radiation and is characterized by pain with defecation, diarrhea, and sometimes rectal bleeding. On colonoscopy, the mucosa is pale and friable with telangiectases which are sometimes large, multiple, and serpiginous
19 220
🇨🇦 MCCQE1,2 | #Case_105
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A 75-year-old male complains of pain with defecation, and loose stools. This problem seems to have developed gradually over the last several months. His past medical history includes prostate cancer treated with radiation therapy 5 years ago, hypertension, and osteoarthritis. Medications include hydrochlorothiazide (HydroDIURIL), a Beta-blocker, and acetaminophen. On colonoscopy, no polyps or cancer are found, but the rectal and sigmoid areas show pallor with friability and telangiectasias.The most likely diagnosis is:
a) Familial angiodysplasia
b) Osler-Weber-Rendu syndrome
c) Radiation proctitis
d) Late-onset ulcerative colitis
e) Sensitivity to acetaminophen breakdown products
19 220
🇨🇦 MCCQE1,2 | #Case_104 | #answer
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✅ D
🔎 Explanation
Benign nocturnal limb pains of childhood (growing pains) occur in as many as one-third of children, most often between 4 and 6 years of age. The etiology is unknown, but the course does not parallel pubescent growth, as would be expected if bone growth was the source of pain. The pain often awakens the child within hours of falling asleep following an active day. The pain is generally localized around the knees, most often in the shins and calves, but also may affect the thighs and the upper extremities. A characteristic history coupled with a normal physical examination will confirm the diagnosis. Reassurance that no additional tests or treatments are necessary and that the condition is self-limiting is the most appropriate response.
19 220
🇨🇦 MCCQE1,2 | #Case_104
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During a preparticipation examination of a 5-year-old male for summer soccer camp, his mother states that he frequently awakens during the night with complaints of cramping pain in both legs, and that he seems to experience this after a day of heavy physical activity. She says that he appears to drag his legs at times, but she has never noticed a definite limp. A physical examination of the hips, knees, ankles, and leg musculature is entirely normal.Which one of the following would be the most appropriate next step in the evaluation and management of this patient?
a) Plain films of both hips and knees
b) Serum electrolyte levels
c) Recommending that he not participate in running sports
d) Reassurance, with no activity restrictions or treatment
e) Referral to a pediatric orthopedist
19 220
🇨🇦 MCCQE1,2 | #Case_103 | #answer
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✅ A
🔎 Explanation
This presentation is typical of either transient synovitis or septic arthritis of the hip. Because the conditions have very different treatment regimens and outcomes, it is important to differentiate the two. It is recommended that after plain films, the first studies to be performed should be a CBC and an erythrocyte sedimentation rate (ESR). Studies have shown that septic arthritis should be considered highly likely in a child who has a fever over 38.7 degrees C (101.7 degrees F), refuses to bear weight on the leg, has a WBC count 3 > 12^9/L, and has an ESR > 40 mm/hr. If several or all of these conditions exist, aspiration of the hip guided by ultrasonography or fluoroscopy should be performed by an experienced practitioner. MRI may be helpful in cases that are unclear based on standard data, or if other etiologies need to be excluded
19 220
🇨🇦 MCCQE1,2 | #Case_103
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A 3-year-old male is carried into the office by his mother. Yesterday evening he began complaining of pain around his right hip. Today he has a temperature of 37.6°C(99.7°F), cries when bearing weight on his right leg, and will not allow the leg to be moved in any direction. A radiograph of the hip is normal.Which one of the following would be most appropriate at this time?
a) A CBC and an erythrocyte sedimentation rate
b) A serum antinuclear antibody level
c) Ultrasonography of the hip
d) MRI of the hip
e) In-office aspiration of the hip
19 220
🇨🇦 MCCQE1,2 | #Case_102 | #answer
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✅ C
🔎 Explanation
The scenario described is suspicious for an occult fracture of the scaphoid bone of the wrist. The mechanism of injury, falling on an outstretched hand with the wrist extended, combined with tenderness in the anatomic snuff box (between the extensor pollicis longus and extensor pollicis brevis tendons) raises the possibility of a scaphoid fracture even if initial radiographs are negative. In order to reduce the potential for serious complications, including vascular necrosis and non-union, it is imperative that both the wrist and the thumb be immobilized. In the case described, a thumb spica splint is the best option initially. It should be worn continuously until a follow-up evaluation, including radiographs, in 1-2 weeks.
19 220
🇨🇦 MCCQE1,2 | #Case_102
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While playing basketball, a 29-year-old male falls on his outstretched hand with his wrist fully extended. He sees you the following day because of diffuse wrist pain and decreased range of motion. The point of maximal tenderness is on the dorsal aspect of the wrist between the extensor pollicis brevis and extensor pollicis longus tendons. There is no visible deformity. Radiographs show no fracture.Which one of the following is the most appropriate initial treatment of this patient?
a) A wrist extension splint
b) An ulnar gutter splint
c) A thumb spica splint
d) A short arm cast
e) Physical therapy
19 220
🇨🇦 MCCQE1,2 | #Case_101 | #answer
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✅ D
🔎 Explanation
With extensive tubal disease on both the HSG and laparoscopy, operative assistance will be needed in order for an egg to reach the uterine cavity. Due to the tubal disease, GIFT is not possible. ICSI is the treatment of choice for azoospermia and severe oligospermia. The patient is ovulatory based on her basal body temperature chart, so ovulation induction alone is not necessary. IVF with transcervical transfer of the embryo is the optimal treatment for this couple. With blastocyst transfer, the current success rates are above 50%.
⚠ The two tests of tubal function both demonstrate that it is highly unlikely for the egg to successfully transport down the tube. Thus, IUI will be of no benefit, since the sperm and egg will not meet.
⚠ ICSI is used for oligospermic and even some azospermic males to achieve fertilization.
⚠ Again, ovulation induction alone will not be successful if the tubes are blocked bilaterally.
⚠ This technique can only be used if there is tubal patency. The egg and sperm mixture is placed in the distal fallopian tube via laparoscopy. The tubes here are blocked
19 220
🇨🇦 MCCQE1,2 | #Case_101
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A 35-year-old woman presents to your office. She and her 32-year-old husband have been unsuccessful in their attempts to get pregnant for the last 6 years. He has fathered two children in a prior marriage and has a normal semen analysis. Her basal body temperature chart is biphasic. Her past history notes multiple episodes of chlamydia and gonorrhea. A hysterosalpingogram demonstrates blocked fallopian tubes bilaterally, and a laparoscope notes dense and profuse peritubal and pelvic adhesions, along with bilateral clubbed tubes. The most appropriate fertility treatment would be:
a) Intrauterine insemination with husband’s sperm (IUI)
b) Intracytoplasmic sperm injection with husband’s sperm (ICSI)
c) Gonadotropin induction of ovulation
d) In vitro fertilization (IVF)
e) Gamete intrafallopian transfer (GIFT
19 220
🇨🇦 MCCQE1,2 | #Case_100 | #answer
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✅ A
🔎 Explanation
Amoxicillin is preferred for the treatment of Lyme disease in children, as well as for pregnant or lactating women. Doxycycline is effective, but should not be used in pregnant women. Macrolides are not considered first-line agents because controlled trails of azithromycin or erythromycin in patients with erthema migrans found a high rate of clinical failure.
19 220
🇨🇦 MCCQE1,2 | #Case_100
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A 24-year-old white female in her first trimester of pregnancy presents with low-grade fever, myalgias, headache, and a rash consistent with erythema migrans. Ten days ago she was hiking in an area where deer ticks are present. She remembers being bitten by a tick which she discovered and removed 2 days after her hike. Which one of the following is the most appropriate treatment option?
a) Amoxicillin
b) Azithromycin
c) Doxycycline
d) Erythromycin
19 220
🇨🇦 MCCQE1,2 | #Case_99 | #answer
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✅ E
🔎 Explanation
This patient displays most of the criteria for borderline personality disorder. This is a maladaptive personality type that is present from a young age, with a strong genetic predisposition. It is estimated to be present in 1% of the general population and involves equal numbers of men and women; women seek care more often, however, leading to a disproportionate number of women being identified by medical providers.Borderline personality disorder is defined by high emotional lability, intense anger, unstable relationships, frantic efforts to avoid a feeling of abandonment, and an internal sense of emptiness. Nearly every patient with this disorder engages in self-injurious behavior (cutting, suicidal gestures and attempts), and about 1 in 10 patients eventually succeeds in committing suicide. However, 90% of patients improve despite having made numerous suicide threats. Suicidal gestures and attempts peak when patients are in their early 20s, but completed suicide is most common after age 30 and usually occurs in patients who fail to recover after many attempts at treatment. In contrast, suicidal actions such as impulsive overdoses or superficial cutting, most often seen in younger patients, do not usually carry a high short-term risk, and serve to communicate distress.
Inpatient hospitalization may be an appropriate treatment option if the person is experiencing extreme difficulties in living and daily functioning, and pharmacotherapy may offer a mild degree of symptom relief. While these modalities have a role in certain patients, psychotherapy is considered the mainstay of therapy, especially in a relatively stable patient such as the one described
19 220
🇨🇦 MCCQE1,2 | #Case_99
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A 19-year-old female high-school student is brought to your office by a friend who is concerned about the patient having cut her wrists. The patient denies that she was trying to kill herself, and states that she did this because she “just got so angry” at her boyfriend when she caught him sending a text message to another woman. She denies having a depressed mood or anhedonia, and blames her fluctuating mood on everyone who “keeps abandoning her,” making her feel like she’s “nothing.” She admits that she has difficulty controlling her anger. Her sleep quality and pattern appear normal, as does her appetite. She denies hallucinations or delusions. The wounds on her wrists appear superficial and there is evidence of previous cutting behavior on her forearms. Her vital signs are stable.Which one of the following would be most beneficial for this patient?
a) Clonazepam
b) Fluoxetine
c) Quetiapine
d) Inpatient psychiatric admission
e) Psychotherapy
19 220
🇨🇦 MCCQE1,2 | #Case_98 | #answer
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✅ C
🔎 Explanation
The presence of dysmorphic RBC's in urine suggests a renal or glomerular hematuria.This patient most likely suffers from IgA nephropathy. Two common presentations of patients with IgA nephropathy are episodic gross hematuria and persistent microscopic hematuria. Recurrent macroscopic hematuria, usually associated with an upper respiratory tract infection, or, less often, gastroenteritis is the most frequent clinical presentation and is observed in 40-50% of presenting patients. In 30-40% of patients, the disease is asymptomatic, with erythrocytes (RBCs), RBC casts, and proteinuria discovered on urinalysis. Patients with IgA nephropathy can also present with acute or chronic renal failure.
🔖Note: Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates.
