Case-based MCQ

⏳ Case-based MCQ | #Case_347 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 A 55-year-old gentleman is admitted with central colicky abdominal pain. The pain has been present for 6 days and is getting worse. He has also noticed the passage of watery diarrhoea for 3 days prior to presentation. Past medical history includes angina and peripheral vascular disease and he is a current smoker. Examination reveals generalised tenderness which is most marked over the left colon. An abdominal x-ray study is performed.

⏳ Case-based MCQ | #Case_346 | #answer 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 ✅ E Clang association is an abnormality of speech where the connection between words is their sound rather than their meaning. May occur during manic flight of ideas. Clang associations generally sound a bit like rhyming poetry, except that the poemsdon't seem to make any sense. Example, one may say “systematic, sympathetic, quitepathetic, apologetic, paramedic, your heart is prosthetic."

🧩 Medical Mnemonics What's the difference ... 🤔 ACAMPROSATE vs DISULFIRAM in alcohol use disorder 🔺Disulfiram ➖ Acts as a deterrant – Around 5 to 10 minutes after alcohol intake, patients may experience the effects of a severe hangover for a period of 30 minutes up to several hours. ➖ It is used after 24 horus from the last alcoholic drink. 🔻Acamprosate ➖ Reduces cravings. ➖ It is used after the patient has finished a planned withdrawal from alcohol. A useful #mnemonic to remember is DiSulfiram is a Deterrant that makes you Sick whereas aCamprosate reduces Cravings. #psychiatry 〰〰〰〰〰〰〰〰〰〰〰 ©Medical Mnemonics

🔴⚫⚫⚫⚫⚫⚫⚫⚫⚫⚫ 🔴🔴⚫⚫⚫⚫⚫⚫⚫⚫⚫ 🔴🔴🔴⚫⚫⚫⚫⚫⚫⚫⚫ 🔴🔴🔴🔴⚪⚪⚪⚪⚪⚪⚪ 🔴🔴🔴🔴🔴⚪⚪⚪⚪⚪⚪ 🔴🔴🔴🔴⚪⚪⚪⚪⚪⚪⚪ 🔴🔴🔴🟢🟢🟢🟢🟢🟢🟢🟢 🔴🔴🟢🟢🟢🟢🟢🟢🟢🟢🟢 🔴🟢🟢🟢🟢🟢🟢🟢🟢🟢🟢

🧩 Medical Mnemonics Hypokalemia causes Eid Mubarak 🌺🌙 🎆🕋 ⚡Enteric losses ( diarrhea) ⚡Insulin excess, Increase of Glucocorticoid (Cushing's, exogenous steroids, ectopic ACTH), Increased sweat losses ⚡Dialysis, Decrease of body temperature (hypothermia) ⚡Magnesium depletion ⚡Urinary losses(Diuretics) ⚡β-adrenergic activity, Bartter's or Gitelman's syndrome ⚡Alkalosis, Amphotericin B ⚡RTA types I and II ⚡Aldosteronism ⚡Ketoacidosis #nephrology 〰〰〰〰〰〰〰〰〰〰〰 ©Medical Mnemonics

The Most Updated & Regular Medical Channels Containing Premium Medical Packages:

The Most Updated & Regular Medical Channels Containing Premium Medical Packages:

🧩 Medical Mnemonics Learn Hummingbird sign in Progressive supranuclear palsy (PSP) by #visual_mnemonics. ━━━━━━━━━━━━━━━━ 👨‍⚕ Explanation Progressive supranuclear palsy (PSP) is a neurodegenerative disorder characterized by supranuclear vertical gaze palsy, postural instability and falls, parkinsonian features, speech disturbance, and cognitive impairment. The hummingbird sign in brain MRI is an interesting radiological sign in the patients with PSP. It is due to atrophy of the midbrain and relative lengthening of the interpeduncular fossa and preserved pons. #radiology 〰〰〰〰〰〰〰〰〰〰〰 ©Medical Mnemonics

Follow the most interesting scenes of technology and engineering progress in this channel 👇👇👇👇 T.me/pishraftmohandesi

⏳ Case-based MCQ | #Case_345 | #answer 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 ✅ B This patient has delayed bone agecoupled with a reduced growth velocity, which suggests an underlying systemic cause. Growth hormone deficiency is onepossible cause for this. Although bone age can bedelayed with constitutional growthdelay, after 24 months of age growth curves are parallel to the 3rd percentile. Bone age would be normal with genetic short stature. Patients with Turner syndrome or skeletal dysplasia have dysmorphic features, and bone age would be normal.

⏳ Case-based MCQ | #Case_345 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 A 5‐year‐old female is seen for a kindergarten physical and is noted to be below the 3rd percentile for height. A review of her chart shows that her height curve has progressively fallen further below the 3rd percentile over the past year. She was previously at the 50th percentile for height. The physical examination is otherwise normal, but your workup shows that her bone ageis delayed.

The Hated One Premium Courses Free : Computer Science 🎉 ● Udemy ● Clever Programmer ● CBT Nuggests ● AlgoExpert ● Code with Mosh ● Coding Blocks ● Design Code ● GeeksForGeeks ● SANS ● Offensive Security ● Linux Academy ● INE and counting... Limited Invites: https://t.me/joinchat/sTzNOjYJ8DE4NzU1 👆👆👆

⏳ Case-based MCQ | #Case_344 | #answer 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 ✅ C The patient is having absence or petit mal seizures, and the drug of choice is ethosuximide (choice C) or valproic acid. ⚠ Diazepam (choice A) is effective in treating status epilepticus but is not used in treating petit mal seizures. ⚠ Diphenhydramine (choice B) is an antihistamine and would not be of benefit in treating this illness. ⚠ Phenobarbital (choice D) and Phenytoin (choice E) are anticonvulsants, but are not used for absence seizures.

⏳ Case-based MCQ | #Case_344 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 A 12‐year‐old boy is brought to the clinic because of a several monthhistory of strange behavior. According to his parents, the boy occasionally starts staring and does not respond at all. He also has tears in his eyes during these events. These episodes last several seconds and he then returns to his baseline. He has not sustained any head trauma andis on no medications.

⏳ Case-based MCQ | #Case_343 | #answer 〰〰〰〰〰〰〰〰〰〰〰〰〰〰 ✅ B This patient has mixed metabolic acidosis and metabolic alkalosis (choice B) despite the normal values of pH, [HCO‐3], PaCO2. The evidence supporting an acid base disturbance in this patient is the highplasma anion gap (PAG) of 21mmol/L (calculated as: [Na] – [HCO‐3] – [Cl]). The discrepancy between DPAG and D[HCO‐3] indicates high anion gap metabolic acidosis. DPAG and D[HCO‐3] are calculated by subtracting the normal values of these parameters from the prevailing patient values. DPAG is thus, 11mmol/L (21 – 10) and D[HCO‐3] is ‐3mmol/L (24 – 27). This means that there are 8mmol /L of unmeasured anions and indicates existence of high anion gap metabolic acidosis. These unmeasured anions are most likely ketoacids from starvation that accompanies Hyperemesis Gravidarum. Indeed, ketoacidosis and kentonuria are essential criteria for diagnosis of this disorder. Metabolic alkalosis is suggested by the normal pH in the presence of metabolic acidosis (due to ketoacids) and this is further supported by the fact that the patient has severe vomiting which is known to cause metabolic alkalosis. When vomiting stops in this patient and before she starts normal feeding, pH may transiently decrease because metabolic acidosis will then be uncovered. On the other hand if this patient is fed parenterally and vomiting persists pH may transiently increase because metabolic alkalosis will then be uncovered. ⚠ She has normal acid base status (choice A) is an incorrect statement. The high plasma anion gap (PAG) and the  discrepancy between DPAG and D[HCO‐3] indicates an abnormal acid base status. ⚠ She has mixed metabolic acidosis and respiratory alkalosis (choice C) is not correct. If this patient had mixed metabolic acidosis and respiratory alkalosis, PaCO2 would not be normal. By definition, respiratory alkalosis results from low PaCO2 due to excessive washout of CO2 from the body. If this patient had an isolated or simple metabolic acidosis (ketoacidosis from starvation and she is not vomiting) and normal respiratory system, respiratory compensation would bring PaCO2 down and raise the pH back towards normal. If she had respiratory alkalosis on top of metabolic acidosis, PaCO2 would be brought down even more that what usually occurs during ordinary respiratory compensation to metabolic acidosis and pH might return all the way back to normal. ⚠ She has mixed metabolic alkalosis and respiratory acidosis (choice D) is not correct. If this patient had mixed metabolic alkalosis and respiratory acidosis PaCO2 would not be normal. By definition, respiratory acidosis results from high PaCO2 due to retention of CO2 in body fluids. If this patient had an isolated or simple metabolic alkalosis (due to vomiting but no ketoacidosis) and normal respiratory system, respiratory compensation would raise PaCO2 and decrease the pH back towards normal. If she had respiratory acidosis on top of metabolic alkalosis, PaCO2 would  be raised even more that what would occur during ordinary respiratory compensation to metabolic alkalosis and pH might return all the way back to normal. ⚠ Her acid base status is unclassifiable and needs further evaluation (choice E) is not correct. Obviously, the acid base status of this patient is classifiable and is classified as mixed metabolic acidosis and metabolic alkalosis. 🔖 Key point: In a patient with Hyperemesis Gravidarum, normal values of pH, D [HCO‐3] and PaCO2 do not excludeacid base disturbance. The anion gap should be calculated to look for concealed acid base disturbances.

Full Dr. Najeeb's premium videos👇 https://t.me/joinchat/YQZUcbvJdyIxOTk9