MEDICINEnotes

A 35-year-old woman has fatigue, constipation, weight gain, dry skin, bradycardia, and delayed relaxation of the ankle jerk. Which investigation is recommended to diagnose the condition? A. Free T3 and TSH. B. Free T4 and TSH. C. Total T4 and total T3. D. TSH-receptor antibodies. E. Free T4 index alone.

اطفال باطنة جراحة جلدية للاستفسار التواصل خاص @Ducktor47

Which of the following is the most likely diagnosis? A. Emphysema B. Interstitial lung disease C. Bronchial asthma D. Pulmonary hypertension E. Obesity-related restriction

A 46-year-old patient presents with intermittent cough and exertional shortness of breath for several months. Physical examination is unremarkable between episodes. Pulmonary function testing shows: FEV1 = 67% predicted FVC = 88% predicted FEV1/FVC = 0.61 TLC = 104% predicted DLCO = 105% predicted After bronchodilator administration, FEV1 increases by 16% and 320 mL.

#Lung_function_test

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عارفين ليش مش A

A 46-year-old man with severe bronchial asthma continues to have recurrent exacerbations despite optimized high-dose ICS-LABA therapy. Adherence, inhaler technique, and comorbidities have been carefully addressed. His blood eosinophil count remains persistently elevated, and specialist assessment confirms severe eosinophilic asthma. He prefers a treatment administered under supervision in an infusion unit rather than self-injections at home.

What is the most appropriate next step? A. Start mepolizumab immediately because the eosinophil count confirms severe eosinophilic asthma B. Start dupilumab because nasal polyposis and elevated eosinophils predict a good response C. Increase the inhaled corticosteroid dose and reassess after 3 months D. Refer for specialist evaluation for a systemic eosinophilic disorder before attributing the findings solely to severe asthma E. Start omalizumab because recurrent exacerbations indicate severe allergic asthma

A 44-year-old man with adult-onset bronchial asthma remains poorly controlled despite high-dose ICS-LABA therapy. Adherence and inhaler technique have been repeatedly confirmed. During the last year, he has required four courses of systemic corticosteroids. He also has chronic rhinosinusitis with nasal polyps. His blood eosinophil count, previously around 600 cells/µL, is now 2,400 cells/µL. Over the past month, he has developed a painful purpuric rash over both legs and new numbness with weakness of his right foot.

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