Pharm MCQS

Med & Surg MCQs

 Q1.A 49 year old male presents with dyspnea and general malaise of 2 months duration. He denies any travel, allergies or injury. However, he does report fever and a sore throat several months ago. He is on no medications but is a heavy smoker and drinks alcohol regularly. Blood work is pending. His Chest x-ray is shown. What is your working diagnosis? 

a. Ruptured esophagus

b. Lung mass

c. Post pneumonic effusion

d. Chylothorax

e. CHF

f. Tuberculosis

For more on the case and answer

https://youtu.be/V2LHQYpnH1Y

Med & Surg Case Scenario

 Q1. A 27 yo with no significant past medical history presents with a cough, dyspnea and chest discomfort of 4 weeks duration. He revealed an URTI about 6 weeks ago which spontaneously resolved.  His past medical history is unremarkable, he denies smoking and has no allergies. Vital signs are normal and the exam reveals rubbery nodules in the left neck. His chest x-ray is shown.  The radiologist feels that there is a mass lesion in the mediastinum. Which of the following is the least likely cause of his symptoms?

a. Thymoma

b. Thyroid

c. Teratoma

d. Lymphoma

e. Pheochromocytoma

For more on the case and answers

https://youtu.be/V2LHQYpnH1Y

Med & Infect Disease MCQs

 While on a trip to Hawaii, a teenager swallowed the creature shown in the image. The 16-year then returned back to this home in NY only to develop nausea, vomiting, and severe abdominal cramps a few days later. Over the next few days, the GI symptoms eased but then he developed a fever, headache, and stiffness of the neck. He presented to the ED where he was found to have facial nerve palsy on the right side. A lumbar puncture revealed marked eosinophilia but the fluid was negative for any organisms. All other workup was negative. He was admitted and monitored in the ICU. Because the patient was showing gradual clinical improvement, no antibiotics were administered. The infectious disease expert felt that the infection may have been due to a parasite endemic to the Hawaii and Pacific region. By the end of 2 weeks, all the symptoms had resolved and the patient was discharged. Based on the history and presentation, what is the definitive HOST for this parasite?

A. Mosquito

B. Pig

C. Rat

D. Bird

For answer & explanation

https://www.youtube.com/watch?v=r4pKz1yji8w

Med MCQs

 A 27-year old male presents with complaints of general malaise, fever, vague joint and muscle pain that have been going on for about 12 weeks. Last 4 days, he has had 2 episodes of hemoptysis and coughing spells. He claims that he has never had an appetite for food and was never able to participate in sports because he was always short of breath. He has been to many healthcare providers but no cause was ever found. On physical, his vitals are BP 160/95, P 110, RR 26 and T 99.8 F. Auscultation reveals crackles bilaterally. He has mild pedal edema. Blood work reveals elevated BUN and creatinine levels with a mild leucocytosis. The urine shows microscopic hematuria and red cell casts. The patient is admitted and referred to a nephrologist who performs a kidney biopsy. The immunofluorescence stain is shown in the image. Five days later, the patient develops massive hemoptysis and his blood pressure is 90/55. The patient’s arterial blood gas is pH 7.21, PO2 87, PCO2 50 and bicarbonate 18.3. What is your next step in the management of this patient?

A. Hemodialysis

B. Plasmapheresis

C. Immediate Thoracotomy

D. Angiographic embolization

E. Start corticosteroids IV

1. Goodpasture disease is rare cause of glomerulonephritis and may present with or without pulmonary hemorrhage

2. The key laboratory feature is the presence of circulating anti–glomerular basement membrane (anti-GBM) antibodies. This binding of antibodies can be visualized as the linear deposition of immunoglobulin along the glomerular basement membrane and, less commonly, the alveolar basement membranes, by direct immunofluorescent techniques.

3. In many studies, plasmapheresis has been shown to be beneficial in the treatment of Goodpasture syndrome by removal of anti-GBM antibodies. Plasmapheresis is usually performed after the diagnosis of Goodpasture syndrome is established either by renal biopsy or by detection of anti-GBM antibodies.

4. When a patient presents in a life-threatening situation secondary to pulmonary hemorrhage, however, plasmapheresis may be initiated if the diagnosis appears very likely, even though confirmation is not available immediately.

More MCQs

https://www.youtube.com/watch?v=r4pKz1yji8w