Case- Guaiac positive stools

 Q1. A 65-year-old female presents with generalized fatigue and malaise of 3 months duration. Lately she has been feeling dizzy, has no appetite, easily runs out of breath and  has to use a laxative every other day. Other than smoking, she has no other medical history. She is a retired schoolteacher. Her meds include an inhaler and multivitamins. Physical exam is unremarkable. The results of the digital rectal and stool Guaiac test are shown - see image.  What is a very common cause of a false negative with this test? 

a. Red meat

b. Green veggies

c. Iron supplements

d. Citrus fruits

e. Use of laxatives

f. Starvation

For answer & rest of the case

https://youtu.be/M7pU5fKSrUU

Pharm MCQs

 Which of the following agents will bind to the purine base shown in the image and cause the changes observed?

a. Azathioprine

b. Vincristine

c. Cyclosporine

d. Cisplatin

e. Paclitaxel

Answer D

1. An alkylating antineoplastic agent is an alkylating agent used in cancer treatment that attaches an alkyl group (CnH2n+1) to DNA.

2. The alkyl group is attached to the guanine base of DNA, at the number 7 nitrogen atom of the purine ring.

3. Cisplatin is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell cycle non-specific.

4. They stop tumor growth by cross linking guanine nucleobases in DNA double-helix strands, directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. These drugs act non-specifically.

For more MCQs

https://youtu.be/rD0bxUU8hFk

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