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Here are four of the multiple choice
questions along with their corresponding answers.
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You were called from a juvenile
psychiatric ward to evaluate a new admit with elevated liver
enzymes. What is the most likely differential diagnosis? |
(A) Hemochromatosis
(B) Cystic fibrosis
(C) Wilson's disease
(D) Hepatic encephalopathy
(E) Chronic hepatitis C
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A 60 year old Caucasian female
with 80 pack history of smoking complains of proximal muscle weakness,
which improves with activity. Physical examination revealed tanning
of the skin in the areas not exposed to the sun. The abnormal lab
results are Na+124, Urine Na+75 mg/dl. The chest x-ray is consistent
with a mediastinal mass. This is: |
(A) Lymphoma
(B) Myasthenia Gravis
(C) Pareneoplastic syndromes of squamous cell carcinoma
(D) Paraneoplastic syndromes of small cell carcinoma
(E) Sarcoidosis
Q3. Which of the following is the best
predictor of mortality in patients with congestive heart failure?
(A) Ejection fraction
(B) Ventricular size
(C) Age
(D) Smoking
(E) History of Angina
Q4. Which of the following antibiotics covers
anaerobes?
(A) Amikacin
(B) Aztreonam
(C) Ciprofloxacin
(D) Penicillin
BRIEF MULTIPLE CHOICE
EXPLANATIONS
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A young patient
with abnormal liver function and psychiatric disorder should raise the
suspicion of Wilson's disease. The classic ocular finding is
the brown green or yellow brown pigmentation around the periphery
of the cornea. (See Wilson's Disease Pearl for more detail).
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Paraneoplastic
syndrome of small cell carcinoma includes hyperpigmentation (secondary to
overproduction of ACTH), SIADH (hypnotic euvolemic hyponatremia with Una
> 25meq/L, Uosm > Sosm, low serum BUN and uric acid), and
Eaten-Lambert
syndrome
(proximal muscle weakness which improves with activity; as
opposed to
myasthemia gravis which has worsening
fatigue with
activity).
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Ejection
fraction is the best predictor of mortality in congestive heart failure
patients.
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Penicillin
covers anaerobes (Ex: clostridium perfringes). Amikacin/Aztreonam
and ciprofloxacin provide good gram negative coverage. |
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