Image Challenge

Diagnosis

Ans:) A Large Bullae in left hemithorax: Pt with COPD.

Regarding Coronary artery disease

Which one of the following is NOT a definitive major risk factor for the development of coronary artery disease.

a)Diabetes Mellitus
b)Alcoholism
c)Tobacco Smoking
d)Age of patient
e)Hypertension

Answer: B) Alcoholism

Regarding SLE

Which of the following Antibody titer is helpful in determining flare ofSLE?

a)ANA
b)Anti Smith
c)Anti dsDNA
d)Anti SSA
e)Anti SSB

Answer: c) Anti dsDNA

40 Year old smoker

A 40yearold smoker presented to  the A & E department with sudden onset of  severe shortness of breath, his respiratory rate was 36/min, O2 Saturation at room air was 82%,heart rate 136/min, Blood pressure 80/55 mmhg. He was profusely sweating, neck veins were distended, on auscultation there was reduced air entry on  the right hemithorax.

What is the most appropriate next best step

a)Do a Chest Xray
b)Insert a partially saline filled syringe at right 2nd I.C Space
c)Call to arrange a chest drain
d)CT Chest
e)Give Streptokinase

Answer : B)Insert a partially saline filled syringe at right 2nd I.C Space. (case of tension pneumothorax. This needs  to be done even before ordering a chest xray.)

Hematuria

Which one of the following is the cause of False Negative Hematuria?

a) Rhabdomyolysis
b)Myoglobinuria
c)High Dose vitamin B intake
d)High Dose vitamin C intake
e)Bacteuria

Answer: D) High Dose Vitamin C Intake

Hypertensive Encephalopathy

What is the target reduction of mean arterial pressure at first 3 hours in case of hypertensive encephalopathy?

a) 10%
 b)25%
 c)35%
 d)40%
 e)50%

 Answer : b) 25%

65 Year old female with acute shortness of breath

A 65 year old female presented in Accident and Emergency department with acute shortness of breath. She had a respiratory rate of 30/min. Heart rate of 126/min BP 90/60, Afebrile. On examination her chest had  HVB. Oxygen Saturation was 88 %with 5Liter O2/min. CXR was normal. She was discharged 2 days back from hospital, suffered from wound infection after open cholecystectomy.
What is the gold standard to diagnose her condition?

a) U/S chest
b) Serum troponins
c)D-Dimers
d) CT Pulmonary Angio
e)ABG's

Answer: c) CT Pulmonary Angio (Case of Acute Pulmonary Embolism)

Sleep Apnoea

How many episodes of apnoea or hypopnea are required in 1hour of sleep to indicate significant Sleep Apnoea

a)5
b)10
c)15
d)20
e)25


Answer : C) 15

Daily Challenge

What of the following is the characteristic of pleural effusion secondary to rheumatoid arthritis?

a) Increased LDH
b)Decreased Glucose
c)Mesothelial cells
d)Increased neutrophils
e)Elevated amylase

ANSWER : B) Decreased Glucose

Daily Challenge

Which one of the following is the cause of renal failure with preserved hemoglobin
a)Renal TB
b)Chronic tubulointerstitial nephritis
c)Diabetic nephropathy
d)Polycystic kidney disease
e)Multiple Myeloma

Answer; D) Polycyctic kidney disease

Daily challenge

How much iron does one pint of packed RBC contain?

a)100mg
b)200mg
c)300mg
d)400mg
e)500mg

ANSWER:


 B> 200mg apprx

IMM Page added

 A new IMM (intermediate module exam) page is added to the blog.
As this exam is the most confusing and least talked about from all the cpsp exams, i have decided to make a page of it stuffed with all the IMM related questions