Scan for drugs causes TEN other than 2P
S= Sulphonamides
C= Carbamezapine
A= Allopurinol
N= NSAIDs
2P= Penicillin &Phenytoin
A 28 year old female presents with weight loss, palpitations, heat intolerance and anxiety. She is a health fanatic and takes supplements including kelp. Her bloods reveal a TSH which is very low and there is no evidence of autoantibodies. What is the likely cause of the picture seen here?
1.Excessive iodine ingestion
2.Graves Disease
3.Hashimotos Disease
4.De Quervain thyroiditis
5.Exogenous thyroxine
The following are serial liver function tests of a 60-year-old retired businessman. He had an abdominal aortic
aneurysm repair for ruptured aneurysm 20 years previously while on holiday in Turkey. He takes antacids for
dyspepsia and drinks approximately 5 units of alcohol per week. He was prescribed atorvastatin five years ago by his
general practitioner for hvpercholesterolaemia. Apart from mild jaundice, physical examination is unremarkable. His
BMI is 25.
Liver function tests reveal:
1992 1994 1996 2000
Bilirubin (mmol/) (<17 1) 16 21 28 40
Alanine aminotransferase (U/l) (5-35) 35 36 45 51
Aspartate aminotransferase (U/l) (10-40) 43 49 70 79
Alkaline phosphatase (U/l) (30-150) 111 135 156 170
What is the most likely cause for his abnormal liver function tests?
O Chronic active hepatitis due to autoimmune pathology
O Primary biliary cirrhosis
O Drug-induced hepatitis
O Chronic active hepatitis due to hepatitis C
O Non-alcoholic steatohepatitis
A 38 year old female has difficult to control hypertension. She has intermittently suffered from headaches and anxiety. She is due to undergo abdominal surgery. Given the underlying diagnosis, which treatment should be performed before her surgery?
1.Introduction of an irreversible alpha blocker
2.Nil required
3.Increase dosage of antihypertensives
4.Introduction of a beta blocker
5.IV fluid administration
Xanthoma >> all over the body
Xanthalasma >> eyelid
Xanthochromia>> yellow color of csf in pt. With SAH
Xanthopsia>> SE of digoxin cause yellow vision
What should a healthy diet comprise?
1.Daily calorie intake should comprise carbohydrate 25%, protein 15% and fat 60%
2.Daily calorie intake should comprise carbohydrate 35%, protein 15% and fat 50%
3.Daily calorie intake should comprise carbohydrate 15%, protein 55% and fat 30%
4.Daily calorie intake should comprise carbohydrate 55%, protein 15% and fat 30%
5.Daily calorie intake should comprise carbohydrate 30%, protein 30% and fat 40%
A patient who has confirmed Cushings disease following a low dose dexamethasone suppression test, is found to have an incomplete response to a high dose dexamethasone suppression test but shows an increased cortisol level following administration of corticotropin releasing hormone. What is the most likely definitive diagnosis?
1.Exogenous steroids
2.Conns syndrome
3.Adrenal adenoma
4.Cushings disease
5.Ectopic ACTH secretion
43-year-old man with a ventricular septal defect has had a cough and fever for the past 2 days. On examination, he
has a temperature of 37.6°C and a cardiac murmur. A blood culture grows Streptococcus, viridans group. His erythrocyte
sedimentation rate (ESR) is increased. Microbial cells are opsonized and cleared. Which of the following chemical
mediators is most important in producing these findings?
□ (A) Bradykinin
□ (B) C-reactive protein
□ © Interferon-γ
□ (D) Nitric oxide
□ (E) Prostaglandin
□ (F) Tumor necrosis factor
The most appropdriate treatment for occupational Asthma:
1_steroids.
2_SABA sos.
3_ review of the work inviroment to minimise d exposure.
4_ change the jobe.
How would you investigate a patient in the first instance if you suspected Addisons disease?
1.ACTH level
2.Short synacthen test
3.High dose dexamethasone test
4.Low dose dexamethasone suppression test
5.Urinary cortisol
Von Hippel Lindau disease, what is the most common cause of death?
1.Hypertension
2.CNS Haemangioblastoma
3.Renal cell carcinoma
4.Pancreatic neuroendocrine tumours
5.Phaeochromocytoma
a 65 years old bedridden patient presents to emergency department with complains of dyspnea at rest and orthopnea, and pleuritic chest pain. he is known CRF patient for which he has undergone heamodialysis a couple of times in past two years . his fresh urea is 98 and serum creatinine level is 2.1.
his fresh hb is 6.9mg/dl.
his chest xray is normal with normal cardiac thoracic ratio. no effusion on chest xray. ECG shows right axis deviation. and slight ischemic changes in anatomical inconsistent leads
the clinician suspects pulmonary embolism . for which d-dimers are sent to the laboratory and his ct angiopraghy is being planned .
Q . what is the most appropriate immediate management plan.
- low molecular weight heparin.
- low dose aspirin
- warfarin with inr 2-3
- call ITU to prepare for mechanical ventialation.
Most likely cause of erectile dysfunction in a 32 year old gentleman?
1.Cold weather
2.Alcohol
3.Psychological
4.Peripheral vascular disease
5.Type 2 Diabetes mellitus
25y/o female.has 10 months history of nocturnal cough,chest wheez.she has GERD .not smoker.normal CXR and low PEFR…
First line of TTT?
1_ PPI and head elevation at bedtime.
2_ regular low dose betmethazone inhalation.
3_ high dose oral prednisolone with PPI.
4_ regular high dose Salemtrol.
A patient is diagnosed with a microadenoma which has lead to acromegaly. How should this patient be managed?
1.Pegvisomant
2.Octreotide
3.Bromocriptine
4.Transsphenoidal surgery
5.Radiotherapy
60 years old lady has undergone staging laparoscopy for ovarian cancer .the detected on this procedure are characteristic of
a.trans celomic spread
b.direct invasion
c.peritoneal invasion
d.lymphatic
e.metabolic change