A 57-year-old man comes to his physician for his semi-annual visit. He has a medical history significant for long-standing chronic obstructive pulmonary disease (COPD). He has had a two to three pack per day smoking history for the past 40 years. He also has hypertension and diet-controlled type 2 diabetes mellitus. His medications include lisinopril [...]
A 71 year old man had transfemoral catheterization for coronary angiography which revealed the presence of severe atherosclerotic narrowing of all major coronary arteries. Within hours of the procedure, he developed severe left lower quadrant abdominal pain, which was later associated with rebound tenderness, livido reticularis (erythematous skin rash) of the abdominal skin, increasing hypertension, cold [...]
Which of the following tests can assess risk or indicate prognosis? A. CK-MB B. myoglobin C. troponin D. CK-Isoforms E. CK Index The correct answer is C. Troponin Troponin is the inhibitory or contractile regulating protein complex of striated muscle. It is located periodically along the thin filament of the muscle and consists of three [...]
A 53-year-old woman presents complaining of fatigue over the past 6 months. During this time, she has also developed pruritus and lost 4 pounds. She is not sexually active, and her past medical history is significant only for Sjögren syndrome. On physical examination, she is afebrile and has mildly icteric sclera. There are excoriations noted [...]
Which features are seen with the Tetrology of Fallot? A. Ventricular septal defect B. Overriding aorta C. Right ventricular outflow obstruction D. Right ventricular hypertrophy E. All of the above The Correct Answer is E Tetralogy of fallot is characterized by four major defects. These four conditions include pulmonary stenosis, ventricular septal defect, overriding aorta, [...]
Which one of the following is not true about the development of acute rheumatic fever? A. It develops during the acute phase of a group A beta-hemolytic streptococcal infection of the throat. B. It is not associated with streptococcal infection of sites other than the pharynx. C. It usually occurs during the course of epidemics [...]
An elderly woman consults a physician because she is “feeling so tired all the time”. Intraoffice hematocrit is 35%. Peripheral blood smear shows many macrocytic red cells. On questioning, the woman, whose finances are limited, admits that has been living on a “tea and toast” type diet. She has been drinking a powdered orange juice [...]
A 65-year-old woman is admitted to the hospital for constant, severe abdominal pain that has worsened over the prior week. She has no other associated symptoms, such as nausea or vomiting, but has noticed that her daily urine output has sharply decreased. She has had a constant desire to urinate, but, when she tries, only [...]
The use of thrombolytics by GPs in the management of suspected myocardial infarction is indicated if: A. More than 12 hours have elapsed since the onset of pain B. Clinical suspicion remains despite a normal ECG C. Intramuscular opiates have been given D. ‘The call to needle time’ will exceed 90 minutes The Correct Answer [...]
The treatment of choice for recurrent transient ischemic attacks in a patient on aspirin with new-onset atrial fibrillation: a) Anticoagulation b) Carotid endarterectomy c) Clopidogrel d) Corticosteroid treatment e) Carotid stent The correct answer is A. Patient compliance with antiplatelet therapy should be determined. When possible, the cause of the TIA or sroke should be [...]