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♥️
Опрос
  •   A
  •   B
  •   C
  •   D
6 голосов


#Microbiology #Pathology


A 48-year-old male patient who is being treated for chronic hepatitis caused by HBV presents to clinic complaining of worsening jaundice, fatigue and weight loss.
Hepatocellular carcinoma is suspected, so a liver biopsy is obtained and evaluated.
If the patient has cancer, which one of the following is implicated in the tumorigenesis?

A) HBx
B) HBsAg
C) HBeAg
D) HBcAg


🩺 How does liver disease cause encephalopathy?

_Liver plays a major role in ammonia fixation via the urea cycle.
When this cycle is shut down, ammonia will build up in the blood, reaching the CNS.
In the CNS, in order to fix ammonia, alpha-ketoglutarate is shunted out of Krebs cycle and converted to glutamate, fixing ammonia.
The brain now has low levels of ATP, in turn, Na+/K+ ATPase isn't functioning well. Thus electrolyte balance is deranged, resulting in osmotic lysis of neurons.

_ Glutamate is also converted to glutamine in an attempt to fix the ammonia. The resultant glutamine builds up in neurons, resulting in osmotic lysis too.


💡Explanation:

Histoplasma capsulatum is found in soil enriched with bat droppings.
This is why cave explorers are most likely to get infected with it.


♥️
Опрос
  •   A
  •   B
  •   C
  •   D
7 голосов


#Microbiology

A 37-year-old female presents to clinic with complaints of anorexia, fever, weight loss, night sweats and dyspnea.
She has COPD as a pre-existing condition.
She has a history of exploring caves in Latin America.
Radiological imaging shows hilar lymphadenopathy.
The initial diagnosis is tuberculosis so the patient is started on a 6-month RIPE regimen, but no improvement is observed, so TB is a misdiagnosis.

What's the diagnosis then?
A) Cryptococcosis
B) Histoplasmosis
C) Coccidioidomycosis
D) Blastomycosis


♥️
Опрос
  •   A
  •   B
  •   C
  •   D
6 голосов


#ENDOCRINOLOGY


A 32-year-old man is reffered to an endocrinologist due to obesity and short stature.
The patient gives a history of smoking 7 cigarettes per day for 5 years.
Blood pressure is 140/90 mmHg.
Laboratory assessment of electrolytes shows hypocalcaemia and hyperphosphataemia.
PTH is markedly elevated.
Physical examination reveals moon face and short fourth metacarpals and metatarsals.


Depending on the information given above, what's the diagnosis?

A) Primary hypoparathyroidism
B) Pseudohypoparathyroidism
C) Pseudopseudohypoparathyroidism
D) Familial hypocalciuric hypercalcaemia


♥️
Опрос
  •   A
  •   B
  •   C
  •   D
9 голосов


#Microbiology



A 67-year-old male who had been treated for prostate cancer presents to clinic complaining of persistent fever with abdominal pain.
The patient is recovering form iatrogenic neutropenia.
Laboratory assessment reveals elevated ALP, and some lesions in the liver and spleen are seen on radiologic imaging.
The patient is on broad-spectrum antibiotics but there's no improvement.

Basing on the findings, what's the preliminary diagnosis?

A) Candidiasis
B) Aspergillosis
C) Tuberculosis
D) Leprosy


♥️
Опрос
  •   A
  •   B
  •   C
  •   D
17 голосов


#Pharmacology

A 64-year-old male presents to clinic with complaints of difficulty thinking, making things up, and forgetfulness.
The patient is diagnosed with alzheimer's disease.
Cholinergic neurons undergo degenerative changes in such a disease. In order to treat the symptoms to some extent, we must administer an AChE inhibitor.
Choose the one correct drug that can be given in such a case:

A) Neostigmine
B) Rivastigmine
C) Pyridostigmine
D) Edrophonium


Anticholinergic drugs used in alzheimer's disease:
-Tacrine
-Donepezil
-Rivastigmine
-Galantamine.


KEEP IN YOUR MIND:

Patients with parathyroid bone disease run a significant risk of developing hypocalcemia post-operativaly but we reduce this risk by correcting vitamin D deficiency pre-operativaly.

Cinacalcet is given to patients with tertiary hyperparathyroidism and as a treatment for patients with primary hyperparathyroidism who are unwilling of having the surgery or are medically unfit.


♥️
Опрос
  •   A
  •   B
  •   C
  •   D
11 голосов


A 48-year-old female presents to an endocrinologist with complaints of ployuria, polydipsia, bone pain, repeated bone fractures, severe pain in the knees and constipation.
There are no past medical conditions.
Laboratory tests show an increase in PTH and calcium concentrations.
Urine sample reveals renal stones.
What's the treatment of choice for the case presented above?
A) Cinacalcet
B ) parathyroidectomy
C) Intrvenous fluids with bisphosphonate
D ) there is no need for treatment


Which is correct answer
Опрос
  •   A
  •   B
  •   C
  •   D
24 голосов


A 26-year-old female was brought to an endocrinologist due to neck pain, weight loss, heat intolerance and emotional lability.
Physical examination showed spider naevi.
TSH receptor antibodies came back negative and GGT was high.
Thyroid scintigraphy was ordered (see the picture above).
What's the diagnosis?
A) Graves' disease
B) Hashimoto's thyroiditis
C) Mlutinodular goitre
D) toxic adenoma


💖
Опрос
  •   A
  •   B
  •   C
  •   D
30 голосов


A 23-year-old female patient presents to an orthopedist complaining of knee pain.
Her legs are misaligned so she has to undergo surgery.
After the surgery, the patient is given a drug to control pain.
Whenever the patient falls asleep her oxygenation drops dramatically, so the patient is kept awake.
All of the following drugs might be given except which?
A) Fentanyl
B) Diazepam
C) Tramadol
D) Ibuprofen

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