Medplexus

61). A  60-year -old  woman ,  mother of 6 children , developed a sudden  onset of upper abdominal pain  radiating to the back, accompanied by nausea, vomiting, fever and chills. Subsequently, she noticed yellow discoloration of her sclera and skin. On physical examination the patient was found to be febrile with temp. of 38, 9oC, along with right upper quadrant tenderness. The most likely diagnosis is: A. Choledocholithiasis B. Benign biliary stricture C. Malignant biliary stricture D. Carcinoma of the head of the pancreas E. Choledochal cyst Explanation :  5F  are to risk factors for the development of cholelithiasis in an event of upper abdominal pain: F air: more prevalent in Caucasian population(fair) F at: BMI >30 F emale gender F ertile: one or more children F orty: age ≥40 62).  In which of the following disorders does the pathophysiology of portal hypertension involve presinusoidal intrahepatic obstruction? A. Congenital hepatic fibrosis B. Alcoholic cir

51). A 27 year old man complains of pains in epigastrium which are relieved by food intake. EGDFS shows antral erosive gastritis, biopsy of antral mucous presents  Hеlicobacter Pylori . Diagnosis is: A. Gastritis of type B B. Gastritis of type A C. Reflux-gastritis D. Menetrier’s gastritis E. Rigid antral gastritis Mnemonic : Autoimmune gastritis type  A  =  A utoimmune ( A trophy) Autoimmune gastritis type  B  =  B acteria (H. pylori) Autoimmune gastritis type  C  =  C hemical (Bile) 52). A  75  year old man who has been suffering from diabetes for the last six months was found to be jaundiced. He was asymptomatic except for  weight loss  at the rate of 10 pounds in 6 months. Physical examination revealed a hard, globular, right upper quadrant mass that moves during respiration. A  CT scan shows enlargement of the head of the pancreas , with no filling defects in the liver. The most likely diagnosis is: A. Carcinoma of the head of the pancreas B. Infectious hepatitis

Alopecia barbae is an autoimmune disorder in which our body own immune system mistakenly attacks our own hair follicles and get inflamed thus, causing hair follicles to fall out ,resulting hairless patches in beard.It's a type of alopecia areata. Causes Some studies suggest that the following factors that can cause alopecia barbae includes autoimmune disease hereditary link in some cases the stress ,anxiety and depression also contribute to accelerate the condition. Note : Fungal or other kinds of infections are not associated with alopecia Barbae. Sign and symptoms  a small round bald patches on the beard ,usually no itching but sometimes patient do experiences a burning and tingling sensation on affected area .The bald patches are almost smooth and appear  peach in color. Treatment Recovery from Alopecia barbae may be tough if left untreated right at the onset itself. lots of person used to ignore a small patch thinking hair grow  comes by itself but it is not like that it ,worse

11). A 43 y.o. woman complains of  severe pain in the right abdominal side irradiating in the right supraclavicular area , fever, dryness and bitterness in the mouth. There were multiple vomitings without relief. Patient relates the  onset of pain to the taking of fat and fried food . Physical examination: the patient lies on the right side, pale, dry tongue, tachycardia. Right side of abdomen is painful during palpation and somewhat tense in right hypochondrium. What is the most likely diagnosis? A. Perforative ulcer B. Acute cholecystitis C. Acute bowel obstruction D. Acute appendicitis E. Right-sided renal colic Explanation:  Correct    answer is   Acute cholecystitis but in krok base gives perforative ulcer. 12). A 74 y.o. female patient complains of pain, distended abdomen, nausea. She suffers from heart ichemia, postinfarction and diffusive cardiosclerosis . On examination: grave condition, distended abdomen, abdominal wall fails to take active part in breathing. On l

Correct answer for all Question is A 1). The 28 y.o. woman applied to doctor because of limited loss of the hair. In the anamnesis - she had frequent headache indisposition, arthromyalgia, fever, irregular casual sexual life, drug user . RW is negative. What examination must be done first? A. Examination for HIV B. Examination for neuropathology C. Examination for gonorrhea D. Examination for fungi E. Examination for trichomoniasis Explanation : Because of history of  causal sex , drug user are major risk factor for HIV transmission associated  to this given patient.  2). 33 y.o. woman works as the secretary. Her diet contains 150 g of protein (including 100 g of animal protein), 200 g of fat, 600 g of carbohydrates . What pathologycan develop from this diet? A. Obesity B. Schizophrenia C. Paradontosis D. Common cold E. Uterine fibromyoma Explanation:  She is secretary meaning her work doesn’t need much energy so diet containing that amount of fat and carbohydrate

  I) Medications Note:- Actually there is no cure for RA , but treatments can uplifts symptoms & slow the progression of the disease. A)   NSAIDs :  first line drugs( eg; indomethacin , naproxen,diclofenac etc.) for RA used to reduced inflammation. B)   Disease modifying antirheumatic drugs (DMARDs) - Secon d line of drugs for RA. 1. Immunosuppressants Methotrexate (MTX) , Azathioprine, Cyclosporin. Methotrexate(MTX) :-  single oral low-dose (7.5-15 mg) weekly. Maximun weekly dose -20 mg. Duration of treatment unknown. Side effects :- nodulosis, oral ulceration, GI upsest . with prolonged therapy liver get damaged      leading to cirrhosis, incidence of chest infarct also may cause. Contraindication: - pregnancy, breast feeding ,liver disease, active infection, leucopenia & peptic ulcer.    Azathioprin: - 50-150 mg per day. It is not combined with MTX. It's given  along with corticosteroids ,it has steroid sparing effect. 2. Sulphasalazine Doses 1-3 g / day in 2-3 divide

41.) A 28-year-old female patient with a six-year history of Raynaud’s syndrome has recently developed pain in the small joints of hands, difficult movement of food down the esophagus. What kind of disease can you think of in this case? A. Systemic scleroderma B. Periarteritis nodosa C. Rheumatoid arthritis D. Systemic lupus erythematosus E. Pseudotrichiniasis EXPLANATION: - Systemic scleroderma, also called diffuse scleroderma or systemic   sclerosis, is an autoimmune disease of the connective tissue. It is characterized by thickening of the skin caused by accumulation of collagen, and by injuries to small arteries. CREST syndrome  ( C alcinosis ,  R aynaud's phenomenon ,  E sophageal  dysfunction,  S clerodactyly , and  T elangiectasia ) is associated with limited scleroderma.There are two forms of  scleroderma : localized and systemic. The  localized (limited) form  affects the skin of only the face, hands, and feet. The systemic (diffuse) form involves thos