A 60-year-old man was diagnosed last year with adenocarcinoma of the lung, and a 4 cm mass lesion was treated with a right lower lobectomy. He now has an abdominal CT scan that reveals scattered hepatic mass lesions and hilar lymphadenopathy. For several weeks, he has had increasing malaise. A urinalysis reveals marked proteinuria, and a 24 hour urine protein collection is 2.7 g/24hr. His serum urea is 30 mmol/L (2.5 - 7.5) with creatinine of 450 µmol/L (60 - 110). A renal biopsy is performed, and there is focal deposition of IgG and C3 with a granular pattern. He is most likely to have which of the following conditions? 1) Goodpasture's syndrome 2) Membranous glomerulonephritis 3) Minimal change glomerulonephritis 4) Nodular glomerulosclerosis 5) Rapidly progressive glomerulonephritis

A 60-year-old man was diagnosed last year with adenocarcinoma of the lung, and a 4 cm mass lesion was treated with a right lower lobectomy. He now has an abdominal CT scan that reveals scattered hepatic mass lesions and hilar lymphadenopathy. For several weeks, he has had increasing malaise. A urinalysis reveals marked proteinuria, and a 24 hour urine protein collection is 2.7 g/24hr. His serum urea is 30 mmol/L (2.5 - 7.5) with creatinine of 450 µmol/L (60 - 110). A renal biopsy is performed, and there is focal deposition of IgG and C3 with a granular pattern. He is most likely to have which of the following conditions? 1) Goodpasture's syndrome 2) Membranous glomerulonephritis 3) Minimal change glomerulonephritis 4) Nodular glomerulosclerosis 5) Rapidly progressive glomerulonephritis
by

1 Answer

Answer :

Answers-2 Most cases of membranous GN are idiopathic, but in some patients there is a history of an infection or a malignancy (usually lung) with antigenemia.
by
selected

Related questions

A 15-year-old girl was seen by her family physician because of increasing lethargy. She had a recent history of the "flu". Biochemistry tests show that she has renal impairement. serum sodium 140 mmol/L (137 - 144) serum potassium 4.2 mmol/L (3.5 - 4.9) serum urea 28 mol/L (2.5 - 7.5) serum creatinine 280 µmol/L (60 - 110) Her condition does not improve after several weeks on corticosteroid therapy, so a renal biopsy is performed. The biopsy demonstrates the presence of segmental sclerosis of 3 of 10 glomeruli identified in the biopsy specimen. Immunofluorescence studies and electron microscopy do not reveal evidence for immune deposits. What is the most appropriate advice to give regarding her condition? 1) She has an underlying malignancy 2) She may require a renal transplant in 10 years

Description : A 15-year-old girl was seen by her family physician because of increasing lethargy. She had a recent history of the "flu". Biochemistry tests show that she has renal impairement. ... will likely develop a restrictive lung disease 5) She will probably improve with additional corticosteroid therapy

Last Answer : Answers-2 The findings point to focal segmental glomerulosclerosis (FSGS), which leads to chronic renal failure in half of cases. The lack of resolution with corticosteroid therapy and the progression to chronic renal failure is what sets FSGS apart from minimal change disease.

A 53-year-old man presented with hypertension of 150/110 mmHg. He is generally asymptomatic and has no previous medical history of note. He is a smoker of 5 cigarettes daily and drinks modest quantities of alcohol. He takes no prescribed medications. Examination reveals a BMI of 33.5 kg/2 but nil else. The following detail his investigations: Serum sodium 146 mmol/l (NR 133-145) Serum potassium 3.2 mmol/l (NR 3.5 - 5) Urinary potassium excretion 42 mmol/l (NR less than 30) What is the likely diagnosis? 1) Adrenocortical adenoma 2) Bartter's syndrome 3) Liddle's syndrome 4) Liquorice ingestion 5) Pheochromocytoma

Description : A 53-year-old man presented with hypertension of 150/110 mmHg. He is generally asymptomatic and has no previous medical history of note. He is a smoker of 5 cigarettes daily and drinks ... Adrenocortical adenoma 2) Bartter's syndrome 3) Liddle's syndrome 4) Liquorice ingestion 5) Pheochromocytoma

Last Answer : Answers-1 This patient is most likely to have Conn's syndrome as reflected by the hypokalaemic hypertension. Liquorice ingestion or Liddle's syndrome are again possible causes of ... hypertension (often diastolic hypertension), muscular weakness, paresthesias, headache, polyuria, and polydipsia."

A 16 year old male with a day history of malaise, weakness and vomiting. He was diagnosed with Insulin dependent diabetes mellitus 3 years prviously. Which ONE of the following supports a diagnosis of diabetic ketoacidosis: 1) Abdominal pain at onset 2) A serum bicarbonate of 10 mmol/l 3) A serum glucose 14 mmol/l 4) Decreased appetite in the past few days 5) Shallow respirations

Description : A 16 year old male with a day history of malaise, weakness and vomiting. He was diagnosed with Insulin dependent diabetes mellitus 3 years prviously. Which ONE of the following supports a diagnosis of ... serum glucose 14 mmol/l 4) Decreased appetite in the past few days 5) Shallow respirations

Last Answer : Answers-2 a-An unusual but recognised feature particularly in children. However does not support a diagnosis of DKA. b-Suggests metabolic acidosis. c-'Normoglycaemic DKA' can occur and a glucose ... anorexia. e-Respiratory compensation leads to rapid deep (Kussmaul's) breathing. (Dr Mike Mulcahy)

A 19 year-old female is referred following a visit to the dentist where marked erosion of her teeth was noted. She was entirely asymptomatic and her only medication was the oral contraceptive pill. On examination her blood pressure was 110/70 mmHg and her body mass index was 21.5 kg/m2 (18 - 25). Investigations sodium 135 mmol/l potassium 2.1 mmol/l bicarbonate 42 mmol/l urea 2.6 mol/L corrected calcium 2.08 mmol/ alkaline phosphatase 201 iu/l (50-110) What is the most likely diagnosis? 1) Bulimia nervosa 2) Conn's syndrome 3) Laxative abuse 4) Pregnancy 5) Primary hypoparathyroidism

Description : A 19 year-old female is referred following a visit to the dentist where marked erosion of her teeth was noted. She was entirely asymptomatic and her only medication was the oral contraceptive pill ... ) Bulimia nervosa 2) Conn's syndrome 3) Laxative abuse 4) Pregnancy 5) Primary hypoparathyroidism

Last Answer : Answers-5 This patient has tooth erosion associated with hypokalaemic metabolic alkalosis and hypocalcaemia. This suggests a diagnosis of hypoparathyroidism. Conn's is unlikely in this age group, is ... raised alkaline phosphatase would not be expected. Early pregnancy would not fit this picture.

Serum biochemistry of a 60 year old man revealed calcium of 1.98 mmol/l and phosphate of 0.55 mmol/l with an alkaline phosphatase of 450 IU/l.Which among the following mosts suits with the above serum biochemistry? 1) Osteoporosis 2) Osteomalacia 3) Pagets Disease 4) Secondary Hyperparathyroidism 5) Renal failure

Description : Serum biochemistry of a 60 year old man revealed calcium of 1.98 mmol/l and phosphate of 0.55 mmol/l with an alkaline phosphatase of 450 IU/l.Which among the following mosts suits ... biochemistry? 1) Osteoporosis 2) Osteomalacia 3) Pagets Disease 4) Secondary Hyperparathyroidism 5) Renal failure

Last Answer : Answers-2 Osteomalacia is associated with low calcium and phosphate with raised alkaline phosphatase. Serum biochemistry is normal in osteoporosis. Pagets disease is associated with normal ... renal failure when tertiary hyperparathyroidism sets in there is low calcium with raised phosphate.

An Afro-Carribean male aged 48 years presents with gradual onset of exertional dyspnoea, non productive cough, malaise, weight loss and polyarthralgia. Schirmers test indicates a dry eye. X-ray of the hand shows punched out osteopenic lesions. Which of the following investigation is unlikely to be helpful in establishing the diagnosis of this condition: 1) Serum calcium 2) Serum phosphorus 3) Urea and electrolytes 4) Thallium Scan 5) Quantitative Immunoglobulins.

Description : An Afro-Carribean male aged 48 years presents with gradual onset of exertional dyspnoea, non productive cough, malaise, weight loss and polyarthralgia. Schirmers test indicates a dry eye. X-ray ... 2) Serum phosphorus 3) Urea and electrolytes 4) Thallium Scan 5) Quantitative Immunoglobulins.

Last Answer : Answers-4 This condition is sarcoidosis. Serum calcium, Serum phosphorus, Chem7 and Chem 20 and Quantitative Immunoglobulins are all used in establishing the diagnosis. Gallium scan is helpful in ... areas of poor perfusion. It is particularly used in cardiology to detect areas of ischaemia.

A 55 year-old female complaining of vague tiredness is found to have a serum corrected calcium concentration of 2.9 mmol/l. Examination was unremarkable. Which of the following results confirms the suspected diagnosis of primary hyperparathyroidism? 1) High normal 1,25-dihydroxyvitamin D concentration 2) High normal 24 hour urinary calcium concentration 3) High normal plasma parathyroid hormone concentration 4) Low normal plasma phosphate concentration 5) Low normal serum 25-hydroxyvitamin D concentration

Description : A 55 year-old female complaining of vague tiredness is found to have a serum corrected calcium concentration of 2.9 mmol/l. Examination was unremarkable. Which of the following results ... 4) Low normal plasma phosphate concentration 5) Low normal serum 25-hydroxyvitamin D concentration

Last Answer : Answers-3 Bit too easy really. A high or even normal PTH concentration in the presence of hypercalcaemia would support the diagnosis of hyperparathyroidism. A high urinary Calcium concentration may ... but neither confirm the diagnosis. Elevated 1,25 VitD suggests a diagnosis of hypervitaminosis D.

Which of the following statement(s) is/are true concerning metabolic derangements in sepsis and the systemic inflammatory response syndrome which may follow progressive shock? a. Alterations in glucose metabolism lead to the development of efficient substrate utilization b. A progressive rise in serum triglyceride levels result from less efficient clearance and increased hepatic lipogenesis c. A net negative nitrogen balance occurs due to the oxidative metabolism of proteins to meet energy needs d. The serum aromatic amino acids fall rapidly as they are actively used in oxidative metabolism

Description : Which of the following statement(s) is/are true concerning metabolic derangements in sepsis and the systemic inflammatory response syndrome which may follow progressive shock? a. Alterations in glucose ... The serum aromatic amino acids fall rapidly as they are actively used in oxidative metabolism

Last Answer : Answer: b, c A broad spectrum of metabolic abnormalities become apparent in sepsis and the systemic inflammatory response syndrome following shock. Disruption of the normal cycles of carbohydrate, ... acetyl coenzyme A. This results in reduced serum level of leucine, isoleucine and valine

A simple way to assess tubular function is to withhold food and water for 12 hours and, then, measure (A) Serum urea (B) Serum creatinine (C) Urine output in one hour (D) Specific gravity of urine

Description : A simple way to assess tubular function is to withhold food and water for 12 hours and, then, measure (A) Serum urea (B) Serum creatinine (C) Urine output in one hour (D) Specific gravity of urine

Last Answer : Answer : D

A 75 year old man presents with a long history of shortness of breath and ankle oedema. His serum biochemistry shows sodium 122 mmols/l and potassium of 2.9 mmols/l. He now complains of weakness.Which of the following is likely to explain the above biochemical picture? 1) Addison's Disease 2) Nephrotic syndrome 3) Primary hyperaldosteronism 4) SIADH 5) Diuretic therapy

Description : A 75 year old man presents with a long history of shortness of breath and ankle oedema. His serum biochemistry shows sodium 122 mmols/l and potassium of 2.9 mmols/l. He now complains of ... ? 1) Addison's Disease 2) Nephrotic syndrome 3) Primary hyperaldosteronism 4) SIADH 5) Diuretic therapy

Last Answer : Answers-5 The long history of his symptoms and serum biochemistry suggests that his condition is due to treatment with frusemide for CCF.

Heavy proteinuria occurs in (A) Acute glomerulonephritis (B) Acute pyelonephritis (C) Nephrosclerosis (D) Nephrotic syndrome

Description : Heavy proteinuria occurs in (A) Acute glomerulonephritis (B) Acute pyelonephritis (C) Nephrosclerosis (D) Nephrotic syndrome

Last Answer : B

An incision biopsy of an ulcerated and intruded clinically suspicious lesion in a 50 years-old female reveals chronic inflammation; you would:** A. Inform the patient and her physician of your findings and instruct the patient to return in six months B. Surgically excise the entire lesion since you know it is not malignant C. Dismiss the patient with instructions for warm saline rinses and re-examination D. Repeat the biopsy

Description : An incision biopsy of an ulcerated and intruded clinically suspicious lesion in a 50 years-old female reveals chronic inflammation; you would:** A. Inform the patient and her physician of ... . Dismiss the patient with instructions for warm saline rinses and re-examination D. Repeat the biopsy

Last Answer : D. Repeat the biopsy

A 75-year-old man had been receiving gentamicin (an aminoglycoside antibiotic) to treat an urinary tract infection. After three months of therapy patient's serum creatinine levels were 10 mg/dL ( normal 0.5-1.2) and serum gentamicin concentrations obtained just before the last dose were 9 mg/dL (normal < 2). Which of the following is the most likely adverse drug reaction the patient was suffering from? a) Type II allergic reaction b)Type III allergic reaction c) Pseudo allergic reaction d) Overdose toxicity

Description : A 75-year-old man had been receiving gentamicin (an aminoglycoside antibiotic) to treat an urinary tract infection. After three months of therapy patient's serum creatinine levels were 10 mg/ ... Type II allergic reaction b)Type III allergic reaction c) Pseudo allergic reaction d) Overdose toxicity

Last Answer : d) Overdose toxicity 

Rank the following laboratory tests and procedures in terms of their relative value to a 65-year-old woman who is to undergo elective resection of a sigmoid cancer. A. Carcinoembryonic antigen (CEA). B. Blood urea nitrogen (BUN). C. Electrocardiogram (ECG). D. Hemoglobin concentration (Hgb). E. Serum creatinine (Cr). F. Arterial blood oxygen tension (PaO 2) on room air. G. Serum sodium concentration (Na+).

Description : Rank the following laboratory tests and procedures in terms of their relative value to a 65-year-old woman who is to undergo elective resection of a sigmoid cancer. A. Carcinoembryonic antigen (CEA). B. ... Arterial blood oxygen tension (PaO 2) on room air. G. Serum sodium concentration (Na+).

Last Answer : Answer: CDFEBAG DISCUSSION: The most important test by far is the electrocardiogram, with its capacity to indicate signs of occult heart disease. The second most important evaluation is the hemoglobin ... for resection of the colon is always normal and would be of least value among these tests

The formula to calculate maximum urea clearance is U V× B , where U denotes (A) Concentration of urea in urine in gm/24hr (B) Concentration of urea in urine in mg/100 ml (C) Concentration of urea in blood in mg/100 ml (D) Volume of urine in ml/mt

Description : The formula to calculate maximum urea clearance is U V× B , where U denotes (A) Concentration of urea in urine in gm/24hr (B) Concentration of urea in urine in mg/100 ml (C) Concentration of urea in blood in mg/100 ml (D) Volume of urine in ml/mt

Last Answer : Answer : B

A 59-year-old trauma patient has suffered multiple septic complications including severe pneumonia, intraabdominal abscess, and major wound infection. He has now developed signs of multisystem organ failure. Which of the following statement(s) is/are true concerning necessary changes to be made in his nutritional management? a. Carbohydrate load should be reduced in the face of respiratory failure b. In patients with renal failure, protein intake should be diminished c. During hemodialysis protein intake should be limited to the same extent d. In patients with hepatic failure, carbohydrate load should be increased

Description : A 59-year-old trauma patient has suffered multiple septic complications including severe pneumonia, intraabdominal abscess, and major wound infection. He has now developed signs of multisystem organ ... the same extent d. In patients with hepatic failure, carbohydrate load should be increased

Last Answer : Answer: a, b The most severe complication of sepsis is multiple system organ dysfunction syndrome, which may result in death. The development of organ failure requires changes in the ... should be provided as fat emulsion. If encephalopathy develops, protein load should also be reduced0

Bleeding complications are frequently associated with fibrinolytic therapy. Which of the following statement(s) concerning complications of fibrinolytic therapy is/are true? a. Careful monitoring of prothrombin time and aPTT time are necessary to avoid bleeding complications b. A level of serum fibrinogen less than 100 mg/dl is associated with an increased risk of bleeding c. Recent (less than 10 days) major surgery is a contraindication to systemic but not regional fibrinolytic therapy d. A patient with a cerebrovascular event occurring less than two months ago can be treated with fibrinolytic therapy if head CT scan is normal

Description : Bleeding complications are frequently associated with fibrinolytic therapy. Which of the following statement(s) concerning complications of fibrinolytic therapy is/are true? a. Careful monitoring of prothrombin time ... months ago can be treated with fibrinolytic therapy if head CT scan is normal

Last Answer : Answer: b Fibrinolytic therapy induces a hemostatic defect through a combination of factors. Hypofibrinogenemia and fibrin degradation products inhibit fibrin polymerization and, in combination ... is considered a major relative contraindication to either regional or systemic thrombolytic therapy

Lesch-Nyhan syndrome, the sex linked, recessive absence of HGPRTase, may lead to (A) Compulsive self destructive behaviour with elevated levels of urate in serum (B) Hypouricemia due to liver damage (C) Failure to thrive and megaloblastic anemia (D) Protein intolerance and hepatic encephalopathy

Description : Lesch-Nyhan syndrome, the sex linked, recessive absence of HGPRTase, may lead to (A) Compulsive self destructive behaviour with elevated levels of urate in serum (B) Hypouricemia due to liver damage (C) Failure to thrive and megaloblastic anemia (D) Protein intolerance and hepatic encephalopathy

Last Answer : Answer : A

A 65-year-old man was brought to the hospital with complaints of pain in lower abdomen and not having passed urine for 16 hours. The bladder was found to be full. His son informed that he was depressed for the last 2 years and only the day before a doctor had given him some medicine. Which of the following drugs is he most likely to have received: A. Alprazolam B. Sertraline C. Amitryptyline D. Trazodone

Description : A 65-year-old man was brought to the hospital with complaints of pain in lower abdomen and not having passed urine for 16 hours. The bladder was found to be full. His son informed that he ... drugs is he most likely to have received: A. Alprazolam B. Sertraline C. Amitryptyline D. Trazodone

Last Answer : C. Amitryptyline

An 16-year-old man presents with polyuria and polydipsia. Which of the following may confirm the diagnosis of diabetes mellitus? 1) A random plasma glucose of >7.5 mmol/L 2) A finding of 3+ ketonuria 3) An HbA1c of 7.0% 4) A fasting plasma glucose of 7.5 mmol/L 5) An abnormal glucose tolerance test

Description : An 16-year-old man presents with polyuria and polydipsia. Which of the following may confirm the diagnosis of diabetes mellitus? 1) A random plasma glucose of >7.5 mmol/L 2) A finding of 3+ ketonuria 3) An HbA1c of 7.0% 4) A fasting plasma glucose of 7.5 mmol/L 5) An abnormal glucose tolerance test

Last Answer : Answers-4 The diagnosis is usually relatively easy to confirm in a symptomatic subject. A random glucose of >11.1 mmol/L or a fasting glucose of >7.0 mmol/L would be regarded as ... haemoglobin (HbA1c) is also highly suggestive but not diagnostic. A glucose tolerance test is rarely needed.

A 55-year-old male undergoes a total abdominal colectomy. Which of the following statement(s) is/are true concerning the hormonal response to the surgical procedure? a. Adrenocorticotropic hormone (ACTH) is secreted from the anterior pituitary gland b. ACTH stimulation results in elevation of serum cortisol levels for up to a week after the operation c. An increased secretion of aldosterone and ADH may contribute to postoperative fluid retention d. An increase in serum insulin and a fall in glucagon accelerate hepatic glucose production and maintain gluconeogenesis

Description : A 55-year-old male undergoes a total abdominal colectomy. Which of the following statement(s) is/are true concerning the hormonal response to the surgical procedure? a. Adrenocorticotropic ... in serum insulin and a fall in glucagon accelerate hepatic glucose production and maintain gluconeogenesis

Last Answer : Answer: a, c One of the earliest consequence of a surgical procedure is the rise in levels of circulating cortisol that occur in response to a sudden outpouring of ACTH ... hepatic glucose production, and, with other hormones (epinephrine and glucocorticoids), gluconeogenesis is maintained

12 years old child presents with symptoms of widespread gingivitis with bleeding and general malaise for several weeks. How would you manage this patient? M07 ********* A. Prescribe Metronidazole 100mg B. Locally debride, give oral hygiene instruction and prescribe H2O2 mouth wash. C. Give a prophylaxis with ultra sonic scaling D. Refer for haematological screening

Description : 12 years old child presents with symptoms of widespread gingivitis with bleeding and general malaise for several weeks. How would you manage this patient? M07 ********* A. Prescribe ... mouth wash. C. Give a prophylaxis with ultra sonic scaling D. Refer for haematological screening

Last Answer : D. Refer for haematological screening

Rank the clinical scenarios in order of greatest likelihood of serious postoperative pulmonary complications. A. Transabdominal hysterectomy in an obese woman that requires 3 hours of anesthesia time. B. Right middle lobectomy for bronchogenic cancer in a 65-year-old smoker. C. Vagotomy and pyloroplasty for chronic duodenal ulcer disease in a 50-year-old who had chest film findings of old, healed tuberculosis. D. Right hemicolectomy in an obese 60-year-old smoker. E. Modified radical mastectomy in a 58-year-old woman who is obese.

Description : Rank the clinical scenarios in order of greatest likelihood of serious postoperative pulmonary complications. A. Transabdominal hysterectomy in an obese woman that requires 3 hours of anesthesia time. B. Right ... smoker. E. Modified radical mastectomy in a 58-year-old woman who is obese.

Last Answer : Answer: BDCAE DISCUSSION: If one considers the constellation of risk factors for pulmonary complications that is provided in tabular form in the accompanying chapter, one should ... is associated with relatively little postoperative pain, and provides free and unrestricted respiratory function

Among the following, the most sensitive indicator of glomerular function is (A) Serum urea (B) Serum creatinine (C) Urea clearance (D) Creatinine clearance

Description : Among the following, the most sensitive indicator of glomerular function is (A) Serum urea (B) Serum creatinine (C) Urea clearance (D) Creatinine clearance

Last Answer : Answer : D

A 28 years old woman has 14 weeks size irregular uterus. She does not complain of abdominal pain or menorrhagia. Her pap smear is normal. The best next step in her management would be: a) Continued observation. b) Endometrial biopsy. c) Hysterectomy. d) Pelvic ultrasonography. e) Laparoscopy.

Description : A 28 years old woman has 14 weeks size irregular uterus. She does not complain of abdominal pain or menorrhagia. Her pap smear is normal. The best next step in her management would be: a) Continued observation. b) Endometrial biopsy. c) Hysterectomy. d) Pelvic ultrasonography. e) Laparoscopy.

Last Answer : continued observation is required in such a case as the patient is stable

Altering the amino acid profile in total parenteral nutrition solutions can be of benefit in certain conditions. Which of the following conditions are associated with a benefit by supplementation with the amino acid type listed? a. Acute renal failure and essential amino acids b. Hepatic failure and aromatic amino acids c. Short gut syndrome and glutamine d. Chronic renal failure and essential amino acids

Description : Altering the amino acid profile in total parenteral nutrition solutions can be of benefit in certain conditions. Which of the following conditions are associated with a benefit by supplementation with the ... c. Short gut syndrome and glutamine d. Chronic renal failure and essential amino acids

Last Answer : Answer: a, c In a number of conditions, altering the amino acid profile of the total parenteral nutrition solution can be of benefit. TPN with amino acids of high biologic value ... Glutamine-enriched TPN partially attenuates villous atrophy and may be useful in treatment of short gut syndrome

An 80 year old male presented with dull aching loin pain & interrupted voiding of urine. BUN and creatinine were increased. US revealed a bilateral hydronephrosis. What is the most probable Dx? a) Stricture of the urethra b) Urinary bladder tumor c) BPH d) Pelvic CA e) Renal stone

Description : An 80 year old male presented with dull aching loin pain & interrupted voiding of urine. BUN and creatinine were increased. US revealed a bilateral hydronephrosis. What is the most probable Dx? a) Stricture of the urethra b) Urinary bladder tumor c) BPH d) Pelvic CA e) Renal stone

Last Answer : c) BPH

A diabetic develops a severe perineal infection with skin necrosis, subcutaneous crepitance, and drainage of a thin, watery, grayish and foul-smelling fluid. Management should consist of: a. Gram stain of the fluid, which will likely demonstrate multiple bacteria including predominantly gram-positive rods b. A CT scan is indicated in a stable patient to define the extent of the disease c. Broad spectrum antibiotics followed with prompt extensive debridement is indicated d. A safe guideline is to resect infected necrotic tissue so that a several centimeter margin of grossly normal, healthy tissue can be achieved e. A colostomy is of little benefit in this situation

Description : A diabetic develops a severe perineal infection with skin necrosis, subcutaneous crepitance, and drainage of a thin, watery, grayish and foul-smelling fluid. Management should consist of: a. Gram stain ... normal, healthy tissue can be achieved e. A colostomy is of little benefit in this situation

Last Answer : Answer: a, b, c, d The presence of severe perineal infection (referred to as Fournier gangrene when this process involves the perineum and scrotum in males) is associated with a ... often provides improved wound care and patient management, although it is not invariably a positive outcome

Urine examination (Benedict’s test) of a 40 yr old obese male showed a brick red precipitate. This can result from all except Options: 1) Diabetes Mellitus 2) Drugs 3) Acute post-streptococcal glomerulonephritis 4) Cushing’s syndrome

Description : Urine examination (Benedict’s test) of a 40 yr old obese male showed a brick red precipitate. This can result from all except Options: 1) Diabetes Mellitus 2) Drugs 3) Acute post-streptococcal glomerulonephritis 4) Cushing’s syndrome

Last Answer : Correct Answer: 3) Acute post-streptococcal glomerulonephritis

Urea clearance test is used to determine the (A) Glomerular filtration rate (B) Renal plasma flow (C) Ability of kidney to concentrate the urine (D) Measurement of tubular mass

Description : Urea clearance test is used to determine the (A) Glomerular filtration rate (B) Renal plasma flow (C) Ability of kidney to concentrate the urine (D) Measurement of tubular mass

Last Answer : Answer : A

A CT scan of me resulted in the following statement "The right renal artery has a stent in it which remains widely patent". What is meant by this?

Description : A CT scan of me resulted in the following statement "The right renal artery has a stent in it which remains widely patent". What is meant by this?

Last Answer : Why didn’t you ask the doctor when he gave you the results?

60-year-old patient with creatinine clearance 50 ml/min has to be treated with gentamicin. His daily dose of gentamicin should be reduced to the following percentage of the usual adult dose: A. 70% B. 50% C. 40% D. 30%

Description : 60-year-old patient with creatinine clearance 50 ml/min has to be treated with gentamicin. His daily dose of gentamicin should be reduced to the following percentage of the usual adult dose: A. 70% B. 50% C. 40% D. 30%

Last Answer : B. 50%

A 60-year-old patient with creatinine clearance 50 ml/min has to be treated with gentamicin. His daily dose of gentamicin should be reduced to the following percentage of the usual adult dose: A. 70% B. 50% C. 40% D. 30%

Description : A 60-year-old patient with creatinine clearance 50 ml/min has to be treated with gentamicin. His daily dose of gentamicin should be reduced to the following percentage of the usual adult dose: A. 70% B. 50% C. 40% D. 30%

Last Answer : B. 50%

Which of the following statement(s) concerning laboratory studies used in monitoring a patient with intravenous heparinization is/are correct? a. The platelet count should be followed because of the risk of heparin-associated thrombocytopenia b. The prothrombin time should be observed if prolonged treatment is necessary c. The activated partial thromboplastin time (aPTT) should be maintained at approximately 1.5 times normal d. The serum creatinine should be measured daily to allow adjustments in dose based on renal function

Description : Which of the following statement(s) concerning laboratory studies used in monitoring a patient with intravenous heparinization is/are correct? a. The platelet count should be followed because of the ... serum creatinine should be measured daily to allow adjustments in dose based on renal function

Last Answer : Answer: a, c In monitoring the effect of heparin, an activated partial thromboplastin time (aPTT) of 1.5 control or a thrombin clotting time (TCT) of 2 times control reflects adequate ... system. Therefore the dose of heparin need not be adjusted in cases of liver or renal dysfunction

In syphilis: A. Primary lesion is not contagious B. Oral lesions are not seen in less than 1% C. Spirochetes disseminate in 24 hours

Description : In syphilis: A. Primary lesion is not contagious B. Oral lesions are not seen in less than 1% C. Spirochetes disseminate in 24 hours

Last Answer : C. Spirochetes disseminate in 24 hours

The most significant finding in clinical evaluation of parotid mass may be accompanying,** A. Lympha adenopathy B. Nodular consistency C. Facial paralysis D. Slow progressive enlargement E. Xerostomia

Description : The most significant finding in clinical evaluation of parotid mass may be accompanying,** A. Lympha adenopathy B. Nodular consistency C. Facial paralysis D. Slow progressive enlargement E. Xerostomia

Last Answer : C. Facial paralysis

Creatinine clearance is deceased in (A) Acute tubular necrosis (B) Acute glomerulonephritis (C) Hypertension (D) Myopathies

Description : Creatinine clearance is deceased in (A) Acute tubular necrosis (B) Acute glomerulonephritis (C) Hypertension (D) Myopathies

Last Answer : Answer : D

Why might a doctor order a pelvic/abdominal CT scan after a colonoscopy?

Description : Why might a doctor order a pelvic/abdominal CT scan after a colonoscopy?

Last Answer : It could be any irregularity that they saw in your blood work. You could call your doctor and ask.

A bomb blast victim presents with nausea and abdominal pain. A Computed Tomography (CT) scan shows no hemorrhage. What treatment should be recommended?

Description : A bomb blast victim presents with nausea and abdominal pain. A Computed Tomography (CT) scan shows no hemorrhage. What treatment should be recommended?

Last Answer : watch for hematoma to develop

Serum LDL has been found to be increased in (A) Obstructive jaundice (B) Hepatic jaundice (C) Hemolytic jaundice (D) Malabsorption syndrome

Description : Serum LDL has been found to be increased in (A) Obstructive jaundice (B) Hepatic jaundice (C) Hemolytic jaundice (D) Malabsorption syndrome

Last Answer : Answer : A

Essential amino acids have been advocated as standard therapy for renal failure. Which of the following statements are true? A. Increased survival from acute renal failure has been reported with both essential and nonessential amino acid therapy of patients in renal failure. B. Essential amino acids retard the rise of blood urea nitrogen (BUN) secondary to decreased urea appearance. C. Essential amino acids and hypertonic dextrose are a convenient form of therapy for hyperkalemia. D. Essential amino acids decrease BUN and creatinine to the same degree as solutions containing excessive nonessential amino acids.

Description : Essential amino acids have been advocated as standard therapy for renal failure. Which of the following statements are true? A. Increased survival from acute renal failure has been reported ... BUN and creatinine to the same degree as solutions containing excessive nonessential amino acids.

Last Answer : Answer: BC DISCUSSION: Essential amino acids and hypertonic dextrose, as opposed to hypertonic dextrose alone, was reported by Abel and co-workers to be associated with a decreased mortality rate ... renal failure have not been carried out in sufficient numbers to yield answers to this question

Normal range of serum sodium is (A) 30–70 mEq/L (B) 70–110 mEq/L (C) 117–135 mEq/L (D) 136–145 mEq/L

Description : Normal range of serum sodium is (A) 30–70 mEq/L (B) 70–110 mEq/L (C) 117–135 mEq/L (D) 136–145 mEq/L

Last Answer : Answer : D

A 70-year-old patient presented with weakness, tiredness and muscle cramps. The ECG showed Q-T prolongation, flattening of T wave and occasional A-V block. His serum K+ was low (2.8 mEq/L). He admitted taking a laxative every day for the past several months. Which laxative could be responsible for the above condition: A. Bisacodyl B. Liquid paraffin C. Methylcellulose D. Bran

Description : A 70-year-old patient presented with weakness, tiredness and muscle cramps. The ECG showed Q-T prolongation, flattening of T wave and occasional A-V block. His serum K+ was low (2.8 mEq ... could be responsible for the above condition: A. Bisacodyl B. Liquid paraffin C. Methylcellulose D. Bran

Last Answer : A. Bisacodyl

Normal range of serum creatinine is (A) 0.6–1.5 mg/dl (B) 9–11 mg/dl (C) 20–45 mg/dl (D) 60–100 mg/dl

Description : Normal range of serum creatinine is (A) 0.6–1.5 mg/dl (B) 9–11 mg/dl (C) 20–45 mg/dl (D) 60–100 mg/dl

Last Answer : Answer : A

The following findings are normal in pregnancy: a. elevated erythrocyte sedimentation rate (ESR) b. raised serum urea c. raised serum creatinine d. elevated white blood cell count

Description : The following findings are normal in pregnancy: a. elevated erythrocyte sedimentation rate (ESR) b. raised serum urea c. raised serum creatinine d. elevated white blood cell count

Last Answer : elevated white blood cell count

Which of the following statement(s) is/are true concerning the assessment of protein reserve? a. Conventional serum proteins such as albumin and globulin are early indicators of malnutrition b. The total lymphocyte count reflects immune status and not nutrition c. Antigen skin testing reflects patient immunity and not nutrition d. Measurement of urea excretion in urine can be used as a measurement of protein breakdown

Description : Which of the following statement(s) is/are true concerning the assessment of protein reserve? a. Conventional serum proteins such as albumin and globulin are early indicators of malnutrition b. The ... d. Measurement of urea excretion in urine can be used as a measurement of protein breakdown

Last Answer : Answer: d Since protein is the functional and structural chemical of the body, most nutritional assessment techniques are estimates of protein reserves. The actual nitrogen balance can ... patients convert from reactive to anergic, and reactivity can be restored by nutritional repletion