Pulmonary Embolism and DVTQuestion: A patient with a first-time pulmonary embolism (PE) is treated with anticoagulation. For how long should the anticoagulation therapy continue?
Answer: A. 6 months (if unprovoked, anticoagulation should last for 6 months; if provoked, it lasts for 3 months).
Pulmonary Embolism and DVTQuestion: A young patient presents with unilateral progressive leg swelling without a history of surgery or prolonged bed rest. What is the most important question to ask in the patient's history?
Answer: History of smoking (smoking is a major risk factor for venous thromboembolism).
Pulmonary Embolism and DVTQuestion: If a patient presents with pulmonary embolism (PE) or deep vein thrombosis (DVT) and is stable, what is the appropriate treatment?
Answer: Heparin (5,000 units) or Enoxaparin (1 mg) (both are commonly used for anticoagulation therapy in stable patients).
Pulmonary Embolism and DVTQuestion: A patient with a DVT thrombus from the popliteal vein extends to the femoral vein, and the patient is vitally stable. What is the treatment?
Answer: Enoxaparin (commonly used in DVT treatment).
Pulmonary Embolism and DVTQuestion: A pregnant patient presents with DVT. What is the most appropriate anticoagulant to use?
Answer: Enoxaparin (safe for use in pregnancy for managing DVT).
Pulmonary Embolism and DVTQuestion: A patient with atrial fibrillation (AF) and leg pain is treated with:
Answer: Heparin (used to manage anticoagulation in AF with leg pain).
Pulmonary Embolism and DVT Question: In a case of massive pulmonary embolism, what is the treatment?
Answer: Thrombolytics (the only indication for thrombolytics in massive PE is if the patient is unstable).
Pulmonary Embolism and DVTQuestion: A patient with a history of one-year paraplegia and hypotension is found to have a DVT extending to the thigh on angiography. What is the next step in management?
Answer: Thrombolysis (recommended for massive PE or severe DVT in unstable patients).
Pulmonary Embolism and DVTQuestion: A female patient presents with pyelonephritis and then suddenly develops symptoms of pulmonary embolism (PE) with unstable vitals. What is the best treatment?
Answer: Alteplase (a thrombolytic used for managing massive PE).
Pulmonary Embolism and DVTQuestion: A patient with saddle pulmonary embolism and hypotension. What is the most appropriate treatment?
Answer: Alteplase (thrombolytic therapy for massive PE with hypotension).
Pulmonary Embolism and DVTQuestion: What is the best DVT prophylaxis after a long surgery, such as orthopedic or hip surgery?
Answer: Enoxaparin (Enoxaparin is commonly used to prevent DVT after long surgeries).
Pulmonary Embolism and DVTQuestion: A patient develops massive DVT after surgery. What is the most appropriate treatment?
Answer: Enoxaparin (used to manage DVT after surgery).
Pulmonary Embolism and DVTQuestion: A woman on Enoxaparin for DVT prophylaxis presents with a sudden onset of shortness of breath (SOB) and dyspnea. Imaging shows a pulmonary embolus lodged in the small bronchial tree. What should be done?
Answer: Increase the dose of Enoxaparin (for a patient already on Enoxaparin, the dose may need to be increased if a PE develops).
Pulmonary Embolism and DVTQuestion: A patient develops pulmonary embolism (PE) while on heparin for DVT. There are no contraindications to thrombolytics. What is the next step?
Answer: Increase the dose of Heparin (if thrombolytics are not indicated, increasing heparin dosage is an appropriate step).
Pulmonary Embolism and DVTQuestion: In a patient with DVT and chronic renal failure, what is the best anticoagulant to use?
Answer: Unfractionated heparin (UFH) (UFH is the preferred choice in patients with renal impairment).
Pulmonary Embolism and DVTQuestion: A patient with hypertension, diabetes, and end-stage renal disease (ESRD) is about to undergo hemodialysis. How can you prevent DVT?
Answer: Unfractionated heparin (UFH) (used in dialysis patients to prevent DVT).
Pulmonary Embolism and DVTQuestion: A patient with pyelonephritis and DVT presents. What is the appropriate anticoagulant?
Answer: Enoxaparin (Enoxaparin is used for DVT in patients with pyelonephritis).
Pulmonary Embolism and DVTQuestion: When should a filter IVC be used to remove a clot from the lungs?
Answer: When thrombolytic therapy is contraindicated, such as in patients with a history of intracranial hemorrhage, to prevent further bleeding.
Pulmonary Embolism and DVTQuestion: A 72-year-old male with episodic weakness and a history of AFib asks about treatment. What is the best treatment for this patient?
Answer: Warfarin (INR 2-3) (INR of 2-3 is the target for anticoagulation in patients with AFib).
Pulmonary Embolism and DVTQuestion: A patient presents with signs of DVT but has no family history. What is the most important question to ask in the patient's history?
Answer: Using oral contraceptive pills (OCP) (OCPs increase the risk of DVT).
Pulmonary Embolism and DVTQuestion: What is an absolute contraindication for thrombolytic therapy?
Answer: Intracranial hemorrhage within the past 2 years.
Pulmonary Embolism and DVTQuestion: A patient on heparin develops thrombocytopenia with no obvious symptoms. What is the next step?
Answer: Stop heparin and start Argatroban (for Heparin-Induced Thrombocytopenia).
Pulmonary Embolism and DVTQuestion: A foot wound that does not heal is likely due to:
Answer: Decreased blood supply (commonly seen in patients with diabetes and vascular issues).
Pulmonary Embolism and DVTQuestion: A diabetic smoker presents with claudication, and femoral pulses are intact but distal pulses are diminished. What is the best next step in management?
Answer: Smoking cessation with aggressive blood sugar control (improves circulation and prevents further complications).
Pulmonary Embolism and DVTQuestion: A patient post MI and PCI is on warfarin. What should you do next?
Answer: Continue warfarin + add 2 antiplatelets (standard management after PCI for additional protection).
Pulmonary Embolism and DVTQuestion: A patient post PCI develops AFib and is already on warfarin and statins. What should you do next?
Answer: Continue warfarin and add 2 antiplatelets (to manage both anticoagulation and antiplatelet therapy).
Pulmonary Embolism and DVTQuestion: A man in his 50s with a history of brain infarction 6 months ago is on warfarin. What is the most appropriate management?
Answer: Same Management (continue warfarin as per the standard care for stroke prevention).
Pulmonary Embolism and DVTQuestion: A patient on warfarin has an INR of 7. What should you do next?
Answer: Stop warfarin and repeat INR the next day (INR of 7 is too high, requiring adjustment).
Pulmonary Embolism and DVTQuestion: In a case of peripheral artery disease, what is the best next step in management?
Answer: CTA (computed tomography angiography) to evaluate the arterial blockages.
Pulmonary Embolism and DVTQuestion: A patient with a history of paraplegia after an RTA presents with clear signs of DVT and right-sided heart failure. What is the most appropriate management?
Answer: Enoxaparin (heparin is used in DVT cases, especially in patients with complications like heart failure).
Pulmonary Embolism and DVTQuestion: A patient with arrhythmia on warfarin and a high risk of stroke. What should be done next?
Answer: Only warfarin (continued anticoagulation to reduce the risk of stroke in atrial fibrillation).
Pulmonary Embolism and DVTQuestion: A 77-year-old patient with diabetes, hypertension, and a history of TIA presents with irregular pulse and ECG showing AFib. What is the most appropriate management?
Answer: Give warfarin to prevent stroke (warfarin is the most effective option for stroke prevention in AFib).
Pulmonary Embolism and DVTQuestion: If a patient on warfarin has a low INR, what complication is likely?
Answer: Vitamin K deficiency (low INR indicates that the blood is clotting too quickly, possibly due to insufficient vitamin K).
Pulmonary Embolism and DVTQuestion: A 52-year-old patient diagnosed with chronic AFib. In which of the following is the patient at an increased risk?
Answer: Cerebrovascular accident (stroke is a common complication of chronic atrial fibrillation).
Pulmonary Embolism and DVTQuestion: An elderly patient with DVT is being evaluated. Which of the following would indicate a need for a thrombophilia test?
Answer: Connective tissue disease (connective tissue diseases can increase the risk of thrombophilia).
Pulmonary Embolism and DVTQuestion: A patient with chronic kidney disease (CKD) is being treated. What is the appropriate anticoagulant to use?
Answer: UFH (Unfractionated heparin) (UFH is typically used in patients with renal impairment).
Pulmonary Embolism and DVTQuestion: A patient with a history of ESRD undergoes hemodialysis regularly. What is the best prophylaxis for DVT at the hospital?
Answer: A. UFH (Unfractionated heparin) (recommended as the prophylactic anticoagulant for these patients).
Pulmonary Embolism and DVTQuestion: An elderly patient presents with abdominal pain and a history of heart disease. What is the most likely diagnosis?
Answer: Mesenteric ischemia (abdominal pain combined with heart disease often points to mesenteric ischemia).
Pulmonary Embolism and DVTQuestion: A patient has a thumbprint sign on X-ray. What is the most likely diagnosis?
Answer: Mesenteric ischemia (thumbprint sign on imaging suggests mesenteric ischemia).
Pulmonary Embolism and DVTQuestion: A 65-year-old male with cardiomyopathy presents with sudden abdominal pain lasting for 8 hours. He also has tenderness and abnormal bowel sounds, and his amylase is high. What is the most likely diagnosis?
Answer: Mesenteric ischemia (Sudden abdominal pain with high amylase and abnormal bowel sounds is suggestive of mesenteric ischemia).
Pulmonary Embolism and DVTQuestion: A patient with coronary heart disease (CHD) develops epigastric pain and an increased bowel movement. What is the most likely diagnosis?
Answer: Acute mesenteric emboli (This can cause epigastric pain and bowel movement changes).
Pulmonary Embolism and DVTQuestion: An elderly patient with claudication symptoms presents. What is the most likely diagnosis?
Answer: Aortoiliac insufficiency (claudication is a key symptom of aortoiliac insufficiency).
Pulmonary Embolism and DVTQuestion: A diabetic hypertensive patient presents with claudication after walking 200 meters and no distal pulse. What is the first step in treatment?
Answer: A. Heparin and follow-up (initial management of DVT and arterial insufficiency).
Pulmonary Embolism and DVTQuestion: A patient with hemiparesis due to a previous infarction now presents with a CT infarction and no clinical symptoms. What is the next step in management?
Answer: LWMH (Low molecular weight heparin) (LWMH is recommended for these types of ischemic events).
Pulmonary Embolism and DVTQuestion: A patient develops Heparin-Induced Thrombocytopenia (HIT). What should you do next?
Answer: Stop Heparin and start Argatroban (for HIT, stop heparin and initiate Argatroban, a direct thrombin inhibitor).
Pulmonary Embolism and DVTQuestion: A patient presents with signs of acute limb ischemia, absent peripheral pulses in the right leg, and absent dorsalis pulse in the left leg. What is the next step in treatment?
Answer: Catheter-directed thrombolysis (CDT) (CDT is an endovascular treatment for acute limb ischemia).
Pulmonary Embolism and DVTQuestion: A patient who had retinal surgery 7 days ago now requires DVT prophylaxis. What is the most appropriate option?
Answer: Mechanical compression (recommended as DVT prophylaxis in patients at risk, such as after retinal surgery).
ATRIAL FIBRILATION
ATRIAL FIBRILATIONCHA₂DS₂-VASc Score Calculation: C - Congestive heart failure (1 point) H - Hypertension (1 point) A₂ - Age ≥75 years (2 points) D - Diabetes mellitus (1 point) S₂ - Stroke/TIA/thromboembolism (2 points) V - Vascular disease (e.g., MI, PAD, aortic plaque) (1 point) A - Age 65–74 years (1 point) S - Sex (female) (1 point)
ATRIAL FIBRILATIONQuestion: A 65-year-old man with diabetes and hypertension presents with atrial fibrillation. What is the most appropriate management?
Answer: Warfarin
ATRIAL FIBRILATIONQuestion: A 65-year-old patient with asthma and migraine presents with tachycardia and irregular sinus rhythm diagnosed as atrial fibrillation. What is the most appropriate treatment for this patient?
Answer: Aspirin
ATRIAL FIBRILATIONQuestion: A 55-year-old patient with atrial fibrillation and diabetes is being evaluated. What is the most appropriate management?
Answer: No anticoagulation, just aspirin
ATRIAL FIBRILATIONQuestion: A 77-year-old patient with diabetes, hypertension, and a history of TIA presents with atrial fibrillation and a pulse rate of 70. What is the most appropriate management?
Answer: Give warfarin to prevent stroke
ATRIAL FIBRILATIONQuestion: A 55-year-old patient with atrial fibrillation (no other comorbidities mentioned) is being evaluated. What would help prevent further complications?
Answer: Aspirin
ATRIAL FIBRILATIONQuestion: A 77-year-old female with palpitations and diagnosed with asymptomatic atrial fibrillation is asking about the first drug that should be prescribed.
Answer: Anti-coagulant
ATRIAL FIBRILATIONQuestion: A 65-year-old man with diabetes and hypertension presents with atrial fibrillation. What is the most appropriate management?
Answer: No need for anticoagulation
Pneumonia
PneumoniaQuestion: What is the most common cause of bladder outlet obstruction in male newborns?
Answer: Posterior urethral valve (This is an obstructing membrane in the posterior male urethra due to abnormal in utero development).
PneumoniaQuestion: What is the most important next step in aspirin toxicity?
Answer: Urine alkalinization (This helps to enhance the elimination of aspirin).
PneumoniaQuestion: A young patient with recurrent UTIs, kidney stones, and electrolyte disturbances presents with bilateral kidney enlargement and multiple thin-walled cysts on imaging. What is the most likely diagnosis?
Answer: Polycystic kidney disease (This is a genetic disorder characterized by cystic enlargement of the kidneys).
PneumoniaQuestion: A patient presents with absent reflexes, slight anemia, high potassium (5.5), and elevated urea and creatinine levels. What is the most appropriate next step?
Answer: Dialysis (This patient is showing signs of kidney failure, indicated by high creatinine and potassium levels).
PneumoniaQuestion: What is the most common type of nephrotic syndrome in pediatric patients?
Answer: Minimal change disease (This is the most common type of nephrotic syndrome in children).
PneumoniaQuestion: How can you determine that nephrotic syndrome is in remission?
Answer: Disappearance of albumin in urine (When the proteinuria resolves, it indicates that the disease is in remission).
PneumoniaQuestion: What are the indications for dialysis?
Answer: Hyperkalemia, acidosis, and hyperuremia (These are critical signs that suggest the need for dialysis in kidney failure).
PneumoniaQuestion: A patient presents with vibration sensation loss, absent lower limb reflexes, and lab findings of high creatinine, potassium, and low MCV. What is the most appropriate management?
Answer: Hemodialysis (This patient shows signs of kidney failure, which requires dialysis).
PneumoniaQuestion: A patient with pyelonephritis and positive nitrate on urinalysis presents. What is the best next step?
Answer: IV antibiotics (Immediate antibiotic treatment is essential in managing pyelonephritis).
PneumoniaQuestion: What is the best management for a patient with an asymmetrical prostate, normal PSA, and urinary analysis showing median lobe enlargement?
Answer: Periodic PSA monitoring (This helps to track prostate health and detect any changes that may indicate pathology).
PneumoniaQuestion: What is the most likely cause of asymmetrical kidneys on imaging?
Answer: Renal artery stenosis (This condition leads to blood flow obstruction and uneven kidney enlargement).
PneumoniaQuestion: What is the treatment for a patient with pyelonephritis?
Answer: Admission and IV antibiotics (IV antibiotics are necessary for the treatment of pyelonephritis).
PneumoniaQuestion: How can calcium stones be prevented in patients?
Answer: Give thiazides (Thiazides are used to reduce calcium excretion in the urine).
PneumoniaQuestion: What foods should be avoided in patients with high potassium levels?
Answer: Tomato and banana (These are high in potassium and should be avoided).
PneumoniaQuestion: What is the first thing to give to a pregnant patient with blood pressure 160/110 and protein in urine?
Answer: Magnesium sulfate (This is used in cases of preeclampsia to prevent seizures).
PneumoniaQuestion: A patient presents with urine leakage and difficulty controlling urinary stream with bladder distention after voiding. What is the likely diagnosis?
Answer: Overflow incontinence (This condition is characterized by bladder distension and inability to empty the bladder completely).
PneumoniaQuestion: A patient presents with hematuria and hemoptysis. What is the likely diagnosis?
Answer: Goodpasture's syndrome (A rare autoimmune disorder that affects the lungs and kidneys).
PneumoniaQuestion: A patient with fever, dark urine, and a history of constipation presents with high leukocytes, erythrocytes, and protein in urine. What is the most likely diagnosis?
Answer: Pyelonephritis (The patient shows typical signs of pyelonephritis, including fever, chills, and pyuria).
PneumoniaQuestion: What should be done for a patient with nephrotic syndrome, edema, and a low sodium diet?
Answer: Furosemide (Diuretics like furosemide are used to manage fluid retention in nephrotic syndrome).
PneumoniaQuestion: A patient with renal impairment and hyperkalemia (K = 6.5) should receive:
Answer: Calcium gluconate (Used to stabilize the heart in hyperkalemia).
PneumoniaQuestion: What is the most common type of nephrotic syndrome in children?
Answer: Minimal change disease (Most common nephrotic syndrome in pediatric patients).
PneumoniaQuestion: A patient with a recent history of URTI (2 weeks ago) presents with a mid-diastolic murmur. How would you confirm the diagnosis?
Answer: ASO titer (Used to confirm post-streptococcal glomerulonephritis).
PneumoniaQuestion: What is the diagnosis for a patient with symptoms of arthritis and splenomegaly?
Answer: Felty's syndrome (A rare complication of rheumatoid arthritis).
PneumoniaQuestion: A patient presents with renal symptoms after a URTI 3 weeks ago. What would you expect in their lab results?
Answer: Post-streptococcal glomerulonephritis with low C3 and hematuria.
PneumoniaQuestion: A patient presents with symptoms of nephrotic syndrome after a URTI resolved within weeks. What is the most likely diagnosis?
Answer: Post-streptococcal glomerulonephritis (PSGN) (Look for the association with URTI and symptoms of nephrotic syndrome).
PneumoniaQuestion: What is the most important investigation for PSGN?
Answer: Serum creatinine (It is important for assessing renal function).
PneumoniaQuestion: What is the most likely diagnosis in a patient with rheumatoid arthritis, splenomegaly, and neutropenia?
Answer: Felty's syndrome (Characterized by RA, splenomegaly, and neutropenia).
PneumoniaQuestion: What is the complication of lymphadenopathy and membranous lesions over the tonsils?
Answer: Scarlet fever (This is a complication of streptococcal throat infections).
PneumoniaQuestion: What is the characteristic pathology of progressive glomerulonephritis?
Answer: Crescent moon (This is indicative of rapidly progressive glomerulonephritis).
PneumoniaQuestion: What is the most likely diagnosis for an apical lung lesion seen on X-ray?
Answer: Tuberculosis (TB) (Apical lesions are characteristic of TB).
PneumoniaQuestion: What TB medication can cause neuropathy?
Answer: Isoniazid (This drug is known to cause neuropathy as a side effect).
PneumoniaQuestion: A patient with TB presents with red urine. What is the likely cause?
Answer: Isoniazid (A side effect of Isoniazid therapy).
PneumoniaQuestion: What is the most likely cause of pleural effusion in a patient with TB?
PneumoniaQuestion: What is the most common interstitial lung disease associated with TB?
Answer: Silicosis (A pneumoconiosis associated with TB exposure).
PneumoniaQuestion: What is the primary prevention for TB?
Answer: Vaccination (The BCG vaccine is the primary prevention for TB).
PneumoniaQuestion: A smoker with dry cough and shortness of breath is diagnosed with interstitial fibrosis. What is the most likely diagnosis?
Answer: Interstitial fibrosis (This is a common complication in smokers, not bronchoectasis).
PneumoniaQuestion: What is the next step for a patient with small lung cancer and a calcium level of 3.5?
Answer: IV normal saline (To correct hypercalcemia before further treatment).
PneumoniaQuestion: A patient with fever, dyspnea, purulent cough, yellow sputum, and hemoptysis is found to have a consolidation on the X-ray and moderate pleural effusion. What is the next step in management?
Answer: IV ceftriaxone and metronidazole + thoracocentesis (To treat infection and evaluate pleural effusion).
PneumoniaQuestion: What is the most likely diagnosis for a patient with pleural effusion and high interferon gamma?
Answer: Tuberculous pleural effusion (This is indicated by high interferon gamma levels).
PneumoniaQuestion: A patient with TB presents with elevated pleural fluid ADA levels. What does this suggest?
Answer: Tuberculous pleural effusion (ADA >45 IU is highly sensitive for TB).
PneumoniaQuestion: What TB medication is most hepatotoxic and can cause high LFTs?
Answer: Pyrazinamide (This is the most hepatotoxic TB medication).
PneumoniaQuestion: What is the initial action for a patient presenting with symptoms of TB in the ER?
Answer: Isolation (This is crucial to prevent the spread of TB to others).
PneumoniaQuestion: How can you confirm that pleural effusion is exudative?
Answer: Pleural pLDH/serum LDH ratio is greater than 0.6 (This indicates an exudative effusion).
PneumoniaQuestion: "Interstitial pneumonitis" is a hallmark finding for which type of pneumonia?
Answer: Viral pneumonia (Interstitial pneumonitis is commonly associated with viral pneumonias).
PneumoniaQuestion: A patient with small lung cancer presents with back pain. What is the next step in management?
Answer: MRI + IV steroids (To assess the tumor's effect and manage symptoms).
PneumoniaQuestion: What drug in TB treatment is known to cause increased creatinine?
Answer: Rifampin (Rifampin can affect kidney function and increase creatinine levels).
PneumoniaQuestion: What is the standard regimen for TB treatment?
PneumoniaQuestion: What test is most sensitive for detecting pleural TB?
Answer: ADA (Adenosine Deaminase) (Levels greater than 45 IU are highly suggestive of TB).
PneumoniaQuestion: What does the presence of a cavitary lesion in the upper lung on an X-ray indicate?
Answer: TB (Cavitary lesions are commonly seen in tuberculosis, which is airborne).
PneumoniaQuestion: What is the most sensitive test for Tuberculous pleural effusion?
Answer: Elevated pleural fluid ADA levels (This test is sensitive for diagnosing pleural TB).
PneumoniaQuestion: What is the most likely cause of pleural effusion with LDH levels greater than 100 in a TB patient?
Answer: Pleural TB (High pleural LDH is associated with TB pleural effusion).
PneumoniaQuestion: What side effect is commonly associated with TB medication that causes red urine?
Answer: Rifampin (This drug can cause red or orange urine as a harmless side effect).
PneumoniaQuestion: What is the primary diagnostic imaging for apical lung lesions suggestive of TB?
Answer: X-ray (Apical lesions are characteristic of tuberculosis).
PneumoniaQuestion: What is the best diagnostic test for bronchiectasis?
Answer: CT scan (This is the gold standard for diagnosing bronchiectasis).
PneumoniaQuestion: What condition can cause elevated JVP and hepatosplenomegaly in a TB patient?
Answer: Constrictive pericarditis (This is often a complication of TB, leading to heart and liver involvement).
PneumoniaQuestion: Which anti-TB drug is known to increase liver enzymes?
Answer: Isoniazid (INH) (Isoniazid is known for causing hepatotoxicity and liver enzyme elevation).
PneumoniaQuestion: What is the cause of pleural effusion in a TB patient?
Answer: Tubercles pleural effusion (Pleural effusion in TB patients is often due to the presence of tuberculous lesions).
PneumoniaQuestion: What occupation-related risk factor increases the likelihood of developing TB?
Answer: Silicosis (This condition is strongly associated with an increased risk of TB due to lung damage and immunosuppression).
PneumoniaQuestion: What is the most sensitive test for TB pleural effusion?
Answer: High adenosine deaminase (ADA) levels, greater than 45 IU (This test is highly sensitive for diagnosing TB pleural effusion).
PneumoniaQuestion: Which anti-TB drug is most commonly associated with neuropathy?
Answer: Isoniazid (Isoniazid can cause peripheral neuropathy as a side effect).
PneumoniaQuestion: What is the first action when a patient presents with signs and symptoms of TB?
Answer: Isolation (This is the first step to prevent the spread of TB).
PneumoniaQuestion: How do you confirm that a pleural effusion is exudative?
Answer: Pleural pLDH/serum LDH ratio greater than 0.6 (This indicates an exudative effusion).
PneumoniaQuestion: A smoker presents with skin lesions on his back, some crusted, and a CXR showing bilateral infiltrates. What is the next step in management?
Answer: A. Antibiotics (This presentation suggests a possible bacterial infection, and antibiotics are the most appropriate treatment).
PneumoniaQuestion: A 2-year-old presents with fever, cough, and respiratory distress. Exam shows bilateral crackles, and CXR shows bilateral lung infiltrates. What is the most likely diagnosis?
Answer: Bronchopneumonia (This presentation is consistent with pneumonia, particularly bronchopneumonia).
PneumoniaQuestion: What is the treatment for community-acquired pneumonia?
Answer: Fluoroquinolones (These are often used to treat community-acquired pneumonia).
PneumoniaQuestion: An elderly patient develops a productive cough, fever, and dyspnea. Exam shows crepitations, and CXR shows bilateral right middle lobe consolidation. The lab shows a cold agglutination test. What is the diagnosis?
Answer: Atypical pneumonia (Cold agglutinin tests are often associated with atypical pneumonia, which is caused by Mycoplasma pneumoniae).
PneumoniaQuestion: What is the most common organism causing lobar pneumonia?
Answer: Streptococcus pneumoniae (This is the most common causative organism for lobar pneumonia).
PneumoniaQuestion: A patient develops a productive cough and fever. After being given antibiotics, he becomes better but then worsens with shortness of breath. X-ray shows pleural effusion. What is the diagnosis?
Answer: A. Parapneumonic effusion (This is the most likely diagnosis given the progression after antibiotic treatment and pleural effusion on X-ray).
PneumoniaQuestion: A patient has a sudden cyanotic episode while at a family picnic. He was previously healthy. After a cough, chest X-ray shows that the trachea has shifted to the left. What could be the reason for this tracheal shift?
Answer: C. Right lung collapse (Tracheal deviation typically occurs due to a collapse of the lung on one side, pulling the trachea towards the collapsed lung).
PneumoniaFlashcard 761 Question: In a case of lobar pneumonia with moderate effusion, what is the management?
Answer: B. Ceftriaxone and vancomycin with thoracocentesis (The combination of antibiotics and draining the effusion via thoracocentesis is appropriate).
PneumoniaQuestion: A patient who had dialysis 3 days ago via central line comes back for dialysis. The nurse reports he has fever and infection at the previous dialysis site. What should be done?
Answer: B. Culture IV antibiotics and remove the central line (Infections related to dialysis need to be managed by removing the source of infection and administering antibiotics).
PneumoniaQuestion: A 51-year-old patient presents with fever, headache, and neck pain. What is the most likely organism?
Answer: Streptococcus pneumoniae (This is a common pathogen for infections like meningitis and pneumonia with such symptoms).
PneumoniaQuestion: A patient with pneumonia is hypotensive (90/60), lethargic, has a pulse of 160, and a temperature of 38.5°C. What is the diagnosis?
Answer: B. Septic shock (These signs are consistent with septic shock due to severe infection).
PneumoniaQuestion: A patient with pneumonia presents with a pleural friction rub. What is the differential diagnosis?
Answer: Pneumonia (Pleural friction rub can be a sign of pneumonia or pleuritis).
PneumoniaQuestion: How long does it typically take for patches on a chest X-ray in lobar pneumonia to disappear?
Answer: C. 6 weeks (The resolution of lobar pneumonia on X-ray typically takes about 6 weeks).
PneumoniaQuestion: A patient with pneumonia is agitated and confused. What is the most appropriate management?
Answer: B. Keep the family (The presence of family members may help alleviate confusion and agitation in elderly patients with pneumonia).
PneumoniaQuestion: Which patient with lobar pneumonia would be treated as an outpatient?
Answer: D. 55 years old, BP 100/90, temp 39.5°C, pulse 100, RR 30 (Patients under 65 with moderate symptoms, including a respiratory rate of over 30, are candidates for outpatient treatment).
PneumoniaQuestion: A patient with influenza pneumonia is admitted. What isolation precautions should be taken?
Answer: B. Droplets (Influenza is primarily spread by droplets, so droplet precautions should be used).
PneumoniaQuestion: What is the best antibiotic to treat community-acquired pneumonia in healthy adults?
Answer: A. Fluoroquinolones (Fluoroquinolones are commonly used to treat community-acquired pneumonia in healthy adults).
PneumoniaQuestion: What is the pneumonia vaccine recommendation for the elderly?
Answer: B. PCV13 first, followed by a dose of PPSV23 (The recommended sequence for pneumonia vaccination in elderly patients).
PneumoniaQuestion: What reduces mortality in CHF?
Answer: B. ACE inhibitors (ACE inhibitors are known to improve survival in patients with chronic heart failure).
PneumoniaQuestion: Scenario of diphtheria, the diagnosis is not mentioned, but there is pseudomembrane over the tonsils with mild fever. What complication is suspected?
Answer: A. Pneumonia (Pneumonia is a common complication of diphtheria due to the infection affecting the respiratory system).
PneumoniaQuestion: A 68-year-old presents with fever, cough with yellowish sputum, is oriented, RR 23, BP normal, and X-ray shows lobar pneumonia. What is your management?
Answer: B. ABx and discharge with 1-week follow-up in the clinic (Given the patient's normal BUN and stable condition, outpatient management with antibiotics and follow-up is appropriate).
PneumoniaQuestion: "Interstitial pneumonitis" is a pathologic hallmark for:
Answer: Viral pneumonia (Interstitial pneumonitis is commonly associated with viral pneumonia).
PneumoniaQuestion: Dyspnea at night, sternum pain, midline mass compressed trachea. What is the likely diagnosis?
Answer: Lymphoma (The described symptoms, including dyspnea, sternum pain, and a mass compressing the trachea, are suggestive of lymphoma).
PneumoniaQuestion: What has been shown to reduce mortality in patients with CHF (congestive heart failure)?
Answer: ACE inhibitors (ACE inhibitors are known to reduce mortality in heart failure by improving symptoms and preventing further damage to the heart).
PneumoniaQuestion: A patient with a pseudomembrane over the tonsils and mild fever presents. What complication should be suspected?
Answer: Glomerulonephritis (Pseudomembrane over the tonsils is suggestive of diphtheria, and glomerulonephritis can be a complication).
PneumoniaQuestion: A 68-year-old patient presents with fever, cough, and yellowish sputum. The diagnosis is lobar pneumonia. What is the next step in management?
Answer: Admit with antibiotics (Patients with lobar pneumonia often require admission to the hospital for IV antibiotics, especially elderly patients).
PneumoniaQuestion: Where is the site of thoracentesis for pleural effusion?
Answer: C. 9th mid axillary (Thoracentesis is usually performed in the 9th intercostal space along the mid-axillary line).
PneumoniaQuestion: Where to place the mid-axillary thoracentesis?
Answer: 8th to 10th intercostal space (This is the recommended location for performing thoracentesis in the mid-axillary line).
PneumoniaQuestion: A patient with lymph node enlargement, family concerned about cancer because his relative was recently diagnosed with lymphoma. Which is an indication for biopsy?
Answer: D. Fever (Fever, along with persistent regional lymphadenopathy, is an indication for biopsy, especially if the symptoms last for more than 6 weeks).
PneumoniaQuestion: After mechanical ventilation, what is expected to happen?
Answer: B. Hypocapnia (Mechanical ventilation can lead to hypocapnia, especially if hyperventilation is used).
PneumoniaQuestion: What is the definitive diagnostic test for bronchiectasis?
Answer: HRCT (High-resolution computed tomography) (HRCT is the most sensitive and specific imaging technique for diagnosing bronchiectasis).
PneumoniaQuestion: A smoker presents with hemoptysis or hoarseness. What is the most likely diagnosis?
Answer: Bronchogenic carcinoma (Smokers with hemoptysis or hoarseness are at high risk for bronchogenic carcinoma).
PneumoniaQuestion: A patient presents with lymphadenopathy, and his cousin has a known case of leukemia. Which lymph node enlargement should be suspected?
Answer: Cervical or supraclavicular (Lymphadenopathy in the cervical or supraclavicular region is often seen in cancerous conditions like leukemia).
PneumoniaQuestion: A breast mass with weight loss and pleural effusion. What is the most likely nature of the pleural effusion?
Answer: B. Exudate (Breast cancer often leads to an exudative pleural effusion due to its malignancy).
PneumoniaQuestion: A cancer patient has had multiple pleural taps with no improvement. What is the next step in management?
Answer: Chemical pleurodesis (Chemical pleurodesis is used to treat recurrent pleural effusions, particularly in cancer patients).
PneumoniaQuestion: A patient with bronchogenic cancer presents with a massive pleural effusion. After several pleural taps, what should be done next?
Answer: B. Chemical pleurodesis (Recurrent pleural effusion in lung cancer often requires chemical pleurodesis).
PneumoniaQuestion: A patient with idiopathic bronchiectasis presents with progressive SOB and dry cough. On examination, there is decreased airway entry with coarse crepitations. What should be given?
Answer: Prednisone (Prednisone is often used in the treatment of bronchiectasis when inflammation is present).
PneumoniaQuestion: A patient presents with dyspnea at night, sternum pain, and a midline mass compressing the trachea. What is the most likely diagnosis?
Answer: A. Thymoma (Thymoma is known to cause compression of the trachea and can present with these symptoms).
PneumoniaQuestion: A patient complains of SOB and difficulty swallowing. Ultrasound shows a midline mass compressing the trachea. What is the most likely diagnosis?
Answer: B. Thymoma (Thymoma can cause these symptoms and findings on ultrasound).
PneumoniaQuestion: A patient presents with dysphagia and difficulty breathing. There is swelling in the mediastinum. What is the likely diagnosis?
Answer: A. Lymphoma (Lymphoma can cause mediastinal masses that result in these symptoms).
PneumoniaQuestion: A patient is intubated and then develops an ulcer. What type of ulcer is this?
Answer: Stress ulcer (Stress ulcers are common in patients who are critically ill or have been intubated).
PneumoniaQuestion: A sarcoma patient requires assessment of metastasis. What is the most appropriate test?
Answer: B. CT chest (CT chest is used to assess the lung, which is the most common site of distant spread of sarcomas).
PneumoniaQuestion: The most common site of distant spread of sarcomas is:
Answer: The lung (Sarcomas commonly metastasize to the lungs).
PneumoniaQuestion: What is the indication for thoracentesis?
Answer: Glucose should be less than 0.6, pH less than 7.2, or loculated (These are typical indications for performing thoracentesis).
PneumoniaQuestion: Features of lung cancer with SVO (Superior Vena Cava Obstruction) and asking about the type of lung cancer:
Answer: Non-small cell carcinoma (Non-small cell lung carcinoma is the most common type associated with SVO).
PneumoniaQuestion: A patient has barking cough and stridor. What is the likely diagnosis?
Answer: Laryngotracheobronchitis (Commonly known as croup, which is characterized by barking cough and stridor).
PneumoniaQuestion: Which anti-TB drug causes an increase in uric acid?
Answer: Pyrazinamide (Pyrazinamide is known to increase uric acid levels).
PneumoniaQuestion: A smoker presents with hemoptysis or hoarseness. What is the likely diagnosis?
Answer: Bronchogenic carcinoma (Smokers with hemoptysis or hoarseness are at high risk for bronchogenic carcinoma).
PneumoniaQuestion: A chest X-ray shows an apical lesion. What is the diagnosis?
Answer: Tuberculosis (TB) (Apical lesions on chest X-ray are a hallmark of tuberculosis).
PneumoniaQuestion: The highest diagnostic yield for chronic thromboembolic pulmonary hypertension is:
Answer: V/Q scan (A ventilation/perfusion scan is the most accurate test for diagnosing chronic thromboembolic pulmonary hypertension).
PneumoniaQuestion: A smoker with high dysplasia in the esophagus. What is the next step in management?
Answer: Surgical resection (In cases of high dysplasia in the esophagus, especially in smokers, surgical resection is indicated).
PneumoniaQuestion: A child with bronchiolitis after supportive treatment. What is the next step?
Answer: Admit to PICU (Children with worsening bronchiolitis should be admitted to the Pediatric Intensive Care Unit if symptoms persist).
PneumoniaQuestion: A smoker with lung cancer and hypercalcemia. What type of cancer is most likely?
Answer: Squamous cell carcinoma (Lung cancer in smokers with hypercalcemia is typically squamous cell carcinoma).
PneumoniaQuestion: Postoperative patient with dyspnea and hypoxia. What is the likely cause?
Answer: Lower lobe atelectasis (Atelectasis is a common cause of postoperative dyspnea and hypoxia, particularly in the lower lobes).
PneumoniaQuestion: A child with cerebral palsy and hypoxia. What type of respiratory failure is most likely?
Answer: Hypercapnic (Type 2) (Cerebral palsy often leads to Type 2 respiratory failure, which is characterized by hypercapnia).
PneumoniaQuestion: Pulmonary hypertension Type 3 is also known as:
Answer: Hypoxic pulmonary hypertension (Type 3 pulmonary hypertension is associated with hypoxia).
PneumoniaQuestion: A patient with difficulty swallowing and a midline mass compressing the trachea. What is the most likely diagnosis?
Answer: Lymphoma (Lymphoma can cause a mass that compresses the trachea and leads to swallowing difficulty).
PneumoniaQuestion: A patient is intubated and develops an ulcer. What type of ulcer is this?
Answer: Stress ulcer (Stress ulcers are common in critically ill patients, such as those who are intubated).
PneumoniaQuestion: To assess metastasis in a sarcoma patient, what is the most appropriate test?
Answer: CT chest (A CT scan of the chest is used to evaluate lung metastasis in sarcoma patients).
PneumoniaQuestion: The most common site of distant spread of sarcomas is:
Answer: The lung (Sarcomas commonly metastasize to the lungs).
PneumoniaQuestion: A patient with difficulty swallowing and a midline mass compressing the trachea. What is the most likely diagnosis?
Answer: Lymphoma (Lymphoma can cause a mass that compresses the trachea and leads to swallowing difficulty).
PneumoniaQuestion: A patient is intubated and develops an ulcer. What type of ulcer is this?
Answer: Stress ulcer (Stress ulcers are common in critically ill patients, such as those who are intubated).
PneumoniaQuestion: To assess metastasis in a sarcoma patient, what is the most appropriate test?
Answer: CT chest (A CT scan of the chest is used to evaluate lung metastasis in sarcoma patients).
PneumoniaQuestion: The most common site of distant spread of sarcomas is:
Answer: The lung (Sarcomas commonly metastasize to the lungs).
PneumoniaQuestion: What is the indication for thoracentesis?
Answer: Glucose should be less than 0.6, pH less than 7.2, or loculated (These are typical indications for performing thoracentesis).
PneumoniaQuestion: A patient with lung cancer and SVO (Superior Vena Cava Obstruction). What type of lung cancer is most likely?estion: What is the indication for thoracentesis?
Answer: Non-small cell carcinoma (Non-small cell lung carcinoma is the most common type associated with SVO).
PneumoniaQuestion: A patient with lobar pneumonia is being treated. Which patient should be treated as an outpatient?
Answer: CURE 65 (Use the CURB-65 score to determine whether the patient should be treated as an outpatient or inpatient. If the score is 2 or less, the patient can be treated as an outpatient).
PneumoniaQuestion: A patient with influenza pneumonia requires isolation. What is the appropriate type of isolation?
Answer: Airborne (Influenza requires airborne precautions due to the potential for aerosolized transmission).
PneumoniaQuestion: What is the recommended sequence for pneumonia vaccination in elderly patients?
Answer: PCV13 first, followed by PPSV23 (The pneumococcal vaccination schedule for elderly patients includes PCV13 followed by PPSV23).
PneumoniaQuestion: A patient has barking cough and stridor. What is the diagnosis?
Answer: Laryngotracheobronchitis (This is another name for croup, which is characterized by barking cough and stridor).
PneumoniaQuestion: What is the best way to confirm the diagnosis of tuberculosis (TB)?
Answer: A. Sputum culture (Sputum culture is the gold standard for diagnosing tuberculosis).
PneumoniaQuestion: What is the genetic pattern of inheritance for Tuberous sclerosis?
Answer: Autosomal dominant (Tuberous sclerosis is inherited in an autosomal dominant pattern and is caused by mutations in the TSC1 or TSC2 gene).
PneumoniaQuestion: A patient has consolidation in the right upper lung. What is the most accurate diagnostic confirmation?
Answer: Sputum culture (Sputum culture is the gold standard for confirming tuberculosis, whereas a PPD test may not be definitive).
PneumoniaQuestion: If a patient's PPD test is positive (10mm), what does this suggest?
Answer: TB exposure (A positive PPD test indicates exposure to tuberculosis but does not confirm active TB).
PneumoniaQuestion: What is the required precaution for TB patients?
Answer: Airborne precautions (Tuberculosis is transmitted via airborne droplets, so airborne precautions are essential).
PneumoniaQuestion: How to confirm that a pleural effusion in a TB patient is due to TB?
Answer: Pleural LDH > 100 (Pleural effusion with LDH levels greater than 100 can suggest TB as the cause).
PneumoniaQuestion: What is the indication for thoracentesis or chest tube in patients with pleural effusion?
Answer: SAAG low (A low Serum-Ascitic Albumin Gradient (SAAG) indicates conditions like TB or malignancy).
PneumoniaQuestion: What is the required precaution for TB patients?
Answer: Airborne precautions (Tuberculosis is transmitted via airborne droplets, so airborne precautions are essential).
PneumoniaQuestion: What does high SAAG indicate?
Answer: Cirrhosis + CHD (A high SAAG indicates conditions like cirrhosis or congestive heart disease).
PneumoniaQuestion: A patient has back pain, fever, and a calcified right sacroiliac joint. What test should be ordered?
Answer: Tube agglutination test (This test is used to diagnose conditions like brucellosis, which can cause sacroiliac joint calcification).
PneumoniaQuestion: A TB patient on treatment develops paresthesia. What is the treatment?
Answer: Pyridoxine (Pyridoxine (vitamin B6) is used to treat peripheral neuropathy caused by TB medications like isoniazid).
PneumoniaQuestion: A patient presents with facial plethora and distended JVP. Which condition is likely associated?
Answer: Obstructive sleep apnea (This can cause facial plethora and distended JVP due to increased venous pressure from breathing obstruction).
PneumoniaQuestion: What is the best test to diagnose sleep apnea?
Answer: Polysomnography (Polysomnography is the gold standard diagnostic test for sleep apnea).
PneumoniaQuestion: What is the management for a CO2 poisoning patient with 40% HbCO?
Answer: Hyperbaric oxygen (Hyperbaric oxygen therapy is the treatment for severe carbon monoxide poisoning).
PneumoniaQuestion: What is the management for a CO2 poisoning patient with 40% HbCO?
Answer: Hyperbaric oxygen (Hyperbaric oxygen therapy is the treatment for severe carbon monoxide poisoning).
PneumoniaQuestion: In emphysema with progressive dyspnea, ABG shows high CO2 and high O2. What should be done?
Answer: Intubation and hyperventilation (This is necessary for patients with emphysema and CO2 retention to improve ventilation and decrease CO2 levels).
PneumoniaQuestion: For a lung cancer patient found with a nodule on the lung, what should be asked next?
Answer: Previous chest X-ray (A previous X-ray can help determine the nature and growth of the nodule).
PneumoniaQuestion: A patient presents with a midline mass compressing the trachea. What is the most likely diagnosis?
Answer: Lymphoma (A midline mass compressing the trachea is typically associated with lymphoma).
PneumoniaQuestion: Where is the optimal site for thoracentesis in pleural effusion?
Answer: 9th mid-axillary (This is the ideal site for thoracentesis in pleural effusion).
PneumoniaQuestion: In which intercostal space should thoracentesis be performed?
Answer: 8th to 10th intercostal space (This is the recommended area for thoracentesis in pleural effusion cases).
PneumoniaQuestion: A patient presents with lymph node enlargement. What indicates a need for biopsy?
Answer: Fever and persistent enlargement > 6 weeks (Lymph node enlargement with constitutional symptoms like fever warrants a biopsy, especially if it persists longer than 6 weeks).
PneumoniaQuestion: After mechanical ventilation, what is likely to happen?
Answer: Hypocapnia (Decreased CO2) (Mechanical ventilation increases oxygenation and decreases carbon dioxide levels, leading to hypocapnia).
PneumoniaQuestion: What is the definitive diagnostic test for bronchiectasis?
Answer: HRCT (High-Resolution Computed Tomography) (HRCT is the gold standard for diagnosing bronchiectasis).
PneumoniaQuestion: A smoker presents with hemoptysis or hoarseness. What is the most likely diagnosis?
Answer: Bronchogenic carcinoma (Smoking is a major risk factor for lung cancer, which can present with symptoms like hemoptysis or hoarseness).
PneumoniaQuestion: A patient with leukemia presents with lymph node enlargement. Which lymph nodes are most likely involved?
Answer: Cervical or supraclavicular lymph nodes (Lymphoma and leukemia often cause enlargement of cervical or supraclavicular lymph nodes).
PneumoniaQuestion: A patient presents with a breast mass, weight loss, and pleural effusion. What is most likely to be the cause?
Answer: Exudate (Exudative pleural effusions are often associated with cancer, including breast cancer).
PneumoniaQuestion: A cancer patient with pleural effusion has had multiple taps with no improvement. What is the next step?
Answer: Chemical pleurodesis (Chemical pleurodesis can be used to prevent recurrent pleural effusions in cancer patients).
PneumoniaQuestion: A patient with idiopathic bronchiectasis presents with progressive shortness of breath and dry cough. On examination, there is decreased airway entry and coarse crepitations. What should be given?
Answer: Prednisone (Prednisone is used for inflammation management in bronchiectasis flare-ups).
PneumoniaQuestion: A patient with pneumonia presents with skin lesions that are crusted, and CXR shows bilateral infiltrates. What should be given?
Answer: Antibiotics (Acyclovir if suspecting viral) (Crusted skin lesions and bilateral infiltrates suggest a viral infection, such as Herpes Simplex Virus, for which Acyclovir may be appropriate).
PneumoniaQuestion: A 2-year-old patient presents with fever, cough, bilateral crackles, and lung infiltrates on X-ray. What is the likely diagnosis?
Answer: Bronchopneumonia (Bronchopneumonia often presents with fever, cough, bilateral crackles, and infiltrates on chest X-ray).
PneumoniaQuestion: What is the treatment for community-acquired pneumonia?
Answer: Fluoroquinolones (Fluoroquinolones are commonly used to treat community-acquired pneumonia in outpatient settings).
PneumoniaQuestion: An elderly patient presents with a productive cough, fever, dyspnea, crepitations, and a positive cold agglutination test. What is the likely diagnosis?
Answer: Atypical pneumonia (Atypical pneumonia often presents with these symptoms, and cold agglutination is a key test for this type of infection).
PneumoniaQuestion: What is the most common organism causing lobar pneumonia?
Answer: Streptococcus pneumoniae (Streptococcus pneumoniae is the most common pathogen for lobar pneumonia).
PneumoniaQuestion: A patient develops worsening shortness of breath after starting antibiotics for a productive cough and fever. Chest X-ray shows pleural effusion. What is the diagnosis?
Answer: Parapneumonic effusion (This is a common complication of pneumonia, especially if the infection is not fully controlled).
PneumoniaQuestion: A patient with a chest X-ray showing a shifted trachea to the left likely has which condition?
Answer: Right lung collapse (A shift in the trachea to one side often indicates a collapsed lung, typically due to pneumothorax or severe atelectasis).
PneumoniaQuestion: A patient with lobar pneumonia and moderate effusion is being treated. What is the most appropriate management?
Answer: Ceftriaxone and vancomycin with thoracocentesis (For moderate effusion, antibiotics are necessary, and thoracocentesis is used to manage the pleural effusion).
PneumoniaQuestion: A patient with a central line develops fever and infection at the site of a previous dialysis procedure. What should be done?
Answer: Culture IV antibiotics and remove the central line (This approach helps manage central line-associated infections and prevent further complications).
PneumoniaQuestion: A 51-year-old patient presents with fever, headache, and neck pain. What is the most likely organism?
Answer: Streptococcus pneumoniae (Streptococcus pneumoniae is a common pathogen causing meningitis, pneumonia, and other infections with these symptoms).
PneumoniaQuestion: A patient with pneumonia presents with hypotension (90/60), lethargy, pulse of 160, and a temperature of 38.5°C. What is the most likely diagnosis?
Answer: Septic shock (Hypotension, lethargy, tachycardia, and fever are signs of septic shock, a severe complication of pneumonia).
PneumoniaQuestion: A patient with pneumonia presents with a pleural friction rub. What is the most likely diagnosis?
Answer: Pneumonia (A pleural friction rub is often associated with pneumonia, especially if there is a pleural effusion or inflammation).
PneumoniaQuestion: How long does it typically take for patches on an X-ray of lobar pneumonia to disappear?
Answer: 6 weeks (Lobar pneumonia patches typically resolve in about 6 weeks with appropriate treatment).
PneumoniaQuestion: A patient with pneumonia is agitated and confused. What is the most appropriate action?
Answer: Keep the family (In the case of confusion and agitation, it’s important to have family support for the patient).
Rheumatoid Arthritis
ThyroidQuestion: What is the effect of rheumatoid arthritis (RA) on pregnancy?
Answer: Abortion (RA can increase the risk of complications during pregnancy, including miscarriage).
ThyroidQuestion: What is the first-line management for rheumatoid arthritis?
Answer: Steroid and methotrexate (Steroids and methotrexate are commonly used to manage RA).
ThyroidQuestion: A patient with rheumatoid arthritis is on methotrexate and hydroxychloroquine but still has severe pain. What should be added?
Answer: NSAIDs (NSAIDs can be added for pain management when RA symptoms are not well-controlled by other medications).
ThyroidQuestion: A patient with rheumatoid arthritis is still symptomatic while on methotrexate, mycophenolate, and other treatments. What should be added?
Answer: Adalimumab (Adalimumab, a biologic drug, can be added to the treatment regimen for RA).
ThyroidQuestion: What is the lung complication associated with rheumatoid arthritis?
Answer: Caplan syndrome (Caplan syndrome is characterized by the presence of rheumatoid nodules in the lungs along with pneumoconiosis).
ThyroidQuestion: What marker is needed to confirm rheumatoid arthritis in a patient with progressive symptoms?
Answer: Anti-CCP (Anti-citrullinated protein antibodies) (Anti-CCP is a key marker for diagnosing rheumatoid arthritis).
ThyroidQuestion: Which of the following is a minor Jones criterion for diagnosing rheumatic fever?
Answer: Fever (Fever is one of the minor Jones criteria for diagnosing rheumatic fever).
ThyroidQuestion: How can exercise help in the management of rheumatoid arthritis?
Answer: Exercise prevents post-inflammatory contracture (Exercise helps prevent stiffness and joint contracture in patients with RA).
ThyroidQuestion: A 32-year-old male with a swollen and tender left knee presents with WBC 40,000 in knee aspiration and a history of reactive arthritis. What is the initial medication to manage this?
Answer: Ibuprofen (NSAIDs like ibuprofen are commonly used for pain relief and inflammation in reactive arthritis).
ThyroidQuestion: What should be added if reactive arthritis does not respond to NSAIDs?
Answer: Sulfa drug (If NSAIDs fail, disease-modifying antirheumatic drugs like sulfasalazine are used for reactive arthritis).
ThyroidQuestion: What is the initial management for a patient with reactive arthritis and aspiration showing 40,000 neutrophils?
Answer: Ibuprofen (NSAIDs are the first-line treatment to manage symptoms of reactive arthritis).
ThyroidQuestion: What is the most common complication after a strep throat infection?
Answer: Post-streptococcal glomerulonephritis (This is the most common complication following a streptococcal throat infection).
ThyroidQuestion: What is the investigation to order for a patient with rheumatic fever, painful nodules, fever, and joint pain?
Answer: Throat culture or ASO (A throat culture or ASO titer helps confirm streptococcal infection, which can lead to rheumatic fever).
Radiology
Radiology Question: What is the initial and confirmatory test for AAA (Abdominal Aortic Aneurysm)?
Answer: Ultrasound (initial) and CT (confirmatory).
Radiology Question: How is cardiac tamponade diagnosed?
Answer: Echocardiogram (ECO).
Radiology Question: What is the definitive test for Pulmonary Embolism (PE)?
Answer: CT scan.
Radiology Question: What is the diagnostic tool for pleural effusion?
Answer: Chest X-ray (CX).
Radiology Question: What is the confirmatory test for Coarctation of the Aorta (CoA)?
Answer: Echocardiogram (ECO) followed by X-ray.
Radiology Question: What is the diagnostic approach for pericarditis?
Answer: ECG and chest X-ray.
Radiology Question: What is the best initial test for Aortic Disruption (Intrassuption)?
Answer: Ultrasound (US).
Radiology Question: What is the initial test and confirmatory test for Hirschsprung's Disease?
Radiology Question: What is the best next step in management for bilateral heel pain?
Answer: X-ray of both feet.
Radiology Question: What is the most appropriate management for a 30-year-old with a 7x8mm lung mass found incidentally, with everything normal on examination?
Radiology Question: What is the best diagnostic imaging for intestinal obstruction?
Answer: CT scan with contrast.
Radiology Question: A patient with severe, recurring headache, and sinus issues, who has used over-the-counter analgesics and decongestants with no improvement, what is the next step to confirm the diagnosis?
Answer: CT of paranasal sinuses.
Radiology Question: What is the best diagnostic tool for a patient with liquid dysphagia?
Answer: Endoscopy.
Radiology Question: What is the diagnostic approach for a patient with weight loss, vague epigastric pain, and loss of appetite over 3 months?
Answer: Endoscopy.
Radiology Question: Dr. decided to manage the patient by ultrasound-guided percutaneous drainage, how should consent be taken?
Answer: Consent should be taken by the radiologist.
Radiology Question: A 70-year-old patient with multiple hepatic masses seen on CT. What is the next step?
Answer: Colonoscopy.
Radiology Question: For the diagnosis of diaphragmatic hernia, what is the first step?
Answer: Chest X-ray.
Radiology Question: A patient with symptoms and signs of alcoholism and deep breathing. What is the initial test?
Answer: Alcohol concentration in blood.
Radiology Question: How is cardiac tamponade diagnosed?
Answer: Echocardiogram (ECO).
Radiology Question: A 55-year-old patient with DM and HTN complains of thigh swelling and tenderness, with a previous history of trauma in the same area 3 months ago. What is the initial investigation?
Answer: X-ray.
Radiology Question: What is the diagnosis for Meigs syndrome?
Answer: CT scan.
Radiology Question: A patient with thigh mass (5x8 cm), biopsy shows high-grade sarcoma. What investigation should you order for staging?
Answer: CT chest.
Radiology Question: A case with situs inversus and infertility. What is the diagnosis?
Answer: Kartagener syndrome.
Mnemonic: Kart = flipped (inversion), Game = opposite organs (in this disease, the organs are reversed).
Radiology Question: A patient with CKD is about to undergo CT with contrast. What should be given before the procedure?
Answer: IV fluid.
Radiology Question: A patient develops wheezing after receiving CT contrast. What should be done?
Answer: Epinephrine (not steroids).
Radiology Question: A patient is elderly and has anemia. What is the next step if a colonoscopy is needed?
Answer: Colonoscopy.
Radiology Question: A patient post-resection and colostomy presents with spiking fever for 1 week. Chest, abdomen, and wound are clear. What is the next step?
Answer: CT abdomen.
Radiology Question: What is the screening method for polycystic kidney disease?
Answer: Ultrasound (US).
Radiology Question: A patient with lung cancer now has basal crackles and rising JVP. How to confirm the diagnosis?
Answer: CT scan.
Radiology Question: What type of kidney injury can happen when contrast is used?
Answer: Acute tubular necrosis (ATN).
Explanation: Contrast can cause transient kidney injury; IV fluids are given to help protect the kidneys.
Radiology Question: What is the next step in the investigation for high prolactin?
Answer: Brain MRI.
Radiology Question: What is the management for macroadenoma of the pituitary causing signs of hypofunction?
Answer: Surgery.
Radiology Question: A female patient presents with a headache and sudden painful loss of vision. CT brain shows pituitary hemorrhage, and MRI shows a pituitary mass compressing the optic chiasma and cavernous sinus. What is the best next step?
Answer: Urgent neurosurgery referral.
Radiology Question: A CXR shows a horizontal fissure. What is the diagnosis?
Answer: Transient tachypnea of the newborn.
Radiology Question: A patient presents with a loss of height. What is the next investigation?
Answer: X-ray of the spine.
Radiology Question: What is the screening method for HCV?
Answer: Antibody test.
Radiology Question: How do you confirm HCV?
Answer: PCR (Polymerase chain reaction).
Radiology Question: A female presents with lower limb edema and intact distal pulses. There is only dilation of the greater saphenous vein tributaries. What is your next investigation?
Answer: Venous duplex ultrasound.
Radiology Question: Before performing a CT scan, which doctor must order a pregnancy test?
Answer: Pregnancy test.
Radiology Question: What is the sign in radiology for a duodenal ulcer?
Answer: Clover leaf.
Radiology Question: A patient presents with coarctation of the aorta (radial pulse more than femoral pulse). What is the next step?
Answer: X-ray. Confirm the diagnosis with Echocardiogram (ECHO).
Radiology Question: An elderly patient with an E. coli swab from a central line site. What is the next step?
Answer: Remove the central line.
Radiology Question: What is the initial and confirmatory test for AAA (Abdominal Aortic Aneurysm)?
Radiology Question: What is the diagnostic test for Foreign Body aspiration in the lungs?
Answer: Chest X-ray.
Radiology Answer: Abdominal X-ray, if not clear, proceed to CT.
Question: What is the diagnostic approach for Acute Pancreatitis?
Radiology Question: What is the diagnostic approach for Acute Pancreatitis?
Answer: Ultrasound.
Radiology Question: What is the best imaging for Chronic Pancreatitis?
Answer: CT Scan.
Radiology Question: What is the diagnostic approach for Appendicitis?
Answer: Clinical diagnosis, followed by Ultrasound, then CT if needed.
Radiology Question: What is the diagnostic and screening test for Hepatocellular Carcinoma (HCC)?
Answer: Initial: Ultrasound, Confirmatory: CT Scan, and Screening: AFP (Alpha-fetoprotein).
Radiology Question: What is the next step in managing a case of bilateral heel pain?
Answer: X-ray of both feet.
Radiology Question: A 30-year-old asymptomatic patient finds a 7x8mm lung mass incidentally. What is the most appropriate management?
Answer: Repeat CT in 3 months.
Radiology Question: What is the best diagnostic imaging for Intestinal Obstruction?
Answer: CT with contrast.
Radiology Question: A patient with severe headache and paranasal sinus pain that comes and goes, who has used over-the-counter decongestants without relief, what should you order to confirm the diagnosis?
Answer: CT of paranasal sinuses.
Radiology Question: A patient presents with liquid dysphagia. What is the best diagnostic tool to confirm the diagnosis?
Answer: Endoscopy.
Radiology Question: A patient with weight loss, vague epigastric pain, and loss of appetite for 3 months. What is the next step in the investigation?
Answer: Endoscopy.
Radiology Question: How should consent be taken for an ultrasound-guided percutaneous drainage?
Answer: Consent should be obtained by the radiologist.
Radiology Question: A 70-year-old with multiple hepatic masses seen by CT, what is the next step?
Answer: Colonoscopy.
Radiology Question: What is the first diagnostic step for diaphragmatic hernia?
Answer: Chest X-ray.
Radiology Question: A patient with symptoms of alcoholism and deep breathing, what is the initial test to perform?
Answer: Alcohol concentration in blood.
Radiology Question: How do you diagnose cardiac tamponade?
Answer: Echocardiogram (Echo).
Radiology Question: A 55-year-old patient with diabetes and hypertension complains of thigh swelling and tenderness, with a history of trauma in the same area 3 months ago. What is the initial investigation?
Answer: X-ray.
Radiology Question: How is Meigs syndrome diagnosed?
Answer: CT Scan.
Radiology Question: A patient with a thigh mass (5x8 cm), biopsy shows high-grade sarcoma. What investigation should be ordered for staging?
Answer: CT Chest.
Radiology Question: A case with situs inversus and infertility, what is the diagnosis?
Answer: Kartagener syndrome.
Radiology Question: What should be given to a patient with chronic kidney disease (CKD) before a CT scan with contrast?
Answer: IV fluids.
Radiology Question: After giving contrast for a CT scan, the patient develops wheezing. What is the next step?
Answer: Epinephrine (due to an allergic reaction to the contrast).
Radiology Question: What is the next step in the investigation of anemia in an elderly patient, suspected to be due to a colon issue?
Answer: Colonoscopy.
Radiology Question: A patient post-resection and colostomy presents with a spiking fever for 1 week. The chest, abdomen, and wound are clear. What is the next step?
Answer: CT Abdomen.
Radiology Question: What is the screening test for polycystic kidney disease?
Answer: Ultrasound (US).
Radiology Question: A patient with lung cancer now presents with basal crackles and rising JVP. How would you confirm the diagnosis?
Answer: CT Scan.
Radiology Question: What type of kidney injury occurs when using contrast in patients?
Answer: Acute tubular necrosis (ATN), a temporary kidney failure after contrast exposure.
Radiology Question: What is the next step in the investigation for a patient with high prolactin levels?
Answer: Brain MRI.
Radiology Question: A macroadenoma of the pituitary causes signs and hypofunction. What is the management?
Answer: Surgery.
Radiology Question: A female patient presents with a headache and sudden painful loss of vision. CT shows a pituitary hemorrhage and MRI shows a pituitary mass, hemorrhage, and compression on the optic chiasma & cavernous sinus. What is the best next step?
Answer: Urgent neurosurgery referral.
Radiology Question: A patient with gastric pain that worsens after eating. What is the best next step in investigation?
Answer: Endoscopy (to check for ulcers).
Radiology Question: A CXR finding shows a horizontal fissure in a newborn. What is the diagnosis?
Answer: Transient tachypnea of the newborn.
Radiology Question: A patient presents with a loss of height. What is the next investigation?
Answer: X-ray of the spine.
Radiology
Respiratory
RespiratoryQuestion: Smoker with holter syndrome and lung cancer, which type of cancer?
RespiratoryQuestion: Smoker with hemoptysis or hoarseness, what is the likely diagnosis?
Answer: Bronchogenic carcinoma.
RespiratoryQuestion: Patient with leukemia, which lymph node enlargement is commonly associated?
Answer: Cervical or supraclavicular lymph node enlargement.
RespiratoryQuestion: Breast mass with weight loss and pleural effusion, most likely diagnosis?
Answer: Exudate (commonly associated with cancer).
RespiratoryQuestion: Cancer patient with multiple pleural taps for pleural effusion showing no improvement, what is the next step?
Answer: Chemical pleurodesis.
RespiratoryQuestion: Patient with idiopathic bronchiectasis, presenting with progressive shortness of breath (SOB) over the last two months and dry cough. Physical exam shows decreased airway entry bilaterally with coarse crepitation, what should be given?
Answer: Prednisone (immune-mediated response).
RespiratoryQuestion: Pneumonia patient with skin lesions and crusting, CXR showing bilateral infiltrates, what is the appropriate treatment?
Answer: Acyclovir.
RespiratoryQuestion: 2-year-old patient with fever, cough, bilateral crackles, and lung infiltrate, what is the most likely diagnosis?
Answer: Bronchopneumonia.
RespiratoryQuestion: Treatment for community-acquired pneumonia?
Answer: Fluoroquinolones.
Respiratory
SARCOIDOSIS
ThyroidQ: Hypocalcemia after total thyroidectomy
Q: Hypocalcemia after total thyroidectomy
A: Urgent correction + Measure Mg level.
🔹 Hint: Commonly associated, can cause refractory hypocalcemia.
SLE
ThyroidQ: Hypocalcemia after total thyroidectomy
Q: Hypocalcemia after total thyroidectomy
A: Urgent correction + Measure Mg level.
🔹 Hint: Commonly associated, can cause refractory hypocalcemia.
Hypothyroid hyperthyroid hyper-prolactin
ThyroidQ: Hypocalcemia after total thyroidectomy
Q: Hypocalcemia after total thyroidectomy
A: Urgent correction + Measure Mg level.
🔹 Hint: Commonly associated, can cause refractory hypocalcemia.
Vaccine
ThyroidQ: Hypocalcemia after total thyroidectomy
Q: Hypocalcemia after total thyroidectomy
A: Urgent correction + Measure Mg level.
🔹 Hint: Commonly associated, can cause refractory hypocalcemia.
Murmur
ThyroidQ: Hypocalcemia after total thyroidectomy
Q: Hypocalcemia after total thyroidectomy
A: Urgent correction + Measure Mg level.
🔹 Hint: Commonly associated, can cause refractory hypocalcemia.
