Fcps/mrcp/usmle

Finding.
Diagnosis?

Q- Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery?
A- Foramen lacerum
B- Foramen ovale
C- Foramen rotundum
D- Foramen spinosum

Anatomy MCQs- 6 Anatomy MCQs- 6 January 17, 2021January 17, 2021 by Dr Ray Makar Q- Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? A- Foramen lacerum B- Foramen ovale C- Foramen rotundum D- Foramen spinosum D- Foramen spinosum- The on...

- A 60-year-old woman presents with severe tearing abdominal pain, nausea and dizziness. The patient is pale and lethargic with blood pressure of 80/50 and diffuse abdominal tenderness. There is no past history of similar episodes. What is the next step?

A-Amylase and lipase levels

B- Exploratory laparotomy

C- Laparoscopy

D- Ultrasound

Management of H PYLORI in renal transplant patient.??

A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis?

A- Acute myocardial infarction

B- Left bundle branch block

C- Septic shock

D- Hypertrophic cardiomyopathy

E- Pericardial effusion

HHS may also occur in non-diabetics after burns or peritoneal dialysis.

Remember, compared to DKA, HHS has more fluid deficit and more hypokalemia. HHS patients need more fluids and more K.

Death in digoxin toxicity is caused by fatal arrhythmias induced by digoxin's direct effect on automaticity and excessive vagal tone. Hyperkalemia is not the main problem, but rather reflects the degree of toxicity. Treatment of hyperkalemia has not been shown to decrease the risk of death.

The following are CONTRAINDICATED in cases with digoxin toxicity ☠️
- Ca gluconate (can lead to tetany of the myocardium or "stone heart").
- Pacing or cardioversion (can lead to Vfib or pulseless Vtac).

Fab fragments (Digibind) should be given ASAP after diagnosing digoxin-associated arrhythmias. Atropine can be used as a temporizing measure in severe bradycardia.

In the photo attached is the "scooping" effect of digoxin. Remember, biderectional Vtac and paroxysmal atrial tachycardia with AV block are pathognomonic for digoxin toxicity.

In toxic goitre, radioiodine is used mostly in recurrent nodules. Absolute contraindications for radioiodine treatment are pregnancy and lactation. Relative contraindications are thyroid nodules suspected of malignancy and age under 15 years.