Title MTF MEDICAL PRO II COMPILATION ✅

indicated C Haemorrh agic stroke is one of the complicati on One in 5 people surviving an episode of bacterial meningitis may have long lasting after-effects. These after-effects include hearing loss, seizures, limb weakness, difficulties with vision, speech, language, memory, and communication, as well as scarring and limb amputations after sepsis. https://www.who.int/news-room/fact-sheets/detail/meningitis#:~:te xt=One%20in%205%20people%20surviving,and%20limb%20amputat ions%20after%20sepsis. D IV gentamicin is the first choice of medication E Causative organism is gram positive diplococci Neisseria meningitidis - Gram negative cocci 2. Match the correct answer MXZ References : lecture note preclinical prof uday, kumar and clark textbook A Bite cell - G6PD deficiency G6PD deficiency - PBF : bite cell, blister cell (d/t Hb retraction from the membrane) Heinz body(denatures Hb)
B Nucleated RBC - severe bleeding Nucleated RBC seen in C Hypochromic microcytic anemia- thalassaemia Ddx for hypochromic microcytic anemia : - IDA - Thalassaemia - Sideroblastic anemia D Auer rood - CML Auer rod seen in acute myeloid leukaemia E Target cell - autoimmune hemolytic anaemia Target cell seen in thalassaemia. AIHA : spherocytosis, polychromasia 3. Regarding asthma Ref : GINA guidelines 2023 A Reversibility of > 10 % is a feature Positive bronchodilator responsiveness test (reversibility) : Increased FEV1 >12% and >200ml 10-15 mins after 200-400mcg salbutamol B Omalizumab is a treatment for severe allergic asthma SC omalizumab is an anti IgE, is an add on option for patient with severe allergic asthma uncontrolled with high dose ICS-LABA and have evidence of type 2 inflammation C Cannot be diagnosed by bronchoprovocation test Can be diagnosed with bronchoprovocation test : Positive bronchial challenge test - Fall in FEV1 from baseline >20% with standard dose of methacholine OR - Fall > 15% with standardized hyperventilation, hypertonic saline/mannitol challenge It is moderate sensitivity for asthma but limited specificity D PEF of 30% indicate severe asthma Severe asthma indicators: Talk in words, sit hunched forward, agitated, RR >30mins, Accessory muscle used, PR>120, SpO2 <90, PEF<50% predicted /best
E IV magnesium sulphate is a treatment for severe AEBA Yes If IV corticosteroids failed 4. Pertaining to cushing syndrome: MXZ Reference : textbook kumar and clark A Diabetes is the complication. Increased cortisol, increased gluconeogenesis from liver, increased insulin resistance -> hyperglycaemia B White striae is a sign. Typical striae for cushing : Vertical purplish/reddish diameter >1cm C Occur due to extra cortisol level Cushing syndrome aka hypercortisolaemia Defined as a state of increased free circulating glucocortisol Either endogenous or exogenous (more common) D Ketoconazole is a treatment of choice Ketoconazole 200mg tds To inhibit cortisol hypersecresion But not the definite one Need to fine the underlying cause E Diagnosed by dexamethasone supression test Test to confirm the diagnosis of cushing syndrome : -48 hour low dose / overnight dexamethasone suppression test - abnormal if serum cortisol >50 -24 hour urine free cortisol -late night salivary cortisol 2⁄3 test positive can confirm the diagnosis of cushing’s syndrome 5. 62y/o man presents with palpitations (symptomatic) for 1 week. On examination, he is conscious (GCS GOOD)130/80mmHg(BP not hypotensive). ECG shows absent p wave(Atrial fibrillation). HR 100-120bpm(tachycardic). Regarding mx of this patient, MXZ