Property:AnswerAExp
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Cold caloric is commonly used by physicians, audiologists and other trained professionals to validate a diagnosis of asymmetric function in the peripheral vestibular system. It provides no relief in patients of BPPV. +
Acyclovir is the treatment if choice for herpes zoster . Steroids may or may not be added to decrease the pain in zoster. Here CT scan is the correct answer as it is the nest best step. +
A failure to improve even after a repeat steroid and albuterol is typical for decreased hypoxic drive. A quick initial improvement followed by worsening of the dyspnea is specific for decreased hypoxic drive. +
The first symptoms of diabetic neuropathy is loss of ankle jerk. Since this patient has ankle jerk brisk and present this cannot be diabetic neuropathy . +
X-ray should be repeated since the quality of the previous X-ray is doubted . The next best step in this case should be intubation as the GCS is 8. +
Topical steroids do not cause rebound congestion and are not used as a first line in allergic rhinitis. +
Drug free week is not helpful for preventing rhinitis medicamentosa as it usually occurs on the 5-7 th day. +
Incorrect
IV atropine does not stabilize the myocardium from the effects of hyperkalemia. +
Valproate causes birth defects; exposure during pregnancy is associated with about three times as many major anomalies as usual, mainly spina bifida and, more rarely, with several other defects, possibly including a "valproate syndrome".Characteristics of this valproate syndrome include facial features that tend to evolve with age, including trigonocephaly, tall forehead with bifrontal narrowing, epicanthic folds, medial deficiency of eyebrows, flat nasal bridge, broad nasal root, anteverted nares, shallow philtrum, long upper lip and thin vermillion borders, thick lower lip and small downturned mouth. Valproate can cause neural tube defects +
'''Incorrect''': Macrolide are not recommended following failure of amoxicillin in a patient of sinusitis. They are not recommended in the treatment of sinusitis or upper respiratory tract infection buy may prove effective in lower respiratory tract infection. +
'''Incorrect''': Antiepileptic medications should not not be started before obtaining a lumbar puncture. +
The CSF picture in this case points out to a viral encephalitis more specific to Herpes encephalitis. High protein and low/normal glucose is specific for viral meningitis. +
Ganciclovir is indicated in cytomegalovirus infection. There are no indications for adding acyclovir to ganciclovir in patient of HSV-1. +
This patient has Horner’s syndrome and thoracic outlet syndrome due to an apical lung adenocarcinoma. The symptoms of Horner’s syndrome are caused by compression of the right stellate (cervicothoracic) ganglion. +
While sarcoidosis can cause interstitial lung disease, serum ACE is typically elevated and chest CT will classically show hilar lymphadenopathy. +
Ferruginous bodies are characteristic of asbestosis. Asbestosis is a chronic inflammatory and fibrotic medical condition affecting the parenchymal tissue of the lungs caused by the inhalation and retention of asbestos fibers. Asbestosis increases the risk of bronchogenic carcinoma and mesothelioma. While bronchogenic carcinoma is more common in asbestosis, mesothelioma is a more specific complication of asbestosis, as the rate in the unexposed population is extremely low. +
Lithium is a mood-stabilizer used for treating bipolar disorder. Lithium toxicity includes movement disorder (Extrapyramidal symptoms), nephrogenic diabetes insipidus, hypothyroidism, and teratogenicity. Prolonged QT-interval is not considered a feature of lithium toxicity. +