Property:AnswerBExp
Jump to navigation
Jump to search
W
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 next best step. +
Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs. This failure in ventilation may be caused by depression of the central respiratory center by cerebral disease or drugs, inability to ventilate adequately due to neuromuscular disease (e.g., myasthenia gravis, amyotrophic lateral sclerosis, Guillain-Barré syndrome, muscular dystrophy), or airway obstruction related to asthma or chronic obstructive pulmonary disease (COPD) exacerbation.Chronic respiratory acidosis may be secondary to many disorders, including COPD. Hypoventilation in COPD involves multiple mechanisms, including decreased responsiveness to hypoxia and hypercapnia, increased ventilation-perfusion mismatch leading to increased dead space ventilation, and decreased diaphragm function secondary to fatigue and hyperinflation.
Chronic respiratory acidosis also may be secondary to obesity hypoventilation syndrome (i.e., Pickwickian syndrome), neuromuscular disorders such as amyotrophic lateral sclerosis, and severe restrictive ventilatory defects as observed in interstitial fibrosis and thoracic deformities.
Lung diseases that primarily cause abnormality in alveolar gas exchange usually do not cause hypoventilation but tend to cause stimulation of ventilation and hypocapnia secondary to hypoxia. Hypercapnia only occurs if severe disease or respiratory muscle fatigue occu +
Pernicious anemia presents is the loss of ability to absorb vitamin B12 (B12). It is the most common cause of adult B12 deficiency. Impaired absorption of vitamin B12 may be due to a loss of intrinsic factor or to a number of other conditions that decrease production of gastric acid, which also plays a part in the absorption of B12 from foods. +
CT can be performed later to visualize the effect of the fall. The next best step in this case should be intubation as the GCS is 8. +
Topical decongestants are the right choice since they cause rebound congestion after a few days of treatment . Prevention is by stopping the drug after 3 days. +
'''Incorrect''': Cephalosporins are indicated in sinusitis only if the patient has a type 2 hypersensitivity reaction to penicillin. They are not indicated following failure of amoxicillin. +
'''Incorrect''': First a lumbar puncture should be performed before starting antibiotics. +
This is the incorrect answer as thick and thin smear were both negative. Quinine was started as an empirical therapy as the patient is an immigrant from Haiti where malaria is endemic. It should be stopped immediately as son as thick and thin smear are negative. +
Acyclovir is used to treat for HSV-encephalitis. The patient is treated for 3-4 weeks for a minimum. +
This is the correct answer as platelet count is 90,000 and a watchful observation should be done. Serial platelet counts should be ordered once the patient is admitted. One should wait till platelets drop below 10,000 to start transfusion. +
Horner’s syndrome causes ipsilateral symptoms, not contralateral. Furthermore, this patient experienced thoracic outlet syndrome due to tumor compression. His symptoms were all on the right side. +
The patient in this vignette has interstitial lung disease, as evidenced by classic honeycombing pattern of the lung on chest CT. +
Silicosis is a form of occupational lung disease caused by inhalation of crystalline silica dust, and is marked by inflammation and scarring in the form of nodular lesions in the upper lobes of the lungs. Microscopically, silicosis is characterized by silica in alveolar macrophages. +
Chlorpromazine is a typical antipsychotic that can be used to treat schizophrenia. Toxicity of chlorpromazine and other typical antipsychotics includes extrapyramidal side effects (dyskinesias), as well as endocrine side effects such as hyperprolactinemia. +
The dead space in this patient is increased as the volume can be determined by the Bohr equation to be 180 mL. +
Diphenhydramine is a Histamine H<sub>1</sub> receptor blocker. The H<sub>1</sub> receptor is linked to an intracellular G-protein of the G<sub>q</sub> class. +
Thiosulfate reverses methomglobinemia in cases of cyanide poisoning. However, in this case dapsone pharmacotherapy was responsible for this patient’s methomglobinemia. +