Property:AnswerCExp
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Correct
Acute severe hyponatremia treated with 3% NaCl, then Transition to 0.9% NaCl/vaptans at sodium levels > 125 mEq/L. +
Incorrect
Hypertonic saline infusion is only used with sever symptomatic cases of hyponatremia to prevent cerebral edema. +
Soda bicarbonate is the effective treatment for resolving the metabolic acidosis and cardiovascular complications of Tricyclic antidepressant poisoning . +
Zidovudine is not indicated in the treatment of CMV retinitis. It is indicated for treatment of HIV . The patient has HIV since 5 years and doesn't have any other complaints. Hence Zidovudine is not indicated now . It may be started in combination to treatment of CMV . +
HAART is never used alone for maintenance of CMV retinitis. It may be used later in addition to valganciclovir for the treatment of HIV. +
100% nasal oxygen is the treatment of choice to abort an acute attack. It may be used alone or in conjunction with Sumatriptan to treat cluster headache. +
Patients often describe their first experience occurring while turning their head in bed.
The vertigo in BPPV is brief in duration — 5 seconds to 30 seconds, often associated with nausea. Patients do not experience other neurological deficits such as numbness or weakness. Since the patient symptoms lasts only for a few seconds and he has no associated symptoms the answer is BPPV . +
Cold and Hot calorie are commonly used by physicians, audiologists and other trained professionals to validate a diagnosis of asymmetric function in the peripheral vestibular system . It is used to diagnose nystagmus. +
Analgesics may be used to decrease the pain and swelling in patients of herpes zoster .It is not the correct answer here as it is not the bext next step. +
This is the wrong answer as the quick initial improvement followed by worsening of the dyspnea is specific for decreased hypoxic drive. +
The patient is vegan and hence it might be a distractor for inadequate B12 in the diet. But there is no reason to believe that the patient is B12 deficient. +
Antihistaminics cause drying of the mucosa due to decreased histaminic secretion. They also do not cause rebound congestion after few days. +
Rhinitis medicamentosa usually occurs on the 5th-7th day. Hence, stopping the drug on the 5 th day would not prevent this condition +
Tuberculosis is endemic in Bangladesh and presents with the symptoms described above in the question. CT scan shows classical small dots resembling "millets" which is very characteristic for Tuberculosis. +
'''Correct''': Following no response to amoxicillin in a patient of sinusitis newer respiratory fluoroquinolones are prescribed. They include moxifloxacin and levofloxacin. +
'''Incorrect''': Steroids have not been proved to be the effective in meningitis except in Tb meningitis. Also a lumbar puncture is the best initial step in this case to rule out meningitis from encephalitis. +
TB meningitis is the incorrect answer as it presents in CSF as low glucose and high protein and mixed cells < 300/mm³ +
There are no indications to use acyclovir for one week. Acyclovir is used to treat HSV encephalitis. +