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Step 1 practice Qnz

2355 Views 4 Replies 2 Participants Last post by  aktorque
A 26-year-old patient presents to your office with a chief complaint of polyuria and polydipsia. He has also noticed an increase in his skin tone, but has not been outside in the sun for any extended period of time. He mentions that he has early-morning swelling in his legs and finds himself needing to sleep on two pillows to get comfortable at night; you suspect that this discomfort is due to congestive heart failure. What is the most likely diagnosis?
A Addison's disease
B Cushing's syndrome
C Diabetes mellitus
D Hemochromatosis
E Wilson's disease


While on the Medicine service, a third-year medical student admits a 63-year-old woman with longstanding hypertension, diabetes, and hyperlipidemia. The woman was seen in the emergency room, where she was noted to have vomiting, left–sided Horner's syndrome, and loss of facial sensation on the left, but loss of body sensation on the right. A diffusion-weighted MRI and MRA are ordered. Before the radiologic studies are performed, the team asks the medical student where the problem lies. The best explanation for this patient's stroke presentation is occlusion of which artery?
A Left middle cerebral artery
B Right middle cerebral artery
C Left anterior cerebral artery
D Right anterior cerebral artery
E Left posterior cerebral artery
F Right posterior cerebral artery
G Left posterior inferior cerebellar artery
H Right posterior inferior cerebellar artery

An 18-year-old female presents to your office in respiratory distress after taking a couple of aspirins for a headache. Upon further questioning her, you discover that she has a history of asthma and nasal polyps. Why did aspirin ingestion by this patient result in respiratory distress?

A Leukotrienes production
B Phospholipase A2 deficiency
C Prostacyclin production
D Prostaglandin production
E Thromboxane production

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Very good Doc. You are the genius. Now, could you explain to me how did you come with this most correct answer. Just give me a brief explanation. Thank you Doc.

Clinical presentation

Organs commonly affected by haemochromatosis are the liver, heart and endocrine glands.

Haemochromatosis may present with the following clinical syndromes:

Cirrhosis of the liver
Diabetes due to pancreatic islet cell failure
Arthritis (iron deposition in joints)
Testicular failure
Tanning of the skin

Posterior inferior cerebellar artery

Infarction of this artery due to thrombosis or stroke leads to PICA syndrome or Wallenberg syndrome, a neurological disease with characteristic, stereotyped symptoms. Occlusion of this or vertebral arteries can cause Lateral Medullary Sydrome and the descending sympathetic effects likely causeing Horner's Syndrome as well.

Aspirin Induce Asthma

The disorder is caused by an anomaly in the arachidonic acid cascade, which causes undue production of leukotrienes, a series of chemicals involved in the body's inflammatory response. When prostaglandin production (Cyclooxygenase pathway) is blocked by NSAIDS like aspirin, the cascade shunts entirely to leukotrienes (lipooxygenase pathway), causing overproduction of LT-4 and producing the severe allergy-like effects.
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