January vol. 3 no. 1, january. 2013 make.pmd

MEDICAL QUIZ
(Birdem Med J 2013; 3(1): 59)
Medical Quiz : Images
Registrar, Internal Medicine & Pulmonology, BIRDEM A 60 years old diabetic male was admitted under Internal 5 days and dyspnea for 1 day. On examination he had – Medicine & Pulmonology of BIRDEM General Hospital anemia, dehydration, a cystic mass in epigastrium and with gradual onset of dull aching epigastric pain that evidence of left sided pleural effusion. The images of radiates to back for last 2 months, persistent hiccup for What is the diagnosis?
MEDICAL QUIZ
(Birdem Med J 2013; 3(1): 60)
Medical quitz:SBA:
Question 1
Question 4. (www.acphospitalist.org. september
The following treatment has NOT been shown to
improve mortality in heart failure (HF):
A 23 year old woman is admitted to the hospital for (www.medicinecpd.co.uk)
plasma exchange.She was recently diagnosed with myasthenia gravis and remains symptomatic despite intravenous immunoglobine and pyridostigmine.
Medical history is otherwise noncontributory and she has no previous reaction to blood products.
Her respiratory function begins to worsen andtherapeutic plasma exchange is begun. Albumin is used Question 2
as the replacement fluid and citrate is used as the Regarding laboratory markers in the diagnosis of acute
anticoagulant. One hour into the procedure, the patient pancreatitis it is TRUE that: (www.medicinecpd.co.uk)
becomes light-headed, vomits, develops extreme anxiety when presentation is delayed by five days or and experiences perioral numdness and tingling.
more the serum amylase is more likely to still beraised than the serum lipase On physical examination, temperature is 37.0c, bloodpressure is 121/48 mm Hg, pulse rate is 103/min and in severe acute pancreatitis CRP <81mg/l respiration rate is 16/min. She has labored breathing, together with WBC <13 predict little risk ofinfection of the necrosed pancreas appears agitated and has lid lag. She also has proximalmuscles weakness and muscle twitching. Jugular the urinary trypsinogen-2 dipstick test has poor venous distension and peripheral edema are absent.
raised serum alanine amino transferase (ALT) Preplasmapharesis exchange laboratory studies show is helpful in confirming alcohol as the likely complete blood count normal,calcium 9.0mg/dl(2.25 mmol/l),creatinine 0.8 mg/dl(70.7 umol/L),magnesium 2.1 Question 3
mg/dl (0.87 mmol/L),potassium 4.6 meq/L(4.6mmol/L) and The blood film of a 29-year-old woman suffering from anaemia has remained microcytic and hyperchromic In addition to temporary cessation of plasma despite taking ferrous sulphate for 6 months. Her exchange,which of the following is the most appropriate transferrin saturation is 35%. The MOST appropriate treatment? (www.acphospitalist.org. september 2012 )
investigation to elucidate the cause of the persistentmorphological abnormalities is: (www.medicinecpd.co.uk) See Answer Page No. 68

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