CBSE EXAM //NBME CBSE REAL EXAM QUESTIONS AND ANSWERS LATEST 2023 -2024 MEDICAL EXAMINATION// GRADED A+ 36 year old man presents with shortness of breath. Admits to extensive history of alcoholism. Experiences tingling and burning in his legs for past several weeks. PE reveals he is tachycardia, has rales bilaterally, and has bilateral pitting edema. Also ha s decreased sensation in his feet and is hypo reflexive in his lower extremities. An x -ray of his chest shows an enlarged cardiac silhouette and bilateral pulmonary congestion. - ANSWER -Vitamin B1 deficiency -- common in alcoholic and malnourished patients Brain and heart affected first Patient is experiencing BOTH dry and wet beribi Wet beribi: high -output congestive heart failure and dilated cardiomyopathy Dry beribi: peripheral neuropathy consisting of muscular atrophy and diminished sensation and re flexes (You'll see this in B12 deficiency but no wet beribi) THINK BER1B1 to remember B1 Patient could also end up suffering from Wernicke encephalopathy and Wernicke -Korsakoff syndrome What are Wernicke encephalopathy and Wernicke -Korsakoff syndrome? - ANSWER -WE: the CNS manifestation of thiamine deficiency. Nystagmus, ophthalmoplegia, and cerebellar ataxia. When the additional symptoms of confusion/psychosis and confabulation are seen, the disease is known as W -K syndrome. It is standard practice t o give thiamine before glucose to any patient with suspected thiamine deficiency to prevent Wernicke -Korsakoff Alkaptonuria - ANSWER -Absence of homogentisate oxidase - arthritis - discolored sclerae and other areas (ear cartilage) - Dark urine - spinal disc degeneration and dense calcifications possible What is the cause of "bitter almond" breath? - ANSWER -Cyanide poisoning What does cyanide inhibit? - ANSWER -Cytocrhome oxidase in the ETC What is the treatment for cyanide poisoning? - ANSWER -Amyl nitrate (oxidizes hemoglobin to methemoglobin, which stro ngly binds cyanide) 6 month old child with frequent infections and carpopedal spasm and facial spasm upon tapping - ANSWER -DiGeorge Syndrome - hypoparathyroidism and T -cell deficiency Hypocalcemia is what causes the spasms CATCH22 pneumonic: Chromosome 22, Abnormal facies, Thymic hypoplasia, Cleft palate, and Hypocalcemia Young (27 yrs old) man with lots of atherosclerotic plaques and small, raised yellow -brown lesions on extensor surfaces of arms - ANSWER -
Familial hypercholesterolemia (FH)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Bestnursesteve. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.