MEQ

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Questions and Answers

Scenario: A 12-year-old child presents with recurrent wheezing and difficulty breathing, especially at night and during exercise. Task:

Define asthma

Asthma is a chronic inflammatory disease of the airways.

Scenario: A 35-year-old woman experiences asthma symptoms that worsen in response to allergens, such as pollen and dust mites. Task:

Classify her asthma as either extrinsic or intrinsic, and justify your classification.

The asthma in the scenario is likely extrinsic (atopic asthma), as it is triggered by allergens.

Scenario: A 25-year-old man presents with a chronic cough and shortness of breath that worsens during physical activity. Task:

A- List the signs and symptoms commonly associated with asthma. B- Discuss the differential diagnosis for asthma, including at least three other conditions that could present similarly.

Signs and Symptoms: Common signs and symptoms of asthma include:

Wheezing Shortness of breath Chest tightness Coughing (often worse at night or with exercise) 2. Differential Diagnosis: Conditions to consider in the differential diagnosis include:

Chronic Obstructive Pulmonary Disease (COPD) Allergic rhinitis Bronchitis Gastroesophageal reflux disease (GERD) Heart failure

A 58-year-old woman presents to the emergency department with complaints of a severe headache and blurred vision. She has a history of hypertension, which she has not managed consistently. Differentiate between hypertensive emergency and urgency in this scenario.

Hypertensive Emergency: Severe hypertension with acute target organ damage Hypertensive Urgency: Severe hypertension without acute target organ damage. Signup and view all the answers

Secondary causes of hypertension

RECENT: Renal (e.g., renal artery stenosis) , Endocrine (e.g., hyperthyroidism,, Coarctation of the aorta, Estrogen (oral contraceptives), Neurological (raised intracranial pressure,) and Treatment (e.g., glucocorticoids, NSAIDs). Signup and view all the answers

A 58-year-old male presents to the emergency department with a 2-day history of bright red blood in his stools. He reports associated symptoms of abdominal pain and fatigue. He has a history of hypertension and a recent diagnosis of diverticulosis.

a. What type of gastrointestinal bleeding is most likely occurring in this patient, and why? b. Describe the characteristics of this type of bleeding.

a. The patient is likely experiencing hematochezia. b. Hematochezia is characterized by bright red blood in the stool, indicating lower gastrointestinal bleeding, commonly from the colon or rectum. Signup and view all the answers

a. List three potential causes of lower gastrointestinal bleeding in this patient, given his history. b. For each cause, provide a brief explanation of how it leads to bleeding.

a. Potential causes include: Diverticulosis: Outpouchings in the colon can bleed. Hemorrhoids: Swollen vessels that may cause bright red blood. Colorectal cancer: Tumors can lead to bleeding. b. Diverticulosis: The outpouchings can become inflamed or rupture, leading to bleeding. Hemorrhoids: Increased pressure can cause these vessels to bleed, especially during bowel movements. Colorectal cancer: Tumors can invade blood vessels and cause bleeding. Signup and view all the answers

Peptic ulcer disease (PUD) is primarily caused by:

Helicobacter pylori infection - Nonsteroidal anti-inflammatory drugs - Excessive alcohol consumption Signup and view all the answers

A 62-year-old female patient with a long history of poorly controlled hypertension presents to the clinic for routine follow-up. She reports occasional headaches and has recently experienced some episodes of dizziness. On examination, her blood pressure is recorded at 180/110 mmHg.

List two potential cardiovascular complications this patient may develop as a result of her hypertension.

Heart Attack (Myocardial Infarction) Heart Failure Signup and view all the answers

What are two cerebrovascular complications that can arise from long-standing hypertension?

Stroke Transient Ischemic Attack (TIA) Signup and view all the answers

Identify two renal complications associated with uncontrolled hypertension.

Chronic Kidney Disease (CKD) Acute Kidney Injury Signup and view all the answers

What is hypertensive retinopathy, and how can it affect this patient? b. What findings might you expect to see during an eye examination of a patient with hypertensive retinopathy?

Cotton wool spots Retinal hemorrhages Exudates or changes in the blood vessels (narrowing or leakage) Signup and view all the answers

A 34-year-old female presents to the clinic with easy bruising and a recent history of excessive bleeding during dental work. She denies any recent infections or significant weight loss. On examination, her skin shows multiple petechiae, and her spleen is not palpable. A complete blood count reveals a platelet count of 70,000/µL.

A- Define thrombocytopenia,B- List and explain at least four potential causes of thrombocytopenia

Thrombocytopenia is defined as a platelet count of less than 150,000/µL. Decreased Production: Bone Marrow Disorders: Conditions such as aplastic anemia or leukemia can impair the bone marrow's ability to produce platelets. Viral Infections: Infections like HIV or hepatitis can affect platelet production by directly impacting bone marrow or inducing immune responses. Increased Destruction: Immune Thrombocytopenic Purpura (ITP): An autoimmune condition where the body produces antibodies against its own platelets, leading to increased destruction. Drug-Induced Thrombocytopenia: Certain medications (e.g., heparin) can trigger an immune response that reduces platelet counts. Sequestration: Splenomegaly: An enlarged spleen can sequester a significant number of platelets, reducing their availability in circulation. Signup and view all the answers

A 45-year-old male with a history of type 2 diabetes presents to the emergency department with confusion, sweating, and dizziness. His wife mentions that he skipped breakfast and has been more active lately. He is on metformin and glipizide. His blood glucose level is 40 mg/dL.

Question 1: Diagnosis and Management

1.1 What is the most likely diagnosis for this patient’s symptoms? 1.2 Describe the immediate management steps you would take for this patient.

1.1 Diagnosis: The most likely diagnosis is insulin-induced hypoglycemia due to the patient's recent skipping of meals, increased physical activity, and the use of glipizide, which can cause low blood sugar. 1.2 Immediate Management Steps: If conscious: Administer oral glucose (e.g., glucose tablets or sugary drink). If unconscious or unable to swallow: Administer intravenous dextrose (D50W). Monitor blood glucose levels frequently until stable. Signup and view all the answers

A 30-year-old female presents with episodes of sweating, tremors, and weakness. These episodes occur after meals, particularly high in carbohydrates. She denies diabetes and does not take any medications.

Question 2: Differential Diagnosis and Investigations

2.1 List the potential differential diagnoses for her symptoms. 2.2 What investigations would you recommend to confirm your suspected diagnosis? 2.3 Discuss the management plan for the likely diagnosis.

2.1 Differential Diagnoses: Reactive hypoglycemia Insulinoma Endocrine disorders (e.g., adrenal insufficiency) 2.2 Investigations: Fasting blood glucose and insulin levels 72-hour fasting test if insulinoma is suspected Endocrine evaluations (cortisol levels) Signup and view all the answers

Study Notes

Asthma Definition

Asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.

Asthma Classification

Extrinsic asthma is triggered by external allergens such as pollen, dust mites, and pet dander.
This classification applies to the 35-year-old woman as her symptoms worsen in response to allergens.

Asthma Signs and Symptoms

Wheezing
Breathlessness or shortness of breath
Chest tightness
Coughing, especially at night or during exercise
Frequent respiratory infections
A history of allergies

Differential Diagnosis for Asthma

Chronic obstructive pulmonary disease (COPD): Similar symptoms, but usually develops later in life and progresses more slowly.
Bronchitis: A common respiratory infection that inflames the bronchial tubes, causing a cough and shortness of breath.
Pneumonia: Inflammation of the lungs that can cause a cough, shortness of breath, fever, and chills.
Heart failure: This condition can cause shortness of breath and wheezing, particularly when lying down.

Hypertensive Emergency vs. Urgency

Hypertensive emergency is a severe, life-threatening condition characterized by a rapid increase in blood pressure that can damage vital organs.
The 58-year-old woman's severe headache, blurred vision, and history of uncontrolled hypertension suggest a hypertensive emergency.
Hypertensive urgency is a milder form, defined as a dangerously elevated blood pressure that, while requiring immediate treatment, does not show evidence of immediate organ damage.

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Description

This quiz defines asthma and explores its symptoms, particularly in children aged 12 and under. It delves into the recurrent wheezing and breathing difficulties often experienced at night and during physical activities, emphasizing the importance of understanding this chronic condition.

MEQ

Podcast Beta

Questions and Answers

Scenario: A 12-year-old child presents with recurrent wheezing and difficulty breathing, especially at night and during exercise. Task:

Define asthma

Scenario: A 35-year-old woman experiences asthma symptoms that worsen in response to allergens, such as pollen and dust mites. Task:

Classify her asthma as either extrinsic or intrinsic, and justify your classification.