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Correct Answer - A Ans. is 'a' i.e., Kawasaki disease o Kawasaki disease is an acute, self limited vasculitis of unknown etiology that occurs predominantly in infants and young children of all races. Coronary artery aneyrysms or ectasia develops in 15-25% of untreated children with the disease and may lead to ischemic heart disease, myocardial infarction, or even sudden death. In the USA, Kawasaki disease has surpassed acture rheumatic fever as leading cause of acquited heart disease in children @medicinevideoss

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Correct Answer - A Ans. is 'a' i.e., Re-entry .The most common arrhythmia mechanism is re-entry. .Fundamentally, re-entry is defined as the circulation of an activation wave around an inexcitable obstacle. .Re-entry appears to be the basis for most abnormal sustained Supra Ventricular Tachycardias (SVTs) and Ventricular tachycardia. .Examples of re-entry are:- Polymorphic Ventricular tachycardia in patients with a genetically determined ion channel abnormality such as the Brugada syndrome, catecholaminergic polymorphic Ventricular tachycardia. @medicinevideoss

Correct Answer - A Answer is A (Glasgow coma scale): Amongst the option provided GCS is the single best answer of choice. Determining the patient prognosis after TBI (Traumatic Brain Injury) is difficult and complex. Several independent variables have been identified that correlate with severity. Most studies have indicated Glasgow Coma Scale in the field and at arrival at the emergency department as a highly predictive indicator of prognosis. Harrison 17 th / 2601 In severe head injury eye opening, the best motor response and verbal output have been found to be roughly predictive of outcome. There have been summarized using the Glasgow coma scale. Coma score = E + M + V Patient scoring 3 or 4 have an 85% chance of dying or remaining vegetative. Patients scoring 11 or above have only a 5 — 10% chance of dying or remaining vegetative. Intermediate scores correlate with proportional chances of recovery @medicinevideoss

Correct Answer - C Answer- C. Increased protein C levels Nephrotic syndrome is a clinical complex characterized by a number of renal and extrarenal features, most prominent of which are Proteinuria (in practice > 3.0 to 3.5gm/24hrs), Hypoalbuminemia, Edema Hypertension Hyperlipidemia, Lipiduria Hypercoagulabilty(result of Loss of Antithrombin III) @medicinevideoss

Correct Answer - A Ans. is 'a' i.e., Candida Individuals with DM have a greater frequency and severity of the infection. The reasons for this include incompletely defined abnormalities in cell-mediated immunit y and phagocyte function associated with hyperglycemia, as well as diminished vascularization. Hyperglycemia aids the colonization and growth of a variety of organisms (candida and other fungal species) @medicinevideoss

Correct Answer - D Ans. is 'd' i.e., Tumor plop sound Low pitch heart sounds are : S3 S4 Tumor plop sound Mid systolic clicks are Heard in mitral valve prolapse during systole and are high pitch sounds. The pericardial knock (PK) is Also high-pitched and occurs slightly later than the opening snap, corresponding in timing to the abrupt cessation of ventricular expansion after tricuspid valve opening and to an exaggerated y descent seen in the jugular venous waveform in patients with constrictive pericarditis. A tumor plop is A lower-pitched sound that can be heard in patients with atrial myxoma. It may be appreciated only in certain positions and arises from the diastolic prolapse of the tumor across the mitral valve @medicinevideoss

Correct Answer - B Answer- B. Duration of murmur Duration depends on severity of MS. In severe MS, the mid diastolic murmur is long and merges with the presystolic murmur to produce holodiastolic murmur. @medicinevideoss

Correct Answer - A Answer. A. HOCM Murmur will get softer with Valsalva or standing from squatting because less blood is being ejected through the aortic valve. Rapid squatting from a standing position forces increased venous return and would have the opposite effect of Valsalva or rapid standing. @medicinevideoss

Answer is D (Polyarteritis nodosa) Amongst the options provided renal artery stenosis is least likely to be seen in association with Polyarteritis nodosa. Atherosclerosis and Fibromuscular disease - Renal artery stenosis is produced predominantly by atherosclerotic occlusive disease (80% to 90% of patients) or tibromuscular dysplasia (10-15% of patients).- CMDT'06 p 460 - he common cause of renal artery stenosis in the middle aged and elderly is an atheromatous plaque at origin of renal artery. Harrison - In younger women stenosis is due to intrinsic structural abnormalities of the arterial wall caused by a heterogenous group of lesions called 'fibromuscular dysplasia'. PAN or Takayasu arteritis ? CMDT do not mention PAN or Takayasu arteritis as a cause for renal artery stenosis. However, Takayasu arteritis is certainly a more common cause of renal artery stenosis than PAN Causes of Renal artery stenosis : 1. Atherosclerosis 2. Fibromuscular dysplasia 3. Non specific Aorto arteritis 4. Takayasu arteritis and giant cell arteritis (Takayasu > Giant cell) 5. Antiphospholipid syndrome 6. Transplant renal artery stenosis 7. Renal artery embolism 8. Dissecting aneurysm of aorta 9. Radiation arteritis @medicinevideoss

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Correct Answer - D Ans. is 'd' i.e., neuropsychiatric manifestations Hyperkalemia is seen in hemolytic urenic syndrome as a result of renal failure. ABOUT NEUROPSYCHIATRIC MANIFESTATIONS * Neurological manifestations are used to distinguish between Hemolytic uremic syndrome and Thrombotic Throm bocytopenic Purpura. * H.U.S. is distinguished from T.T.P by the absence of neurological symptoms and the prominence of acute renal failure. * Recent studies, however have tended to blurr these clinical distinctions. Many adult patients with "T. T.P. lack one or more of the five criteria and patients with "HUS" have fever and neurological dysfunction. @medicinevideoss

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Correct Answer - C Ans. is 'c' i.e., Acute viral hepatitis Pathological features of acute viral hepatitis 1) Panlobular infiltration of mononuclear cells This mononuclear infiltration primarily consists of —> Lymphocytes, Plasma cells, Eosinophils Inflammatory infiltrate may spill over into the adjacent parenchyma to cause necrosis of periportal hepatocytes 4 interface hepatitis, can occur in both acute and chronic hepatitis. 2) Hepatic cell damage - It consits of a) Hepatic cell necrosis - The necrosis is usually focal or centirzonal. Sometimes severe necrosis such as bridging or subacute hepatic necorsis occurs. b) Ballooning of cells - Damaged cells show diffuse swelling known as ballooning degeneration. c) Acidophilic degeneration of hepatocytes - In this single necrotic liver cell has coagulated pink cytoplasm and it shows pyknosis or karyolysis. These are called councilman bodies. @medicinevideoss

Correct Answer - A Answer- A. Sepsis Thrombocytopenia is a common laboratory abnormality that has been associated with adverse outcomes in ICU patients. Thrombocytopenia is defined as platelet count < 150 X 103 cells / mcL. Common causes of thrombocytopenia in ICU patients: Sepsis Disseminated intravascular coagulation Consumption (eg, major trauma, cardiopulmonary bypass) Dilution (with massive transfusion) Myelosuppressive chemotherapy Mechanical circulatory support devices (eg, intra-aortic balloon pump) Less common but important causes of thrombocytopenia that should not be missed: Heparin-induced thrombocytopenia Hemophagocytic syndrome Uncommon causes of thrombocytopenia that develop during ICU admission Drug-induced thrombocytopenia (other than heparin or cytotoxic chemotherapy) @medicinevideoss

Correct Answer - C Answer- C. Adrenal hemorrhage after meningococcal infection Waterhouse Friderichsen syndrome or massive adrenal hemorrhage is an uncommon usually fatal consequence of overwhelling sepsis. It is most frequently seen as a result of "meningococcal infection". @medicinevideoss

Correct Answer - C Answer- C. Urinary calculi Urinary calculi (oxalate stones in ileal disease), local extension of Crohn disease involving ureter or bladder, amyloidosis, drug-related nephrotoxicity @medicinevideoss