Q- A 45-year-old male presents with sudden-onset chest pain radiating to the left arm. He appears diaphoretic, and an ECG reveals ST-segment elevation in the anterior leads.
Which one of the following is the initial medication for this patient?
A- Alteplase
B- Aspirin
C- Clopidogrel
D- Metoprolol
E- Nitroglycerin
B- Aspirin- This patient presents with symptoms suggestive of an acute myocardial infarction characterized by sudden-onset chest pain, diaphoresis, and ST-segment elevation on the ECG, particularly in the anterior leads. Aspirin is the most appropriate initial medication in this situation.
Q- A 30-year-old female presents with fatigue, pale skin, and shortness of breath. Laboratory results reveal a low hemoglobin level, low mean corpuscular volume (MCV), and an elevated red cell distribution width (RDW). Peripheral blood smear shows microcytic, hypochromic red blood cells.
Which of the following is the most likely diagnosis?
A- Anemia of chronic disease
B- Folate deficiency anemia
C- Iron-deficiency anemia
D-Thalassemia
E- Vitamin B12 deficiency anemia
C- Iron deficiency anemia- This patient is likely experiencing iron-deficiency anemia. The symptoms include feeling tired, having pale skin, and difficulty breathing. Lab results show low hemoglobin, small red blood cells, and a higher-than-normal red cell distribution width. The appearance of small and pale red blood cells on a blood smear supports the diagnosis. Other types of anemia, caused by vitamin B12 or folate deficiency, may have larger red blood cells. Thalassemia, a genetic condition, and anemia of chronic disease is less likely based on the lab results.
Q- A 28-year-old male presents with sudden-onset severe testicular pain and swelling. On examination, the affected testicle is tender, swollen, and elevated compared to the unaffected side. Cremasteric reflex is absent on the affected side.
Which one of the following is the most likely diagnosis?
A- Epididymitis
B- Hydrocele
C- Orchitis
D- Testicular torsion
E- Varicocele
D- Testicular torsion- The sudden-onset severe testicular pain, swelling, and elevation of the affected testicle, along with the absence of the cremasteric reflex, are indicative of testicular torsion. Testicular torsion is a urologic emergency that occurs when the spermatic cord twists, leading to compromised blood flow to the testicle. This results in ischemia and severe pain. Prompt surgical intervention is necessary to untwist the cord and restore blood flow. Epididymitis, varicocele, hydrocele, and orchitis may present with testicular pain, but the clinical presentation described is highly suggestive of testicular torsion.
