A 45 year old man had recently started taking anti-hypertensive therapy. 6 months later his RBS
is 14mmol/l. Which single drug is most likely to have caused this?
- a. Amlodipine
- b. Bendroflumethiazide
- c. Doxazosin
- d. Lorsartan
- e. Ramipril
0 voters
Ans. The key is B. Bendroflumethiazide. [High blood sugar is a well known side effect of thiazide (here
bendroflumethiazide)].
46. A 43 year old lady is admitted with pyrexia, arthropathy, breathlessness and syncope. She was
recently diagnosed with pulmonary emboli. There is an early diastolic sound and a mid-diastolic
rumble. Her JVP is elevated with prominent a-waves. What is the most likely cause?
- a. Mitral regurgitation
- b. Ventricular ectopics
- c. Pulmonary regurgitation
- d. Atrial myxoma
- e. Complete heart block
0 voters
Ans. The key is D. Atrial myxoma. [Atrial myxomas are the most common primary heart tumors. Twodimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign
and can be removed by surgical resection. Constitutional symptoms that include fever, weight loss,
arthralgias, and Raynaud phenomenon. These symptoms may be related to overproduction of
interleukin-6. Left heart failure may cause dyspnea on exertion caused by obstruction at the mitral valve
orifice. Valve damage may result in mitral regurgitation. Jugular venous pressure may be elevated, and
a prominent A wave may be present. An early diastolic sound, called a tumor plop, is heard. A diastolic
atrial rumble may be heard if the tumor is obstructing the mitral or tricuspid valve. Systemic or
pulmonary embolization may occur from left- or right-sided tumors. Embolization to the central nervous
system may result in transient ischemic attack, stroke, or seizure].