Which one is the feature of ankylosing spondylitis?
1.rapid onset
2.pain at day
3.stiffness in morning
4.stiffness relifpves with rest
5.HLAB22
A 31 yr old man is referred to acute medical unit with a painful swollen left leg. The patient report that he has factor 5 leiden mutation. Which one of the following best descibes its pathophysiology?
Protein S deficiency
Activated protein C excess
Antithrombin deficiency
Resistance to action of protein C
Activated protein C deficiency
A patient with recurrent thromboembolic events developed DVT despite full anticoagulation with heparin. Which cause of thrombophilia is associated with resistance to heparin?
Protein C deficiency
Antithrombin 3 deficiency
Protein S deficiency
Lupus anticoagulant
Activated protein C resistance
A 24 yr old man is diagnosed with DVT of right leg. He is initially treated with LMWH but is switched after 3 days to warfarin. He then develops necrotic skin lesions on his lower limbs and forearms. Which condition is associated with it?
Protein S deficiency
Antiphospholipid syndrome
Antithrombin 3 deficiency
Activated protein C resistance
Protein C deficiency
What is the target for uric acid in gout treatment ?
1.more than 100
2.less than 300
3.more the 400
4.less than 450
Clinical physiology
Which of the following vessels constrict in hypoxic condition?
A. Renal arteriole
B. Cerebral arteriole
C. Pulmonary arteriole
D. Hepatic arteriole
E. Coronary arteriole
What effect do class 1c agents have on the heart?
1.Slow transmission at the AV node
2.Little effect on the action potential
3.Shorten the action potential
4.Affect the SA node
5.Lengthen the action potential
What is the complication of paget diaseas?
1.high output failure
2.fracture
3.skull thickening
4.deafness
5.all of above
6.5
What is the percentage of anti CCP specifity in rheuamtoid arthritis?
1.20-30 %
2.60-70%
3.90-95%
4.100%
A 60 year old man is found to be in AF. It is unknown for how long. What will be useful in rate control but will not lead to reversion to sinus rhythm?
1.Amiodarone
2.Sotalol
3.Adenosine
4.Flecainide
5.Digoxin
An 80 year old female collapsed whilst out shopping. A first aider was on the scene who stated he could not find a pulse for the first few seconds. On examination there was nil of note and an ECG is normal. A 24 hour tape is organised and is normal except for a few ectopics. What is the most likely diagnosis?
1.Vasovagal episode
2.Complete heart block
3.Transient Tachyarrhythmia
4.Carotid Sinus Hypersensitivity
5.Sick sinus syndrome
A 68 year old gentleman who has previously suffered an MI presents with collapse. There was no presyncopal symptoms. On examination there was a displaced apex beat an no focal neurology. An ECG revealed ST elevation in the anterior leads , he was pain free. What is the most likely diagnosis?
1.STEMI
2.Vasovagal Episode
3.Seizure
4.TIAs
5.Ventricular tachycardia
Which one is not associated with bad prognosis in rheuamtoid rthrites ?
1.rheumatoid factor negative
2.insidous onset
3.nodules
4.anti ccp positive
5.poor functional status
6.hladr4
A 35 YEAR OLD HAS FREQUENT EPISODES OF HEADACHE ON ONE SIDE OF FACE WITH THAT SIDE HAVING CONGESTED NOSTRILS AND RED EYE ON THAT SIDE .THE ATTACKS CAN BE 15 TO 20 TIMES PER DAY .WHICH OF THE FOLLOWING IS MOST CONSISTENT WITH DIAGNOSIS
ALTERED LIMB REFLEXES
TRANSIENT ANISOCRIA
SLURRING OF SPEECH
THROBBING OF TEMPLE
RELIEF ON VOMITING