P1253037281dEWQF

1
Sunday, January 25, 2004
A 45-year-old woman has had worsening shortness
of breath for several years. She has to sleep
sitting up on two pillows. She has difficulty
swallowing. There is no history of chest pain.
She is afebrile. Recently, she had a "stroke"
with resultant inability to move her left leg and
difficulty moving her left arm. A chest
radiograph reveals a near-normal left ventricular
size with a prominent left atrial border.Which
of the following conditions is most likely
toaccount for these findings (A) Essential
hypertension. (B)  Cardiomyopathy. (C)  Mitral
valve stenosis. (D)  Aortic coarctation. (E) 
Left renal artery stenosis
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2
Monday, January 26, 2004
Yesterday correct answer was C Mitral valve
stenosis leads to left atrial enlargement, but
the left ventricle is usually small. There is
typically a 'fishmouth' shaped mitral valve that
has stenosis as well as insufficiency, since it
does not close completely. Most mitral valvular
disease in adults results from rheumatic
valvulitis. The episode(s) of rheumatic fever
occurred years befor. And the winner is Today
question A 6-year-old child who inhales a peanut
may have allof the following complications
EXCEPT (A)  Cryptococcal pneumonia (B) 
Bronchiectasis (C)  Atelectasis (D)  Endogenous
lipid pneumonia (E)  Hyperinflation
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3
tuesday, January 27, 2004
Yesterday correct answer was A Cryptococcal
pneumoia is a complication seen in an
immunocompromised patient. It does not follow
aspiration. The winner is Today question A
28-year-old woman has had difficulty
concentrating on her job at work for weeks. She
is constantly getting up and walking around to
visit co-workers. She complains that the work
area is too hot. She seems nervous and spills her
coffee a lot. She has been eating more but has
lost 5 kg in the past month. Which of the
following laboratory findings is most likely tobe
present A  Decreased plasma insulin B 
Increased free thyroxine C  Decreased iodine
uptake D  Increased ACTH E  Increased calcitonin
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4
tuesday, January 27, 2004
Yesterday correct answer was B There are both
thyroid-stimulating immunoglobulins (TSI) and
thyroid growth-stimulating immunoglobulins (TGI)
in Grave's disease that produce hyperthyroidism.
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