Property:AnswerBExp
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'''Incorrect''' : Stopping insulin on the day of surgery or the night before surgery is not advisable because of the risk of ketoacidosis in type I diabetic patients. +
'''Correct''' : Patient with TSH more than 10 is started on levothyroxine irrespective of their disease status. +
'''Incorrect''' : MRI of the brain is to look for pituitary dependent Cushing’s syndrome ( Cushing disease), where ACTH will be elevated or normal. +
'''Incorrect''' : IV potassium repletion is done when the patients presents with symptoms of hypokalemia like fatigue, muscle weakness or cramps, ileus. Do not exceed 20 mEq/L/hr. Replace magnesium, as this deficiency complicates potassium repletion. +
'''Incorrect''' : Screening for pheochromocytoma should be the next step in the management of this patient. +
'''Incorrect''' : CT of the abdomen is also done while the patient is on alpha blockers. Though both MRI/CT are equally sensitive, however MRI is more sensitive for extraadrenal tumours. +
'''Incorrect''' : Absent pupillary light reflex, corneal reflexes, oculovestibular reflexes (caloric responses), jaw jerk, gag, sucking, or rooting reflex, cough with tracheal suctioning, sucking or rooting reflexes suggest an irreversible absence of cerebral or brainstem response. +
Acyclovir is a nucleotide analogue that inhibits HSV replication. HSV can cause facial palsy, but it is a less common cause of facial palsy than Lyme disease, especially in a patient who has recently returned from a camping trip. +
'''Incorrect''' : Blood pressure rapidly decreases when labetolol is administered in pheochromocytoma patients. +
'''Incorrect''' : Nerve compression results in damage to the myelin sheath and manifests as delayed distal latencies and slowed conduction velocities. With sustained or more severe compression, axon loss may also occur, resulting in a reduction of the median nerve compound motor or sensory action potential amplitude. +
MERFF is not associated with ketoacidosis. MERRF can cause lactic acidosis. However a related mitochondrial condition, MELAS, is more associated with lactic acidosis. +
Hematologic diseases, such as G6PD deficiency, can cause lactic acidosis due to hemolysis. However, lactic acidosis of G6PD is not typically as severe as the acidosis in this patient. Furthermore, G6PD is an X-linked condition and is therefore highly unlikely to occur in a woman. +
Expression of Ret protein is associated with multiple endocrine neoplasia (MEN) 2A and 2B syndromes. +
Hemophilia A is an X-linked bleeding disorder characterized by internal bleeds as opposed to the cutaneous and mucosal bleeds observed in this patient. Labs in hemophilia reveal a marked elevation in aPTT and a normal bleeding time. +
'''Incorrect'''-Low circulating levels of thyroid hormones with TSH levels more than 10 IU/L characterizes primary hypothyroidism. +