Property:AnswerAExp
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'''Incorrect''' : The alpha and beta blocking property of labetolol does bring blood pressure very rapidly to the normal state +
'''Incorrect''' : The diagnosis of acute gout is most secure when supported by visualization of urate crystals by experienced examiners in a sample of fluid aspirated from an affected joint (or bursa). +
'''Incorrect''' : In patients presenting with gouty arthritis and normal renal function but without visible or palpable tophaceous deposits or radiographic evidence of joint destruction or bony erosions, it should be possible to manage their disease successfully with life-style modifications, combined when necessary with pharmacologic therapy. +
MERRF is associated with elevated lactic acid not associated with hemolysis. Therefore, bilirubin is not elevated in MERRF. +
Glucose-6-Phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive genetic disease. +
A patient with stroke-like symptoms and lactic acidosis suggests MELAS syndrome. An MRI might show increased signals in the posterior cerebrum during an episode, but these findings are not usually diagnostic of MELAS. +
Oral penicillin is the first line agent to treat uncomplicated cases of pelvic actinomycosis. Penicillin blocks transpeptidase cross-linking of peptidoglycan. +
Azoles, such as fluconazole, inhibit fungal ergosterol synthesis by blocking the conversion from lanosterol to ergosterol. Fluconazole is prescribed for vaginal candidiasis, which is in the differential diagnosis of bacterial vaginosis. Vaginal candidiasis is caused by the fungus ''Candida albicans''. It manifests as vaginal inflammation with pruritus, along with the presence of a thick, cottage-cheese, white discharge that typically has no odor. Vaginal pH is typically between 4 and 4.5, and vaginal smear shows pseudohyphae. +
While Bernard-Soulier syndrome (BSS) is a platelet disorder characterized by a defect in platelet adhesion to von Willebrand factor. BSS may result in a bleeding disorder and prolongation of bleeding time. However, patients usually have thrombocytopenia, which is not present in this patient. +
'''Incorrect'''-Mildly elevated serum TSH levels and normal circulating thyroid hormone levels characterize subclinical hypothyroidism. Patients do not have clinical features of hypothyroidism. +
'''Incorrect'''-Placement of a nasogastric tube to the level of perforation, intravenous antibiotics, close observation and repeated esophagograms to confirm healing are conservative approaches for treating small perforations with a diameter of few millimeters without any diagnostic delay or septic symptoms. +
'''Incorrect'''-Increasing the evening dose of NPH insulin further might not be helpful since a previous attempt did not turn out to be useful +
'''Incorrect'''-Since spontaneous and surgical repair of ruptured tympanic membrane is possible, permanent conductive hearing loss usually does not occur. +
'''Incorrect'''-The use of barium is contraindicated since spillage of barium mixed with feces into the peritoneal cavity would increase the likelihood of subsequent intraabdominal abscess. +
'''Incorrect'''-Metformin induced lactic acidosis is a type B lactic acidosis that occurs without any clinical evidence of poor tissue perfusion or oxygenation. Type A lactic acidosis occurs in association of clinical evidence of poor tissue perfusion or oxygenation. +
This represents the normal range of calcium and PTH values in serum; calcium levels vary from 8.5 to 10.2 mg/dL and PTH levels vary from 15-65 pg/mL. PTH increases when the ionized calcium level decreases. +