TOXIC MULTI NODULAR GOITRE-MCQS
1.Thyroid gland with at least 2 autonomously functioning nodules that secretes excess thyroid hormones.
2.Symptoms include dysphagia, dyspnoea dizziness and /or neck discomfort.
3.Tc -99 scan shows a homogeneous pattern.
4. Non contrast CT scan along with spirometry is useful to evaluate when there is a suspected tracheal compression.
5. Pemberton's sign is used to evaluate venous obstruction in patients with goitre
Answers
1. TRUE
2. TRUE-retrosternal goitre may cause dizziness when raising arms above the head.
3. FALSE-Heterogeneous pattern with many areas with hyperactivity and hypo-activity throughout the gland.
4. TRUE- Non contrast CT scan and inspiratory flow volume loop obtained during the spirometry manoeuvre may be helpful for functional evaluation of tracheal compromise.
5. TRUE-The sign is positive when bilateral arm elevation causes facial plethora
Showing posts with label AMC. Show all posts
Showing posts with label AMC. Show all posts
Friday 25 December 2020
Saturday 28 March 2009
Administration of Anti -D
At the first pregnancy consultation the mother's blood
group should be determined and blood taken for detection/
measurement of blood group antibodies. For
complete and incomplete miscarriages all Rh(D) negative
women who have not actively formed their own
anti-D should be given 250IU of anti-D.
There is insufficient evidence to suggest that a threatened
miscarriage before 12 weeks gestation necessitates
use of anti-D, but meta-analyses indicate that antenatal
administration of anti-D (for all indications
including miscarriage) can result in a 78% reduction
in allo-immunisation.
group should be determined and blood taken for detection/
measurement of blood group antibodies. For
complete and incomplete miscarriages all Rh(D) negative
women who have not actively formed their own
anti-D should be given 250IU of anti-D.
There is insufficient evidence to suggest that a threatened
miscarriage before 12 weeks gestation necessitates
use of anti-D, but meta-analyses indicate that antenatal
administration of anti-D (for all indications
including miscarriage) can result in a 78% reduction
in allo-immunisation.
Sunday 1 February 2009
THE MANAGEMENT OF VARIZELLA ZOSTER VIRUS EXPOSURE AND INFECTION IN PREGNANCY AND NEW BORN PERIOD
GOOD DAY
1.Zoster immunoglobulin (ZIG) should be offered to pregnant, varicella-seronegative women with significant exposure to varicella-zoster virus (VZV) (chickenpox) infection.
2.Oral aciclovir prophylaxis should be considered for susceptible pregnant women exposed to VZV who did not receive ZIG or have risk factors for severe disease.
3.Intravenous aciclovir should be given to pregnant women who develop complicated varicella at any stage of pregnancy.
4.Counselling on the risk of congenital varicella syndrome is recommended for pregnant women who develop chickenpox.
5.ZIG should be given to a baby whose mother develops chickenpox up to 7 days before delivery or up to 28 days after delivery.
6.Intravenous aciclovir should be given to babies presenting unwell with chickenpox, whether or not they received ZIG.
7.Breastfeeding of babies infected with or exposed to VZV is encouraged.
8.A mother with chickenpox or zoster does not need to be isolated from her own baby.
9.If siblings at home have chickenpox, a newborn baby should be given ZIG if its mother is seronegative.
10.The newborn baby does not need to be isolated from its siblings with chickenpox, whether or not the baby was given ZIG.
11.After significant nursery exposure to VZV, ZIG should be given to seronegative babies and to all babies born before 28 weeks' gestation.
1.Zoster immunoglobulin (ZIG) should be offered to pregnant, varicella-seronegative women with significant exposure to varicella-zoster virus (VZV) (chickenpox) infection.
2.Oral aciclovir prophylaxis should be considered for susceptible pregnant women exposed to VZV who did not receive ZIG or have risk factors for severe disease.
3.Intravenous aciclovir should be given to pregnant women who develop complicated varicella at any stage of pregnancy.
4.Counselling on the risk of congenital varicella syndrome is recommended for pregnant women who develop chickenpox.
5.ZIG should be given to a baby whose mother develops chickenpox up to 7 days before delivery or up to 28 days after delivery.
6.Intravenous aciclovir should be given to babies presenting unwell with chickenpox, whether or not they received ZIG.
7.Breastfeeding of babies infected with or exposed to VZV is encouraged.
8.A mother with chickenpox or zoster does not need to be isolated from her own baby.
9.If siblings at home have chickenpox, a newborn baby should be given ZIG if its mother is seronegative.
10.The newborn baby does not need to be isolated from its siblings with chickenpox, whether or not the baby was given ZIG.
11.After significant nursery exposure to VZV, ZIG should be given to seronegative babies and to all babies born before 28 weeks' gestation.
Saturday 31 January 2009
Asthma Management of Exacerbations
GOOD DAY !
ASTHMA
Managing exacerbations
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Management of exacerbations in adults
A short (7-10 days) course of oral corticosteroids is the current standard treatment for adults with moderate-to-severe asthma exacerbations.
I
When administering a SABA via MDI during an exacerbation, use a spacer. [√]
In adults with acute exacerbations not considered severe enough for admission to hospital, high-dose ICS may be effective. II
Merely doubling the maintenance ICS dose is not effective in managing exacerbations. II
Management of exacerbations in children
A short (up to 5 days) course of oral corticosteroids (prednisolone 1 mg/kg up to 60 mg daily) is the current standard treatment for severe exacerbations. Closely monitor response to treatment. I
Children who are taking regular preventive medication should continue taking the same dose during an exacerbation. II
When administering a SABA via MDI during an exacerbation, use a spacer. III-1
Merely doubling the maintenance ICS dose is not effective in managing exacerbations in children. II
ASTHMA
Managing exacerbations
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Management of exacerbations in adults
A short (7-10 days) course of oral corticosteroids is the current standard treatment for adults with moderate-to-severe asthma exacerbations.
I
When administering a SABA via MDI during an exacerbation, use a spacer. [√]
In adults with acute exacerbations not considered severe enough for admission to hospital, high-dose ICS may be effective. II
Merely doubling the maintenance ICS dose is not effective in managing exacerbations. II
Management of exacerbations in children
A short (up to 5 days) course of oral corticosteroids (prednisolone 1 mg/kg up to 60 mg daily) is the current standard treatment for severe exacerbations. Closely monitor response to treatment. I
Children who are taking regular preventive medication should continue taking the same dose during an exacerbation. II
When administering a SABA via MDI during an exacerbation, use a spacer. III-1
Merely doubling the maintenance ICS dose is not effective in managing exacerbations in children. II
ASTHMA KEY POINTS
GOOD DAY !
ACUTE ASTHMA
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Managing acute asthma in adults
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Assess response to treatment using spirometry, oxygen saturation, heart rate, respiratory rate and pulsus paradoxus status.
[√]
Wheeze is an unreliable indicator of the severity of an asthma attack and may be absent in severe asthma.
[√]
Ensure every patient receives adequate follow-up after an acute asthma episode, including review of medications, triggers and asthma action plan.
[√]
Managing acute asthma in children
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Emergency management of acute asthma in a child is based on initial administration of salbutamol 4-6 puffs (< 6 years) or 8-12 puffs (≥6 years) via MDI.
I
Load the spacer with one puff at a time and give each puff separately.
III-1
If treatment with an oral corticosteroid (e.g. prednisolone 1 mg/kg up to 60 mg as a single daily dose) has been initiated for a moderate-to-severe acute episode, continue for up to 5 days.
ACUTE ASTHMA
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Managing acute asthma in adults
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Assess response to treatment using spirometry, oxygen saturation, heart rate, respiratory rate and pulsus paradoxus status.
[√]
Wheeze is an unreliable indicator of the severity of an asthma attack and may be absent in severe asthma.
[√]
Ensure every patient receives adequate follow-up after an acute asthma episode, including review of medications, triggers and asthma action plan.
[√]
Managing acute asthma in children
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Emergency management of acute asthma in a child is based on initial administration of salbutamol 4-6 puffs (< 6 years) or 8-12 puffs (≥6 years) via MDI.
I
Load the spacer with one puff at a time and give each puff separately.
III-1
If treatment with an oral corticosteroid (e.g. prednisolone 1 mg/kg up to 60 mg as a single daily dose) has been initiated for a moderate-to-severe acute episode, continue for up to 5 days.
Thursday 29 January 2009
MCQs
GOOD DAY !
Hi next to come is MCQ discussion............please mind that you needs to know what exactly is "ASKING".......this will help to select what is the answer.....!!!
Hi next to come is MCQ discussion............please mind that you needs to know what exactly is "ASKING".......this will help to select what is the answer.....!!!
Wednesday 28 January 2009
Sunday 25 January 2009
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