Practice Session for Upcoming Exams

Introduction

• Focus on revising key facts for upcoming exams.
• Acknowledge reduced efficiency due to external stressors.
• Emphasis on practicing MCQs to sharpen reflexes.

Session Overview

• Aim to cover as many MCQs as possible in one hour.
• Each question will be discussed for about 1-1.5 minutes.

Key Concepts and Questions Discussed

Question 1: Obstructive Sleep Apnea vs. Obesity Hypoventilation Syndrome

• Patient Profile: 33-year-old woman, excessive daytime sleepiness, forgetfulness, BMI of 43.
• Differential Diagnosis:
  • Obstructive Sleep Apnea: Generally has normal daytime PCO2.
  • Obesity Hypoventilation Syndrome: Elevated PCO2 during the day.
• Correct Answer: Obesity Hypoventilation Syndrome.

Question 2: Hypokalemia Causes

• All true about hypokalemia except: RTA type 4 leads to hyperkalemia.
• Explanation: Inability to excrete potassium leads to hyperkalemia in RTA type 4, while other types typically present with hypokalemia.
• Correct Answer: Option C (conditions that do not show hypokalemia).

Question 3: Tubercular Meningitis

• Patient Profile: 10-year-old with irritability, stiffness, and history of not feeding well.
• Characteristics of CSF in Tubercular Meningitis:
  • Lymphocytosis, low glucose, high protein content.
• Correct Answer: Tubercular Meningitis.

Question 4: Cardiac Tamponade Symptoms

• Symptoms: Muffled heart sounds, hypotension, elevated JVP.
• Key Findings: Giant V waves or steep Y descent.
• Correct Answer: Cardiac Tamponade.

Question 5: Pneumonia with Pleural Effusion

• Patient Profile: Lung cancer with breathlessness and dull percussion note.
• Correct Answer: Parapneumonic effusion.

Question 6: ABCD2 Score

• ABCD2 Score Components:
  • Age, Blood pressure, Clinical features of stroke, Duration of symptoms.
• Correct Answer: History of stroke is NOT a component.

Question 7: Neurological Impairment in Stroke

• Patient Profile: 60-year-old man with sudden hemiparesis, high BP, NCCT head shows hyperdensity.
• Implication: Indicates brain hemorrhage; thrombolysis contraindicated.
• Correct Answer: Management focuses on blood pressure control and monitoring.

Question 8: Huntington's Disease vs. Parkinsonism

• Characteristics: Involuntary movements, cognitive/emotional issues.
• Key Point: No bradykinesia present in this case, which rules out Parkinsonism.
• Correct Answer: Huntington's Disease.

Question 9: Sjögren’s Syndrome Diagnosis

• Symptoms: Dry mouth and dry eyes.
• Key Diagnostic Tool: Salivary gland biopsy.
• Correct Answer: Sjögren’s Syndrome.

Question 10: Nephritic Syndrome Indicators

• Symptoms: Cola-colored urine, elevated protein levels.
• Correct Answer: Post-streptococcal glomerulonephritis.

Conclusion

• Recap of the practice session.
• Encouragement for continued practice and focus on key concepts.
• Reminder about the importance of revising core topics related to the exam.
• Next session will cover MCQs from Surgery.

Additional Notes

• Stay positive and persistent in preparation.
• Importance of understanding key words in questions to improve answering accuracy.