MCQ IN MEDICINE

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MEDICINE MCQ

RENAL MEDICINE

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
A 76 year old woman with a history of coronary artery disease and diabetes presents to her primary care physician with a complaint of greatly increasing fatigue. She states that she tires easily, even with low levels of activity. Her vital signs include a temperature of 36.7 (98.1), a heart rate of 123, and blood pressure of 90/70 mm Hg. Her physician has difficulty hearing her heart sounds. Her physical examination indicates an altered mental status, diminishing arterial pulse on inspiration, and pulsus paradoxus. She is immediately admitted to the local community hospital, and an echocardiogram is ordered to confirm the putative diagnosis. What procedure will be necessary for the treatment of this patient?
A
Aortic valve replacement
B
Thoracentesis
C
Percutaneous coronary intervention
D
Pericardiocentesis
E
Surgical repair of thoracic aortic aneurysm
Explanation: 

Detailed explanation-1: -Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It’s typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.

Detailed explanation-2: -Chronic dyspnea is usually due to one of a small number of causes: bronchial asthma, COPD, congestive heart failure, interstitial lung disease, pneumonia, and mental disorders (e.g., anxiety disorders, panic disorders, somatization disorders) (3, 12).

Detailed explanation-3: -COPD occurs more commonly in elderly patients because breathing causes many substances to enter the body through the bronchi and many inflammations occur during life. It can be considered a normal way of ageing of the respiratory system but problems arise when the inflammation damages the walls of the bronchi.

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