Free FMGE Medicine questions

Explanation

ST elevation in II, III, and aVF indicates an inferior-wall myocardial infarction. The right coronary artery is the most common culprit in a right-dominant circulation.

Explanation

ACE inhibitors reduce angiotensin II and aldosterone effects and improve outcomes in heart failure with reduced ejection fraction. Diuretics mainly improve congestion rather than independently providing the same mortality benefit.

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The classic symptom triad is angina, syncope, and dyspnea. A crescendo-decrescendo systolic murmur radiating to the carotids strongly supports aortic stenosis.

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Typical positive blood cultures and echocardiographic evidence of endocardial involvement are major Duke criteria. Together they strongly support definite infective endocarditis.

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Asthma is characterized by variable and often reversible airflow obstruction. A meaningful bronchodilator-related improvement in FEV1 supports this physiology.

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Persistent post-bronchodilator airflow obstruction in an appropriate clinical context supports COPD. Hyperinflation further fits obstructive physiology.

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Acute unexplained dyspnea and pleuritic pain in an immobilized or postoperative patient are classic clues to pulmonary embolism. Risk derives from venous thromboembolism.

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Light-type biochemical criteria use pleural-to-serum protein and LDH relationships to identify exudates. Exudates usually reflect increased pleural permeability or impaired lymphatic drainage.

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Hyperglycemia, ketosis, and metabolic acidosis define diabetic ketoacidosis. Volume depletion and potassium abnormalities are also common.

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Excess thyroid hormone suppresses pituitary TSH through negative feedback. Primary hyperthyroidism therefore typically shows elevated circulating thyroid hormone with suppressed TSH.

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Primary adrenal failure causes deficiency of cortisol and aldosterone, with increased ACTH producing hyperpigmentation. Hyperkalemia helps distinguish primary from central adrenal insufficiency.

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Alpha blockade is established first to control catecholamine-mediated vasoconstriction. Giving beta blockade first can leave unopposed alpha-adrenergic activity and worsen hypertension.

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Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, edema, and often hyperlipidemia. Hematuria and red-cell casts are more characteristic of nephritic processes.

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Hematuria with red-cell casts, hypertension, and reduced filtration are hallmarks of nephritic syndrome. Postinfectious glomerulonephritis is a classic cause in children.

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IV calcium rapidly stabilizes myocardial membranes but does not remove potassium from the body. Insulin with glucose and other therapies are then used to shift or eliminate potassium.

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Cirrhotic patients with ascites can develop spontaneous bacterial peritonitis, often presenting with fever, pain, renal deterioration, or encephalopathy. Ascitic neutrophilia is a key diagnostic clue.

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Asterixis is a negative myoclonus classically seen in hepatic encephalopathy and some other metabolic encephalopathies. It appears as intermittent lapses in sustained posture.

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The dominant left MCA supplies language areas and lateral motor cortex serving the face and upper limb. Aphasia with contralateral face-arm weakness therefore strongly suggests a left MCA lesion.

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Bradykinesia is essential to the parkinsonian syndrome and commonly accompanies rigidity and resting tremor. Postural instability often appears later.

Explanation

Myasthenia gravis causes fatigable weakness, often beginning with ocular or bulbar muscles. Sensation is preserved because the disorder affects neuromuscular transmission rather than sensory pathways.