Thursday, August 27, 2009

Question 26

62 year old Caucasian alcoholic male is brought to the ER in a semi-concious state. He remains drowsy and is unable to answer to questions. On examination, he is drowsy, responds to shaking, and then goes back to drowsiness. His Serum ketone levels are high, and his blood sugar level on glucometer shows 36 mg%. He has swelling on his great toes bilaterally. Serum AST is greater than ALT. Serum Bilirubin is 9.2 mg%. What is the biochemical cause of his swelling of toes?

A) Lactic Acid & Beta Hydroxy butyric Acid

B) Raised GGT

C) Hypertriglyceridemia

D) Mitochondrial Toxins

E) Increased NAD


Question 25

A 47 year old veterinarian from Texas arrives at ER with history of low grade fever and cough. He has been having flu like symptoms for the past few days, and non productive cough since three days. He does not remember of being exposed to cases of TB and his last PPD test done 2 months back was negative. He also complains of myalgias and headaches since three days which was relieved with Acetaminophen. On Chest X ray, the physician finds patchy interstitial infiltrates. On chest auscultation, air entry is equal bilaterally and few rhonchi are heard which are scattered. The patient does not look toxic. He has not lost weight recently, and has not experienced any loss of appetite or night sweats. The liver is mildly enlarged and otherwise all examination is unremarkable. What is the vector involved in transmitting the pathogen causing the symptoms?

A) Tse-Tse Fly

B) Wood Tick

C) Dog Tick

D) Rat Tick

E) Body Louse

F) Lone Star Tick

G) No vector involved

Answer will be posted under the Comments section.


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