MCQS 180-182 :A 55 year old man with diet controlled diabetes is being seen regularly at the cardiac unit because of several episodes of angina

one of the most recognised features of the VATER anomaly is
a) Choanal Atresia
b) Laryngomalacia
c) Tracheoesophageal Fistula
d) Double aortic arch
e) Foreign body aspiration
f) Esophageal duplication
g) Acute Pharyngitis
h) Lymphangioma
i) dermoid cyst
j) cleft lip

A 65 year old complains of severe bone pain, continous severe thirst and polyuria. She is noted to be confused and lethargic.
a) Colour vision test
b) Computed tomography scan of the brain
c) Electroencephalogram
d) Erythrocyte sedimentation rate
e) Full blood count FBC
f) Intraocular pressure measurement
g) Serum calcium concentration
h) Serum urea and electrolyte concentration
i) Visual acuity assessment
j) Visual field mapping

A 55 year old man with diet controlled diabetes is being seen regularly at the cardiac unit because of several episodes of angina. He has a history of a refractory ventricular arrhythmia that is being treated with amiodarone. Which complication of amiodarone would you most particularly be looking for in this patient?
a) pulmonary hemorrhage
b) avascular necrosis of the femoral head
c) interstitial infiltrates and peripheral consolidation
d) large pleural effusions
e) pulmonary edema
f) massive hilar adenopathy
g) marked decrease in the glomerular filtration rate
h) hydronephrosis
i) pericarditis
j) pneumothorax

Correct Answer: C
The VATER association is a grouping of complex anomalies which is comprised of congenital abnormalities of many systems. At least 3 or more of these following anomalies must be present for a child to be diagnosed as having VATER association : Vertebral defect i.e., hemi-vertebra, sacral agenesis. Isaac has an extra vertebra in his neck and seven hemi-vertebra (half formed) in his upper back. Anorectal malformation or imperforate anus. Isaac had no anal opening when he was born. Dr. Morgan actually created one, through a series of surgeries this year. Tracheoesophageal fistula. AND Esophageal atresia with or without TE (tracheoesophageal) fistula. Renal anomalies. Some children are born with one kidney or other renal deformities. Isaac had a lower intestine connection to his renal system. Radial dysplasia or aplasia. Isaac is missing his left radial. (One of the bones in his forearm.)
Correct Answer: G
Common clinical manifestations of acute hypercalcemia include fatigue, gastrointestinal disturbances, bone pain, confusion, lethargy, polydipsia, polyuria and dehydration. Common gastrointestinal disturbances include nausea, vomiting, and constipation. Seizures are the most frequent neurological complication associated with acute hypercalcemia. Cardiac disturbances include bradycardia and arrhythmias
Correct Answer: C
amiodarone results in pulmonary insufficiency after 1 - 12 months in up to 20% of patients on long-term therapy. It typically results in alveolar and interstitial infiltrates with peripheral consolidation and pleural thickening adjacent to the consolidation


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