MCQS 195-198 :clinical signs with the most correct term Body tremor when standing or walking:

a patient is having an operative hemodynamic assessment. A discrepancy is noted between the heart rate of the ECG and the pulse rate. This discrepancy is known as
a) left ventricular end-diastolic volume
b) stroke volume
c) mean arterial pressure
d) pulse deficit
e) systemic vascular resistance
f) cardiac output
g) ejection fraction
h) central Venous Pressure
i) right atrial presure
j) left atrial presure

Match the clinical signs with the most correct term Body tremor when standing or walking:
a) Dysarthria
b) Dyssynergia
c) spasmodic dysphonia
d) Hypometria
e) intention tremor
f) Titubation
g) Dysdiadochokinesia
h) Dysmetria
i) Scanning Speech
j) ataxia

A young man develops acute hepatitis B. Four months after his presentation he asks for a test that would predict the likelihood of developing long term disease. Which agent would be most helpful in estimating the likelihood of developing chronic active hepatitis in this patient?
a) recombinant hepatitis B vaccine
b) hepatitis C virus
c) Hepatitis B surface antigen
d) hepatitis C vaccine
e) hepatitis D
f) hepatitis B immune globulin (HBIG)
g) hepatitis B virus DNA
h) hepatitis B e antigen
i) hepatitis A
j) atopic dermatitis

Correct Answer: D
Pulse deficit describes the extent to which the pulse rate is less than the heart rate. This is typically seen in patients with atrial fibrillation, in which short R-R intervals compromise cardiac filling during diastole, resulting in reduced stroke volume and imperceptible arterial pulse. The most extreme example of a pulse deficit is electrical-mechanical dissociation or pulseless electrical activity, seen in patients with cardiac tamponade, extreme hypovolemia, and other conditions in which cardiac contraction does not generate a palpable peripheral pulse Monitoring pulse rate is more important than monitoring heart rate in terms of perioperative hemodynamic assessment. Any deficit depends on whether a given electrical depolarization and systolic contraction of the heart (heart rate) generates a palpable peripheral arterial pulsation (pulse rate). .
Correct Answer: F
Titubation: Body tremor when standing or walking, titubation is a postural and limb tremor that results in a rhythmic tremor of the body
Correct Answer: H
Hepatitis B e antigen ( HBeAg ) is a product of the gene that codes for the nucleocapsid core; its presence signifies the presence of a state of high virus replication. As such, patients with HBeAg have a high level of circulating virions, high infectivity, and substantial liver injury. HBeAg becomes detectable in all patients early during acute hepatitis B, and, therefore, there is no clinical utility to the test during early acute hepatitis B; however, if circulating HBeAg persists beyond the first 3 months of acute hepatitis, the likelihood of chronic infection is increased. Testing for HBeAg is more important during chronic infection, for the presence of HBeAg denotes a more highly replicative chronic infection, associated with increased infectivity (eg, 20-25% infectivity of a needlestick) and liver injury (eg, chronic active hepatitis). When anti-HBe can be detected in the absence of HBeAg during chronic infection, the patient can be classified as having a less replicative infection, with limited infectivity (eg, 0.1% infectivity of a needlestick) and liver injury (chronic carrier). Hepatitis B virus DNA (HBV DNA) is a more quantitative marker of HBV replication, and is helpful in following patients with chronic disease and in monitoring the success of antiviral therapy


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