(MCQS 313 –315):Choose the most appropriate investigation for the following organisms:Schistosoma hematobium

Correct Answer: B
Bretylium tosylate (Bretylol) has recently been approved for parenteral use against resistant ventricular arrhythmias. The pharmacologic action of bretylium is complex, and its antiarrhythmic action differs significantly from other drugs. Bretylium is an adrenergic neuronal blocking agent taken up selectively at peripheral adrenergic nerve terminals, where it initially releases norepinephrine (sympathomimetic effect) and then produces adrenergic neuronal blockade. It has direct cardiac membrane effect to prolong action potential duration and effective refractory period but, unlike other membrane active antiarrhythmic agents, does not depress conduction velocity or automaticity. Bretylium increases ventricular fibrillation threshold and prevents the decrease in ventricular fibrillation threshold associated with myocardial ischemia. It does not depress myocardial contractility. Clinical studies have shown parenteral bretylium to be effective in suppressing ventricular arrhythmias, particularly recurrent, drug resistant ventricular tachycardia or ventricular fibrillation.
Correct Answer: G
As noted in the history, this patient underwent an angiogram of the internal carotid artery. An atheromatous plaque located in the internal carotid artery could have been disturbed during the procedure, with resulting embolization of a plaque into the ophthalmic artery.
Correct Answer: J
j) mid-day urine sample The presence of terminally spined eggs in urinary sediment is diagnostic of active S. haematobium infection. In moderate to heavy infections, eggs are almost always present in a routine test of urinary sediment. In lighter infections, routine urinalysis does not always reveal eggs, and the measurement of sedimentation or filtration of larger volumes of urine, up to three consecutive 24-hour collections, is necessary. Because egg excretion follows a diurnal periodicity, with maximal egg excretion occurring between 10 A.M. and 2 P.M., a mid-day urine sample is most likely to contain eggs. Excretion of viable eggs of S. haematobium in the urine also indicates current activity of the infection, which necessitates schistosomacidal chemotherapy. Eggs may be seen in rectal or bladder mucosal biopsy specimens. If eggs are not found in several urine specimens, rectal biopsy should be attempted before bladder biopsy, because eggs are nearly as common in the rectum and the hazard of urinary tract infection is avoided.


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