MCQS 325-327:A 17-year-old develops a tightening sensation in his mid sternum during exercise



A 17-year-old develops a tightening sensation in his mid sternum during exercise. On examination the pulse rate is 180/minute, the respiratory rate is 38/minute, and the blood pressure is 120/90 mm Hg. You hear a suprasternal notch thrill, an apical click, and a 3/6 ejection murmur at the right upper sternal border. The most likely diagnosis is

a) mitral insufficiency
b) aortic stenosis
c) pericarditis
d) tricuspid incompetence
e) costochondritic pain.
f) hiatus hernia
g) perciardial tamponade
h) reflux esophagitis
i) aortic insufficiency
j) pleuritis


A 55 year old woman has mania associated with cyclic and frequent depressive features. The most appropriate treatment would be

a) selective Serotonin Re-uptake Inhibitors
b) St. Johns Wort
c) lithium
d) monoamine Oxidase Inhibitors
e) carbamazepine
f) lorazepam
g) Electroconvulsive therapy
h) tricyclic antidepressants
i) reserpine
j) Sodium Valproate

A middle aged woman has severe collapse of the right femoral head requiring replacement. The removed femoral head is sent for pathology and is found to contain enlarged fat cells. The pathologist explains that this is the likely cause of the patient's femoral head collapse. A likely aetiology is

a) septic emboli
b) impaired venous drainage
c) Hgb SS disease
d) steroid use
e) alcoholism
f) Gaucher's disease
g) missed fracture
h) Cushing's disease
i) radiation
j) vasculitis


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