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10542 Medicine

A 15-year-old boy presented with one day history of bleeding gum, subconjunctival bleed and purpuric rash. Investigations revealed following results: in-6. 4 gm/dL; TLC-26, 500/mm3 platelet 35,000 mm3; prothrombin time-20 sec with a control of 13 sec; partial thromboplastin time-50sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely?

AMyeloblastic leukemia without maturation
BMyeloblastic leukemia with maturation
CPromyelocytic leukemia
DMyelomonocytic leukemia
Medicine
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10544 Medicine

A female presents with anorexia, weight loss, hyperpigmentation, bowel changes, and light headedness on standing. The cosyntropin stimulation test shows random serum coisol of 11 mcg/dL (normal is greater than or equal to 20 mcg/dL). Serum coisol 1 hour after 0.25 mg cosyntropin N is 14 mcg/dL. (The rise in coisol is expected to be > 7 mcg/dL). Aldosterone level is 10 ng/dL. Which of the following is an appropriate treatment for this patient?

AHydrocoisone 15 mg daily for life
BPrednisone 5 mg daily for life
CHydrocoisone 15 mg and fludrocoisone 0.1 mg daily for life
DPrednisone 60 mg daily tapering to 10 mg a day and fludrocoisone 0.1 daily mg for life
Medicine
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10547 Medicine

A 56-year-old man presents with hypertension and peripheral edema. He is otherwise healthy and takes no medications. Family history reveals that his father and a brother have kidney disease. His father was on hemodialysis before his death at age 68 of a stroke. Physical examination reveals BP 174/96 and AV nicking on funduscopic examination. He has a soft S4 gallop. Bilateral flank asses measuring 16 cm in length are palpable. Urinalysis shows 15 to 20 RBC/hpf and trace protein but is otherwise normal; his serum creatinine is 2.4 mg/dL.Which is the most likely long-term complication of his condition?

AEnd-stage renal disease (ESRD) requiring dialysis or transplantation
BMalignancy
CRuptured cerebral aneurysm
DBiliary obstruction owing to cystic disease of the pancreas
Medicine
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