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12828 Medicine

A 60 year old male had a sudden fall in toilet. His BP was 90/50 mm Hg and pulse was 100/mm. His relatives repoed that his stool was black/dark in colour. Fuher careful history revealed that he is a known case of hypeension and coronary aery disease and was regularly taking aspirin, atenolol and sorbitrate. The most likely diagnosis is:

AGastric ulcer with bleeding
BAcute myocardial infarction with cardiogenic shock
CAcute cerebrovascular accident
DPulmonary embolism
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12833 Medicine

A 27-year-old woman presents with weight loss, fatigue, and weakness. She also experiences nausea and vomiting but no dysphagia. Her physical examination is normal except for increased generalized skin pigmentation. Her serum sodium is low and potassium is high. Which of the following features is also most likely to be present? (See Figure below.)

Athe skin is shiny and pale
Ba diabetic glucose tolerance is characteristic
Cwater diuresis is impaired
Dthe urinary steroids are high
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12834 Medicine

A 60-year-old female is undergoing P.C.I after a coronary narrowing was found on a previous diagnostic angiography. She is known to have coronary vessels which are prone to spasm, therefore, the cardiologist administers 2 puffs of sublingual GTN prior to the procedure and a fuher 400 mg of GTN during the procedure. During the procedure, the patient’s systolic blood pressure suddenly drops to 70mmHg. At this point, the patient is pale, clammy and complaining of light-headedness. The patient’s pulse rate is noted to be 70bpm and regular. What is the most appropriate management plan at this stage?

AAdminister a 150J defibrillator shock
BAdminister atropine
CAdminister metaraminol
DAdminister adrenaline
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