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16471 Medicine

A 29-year-old man presents to the clinic because he is concerned about blue fingers. He reports no other symptoms and is otherwise healthy. On physical examination, his vital signs are normal except for an oxygen saturation of 87% on room air. His lung and cardiac exams are normal but there is bluish discoloration of his fingers consistent with cyanosis. A blood gas reveals hypoxemia and hypercapnia, while the CBC suggests polycythemia. With voluntary hyperventilation he is able to restore his blood gases to normal. Which of the following is the most likely location for the abnormalities seen on his blood gases?

Acerebral cortex
Bkidney
Cheart
Drespiratory center
Medicine
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16477 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 reported that his stool was black/dark in colour. Further careful history revealed that he is a known case of hypertension and coronary artery 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
Medicine
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16479 Medicine

A 32-year-old woman presents to the emergency department after acutely developing a high fever, lightheadedness on standing, and a rash. At the hospital she develops vomiting, diarrhea, confusion, and abdominal pain. She goes on to develop evidence of multiorgan failure and is transferred to the intensive care unit. One week after the acute illness she develops desquamation of the skin. On further history, the illness started 3 days after the onset of menstruation. Which of the following is the most likely diagnosis?

AS aureus toxic shock syndrome (TSS)
Bstreptococcal infection (scarlet fever)
Cclostridial infection
DRocky mountain spotted fever (RMSF)
Medicine
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