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16553 Medicine

An 8 month female baby presented with 1 day h/o lethargy. She had vomited several times. Her drug addict mother said she appeared “intoxicated”.O/E: baby was obtunded but she was easily arousable and muscle tone was normal. RR = 60/min. Pupils are normal. BP was 112/62.Ix: Na+= 135 K+ = 4.2 ,Glucose 5.9 mmol/l , Cl- = 116 ,Urinalysis: pH = 5.0; negative for glucose & ketones, positive for calcium oxalate crystals. ABG: pH = 7.19, pCO2 = 20, PO2 = 100 , HCO3 = 6.2 ?

AMetabolic acidosis compensated
BMetabolic acidosis paially compensated
CMetabolic alkalosis compensated
DMetabolic alkalosis paially compensated
Medicine
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16554 Medicine

A 57-year-old woman experiences frequent symptoms of heartburn. She reports no weight loss, diarrhea, or dysphagia symptoms. Past medical history is significant for vitamin B12 deficiency treated with monthly injections. She appears well, and the examination is normal, except for some patches on her arms where she has lost all the skin pigmentation. Her upper endoscopy is normal, except for gastric biopsies commenting on gastritis.For the above patient with gastritis, select the most likely mechanism of injury.

Abile acid reflux implicated in pathogenesis
Bimmune or autoimmune pathogenesis suspected
Cischemia of the gastric mucosa implicated in the pathogenesis
Dassociated with Helicobacter pylori infection
Medicine
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16559 Medicine

A 33 year old lady present! with polydipsia and polyuria. Har symptoms staed soon after a road traffic accident 6 months ago. The blood pressure is 120/80 mm Hg with no postural drop. The daily urinary output Is 6-8 liters. Investigation showed, Na 130 mEq/L, KJ.5 mEq/L, urea 15mg/dL, sugar-65 mg/dL. The plasma osmolality is 268 mosmol/L and urine osmolatity 45 mosmol/L. The most likely diagnosis is-

ACentral diabetes insipidus
BNephrogenic diabetes insipidus
CResolving acute tubular necrosis
DPsychogenic polydipsia
Medicine
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