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64589 Medicine

A 44-year-old woman has been complaining of a 4-year history of increasing dyspnea and fatigue. Physical examination reveals increased JVP and a reduced carotid pulse. Precordial examination reveals a left parasternal lift, loud P2, and right-sided S3 and S4. There are no audible murmurs. CXR reveals clear lung fields and an ECG shows evidence of right ventricular hypertrophy. Pulmonary function tests show a slight restrictive pattern. A diagnosis of primary pulmonary hypertension (PPH) is made. Which of the following is the most likely cause of death in this condition?

Aintractable left ventricular failure
Bintractable respiratory failure
Cmassive PE
Dintractable right ventricular failure or sudden death
Medicine
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64591 Surgery

A 53 year old male who is a heavy alcoholic presents with 12 hour history of sharp central abdominal pain and vomiting. He prefers to sit up rather than lying fiat as pain increases on lying down. O/E he has mild jaundice. Temp – 38. 3deg C. Pulse 132/min BP 118/82 mm Hg. There is periumbilical discoloration and maximum tenderness in epigastrium. Diagnosis

AAcute pancreatitis
BPyelonephritis
CAcute viral hepatitis
DPerforated duodenal ulcer
Surgery
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