I n t e r n a L medicine questions Bank

Wrong about DKA:

1. 
   Normal anion gap
   

55. 
    Causing organism in rheumatic fever :
    
    1. 
       Group A beta-hemolytic streptococci.
       
       
       

56. 
    All are causes of bloody diarrhoea in a traveler:
    
    1. 
       Shistosoma mansoni
       

57. 
    6 hours after hamburger, abdominal pain:
    
    1. 
       Staph. Aurerus
       
    2. 
       ?
       

58. 
    Not a finding in angina:
    
    1. 
       Normal
       

59. 
    Not a finding in sarcoidosis:
    
    1. 
       Cranial nerve palsy
       
    2. 
       Uveitis
       
    3. 
       Wrong answer
       

60. 
    About renovascular hypertension:
    
    1. 
       Managemetn is drugs if bilateral
       

TREATMENT — Once the diagnosis of hemodynamically significant stenosis is established, with both vessels showing more than a 75 percent stenosis, there are three therapeutic alternatives: Medical therapy with antihypertensive drugs Percutaneous angioplasty, usually with stent placement Surgery We generally agree with the 2005 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on peripheral artery disease, which were produced in collaboration with major vascular medicine, vascular surgery, and interventional radiology societies [4]. Medical therapy for control of hypertension is indicated in all patients with bilateral renal artery stenosis (or unilateral stenosis in a single viable kidney) [4,6]. Revascularization, usually by percutaneous angioplasty with stenting, may be considered in patients with persistent hypertension who have one or more of the clinical features that suggest that the stenosis plays an important role in the elevation in blood pressure (table 1). Surgery is primarily warranted for correction of complex lesions. The following discussion will review the antihypertensive response to therapy in patients with bilateral renal artery stenosis. The use of angioplasty or surgery to preserve renal function in such patients is discussed separately. (See "Chronic kidney disease associated with atherosclerotic renovascular disease".)

61.