I n t e r n a L medicine questions Bank

Which one of the following conditions is an absolute indication for thrombolytic therapy in patients with PE ?

1. 
   Contraindication for anticoagulation .
   
2. 
   Large filling defect(s) on spiral CT scan . c- Hypotention caused by PE .
   

4. 
   Bilateral PE .
   
5. 
   presence of ECG changes suggestive of PE .
   

11. 
    All of the followings are known complications of non invasive ventilation NIV except.
    

1. 
   Gastric insufflations .
   
2. 
   Conjunctival Irritation .. c- Hypotension.
   

d- Pulmonary edema . e- Pneumothorax.

11. 
    A 60 year old man , long standing smoker , has progressive dyspnea and prductive cough for the last 2 years .1 week ago had flue like symptoms followed by increase in his symptoms .His best Spirometry taken 2 months ago showed FEV1 1.1 Liter ,FVC 2.2 without changed after inhaled B2 agonist . The ABG taken 10 minuets ago while breathing room air was PH 7.29 , Pa Co2 56 HCO3 32 Po2 35 .
    

One of the followings is true regarding this patient except :
a- O2 therapy by non rebreathing mask should be started immediately. b- Hypoventilation is the main mechanism of hypoxia in this patient . c- CPAP is superior to BiPAP in this patient .
d- After discharge exercise training may improved his survival. e- After discharge tiotropium is appropriate therapy .

11. 
    A24 year old female patient has 4 days history of fever .chills and left sided chest pain which increased by inspiration .Chest x ray showed consolidation in the left lower zone with signs of pleural effusion on the same side .All of the followings are indications for insertion of chest tube and intrapleural thrombolytic therapy except ;
    

a- multiloculated fluid by CT scan . b- LDH of 1500 mg/l
c- Gram stain of the pleural fluid is positive for Gram positive cocci . d- Fever remained >39 in spite of IV antibiotics .
e- Pleural fluid culture +ve for strep.pneumnia .

11.