MN566 FINAL EXAM WITH 100% VERIFIED SALUTIONS 2024-2025
Question 1:
A 65-year-old male patient presents with a history of hypertension and type 2 diabetes.
He complains of progressive shortness of breath and swelling in his legs. What is the
most likely diagnosis?
Answer: The most likely diagnosis is congestive heart failure (CHF). This condition is
characterized by symptoms such as shortness of breath (dyspnea) and peripheral edema, often
seen in patients with a history of hypertension and diabetes.
Question 2:
What is the mechanism of action of ACE inhibitors in the management of hypertension?
Answer: ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, a
potent vasoconstrictor. This leads to vasodilation, reduced blood pressure, and decreased
workload on the heart. They also reduce aldosterone secretion, which decreases sodium and
water retention.
Question 3:
Describe the role of beta-blockers in the treatment of heart failure.
Answer: Beta-blockers reduce the heart rate and decrease the force of contraction, which
lowers the myocardial oxygen demand. They also help to mitigate the adverse effects of chronic
sympathetic nervous system activation, which is common in heart failure. Long-term use of
beta-blockers can improve survival rates and reduce hospitalizations in heart failure patients.
Question 4:
A 45-year-old female presents with a BMI of 32 kg/m² and fasting glucose of 150 mg/dL.
What is the most appropriate initial management for this patient?
Answer: The patient likely has type 2 diabetes and obesity. The initial management should
include lifestyle modifications such as diet and exercise to promote weight loss and improve
glycemic control. Pharmacologic treatment with metformin is often recommended as the first-
line medication for type 2 diabetes.
Question 5:
What are the clinical features of diabetic ketoacidosis (DKA)?
Answer: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketosis, and metabolic
acidosis. Clinical features include polyuria, polydipsia, nausea, vomiting, abdominal pain, fruity-
scented breath, Kussmaul respirations (deep and labored breathing), and altered mental status.
Question 6:
,Explain the significance of the HgbA1c test in the management of diabetes.
Answer: The HgbA1c test measures the average blood glucose levels over the past 2-3 months
by assessing the percentage of glycated hemoglobin in the blood. It is a key indicator of long-
term glycemic control in diabetic patients. A target HgbA1c level of less than 7% is generally
recommended to reduce the risk of complications.
Question 7:
List the primary symptoms of hyperthyroidism.
Answer: Primary symptoms of hyperthyroidism include weight loss, heat intolerance, increased
appetite, palpitations, nervousness, tremors, sweating, and hyperactivity. Patients may also
experience goiter and ophthalmopathy, particularly in Graves' disease.
Question 8:
What are the recommended lifestyle modifications for managing hypertension?
Answer: Recommended lifestyle modifications for managing hypertension include reducing salt
intake, increasing physical activity, maintaining a healthy weight, eating a balanced diet rich in
fruits and vegetables (such as the DASH diet), limiting alcohol consumption, and quitting
smoking.
Question 9:
Describe the pathophysiology of asthma.
Answer: Asthma is characterized by chronic inflammation of the airways, leading to bronchial
hyperresponsiveness and airflow obstruction. Triggered by allergens, infections, or irritants, this
results in episodic symptoms such as wheezing, coughing, chest tightness, and shortness of
breath. The inflammation causes mucosal edema, increased mucus production, and smooth
muscle contraction.
Question 10:
What are the main complications of uncontrolled diabetes?
Answer: Main complications of uncontrolled diabetes include cardiovascular diseases (such as
coronary artery disease and stroke), nephropathy (leading to chronic kidney disease),
neuropathy (causing peripheral and autonomic nerve damage), retinopathy (resulting in vision
impairment and blindness), and increased risk of infections and poor wound healing.
Question 11:
What are the common side effects of statins?
, Answer: Common side effects of statins include muscle pain (myalgia), liver enzyme elevation,
digestive problems, headache, and, rarely, rhabdomyolysis.
Question 12:
Define the term 'polypharmacy' and explain its significance in elderly patients.
Answer: Polypharmacy refers to the use of multiple medications by a patient, typically seen in
elderly individuals. It increases the risk of drug interactions, adverse effects, and complications
related to medication adherence.
Question 13:
What is the difference between Type 1 and Type 2 diabetes?
Answer: Type 1 diabetes is an autoimmune disorder where the body's immune system attacks
insulin-producing beta cells in the pancreas. Type 2 diabetes is characterized by insulin
resistance and relative insulin deficiency, often associated with obesity and lifestyle factors.
Question 14:
Describe the Glasgow Coma Scale (GCS) and its components.
Answer: The Glasgow Coma Scale (GCS) assesses a patient's level of consciousness based
on three components: eye opening (E), verbal response (V), and motor response (M). Scores
range from 3 to 15, with higher scores indicating better neurological function.
Question 15:
What are the indications for the use of warfarin?
Answer: Warfarin is indicated for the prevention and treatment of thromboembolic disorders,
including atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism (PE), and for
patients with mechanical heart valves.
Question 16:
Explain the pathophysiology of chronic obstructive pulmonary disease (COPD).
Answer: COPD is characterized by chronic inflammation of the airways, lung parenchyma, and
pulmonary vasculature, leading to airflow limitation. It includes chronic bronchitis and
emphysema, causing symptoms like chronic cough, sputum production, and dyspnea.
Question 17:
What are the clinical features of Cushing's syndrome?
Answer: Clinical features of Cushing's syndrome include weight gain, particularly in the trunk
(central obesity), a round face (moon face), fat deposits on the back of the neck (buffalo hump),
purple striae, hypertension, glucose intolerance, and muscle weakness.