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Answer the following medical question: | Can low dose naltrexone be used to treat severe depression? | The purpose of this pilot study is to determine if taking a low dose of naltrexone in addition to an antidepressant medication can help treat relapse or recurrence in people with Major Depressive Disorder (MDD). The U.S. Food and Drug Administration (FDA) has approved naltrexone for the treatment of alcohol dependence and opioid dependence, but the FDA has not approved naltrexone to treat depression. The investigators hypothesize that patients with breakthrough depression on an antidepressant regimen containing a pro-dopaminergic agent assigned to treatment with low dose naltrexone will demonstrate higher rates of response compared to those patients taking placebo. |
Answer the following medical question: | Can low dose naltrexone be used to treat severe depression? | LDN augmentation showed some benefit for MDD relapse on dopaminergic agents. Confirmation in larger studies is needed. |
Answer the following medical question: | What is hepatitis and how is it transmitted? | Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways. Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV. Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV. Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV. Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection. Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available. |
Answer the following medical question: | What is hepatitis and how is it transmitted? | HEPATITIS A is caused by the Hepatitis A virus (HAV) Routes of Transmission Ingestion of fecal matter, even in microscopic amounts, from: * Close person-to-person contact with an infected person * Sexual contact with an infected person * Ingestion of contaminated food or drinks HEPATITIS B is caused by the Hepatitis B virus (HBV) Routes of Transmission Contact with infectious blood, semen, and other body fluids primarily through: * Birth to an infected mother * Sexual contact with an infected person * Sharing of contaminated needles, syringes, or other injection drug equipment * Needlesticks or other sharp instrument injuries HEPATITIS C is caused by the Hepatitis C virus (HCV) Routes of Transmission Contact with blood of an infected person primarily through: * Sharing of contaminated needles, syringes, or other injection drug equipment Less commonly through: * Sexual contact with an infected person * Birth to an infected mother * Needlestick or other sharp instrument injuries |
Answer the following medical question: | Are small lumps around the scrotum a symptom of Jock Itch? | Jock itch usually stays around the creases of the upper thigh and does not involve the scrotum or penis. Jock itch may spread to the anus, causing anal itching and discomfort. Symptoms include: Red, raised, scaly patches that may blister and ooze; patches often have sharply-defined edges with scale at the edges. Patches are often redder around the outside with normal skin tone in the center. Abnormally dark or light skin. Sometimes, these changes are permanent. |
Answer the following medical question: | Are small lumps around the scrotum a symptom of Jock Itch? | Itchy Crotch Cause: Fungal Infections How you know you have it: You'll likely develop a rash along with the itching, though its appearance varies depending on the type of fungus causing it. For instance, if a yeast infection is responsible, you may notice moist, shiny areas of skin on your penis, and possibly some white stuff in the skin folds, along with the red, itchy rash, according to the Mayo Clinic. Yeast is normally present in small amounts on your skin, but an overgrowth of it can cause an infection. This tends to occur in moist places that don't get much light, says Jason Reichenberg, M.D., director of dermatology at the University of Texas Austin. So it usually shows up on the sides of your groin, between your genitals and thighs. Other fungal infections look a little different: They appear dry and flaky, and usually crop up on your thighs, Dr. Reichenberg says. How to treat it: Whatever the type of fungus responsible for your itching, an antifungal cream like Lotrimin AF should do the trick. The cream attacks the fungal cells that cause the infection, while leaving your healthy skin cells unscathed. Pat the region dry before rubbing on the cream. That will help get rid moisture, keeping the fungus from growing and allowing the cream to work better, Dr. Reichenberg says. Itchy Crotch Cause: Chafing How you know you have it: Chafing occurs when your skin rubs together-commonly your thighs. It usually develops when you're doing an activity that involves a lot of friction, like running. The rubbing can disturb your skin barrier, causing tiny cracks and inflammation on your outer layers of skin. This causes a red, irritated rash that burns and itches. Your skin can also grow scaly, too, Dr. Zeichner says. How to treat it: Your goal is to protect your irritated skin and prevent any additional rubbing. A moisturizer like Aveeno Skin Relief Moisturizing Cream will help repair the skin. It also contains colloidal oatmeal, which works to soothe irritation, Dr. Zeichner says. Pair that with a zinc cream, like Destin, which protects your skin from future rubbing by adding a protective barrier. And then use a cream that contains petroleum, like CeraVe Healing Ointment, which helps hydrate and restore your skin. Itchy Crotch Cause: Intertrigo How you know you have it: You'll develop a raw, red rash that itches and stings, usually in areas that contain lots of moisture from sweating, Dr. Zeichner says-so, like your groin, between the folds of your stomach, under your arms, or between your toes, according to the Mayo Clinic. That moisture can spur an overgrowth of bacteria and fungus. How to treat it: Antibacterial creams like Neosporin and antifungal creams, like Lotrimin, can take care of the bacteria and fungus. And a zinc cream, like Destin, shields your skin from more rubbing. If the rash persists for one to two weeks, head to your dermatologist. He or she will likely prescribe stronger versions of these medications to smooth over the irritation, Dr. Zeichner says. Itchy Crotch Cause: Contact Dermatitis How you know you have it: Contact dermatitis occurs when your skin comes in contact with something it's allergic to. You'll likely develop a super itchy, red rash that looks bumpy. It might even ooze a clear or yellowish fluid, which shows that the top layer of your skin has been disrupted, says Dr. Reichenberg. Contact dermatitis is likely the cause if you notice that itchy rash and you've recently changed something in your routine-say, you tried a new laundry detergent or fabric softener, or even bought a new couch made of a different material-right before you noticed it, says Dr. Reichenberg. You'll usually start to notice a reaction hours or even a few days later. You'll also probably experience itching on other body parts that were exposed to the allergen, too, he says. Your itchy balls will likely bother you more, though, since their thin skin is more sensitive to allergens. How to treat it: Stop using the chemical or material you think may be responsible. If it's clothing washed in a new detergent, rewash it a few times with your previous brand, says Dr. Reichenberg. If contact dermatitis was responsible, the reaction should disappear in about two weeks. Itchy Crotch Cause: Pubic lice How you know you have it: If you start to notice intense itching, irritation, and tiny specks in your pubic hair, you might have contracted a type of parasite called pubic lice, also known as crabs. You may see tiny white or yellowish specks near the roots of your pubic hair. Those are the lice eggs, says Dennis Fortenberry, M.D., a professor of adolescent medicine at Indiana University. You might also spot the lice themselves crawling-they're tan or grayish-white, and if you're brave enough to look at one through a magnifying glass, it'd resemble a mini crab, reports the Centers for Disease Control and Prevention. How to treat it: Head to your doctor-he or she will confirm that your problem actually is lice, and send you home with a shampoo or lotion containing either permethrin or pyrethrins with piperonyl butoxide, which will kill the lice Dr. Fortenberry says. Itchy Crotch Cause: Herpes How you know you have it: For some guys, itching can be the first symptom of this sexually transmitted infection (STI), which is caused by the herpes virus, Dr. Fortenberry says. That itch will usually turn to burning, and within about a day, a blister or cluster of blisters can form. Then, the blisters can break, leading to painful sores. If you've experienced those symptoms in the past and they keep cropping back up, that might point to herpes, since the infection usually causes recurrent outbreaks. How to treat it: This is another case where you'll head to your doctor. He or she will diagnose you, either by simply looking at the appearance of your blisters or by performing a blood test or culture of the lesion, reports the CDC. There's no cure for herpes, but your doctor can provide some treatment. Antiviral meds, like Valtrex, Zovirax, or Famvir, can shorten the outbreak or prevent one from occurring. They also may reduce the chances of passing on the virus to your partner. Itchy Crotch Cause: Genital Warts How you know you have it: Genital warts are a common symptom of the STI human papillomavirus (HPV). They are typically soft to the touch and skin colored, and some may even resemble a cauliflower. You might notice just one, or they could crop up in a cluster, Dr. Fortenberry says. But other than some itching, the warts don't feel like anything. How to treat it: If you think you have genital warts, check in with your doctor, Dr. Fortenberry says. He or she will likely prescribe a medication that contains Imiquimod, Podofilox, or Sinecatechins, which will stimulate your body's immune system to clear up the warts. Or, she may apply liquid nitrogen to the growth, which will freeze it off. However, even though you can get rid of the wart, you can't eliminate the virus from your system-meaning more warts could crop up down the road, and you can still spread it to others if you don't have a visible wart. This article originally appeared on MensHealth.com. |
Answer the following medical question: | What causes rib cage pain? How is it remedied? | Ribcage pain may be caused by any of the following: Bruised, cracked, or fractured rib Inflammation of cartilage near the breastbone (costochondritis) Osteoporosis Pleurisy (the pain is worse when breathing deeply) Rest and not moving the area (immobilization) are the best cures for a ribcage fracture. Follow your health care provider's instructions for treating the cause of ribcage pain. |
Answer the following medical question: | What is hantavirus and is it fatal? | Hantavirus is a serious infection that gets worse quickly. Lung failure can occur and may lead to death. Even with aggressive treatment, more than one half of people who have this disease in their lungs die. |
Answer the following medical question: | Is there always an elevated temperature associated with appendicitis? | A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis. The main symptom is pain in the abdomen, often on the right side. It is usually sudden and gets worse over time. Other symptoms may include Swelling in the abdomen Loss of appetite Nausea and vomiting Constipation or diarrhea Inability to pass gas Low fever Not everyone with appendicitis has all these symptoms. |
Answer the following medical question: | How frequently should a dose of 5 mg of oxybutinin be taken? | Adults The usual dose is one 5-mg tablet two to three times a day. The maximum recommended dose is one 5-mg tablet four times a day. A lower starting dose of 2.5 mg two or three times a day is recommended for the frail elderly. |
Answer the following medical question: | What its the efficacy of administering Gabamentine and hydrocodone together and are there any interactions? | 1. Coadministration of NEURONTIN with hydrocodone decreases hydrocodone exposure [see CLINICAL PHARMACOLOGY (12.3)]. The potential for alteration in hydrocodone exposure and effect should be considered when NEURONTIN is started or discontinued in a patient taking hydrocodone. 2. Coadministration of NEURONTIN (125 to 500 mg; N=48) decreases hydrocodone (10 mg; N=50) C max and AUC values in a dose-dependent manner relative to administration of hydrocodone alone; C max and AUC values are 3% to 4% lower, respectively, after administration of 125 mg NEURONTIN and 21% to 22% lower, respectively, after administration of 500 mg NEURONTIN. The mechanism for this interaction is unknown. Hydrocodone increases gabapentin AUC values by 14%. The magnitude of interaction at other doses is not known. |
Answer the following medical question: | The question concerns drug interactions such as the safety of taking Diclofenac with Isinopril or other NSAIDs. | Avoid Concomitant Use of NSAIDs Inform patients that the concomitant use of diclofenac sodium extended-release tablets with other NSAIDs or salicylates (e.g., diflunisal, salsalate) is not recommended due to the increased risk of gastrointestinal toxicity, and little or no increase in efficacy (see WARNINGS: GASTROINTESTINAL BLEEDING, ULCERATION, PERFORATION and DRUG INTERACTIONS). Alert patients that NSAIDs may be present in "over the counter" medications for treatment of colds, fever, or insomnia. |
Answer the following medical question: | The question concerns drug interactions such as the safety of taking Diclofenac with Isinopril or other NSAIDs. | Some foods and medicines may affect how lisinopril works. Tell your doctor if you are using any of the following: Aliskiren, everolimus, lithium, sirolimus, temsirolimus Another blood pressure medicine, including an angiotensin receptor blocker (ARB) Diuretic (water pill, including amiloride, spironolactone, triamterene) Insulin or diabetes medicine NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen) |
Answer the following medical question: | Is trisomy 13 (Patau syndrome) progressive and how is it diagnosed? | Trisomy 13, also called Patau syndrome, is a chromosomal condition associated with severe intellectual disability and physical abnormalities in many parts of the body. Individuals with trisomy 13 often have heart defects, brain or spinal cord abnormalities, very small or poorly developed eyes (microphthalmia), extra fingers or toes, an opening in the lip (a cleft lip) with or without an opening in the roof of the mouth (a cleft palate), and weak muscle tone (hypotonia). Due to the presence of several life-threatening medical problems, many infants with trisomy 13 die within their first days or weeks of life. Only five percent to 10 percent of children with this condition live past their first year. |
Answer the following medical question: | Is trisomy 13 (Patau syndrome) progressive and how is it diagnosed? | Clinical tests (28 available) Cytogenetics Tests FISH-metaphase (3) Fluorescence in situ hybridization (FISH) (2) FISH-interphase (8) Karyotyping (9) Molecular Genetics Tests Detection of homozygosity (2) Sequence analysis of the entire coding region (2) Targeted variant analysis (5) Detection of homozygosity (2) Deletion/duplication analysis (3) Uniparental disomy study (UPD) (1) |
Answer the following medical question: | To what extent is quinine in seltzer water effective in treating leg cramps? | Muscle cramps can occur anywhere and in anyone; however, leg cramps are especially common in older people. Quinine is a medicine which has been used to treat cramps for many years. There is conflicting evidence for its ability to reduce cramps. Quinine can cause serious, even fatal adverse events, especially in overdosage. There is low quality evidence that quinine (200 mg to 500 mg daily) significantly reduces cramp number and cramp days and moderate quality evidence that quinine reduces cramp intensity. There is moderate quality evidence that there are more minor adverse events with quinine compared to placebo but no increase in major adverse events. However, there are reliable reports from other sources that an overdose of quinine can cause serious harm including death. More research is needed to clarify the best dose and duration of treatment, as well as alternatives to quinine for cramps. The evidence is current to October 2014. |
Answer the following medical question: | What is the recommended treatment and prevention protocol for mite infestation in humans? | When a person is infested with scabies mites the first time, symptoms may not appear for up to two months after being infested. However, an infested person can transmit scabies, even if they do not have symptoms. Scabies usually is passed by direct, prolonged skin-to-skin contact with an infested person. However, a person with crusted (Norwegian) scabies can spread the infestation by brief skin-to-skin contact or by exposure to bedding, clothing, or even furniture that he/she has used. Scabies is prevented by avoiding direct skin-to-skin contact with an infested person or with items such as clothing or bedding used by an infested person. Scabies treatment usually is recommended for members of the same household, particularly for those who have had prolonged skin-to-skin contact. All household members and other potentially exposed persons should be treated at the same time as the infested person to prevent possible reexposure and reinfestation. Bedding and clothing worn or used next to the skin anytime during the 3 days before treatment should be machine washed and dried using the hot water and hot dryer cycles or be dry-cleaned. Items that cannot be dry-cleaned or laundered can be disinfested by storing in a closed plastic bag for several days to a week. Scabies mites generally do not survive more than 2 to 3 days away from human skin. Children and adults usually can return to child care, school, or work the day after treatment. Persons with crusted scabies and their close contacts, including household members, should be treated rapidly and aggressively to avoid outbreaks. Institutional outbreaks can be difficult to control and require a rapid, aggressive, and sustained response. Rooms used by a patient with crusted scabies should be thoroughly cleaned and vacuumed after use. |
Answer the following medical question: | What is the recommended treatment and prevention protocol for mite infestation in humans? | Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. Scabicides used to treat human scabies are available only with a doctor's prescription. No "over-the-counter" (non-prescription) products have been tested and approved to treat scabies. Scabicide lotion or cream should be applied to all areas of the body from the neck down to the feet and toes. In addition, when treating infants and young children, scabicide lotion or cream also should be applied to their entire head and neck because scabies can affect their face, scalp, and neck, as well as the rest of their body. Only permethrin or sulfur ointment may be used in infants. The lotion or cream should be applied to a clean body and left on for the recommended time before washing it off. Clean clothing should be worn after treatment. Both sexual and close personal contacts who have had direct prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated. All persons should be treated at the same time to prevent reinfestation. |
Answer the following medical question: | What is the recommended treatment and prevention protocol for mite infestation in humans? | Scabies treatment involves eliminating the infestation with medications. Several creams and lotions are available with a doctor's prescription. You usually apply the medication over all your body, from your neck down, and leave the medication on for at least eight hours. A second treatment is needed if new burrows and rash appear. Because scabies spreads so easily, your doctor will likely recommend treatment for all household members and other close contacts, even if they show no signs of scabies infestation. Medications commonly prescribed for scabies include: Permethrin cream, 5 percent (Elimite). Permethrin is a topical cream that contains chemicals that kill scabies mites and their eggs. It is generally considered safe for adults, pregnant women, and children ages 2 months and older. This medicine is not recommended for nursing mothers. Lindane lotion. This medication - also a chemical treatment - is recommended only for people who can't tolerate other approved treatments, or for whom other treatments didn't work. This medication isn't safe for children younger than age 2 years, women who are pregnant or nursing, the elderly, or anyone who weighs less than 110 pounds (50 kilograms). Crotamiton (Eurax). This medication is available as a cream or a lotion. It's applied once a day for two days. This medication isn't recommended for children or for women who are pregnant or nursing. Frequent treatment failure has been reported with crotamiton. Ivermectin (Stromectol). Doctors may prescribe this oral medication for people with altered immune systems, for people who have crusted scabies, or for people who don't respond to the prescription lotions and creams. Ivermectin isn't recommended for women who are pregnant or nursing, or for children who weigh less than 33 pounds (15 kg). Although these medications kill the mites promptly, you may find that the itching doesn't stop entirely for several weeks. Doctors may prescribe other topical medications, such as sulfur compounded in petrolatum, for people who don't respond to or can't use these medications. |
Answer the following medical question: | Is it safe to take medications with wine at dinnertime? | Mixing alcohol and medicines can be harmful. Alcohol, like some medicines, can make you sleepy, drowsy,or lightheaded. Drinking alcohol while taking medicines can intensify these effects. You may have trouble concentrating or performing mechanical skills. Small amounts of alcohol can make it dangerous to drive, and when you mix alcohol with certain medicines you put yourself at even greater risk. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people. |
Answer the following medical question: | oxytetracycline hydrochloride and neomycin sulfate powder (NEO-OXY 100/100)is used for the treatment of what conditions and in what subjects? | Calves (milk replacer): For Calves (up to 250 lb): For treatment of bacterial enteritis caused by Escheria coli susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by Escheria coli susceptible by neomycin. Feed continuously for 7-14 days in milk replacer or starter feed. Treatment should continue 24 to 48 hours beyond remission of disease symptoms. Calves, Beef Cattle, and Nonlactating Dairy Cattle: For treatment of bacterial enteritis caused by Escheria coli and bacterial pneumonia (shipping fever complex) caused by Pasteurella multocide susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by Escheria coli susceptible by neomycin. Feed continuously for 7-14 days in feed or milk replacersTreatment should continue 24 to 48 hours beyond remission of disease symptoms. Mix Neo-Oxy 100/100 MR with non-medicated milk replacer to provide the following concentrations:Use Level of Oxytetracycline and Neomycin: 10 mg/lb body weight/day |
Answer the following medical question: | oxytetracycline hydrochloride and neomycin sulfate powder (NEO-OXY 100/100)is used for the treatment of what conditions and in what subjects? | MIXING AND USE DIRECTIONS Mix Neo-Oxy 100/100 MR with nonmedicated milk replacer to provide the following concentrations: CALVES (milk replacer) - For calves (up to 250 lb) for increased rate of weight gain and improved feed efficiency. Oxytetracycline and Neomycin Amount: 0.05-0.1 mg/lb of body weight daily. Feed continuously; in milk replacers or starter feed. Lb of Neo-Oxy 100/100 MR per ton of Type C Medicated Feed (1): 0.1-0.2 (2) RESIDUE WARNING: Zero day withdrawal. Use of more than one product containing neomycin or failure to follow withdrawal times may result in illegal drug residues. For calves (up to 250 lb) for treatment of bacterial enteritis caused by E. coli susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by E. coli susceptible to neomycin. Oxytetracycline and Neomycin Amount: 10 mg/lb of body weight daily. Feed continuously for 7-14 days in milk replaces or starter feed. If symptoms persist after using 2 or 3 days, consult a veterinarian. Treatment should continue 24 to 48 hours beyond remission of disease symptoms. Lb of Neo-Oxy 100/100 MR per ton of Type C Medicated Feed (1): 20 (2) RESIDUE WARNING: A withdrawal period has not been established for use in preruminating calves. Do not use in calves to be processed for veal. A milk discard time has not been established for use in lactating dairy cattle. Do not use in female dairy cattle 20 months or older. Withdraw 5 days before slaughter. Use of more than one product containing neomycin or failure to follow withdrawal times may result in illegal drug residues. CALVES, BEEF CATTLE, AND NONLACTATING DAIRY CATTLE For treatment of bacterial enteritis caused by E. coli and bacterial pneumonia (shipping fever complex) caused by Pasteurella multocide susceptible to oxytetracycline; treatment and control of colibacillosis (bacterial enteritis) caused by E. coli susceptible to neomycin. Oxytetracycline and Neomycin Amount: 10 mg/lb of body weight daily. Feed continuously for 7-14days in feed or milk replaces. If symptoms persist after using 2 or 3 days, consult a veterinarian. Treatment should continue 24 to 48 hours beyond remission of disease symptoms. Lb of Neo-Oxy 100/100 MR per ton of Type C Medicated Feed (1): 20 (2) RESIDUE WARNING: A withdrawal period has not been established for use in preruminating calves. Do not use in calves to be processed for veal. A milk discard time has not been established for use in lactating dairy cattle. Do not use in female dairy cattle 20 months or older. Withdraw 5 days before slaughter. Use of more than one product containing neomycin or failure to follow withdrawal times may result in illegal drug residues. (1) Mixing directions are for example only and are based on mixing 1 lb of dry milk with 1 gallon of water. (2) If calf weighs 100 lb, consuming 1 gallon of milk replaced per day. FOR USE IN DRY FEEDS ONLY. NOT FOR USE IN LIQUID FEED SUPPLEMENTS. |
Answer the following medical question: | What causes Hypoglycemia in newborns and is there a way for a pregnant woman to avoid giving birth to a child with Hypoglycemia? | Babies need blood sugar (glucose) for energy. Most of that glucose is used by the brain. The baby gets glucose from the mother through the placenta before birth. After birth, the baby gets glucose from the mother through her milk or from formula, and the baby also produces it in the liver. Glucose level can drop if: There is too much insulin in the blood. Insulin is a hormone that pulls glucose from the blood. The baby is not producing enough glucose. The baby's body is using more glucose than is being produced. The baby is not able to feed enough to keep the glucose level up. Neonatal hypoglycemia occurs when the newborn's glucose level causes symptoms or is below the level considered safe for the baby's age. It occurs in about 1 to 3 out of every 1,000 births. Low blood sugar level is more likely in infants with one or more of these risk factors: Born early, has a serious infection, or needed oxygen right after delivery Mother has diabetes (these infants are often larger than normal) Have slower than usual growth in the womb during pregnancy Are smaller in size than normal for their gestational age If you have diabetes during pregnancy, work with your health care provider to control your blood sugar level. Be sure that your newborn's blood sugar level is monitored after birth. |
Answer the following medical question: | Can a CT scan detect diverticulitis or diverticulosis? | CT scan: This radiology test takes multiple cross-sectional pictures of the body. It is not generally performed to make a diagnosis of diverticulosis, but this type of exam, when done for other reasons, may identify diverticula. |
Answer the following medical question: | Can a CT scan detect diverticulitis or diverticulosis? | What tests do doctors use to diagnose diverticulosis and diverticulitis? Your doctor may use the following tests to help diagnose diverticulosis and diverticulitis:CT scan A computerized tomography (CT) scan uses a combination of x-rays and computer technology to create images of your gastrointestinal (GI) tract. An x-ray technician performs the procedure in an outpatient center or a hospital. A radiologist reads and reports on the images. You don't need anesthesia for this procedure. For a CT scan, a health care professional may give you a solution to drink and an injection of a special dye, called contrast medium. Contrast medium makes the structures inside your body easier to see during the procedure. You'll lie on a table that slides into a tunnel-shaped device that takes the x-rays. A CT scan of your colon is the most common test doctors use to diagnose diverticulosis and diverticulitis. |
Answer the following medical question: | What are the most common ways of spreading cold germs? | Common cold Prevention To lower your chances of getting sick: Always wash your hands. Children and adults should wash hands after nose-wiping, diapering, and using the bathroom, and before eating and preparing food. Disinfect your environment. Clean commonly touched surfaces (such as sink handles, door knobs, and sleeping mats) with an EPA-approved disinfectant. Choose smaller daycare classes for your children. Use instant hand sanitizers to stop the spread of germs. Use paper towels instead of sharing cloth towels. The immune system helps your body fight off infection. Here are ways to support the immune system: Avoid secondhand smoke. It is responsible for many health problems, including colds. DO NOT use antibiotics if they are not needed. Breastfeed infants if possible. Breast milk is known to protect against respiratory tract infections in children, even years after you stop breastfeeding. Drink plenty of fluids to help your immune system work properly. Eat yogurt that contains "active cultures." These may help prevent colds. Probiotics may help prevent colds in children. Get enough sleep. |
Answer the following medical question: | What are the most common ways of spreading cold germs? | Why Some People Are More Likely to Catch a Cold The answer may be in your DNA structures |
Answer the following medical question: | What is maximum daily dosage of Metformin? | The maximum recommended daily dose of metformin hydrochloride tablets are 2550 mg in adults and 2000 mg in pediatric patients (10-16 years of age). |
Answer the following medical question: | Could someone who did not get vaccinated for measles in childhood develop SSPE anytime in adulthood? | Very few cases are seen in the U.S. since the nationwide measles vaccination program. SSPE tends to occur several years after a person has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females. The disease generally occurs in children and adolescents. |
Answer the following medical question: | Could someone who did not get vaccinated for measles in childhood develop SSPE anytime in adulthood? | Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness. Since measles was eliminated in 2000, SSPE is rarely reported in the United States. Among people who contracted measles during the resurgence in the United States in 1989 to 1991, 4 to 11 out of every 100,000 were estimated to be at risk for developing SSPE. The risk of developing SSPE may be higher for a person who gets measles before they are two years of age. |
Answer the following medical question: | What are the most current findings regarding causation, treatment and therapy for children with Kippel-Tranaunay-Syndrome (KTS)? | Supportive care for Klippel-Trenaunay syndrome Compression garments-Your doctor may recommend that your child wear tight-fitting pieces of clothing on the affected limb to reduce pain and swelling. They can also help protect your child's limb from bumps and scrapes, which can cause bleeding. Heel inserts-If your child's legs are slightly different lengths (less than one inch difference), a heel insert can help your child walk normally. Anticoagulant therapy-One of the biggest potential risks of KTS is that a blood clot formed in the abnormal blood vessels may break off and make its way to your child's heart or lungs. Your doctor may recommend medications that thin your child's blood to help prevent blood clots from forming. Other medications-Your doctor may also recommend various pain medications and antibiotic medications for your child. Surgical care for Klippel-Trenaunay syndrome Orthopedic Center-KTS can cause your child's foot or leg to become excessively large; in some cases your doctor may recommend an operation. An orthopedic surgeon can reshape your child's foot to help him fit it into a shoe. An orthopedic surgeon can perform a procedure called epiphysiodesis, which interrupts the growth plate and stops the leg from growing when it's reached a certain length. Other surgeries-Your doctor may recommend one of these other surgical procedures if your child's symptoms call for it. A surgeon can remove some of your child's excessive problematic veins. A surgeon can also help reduce the size of your child's affected limb with a debulking procedure, in which many of the abnormal vessels and some of the overgrown tissue is removed. Sclerotherapy -To help shrink and eliminate your child's abnormal veins in the affected area, your doctor may propose the injection of an irritating solution, which causes the veins to collapse. One of our experienced interventional radiologists can perform this procedure. Laser therapy-Pulsed dye laser treatments can help lighten your child's capillary malformation (port wine stain). Laser treatment can also speed healing if your child's lesion begins to bleed. |
Answer the following medical question: | What are the most current findings regarding causation, treatment and therapy for children with Kippel-Tranaunay-Syndrome (KTS)? | There are many different treatment options for patients with KTS depending on your child's symptoms: Compression garments, like tight-fitting, elastic sleeves, supply blood flow back to the heart (chronic vein insufficiency). They prevent lymphedema and recurrent bleeding from capillary or venous malformations of the limb. They also protect the limb from trauma. Learn more about compression garments (PDF). Pain medicine, antibiotics and elevating the limb to manage swelling. Medicines to prevent blood clotting (anticoagulant therapy). Heel inserts or surgery may be considered when one leg is longer than another. Your child may be referred to an orthopedic specialist to help develop a treatment plan. Laser therapy to lighten the color of the port wine stain, treat pain or help ulcers or open sores heal. Sclerotherapy (SCLAIR-oh-THAIR-uh-pee) to block unneeded veins. Some patients with KTS need surgery. This includes: Vein ligation: Clamping off a section of veins to prevent blood flow through a damaged section. It promotes blood flow through veins that are not damaged. Vein stripping: Using a metal wire to remove swelling inside a damaged vein. Vein resection: Removing a section of veins from the body. |
Answer the following medical question: | What is the treatment for someone who thinks he has taken an overdose of Iron pills? | Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose. Iron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. Before Calling Emergency Have this information ready: Person's age, weight, and condition Name of the product (ingredients and strength, if known) Time it was swallowed Amount swallowed If the medicine was prescribed for the person |
Answer the following medical question: | What is the likelihood that a person with hereditary rickets will pass it to his or her child? | Hereditary hypophosphatemic rickets can have several patterns of inheritance. When the condition results from mutations in the PHEX gene, it is inherited in an X-linked dominant pattern. The PHEX gene is located on the X chromosome, which is one of the two sex chromosomes. In females (who have two X chromosomes), a mutation in one of the two copies of the gene in each cell is sufficient to cause the disorder. In males (who have only one X chromosome), a mutation in the only copy of the gene in each cell causes the disorder. Less commonly, hereditary hypophosphatemic rickets can have an X-linked recessive pattern of inheritance. This form of the condition is often called Dent disease. Like the PHEX gene, the gene associated with Dent disease is located on the X chromosome. In males, one altered copy of the gene in each cell is sufficient to cause the condition. In females, a mutation would have to occur in both copies of the gene to cause the disorder. Because it is unlikely that females will have two altered copies of this gene, males are affected by X-linked recessive disorders much more frequently than females. In a few families, hereditary hypophosphatemic rickets has had an autosomal dominant inheritance pattern, which means one copy of an altered gene in each cell is sufficient to cause the disorder. The rare condition HHRH has an autosomal recessive pattern of inheritance, which means both copies of a gene in each cell have mutations. |
Answer the following medical question: | What is the likelihood that a person with hereditary rickets will pass it to his or her child? | Hypophosphatemic rickets is most often inherited in an X-linked dominant manner. This means that the gene responsible for the condition is located on the X chromosome, and having only one mutated copy of the gene is enough to cause the condition. Because males have only one X chromosome (and one Y chromosome) and females have two X chromosomes, X-linked dominant conditions affect males and females differently. Both males and females can have an X-linked dominant condition. However, because males don't have a second, working copy of the gene (as females do), they usually have more severe disease than females. If a father has the mutated X-linked gene: all of his daughters will inherit the mutated gene (they will all receive his X chromosome) none of his sons will inherit the mutated gene (they only inherit his Y chromosome) If a mother has the mutated X-linked gene, each of her children (both male and female) has a 50% chance to inherit the mutated gene. Less commonly, hypophosphatemic rickets is inherited in an X-linked recessive, autosomal dominant, or autosomal recessive manner. |
Answer the following medical question: | What is fibromyalgia and how is it treated? | What do we know about the effectiveness of complementary health approaches for fibromyalgia? Although some studies of tai chi, yoga, mindfulness meditation, and biofeedback for fibromyalgia have had promising results, the evidence is too limited to allow definite conclusions to be reached about whether these approaches are helpful. It's uncertain whether acupuncture is helpful for fibromyalgia pain. Vitamin D supplements may reduce pain in people with fibromyalgia who are deficient in this vitamin. Some preliminary research on transcranial magnetic stimulation (TMS) for fibromyalgia symptoms has had promising results. |
Answer the following medical question: | What is your position on Homozygout MTHFR A1298C (a genetic change) Issues and long term prognosis? | MTHFR gene mutation is a genetic change that affects an enzyme involved in breaking down the amino acid homocysteine.[1][2][3] C677T and A1298C are two very common MTHFR gene changes. People with MTHFR gene mutations may develop elevated levels of homocysteine in their blood (homocysteinemia) or urine (homocystinuria). Risks for health effects vary depending on the levels of homocysteine.[5] High homocysteine levels in the body may occur if the MTHFR enzyme is not functioning normally due to MTHFR mutations such as C677T and A1298C. Elevated levels of homocysteine can also occur if there is a lack of folate or B vitamins. Homocysteine levels also tend to rise with age, smoking, and use of certain drugs (such as carbamazepine, methotrexate, and phenytoin).[13][14] It is important to ensure that people with and without MTHFR gene mutations receive adequate amounts of folate, choline, and B vitamins (B12, B6, and riboflavin) to mitigate health risks. If adequate nutrition cannot be attained through diet alone, supplementation with folate (e.g., levomefolate (5-methyl THF) or folinic acid) and B vitamins is considered.[3][13] Speak to a healthcare professional if you have questions about your nutrition or need for vitamin supplementation. |
Answer the following medical question: | What is your position on Homozygout MTHFR A1298C (a genetic change) Issues and long term prognosis? | Outlook (Prognosis) Although no cure exists for homocystinuria, vitamin B therapy can help about half of people affected by the condition. If the diagnosis is made in childhood, starting a low-methionine diet quickly may prevent some intellectual disability and other complications of the disease. For this reason, some states screen for homocystinuria in all newborns. People whose blood homocysteine levels continue to rise are at increased risk for blood clots. Clots can cause serious medical problems and shorten lifespan. Possible Complications Most serious complications result from blood clots. These episodes can be life-threatening. Dislocated lenses of the eyes can seriously damage vision. Lens replacement surgery may be needed. Intellectual disability is a serious consequence of the disease. But, it can be reduced if diagnosed early. |
Answer the following medical question: | Is a high dose, 50,000 IUs, of vitamin D safe if you have a deficiency? Can high doses cause flatulence or other side effects? | Can vitamin D be harmful? Yes, when amounts in the blood become too high. Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. And by raising blood levels of calcium, too much vitamin D can cause confusion, disorientation, and problems with heart rhythm. Excess vitamin D can also damage the kidneys.The upper limit for vitamin D is 1,000 to 1,500 IU/day for infants, 2,500 to 3,000 IU/day for children 1-8 years, and 4,000 IU/day for children 9 years and older, adults, and pregnant and lactating teens and women. Vitamin D toxicity almost always occurs from overuse of supplements. Excessive sun exposure doesn't cause vitamin D poisoning because the body limits the amount of this vitamin it produces. |
Answer the following medical question: | What causes shingles and how can it be prevented? | How Can You Reduce Your Risk of Getting Shingles? Vaccination is the only way to reduce your risk of shingles and PHN. CDC recommends adults age 60 years or older receive a single dose of shingles vaccine. Zostavax'ae is the only shingles vaccine currently available. It is available by prescription from a healthcare professional. Talk with your doctor or pharmacist if you have questions about the shingles vaccine. |
Answer the following medical question: | What medication should a 65 year old male use for leg pain? | Take over-the-counter pain medicines like acetaminophen or ibuprofen. 2. Try over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) |
Answer the following medical question: | What are the chances that a person with CVID, who also has a thyroid tumor, will get cancer? | 1. The long-term outlook (prognosis) and life expectancy for people with common variable immunodeficiency (CVID) varies. The prognosis largely depends on whether there is severe autoimmune disease; whether there are recurrent infections that cause structural lung damage; and the development of a malignancy (cancer). Other major factors that influence prognosis include the extent of organ damage and how successfully infections can be prevented. Affected people who have only bacterial infections have a better prognosis than those with additional complications and can have nearly normal life expectancy. This is especially the case if they are diagnosed early and begin treatment soon after the onset of symptoms. 2. In some cases, abnormal growth of small nodules of lymphoid tissue in the gastrointestinal tract (nodular lymphoid hyperplasia) may occur. In addition, an increased percent of individuals with CVID are more prone to developing certain forms of cancer than the general population such as malignancies of lymphatic tissue (lymphoma) and possibly stomach cancer). The risk of gastric carcinoma is almost 50 times greater in patients with CVID than in other individuals. In addition, some individuals with CVID may develop granular, inflammatory nodules (noncaseating granulomas) within tissue of the skin, lungs, spleen, and/or liver. 3. Of the 411 subjects with known follow-up (87% of the cohort), 93 patients (19.6%) had died. The median age at death was 44 years for females (range 10-90 years) and 42 years for males (range 9-79 years), not significantly different. The predominant causes of death included respiratory failure from chronic lung disease, lymphoid or other malignancy, or overwhelming infections (TABLE 6). To further examine the mortality of this cohort, we compared those with known long term follow-up, 226 females (48%) and 185 males (39%) to age-matched population controls. The survival of both male (p=0.0001) and female (p=0.0001) CVID subjects was significantly reduced as compared to 1994 United States reference information.34 (FIGURE 1) The risk of death in this interval was nearly 11 times higher for CVID patients with one or more of the non-infectious complications, than for subjects who had infections only (HR=10.96; p=0.0001) (TABLE 7). Kaplan-Meier Analysis confirmed this observation, with a long term survival of 95% for patients without versus 42% for those with non-infectious complications (FIGURE 2). These data agree with a previous study on CVID subjects from the ESID registry.7 However, we found here that not all complications were associated with reduced survival. Patients with gastrointestinal disease (HR 2.78; p=0.0004), liver disease/hepatitis (HR 2.48; p=0.0003), lymphoma (HR 2.44; p=0.001), chronic lung disease including radiological and/or functional lung disease as described above (HR 2.06; p=0.001), or malabsorption (HR 2.06; p=0.022) had reduced survival in this interval, as compared to CVID patients without these particular complications. In contrast, patients with any of the autoimmune conditions, cancers other than lymphoma, history of splenectomy, presence of granulomatous disease, or the development of bronchiectasis alone, did not have significantly reduced survival over the 4 decades of study. |
Answer the following medical question: | What are the different types of diabetes and how do they affect the body? | Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. |
Answer the following medical question: | How do I taper off from WELLBUTRIN XL 150 mg/day? | 1. he tapered off bupropion SR, taking 150 mg/day for 4 days followed by 150 mg every other day for 8 days (4 total doses) and 150 mg every third day for 6 days (2 total doses) without further complications. 2. For patients taking 300 mg/day during the autumn-winter season, the dose should be tapered to 150 mg/day for 2 weeks prior to discontinuation. Adverse events with onset during the 2 weeks following down-titration of WELLBUTRIN XL from 300 mg/day to 150 mg/day were reported by 14% of patients compared to 18% of patients who continued on placebo. Adverse events with onset during the 2 weeks following discontinuation of WELLBUTRIN XL were reported by 9% of patients compared with 12% of patients following discontinuation of placebo. |
Answer the following medical question: | Is it recommended for patients on Lipitor to have their liver function monitored by blood testing every six months. | prospective monitoring of serum enzymes upon initiating atorvastatin therapy is no longer recommended. Clinically apparent liver injury attributed to atorvastatin is usually self-limited and recovery is complete within 1 to 4 months. |
Answer the following medical question: | Is a calcium supplement beneficial for persons who have osteoporosis, and will the addition of magnesium be of greater benefit? | 1. It's also a good idea to take your calcium supplements at a different time from your multivitamin or an iron-rich meal. Calcium may not be absorbed as well if it's taken at the same time as iron, zinc or magnesium. 2. Vitamin D intake: this nutrient, obtained from food and produced by skin when exposed to sunlight of sufficient intensity, improves calcium absorption. 3. In 1993, the U.S. Food and Drug Administration authorized a health claim related to calcium and osteoporosis for foods and supplements [58]. In January 2010, this health claim was expanded to include vitamin D. Model health claims include the following: "Adequate calcium throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis" and "Adequate calcium and vitamin D as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life" |
Answer the following medical question: | Where can one be tested for Ehlers-Danlos Syndrome (EDS) and Osteogenesis Imperfecta in Southern California? Are the symptoms for those diseases similar? | 1. Invitae Ehlers-Danlos Syndrome Panel Laboratory contact: 1400 16th Street, San Francisco, California 94103, United States 2. Invitae Osteogenesis Imperfecta Panel 3. The milder forms of osteogenesis imperfecta, including type I, are characterized by bone fractures during childhood and adolescence that often result from minor trauma. Fractures occur less frequently in adulthood. People with mild forms of the condition typically have a blue or grey tint to the part of the eye that is usually white (the sclera), and may develop hearing loss in adulthood. Affected individuals are usually of normal or near normal height. Other types of osteogenesis imperfecta are more severe, causing frequent bone fractures that may begin before birth and result from little or no trauma. Additional features of these conditions can include blue sclerae, short stature, hearing loss, respiratory problems, and a disorder of tooth development called dentinogenesis imperfecta. The most severe forms of osteogenesis imperfecta, particularly type II, can include an abnormally small, fragile rib cage and underdeveloped lungs. Infants with these abnormalities have life-threatening problems with breathing and often die shortly after birth. 4. Symptoms of EDS include: Back pain Double-jointedness Easily damaged, bruised, and stretchy skin Easy scarring and poor wound healing Flat feet Increased joint mobility, joints popping, early arthritis Joint dislocation Joint pain Premature rupture of membranes during pregnancy Very soft and velvety skin Vision problems |
Answer the following medical question: | Can chronic cervicitis cause infertility? Why would tampons cause inflammation? | 1. Cervicitis will go away within a few days to a week after you start taking antibiotics. If you have pelvic inflammatory disease, it may take a few weeks to treat the infection completely. Pelvic inflammatory disease can cause more serious problems, such as infertility or pain from scar tissue. 2. Cervicitis may last for months to years. Cervicitis may lead to pain with intercourse (dyspareunia). |
Answer the following medical question: | How does trisomy 7 affect the body and are there any treatments for it? | 1. Trisomy 7 is extremely rare at birth and is generally considered lethal in embryogenesis. All surviving children are mosaics with variable and nonspecific clinical features. Chromosomal mosaicism may be suggested by body asymmetry and/or Blaschkolinear skin pigmentary dysplasia associated with developmental delay. Cultured skin fibroblasts cytogenetic analysis confirms mosaicism and identifies its chromosomal origin. In amniocytes, trisomy 7 is frequently a cell culture artifact leading to single- or multiple-cell pseudomosaicism with normal fetal outcome. 2. 7q11.23 duplication syndrome is considered to be an autosomal dominant condition, which means one copy of chromosome 7 with the duplication in each cell is sufficient to cause the disorder. Most cases result from a duplication that occurs during the formation of reproductive cells (eggs and sperm) or in early fetal development. These cases occur in people with no history of the disorder in their family. Less commonly, an affected person inherits the chromosome with a duplicated segment from a parent. 3. Rearrangements of chromosomes include deletions of DNA sequences and duplications of segments, both of which can encompass thousands to hundreds of thousands of bases. Why do these large rearrangements occur? For one, certain structural features of the genome, also referred to as genome architecture, can render various regions fragile and thus prone to events such as chromosome breakage, which often result in translocations, deletions, and duplications. Often, these alterations happen due to errors during cell division when chromosomes align (Figure 1). Homologous recombination between areas of concentrated repeated sequences frequently creates deletions and duplications. Because they commonly involve more than one gene, the disorders caused by these large deletion and duplication mutations are often severe. |
Answer the following medical question: | Does metformin cause high blood pressure? | 1. This meta-analysis suggested that metformin could effectively lower SBP in nondiabetic patients, especially in those with impaired glucose tolerance or obesity. |
Answer the following medical question: | Does metformin cause high blood pressure? | 2. Metformin does not significantly affect BP in patients with Type 2 diabetes intensively treated with insulin. |
Answer the following medical question: | Is aclidinium a steroid? Is it contraindicated within 12 months prior to cataract surgery? | 1. Aclidinium is in a class of medications called bronchodilators. It works by relaxing and opening the air passages to the lungs to make breathing easier. 2. There are currently six muscarinic receptor antagonists licenced for use in the treatment of COPD, the short-acting muscarinic receptor antagonists (SAMAs) ipratropium bromide and oxitropium bromide and the long-acting muscarinic receptor antagonists (LAMAs) aclidinium bromide, tiotropium bromide, glycopyrronium bromide and umeclidinium bromide. Concerns have been raised about possible associations of muscarinic receptor antagonists with cardiovascular safety, but the most advanced compounds seem to have an improved safety profile. 3. The use of TUDORZA PRESSAIR is contraindicated in the following conditions: *Severe hypersensitivity to milk proteins [see WARNINGS AND PRECAUTIONS (5.5)] *Hypersensitivity to aclidinium bromide or any of the excipients [see Warnings and Precautions (5.5)] |
Answer the following medical question: | What are the effects of smoking and/or nicotine on the digestive system? | 1. Smoking has been found to increase the risk of cancers of the mouth, esophagus, stomach, and pancreas. Research suggests that smoking may also increase the risk of cancers of the liver, colon, and rectum. Smoking increases the risk of heartburn and gastroesophageal reflux disease (GERD). Smoking increases the risk of peptic ulcers. Smoking may worsen some liver diseases, including primary biliary cirrhosis and nonalcoholic fatty liver disease (NAFLD). Current and former smokers have a higher risk of developing Crohn's disease than people who have never smoked. People who smoke are more likely to develop colon polyps. Smoking increases the risk of developing pancreatitis. Some studies have shown that smoking may increase the risk of developing gallstones. 2. Epidemiological and experimental evidence have shown that nicotine has harmful effects on the gastric mucosa. The mechanisms by which cigarette smoking or nicotine adversely affect the gastric mucosa have not been fully elucidated. In this report, clinical and experimental data are reviewed. The effects of nicotine from smoking on gastric aggressive or defensive factors are discussed. Nicotine potentiates gastric aggressive factors and attenuates defensive factors; it also increases acid and pepsin secretions, gastric motility, duodenogastric reflux of bile salts, the risk of Helicobacter pylori infection, levels of free radicals, and platelet-activating factor, endothelin generation, and vasopressin secretion. Additionally, nicotine impairs the therapeutic effect of H2-receptor antagonists and decreases prostaglandin synthesis, gastric mucosal blood flow, mucus secretion, and epidermal growth factor secretion. Although many of the studies provide conflicting results, the bulk of the evidence supports the hypothesis that nicotine is harmful to the gastric mucosa. |
Answer the following medical question: | Does Fibromyalgia cause swelling in your body? | 1. Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them. People with fibromyalgia may also have other symptoms, such as Trouble sleeping Morning stiffness Headaches Painful menstrual periods Tingling or numbness in hands and feet Problems with thinking and memory (sometimes called "fibro fog") 2. Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has a leg infection Has veins in the legs that cannot properly pump blood back to the heart Injury or surgery involving the leg, ankle, or foot can also cause swelling. Swelling may also occur after pelvic surgery, especially for cancer. Long airplane flights or car rides, as well as standing for long periods of time, often lead to some swelling in the feet and ankles. Swelling may occur in women who take estrogen, or during parts of the menstrual cycle. Most women have some swelling during pregnancy. More severe swelling during pregnancy may be a sign of preeclampsia, a serious condition that includes high blood pressure and swelling. Swollen legs may be a sign of heart failure, kidney failure, or liver failure. In these conditions, there is too much fluid in the body. Certain medicines may also cause your legs to swell. Some of these are: Antidepressants, including MAO inhibitors and tricyclics Blood pressure medicines called calcium channel blockers Hormones, such as estrogen (in birth control pills or hormone replacement therapy) and testosterone Steroids |
Answer the following medical question: | Can cancer spread through blood contact? | A healthy person cannot "catch" cancer from someone who has it. There is no evidence that close contact or things like sex, kissing, touching, sharing meals, or breathing the same air can spread cancer from one person to another. Cancer cells from one person are generally unable to live in the body of another healthy person. A healthy person's immune system recognizes foreign cells and destroys them, including cancer cells from another person. |
Answer the following medical question: | What is plantar fasiciitis, and how is it treated? | You are more likely to get plantar fasciitis if you: Have foot arch problems (both flat feet and high arches) Run long distances, downhill or on uneven surfaces Are obese or gain weight suddenly Have a tight Achilles tendon (the tendon connecting the calf muscles to the heel) Wear shoes with poor arch support or soft soles Change your activities |
Answer the following medical question: | Can Lipnodes and/or Liver cancer be detected in an upper GI endoscopy? | 1. Upper GI endoscopy can identify many different diseases anemia gastroesophageal reflux disease ulcers cancer inflammation, or swelling precancerous abnormalities celiac disease 2. Tests for Liver Cancer If you have some of the signs and symptoms of liver cancer, your doctor will try to find if they are caused by liver cancer or something else. Medical history and physical exam Imaging tests: Ultrasound, Computed tomography (CT), Magnetic resonance imaging (MRI), Angiography Needle biopsy: A hollow needle is placed through the skin in the abdomen and into the liver. The skin is first numbed with local anesthesia before the needle is placed. Different-sized needles may be used. Laparoscopic biopsy: Biopsy specimens can also be taken during laparoscopy. This lets the doctor see the surface of the liver and take samples of abnormal-appearing areas. Surgical biopsy: An incisional biopsy (removing a piece of the tumor) or an excisional biopsy (removing the entire tumor and some surrounding normal liver tissue) can be done during an operation. Lab tests |
Answer the following medical question: | Can an abscessed tooth cause a heart attack? | 1. A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD). 2. Endocarditis (EN-do-kar-DI-tis) is an infection of the inner lining of the heart chambers and valves. This lining is called the endocardium (en-do-KAR-de-um). The condition also is called infective endocarditis (IE). The term "endocarditis" also is used to describe an inflammation of the endocardium due to other conditions. This article only discusses endocarditis related to infection. IE occurs if bacteria, fungi, or other germs invade your bloodstream and attach to abnormal areas of your heart. The infection can damage your heart and cause serious and sometimes fatal complications. IE can develop quickly or slowly; it depends on what type of germ is causing it and whether you have an underlying heart problem. When IE develops quickly, it's called acute infective endocarditis. When it develops slowly, it's called subacute infective endocarditis. Overview IE mainly affects people who have: Damaged or artificial (man-made) heart valves Congenital heart defects (defects present at birth) Implanted medical devices in the heart or blood vessels People who have normal heart valves also can have IE. However, the condition is much more common in people who have abnormal hearts. Certain factors make it easier for bacteria to enter your bloodstream. These factors put you at higher risk for IE. For example, poor dental hygiene and unhealthy teeth and gums increase your risk for the infection. |
Answer the following medical question: | Define Syncope (ischemic stroke)? | 1. The defining characteristics of syncope include rapid onset with transient loss of consciousness usually accompanied by falling, followed by spontaneous, complete, and usually prompt recovery without intervention. Because some patients use the term dizziness to describe syncopal events, it is important to ask patients exactly what they mean by dizziness and whether loss of consciousness occurred. Syncope must be differentiated from vertigo, coma, drop attacks, dizziness, sudden cardiac death, and seizures. Vertigo (i.e., sensation of movement) does not include loss of consciousness. Coma involves loss of consciousness without spontaneous recovery. Drop attacks involve sudden falls without loss of consciousness or warning and with immediate recovery. Drop attacks may be idiopathic but also have several specific causes (e.g., underlying cardiovascular disease, spondylotic osteophytes or colloidal cysts that transiently block the vertebral arteries or cerebral aqueduct, vertebrobasilar stroke). The typical signs of epileptic seizures include dejavu, tongue lacerations, limb jerking, and postictal confusion but not common signs of syncope, such as prodromal diaphoresis, palpitations, or provocation by prolonged sitting or standing. Although limb jerking is noted in 15 percent of syncopal patients, the other typical signs of seizures are absent. 2. Correct and early diagnosis of TIA versus mimics is critical because early interventions (e.g., antiplatelet agents, statin therapy, blood pressure-lowering therapy, anticoagulation when appropriate) can lead to an 80 percent reduction in risk of recurrent ischemic events. The most common TIA mimics are seizures, migraines, metabolic disturbances, and syncope. Mimics are more likely with gradual onset of symptoms and with nonspecific symptoms (Table 113), such as memory loss or headache. |
Answer the following medical question: | What are the components of Coenzyme and is it useable for Muslims? | 1. GNC Preventive Nutrition CoQ-10 100 mg Coenzyme Q-10 100 mg; Other Ingredients: Soybean oil, Gelatin, Glycerin, Chlorophyll, Titanium Dioxide (Natural Mineral Whitener). No Sugar, No Starch, No Artificial Colors, No Artificial Flavors, No preservatives, No Wheat, No Gluten, No Corn, No Dairy, Yeast Free. 2. Metabolic Maintenance CoQ10 (Veggie Capsules) Vitamin C (as Ascorbic Acid), CoEnzyme Q10 (Ubiquinone), vegetarian capsule, l-leucine. |
Answer the following medical question: | What doctor specializes in testing for and treating autoimmune diseases? | Since autoimmune diseases vary greatly in presentation, many different physician specialists care for patients with these disorders. The specialist is usually skilled in treating diseases of a particular system. For example: rheumatologists tend to treat diseases affecting the joints and connective tissue; neurologists, autoimmune diseases of the central and/or peripheral nervous system; dermatologists; diseases of the skin; gastroenterologists, diseases of the intestinal tract; and endocrinologists, diseases of endocrine organs. It can be truly said that physicians of any specialty may encounter patients with autoimmune disease. |
Answer the following medical question: | To what extent does Effexor cause ED? | The recommended starting dose for Effexor is 75 mg/day, administered in two or three divided doses, taken with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150 mg/day. If needed, the dose should be further increased up to 225 mg/day. When increasing the dose, increments of up to 75 mg/day should be made at intervals of no less than 4 days. In outpatient settings there was no evidence of usefulness of doses greater than 225 mg/day for moderately depressed patients, but more severely depressed inpatients responded to a mean dose of 350 mg/day. Certain patients, including more severely depressed patients, may therefore respond more to higher doses, up to a maximum of 375 mg/day, generally in three divided doses |
Answer the following medical question: | To what extent does Effexor cause ED? | Antidepressants most likely to cause sexual side effects include: Selective serotonin reuptake inhibitors (SSRIs), which include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Selfemra), paroxetine (Paxil, Pexeva) and sertraline (Zoloft). Serotonin and norepinephrine reuptake inhibitors (SNRIs), which include venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and duloxetine (Cymbalta). Tricyclic and tetracyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and clomipramine (Anafranil). Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate). However, selegiline (Emsam), a newer MAOI that you stick on your skin as a patch, has a low risk of sexual side effects. If you're taking an antidepressant that causes sexual side effects, your doctor may recommend one of these strategies: Waiting several weeks to see whether sexual side effects get better. Engaging in sexual activity before taking an antidepressant if your antidepressant requires a once-a-day dose. Adjusting the dose of your antidepressant to reduce the risk of sexual side effects. But always talk with your doctor before changing your dose. Switching to another antidepressant that may be less likely to cause sexual side effects. Adding a second antidepressant or another type of medication to counter sexual side effects. For example, the addition of the antidepressant bupropion or the anti-anxiety medication buspirone may ease sexual side effects caused by an antidepressant. Adding a medication to improve sexual function, such as sildenafil (Viagra, Revatio), tadalafil (Adcirca, Cialis) or vardenafil (Levitra, Staxyn). Although these medications are used to treat sexual problems in men, initial research suggests sildenafil may also improve sexual problems caused by antidepressants in some women. |
Answer the following medical question: | How long has Non-aspirin NSAID been implicated in erectile dysfunction? | Non-aspirin NSAID use was associated with an increased risk of mild/moderate ED (HR 1.16; P = 0.02) and aspirin use was associated with an increased risk of severe ED (HR 1.16; P = 0.03, respectively). The associations of NSAID use with ED risk were attenuated after controlling for indications for NSAID use. CONCLUSIONS: The modest associations of NSAID use with ED risk in the present cohort were probably attributable to confounding indications for NSAID use. NSAID use was not associated with ED risk. |
Answer the following medical question: | What is aortic stenosis, and is there anything I should do about it? | The aorta is the main artery that carries blood out of the heart to the rest of the body. Blood flows out of the heart and into the aorta through the aortic valve. In aortic stenosis, the aortic valve does not open fully. This decreases blood flow from the heart. |
Answer the following medical question: | What can cause white cells ti uprate | A high white blood cell count usually indicates: An increased production of white blood cells to fight an infection A reaction to a drug that increases white blood cell production A disease of bone marrow, causing abnormally high production of white blood cells An immune system disorder that increases white blood cell production Specific causes of a high white blood cell count include: Acute lymphocytic leukemia Acute myelogenous leukemia (AML) Allergy, especially severe allergic reactions Chronic lymphocytic leukemia Chronic myelogenous leukemia Drugs, such as corticosteroids and epinephrine Infections, bacterial or viral Myelofibrosis Polycythemia vera Rheumatoid arthritis Smoking Stress, such as severe emotional or physical stress Tuberculosis Whooping cough |
Answer the following medical question: | Define temperature exposure and expiration data with regard to pharmacy and warehouse storage for Glimepiride. | 1. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. 2. Store at 20 degrees-25 degrees C (68 degrees -77 degrees F) [see USP Controlled Room Temperature]. Dispense in well-closed containers with safety closures. |
Answer the following medical question with one of the provided options: | Q:A 23-year-old pregnant woman at 22 weeks gestation presents with burning upon urination. She states it started 1 day ago and has been worsening despite drinking more water and taking cranberry extract. She otherwise feels well and is followed by a doctor for her pregnancy. Her temperature is 97.7°F (36.5°C), blood pressure is 122/77 mmHg, pulse is 80/min, respirations are 19/min, and oxygen saturation is 98% on room air. Physical exam is notable for an absence of costovertebral angle tenderness and a gravid uterus. Which of the following is the best treatment for this patient?? {'A': 'Ampicillin', 'B': 'Ceftriaxone', 'C': 'Ciprofloxacin', 'D': 'Doxycycline', 'E': 'Nitrofurantoin'}, | E: Nitrofurantoin |
Answer the following medical question with one of the provided options: | Q:A 3-month-old baby died suddenly at night while asleep. His mother noticed that he had died only after she awoke in the morning. No cause of death was determined based on the autopsy. Which of the following precautions could have prevented the death of the baby?? {'A': 'Placing the infant in a supine position on a firm mattress while sleeping', 'B': 'Routine postnatal electrocardiogram (ECG)', 'C': 'Keeping the infant covered and maintaining a high room temperature', 'D': 'Application of a device to maintain the sleeping position', 'E': 'Avoiding pacifier use during sleep'}, | A: Placing the infant in a supine position on a firm mattress while sleeping |
Answer the following medical question with one of the provided options: | Q:A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without complications and has not had any medical problems up until this time. However, for the past 4 days, he has been fussy, is regurgitating all of his feeds, and his vomit is yellow in color. On physical exam, the child's abdomen is minimally distended but no other abnormalities are appreciated. Which of the following embryologic errors could account for this presentation?? {'A': 'Abnormal migration of ventral pancreatic bud', 'B': 'Complete failure of proximal duodenum to recanalize', 'C': 'Error in neural crest cell migration', 'D': 'Abnormal hypertrophy of the pylorus', 'E': 'Failure of lateral body folds to move ventrally and fuse in the midline'}, | A: Abnormal migration of ventral pancreatic bud |
Answer the following medical question with one of the provided options: | Q:A pulmonary autopsy specimen from a 58-year-old woman who died of acute hypoxic respiratory failure was examined. She had recently undergone surgery for a fractured femur 3 months ago. Initial hospital course was uncomplicated, and she was discharged to a rehab facility in good health. Shortly after discharge home from rehab, she developed sudden shortness of breath and had cardiac arrest. Resuscitation was unsuccessful. On histological examination of lung tissue, fibrous connective tissue around the lumen of the pulmonary artery is observed. Which of the following is the most likely pathogenesis for the present findings?? {'A': 'Thromboembolism', 'B': 'Pulmonary ischemia', 'C': 'Pulmonary hypertension', 'D': 'Pulmonary passive congestion', 'E': 'Pulmonary hemorrhage'}, | A: Thromboembolism |
Answer the following medical question with one of the provided options: | Q:A 20-year-old woman presents with menorrhagia for the past several years. She says that her menses “have always been heavy”, and she has experienced easy bruising for as long as she can remember. Family history is significant for her mother, who had similar problems with bruising easily. The patient's vital signs include: heart rate 98/min, respiratory rate 14/min, temperature 36.1°C (96.9°F), and blood pressure 110/87 mm Hg. Physical examination is unremarkable. Laboratory tests show the following: platelet count 200,000/mm3, PT 12 seconds, and PTT 43 seconds. Which of the following is the most likely cause of this patient’s symptoms?? {'A': 'Factor V Leiden', 'B': 'Hemophilia A', 'C': 'Lupus anticoagulant', 'D': 'Protein C deficiency', 'E': 'Von Willebrand disease'}, | E: Von Willebrand disease |
Answer the following medical question with one of the provided options: | Q:A 40-year-old zookeeper presents to the emergency department complaining of severe abdominal pain that radiates to her back, and nausea. The pain started 2 days ago and slowly increased until she could not tolerate it any longer. Past medical history is significant for hypertension and hypothyroidism. Additionally, she reports that she was recently stung by one of the zoo’s smaller scorpions, but did not seek medical treatment. She takes aspirin, levothyroxine, oral contraceptive pills, and a multivitamin daily. Family history is noncontributory. Today, her blood pressure is 108/58 mm Hg, heart rate is 99/min, respiratory rate is 21/min, and temperature is 37.0°C (98.6°F). On physical exam, she is a well-developed, obese female that looks unwell. Her heart has a regular rate and rhythm. Radial pulses are weak but symmetric. Her lungs are clear to auscultation bilaterally. Her lateral left ankle is swollen, erythematous, and painful to palpate. An abdominal CT is consistent with acute pancreatitis. Which of the following is the most likely etiology for this patient’s disease?? {'A': 'Aspirin', 'B': 'Oral contraceptive pills', 'C': 'Scorpion sting', 'D': 'Hypothyroidism', 'E': 'Obesity'}, | C: Scorpion sting |
Answer the following medical question with one of the provided options: | Q:A 25-year-old primigravida presents to her physician for a routine prenatal visit. She is at 34 weeks gestation, as confirmed by an ultrasound examination. She has no complaints, but notes that the new shoes she bought 2 weeks ago do not fit anymore. The course of her pregnancy has been uneventful and she has been compliant with the recommended prenatal care. Her medical history is unremarkable. She has a 15-pound weight gain since the last visit 3 weeks ago. Her vital signs are as follows: blood pressure, 148/90 mm Hg; heart rate, 88/min; respiratory rate, 16/min; and temperature, 36.6℃ (97.9℉). The blood pressure on repeat assessment 4 hours later is 151/90 mm Hg. The fetal heart rate is 151/min. The physical examination is significant for 2+ pitting edema of the lower extremity. Which of the following tests o should confirm the probable condition of this patient?? {'A': 'Bilirubin assessment', 'B': 'Coagulation studies', 'C': 'Hematocrit assessment', 'D': 'Leukocyte count with differential', 'E': '24-hour urine protein'}, | E: 24-hour urine protein |
Answer the following medical question with one of the provided options: | Q:A 3900-g (8.6-lb) male infant is delivered at 39 weeks' gestation via spontaneous vaginal delivery. Pregnancy and delivery were uncomplicated but a prenatal ultrasound at 20 weeks showed a defect in the pleuroperitoneal membrane. Further evaluation of this patient is most likely to show which of the following findings?? {'A': 'Gastric fundus in the thorax', 'B': 'Pancreatic ring around the duodenum', 'C': 'Small and cystic kidneys', 'D': 'Hypertrophy of the gastric pylorus', 'E': 'Large bowel in the inguinal canal'}, | A: Gastric fundus in the thorax |
Answer the following medical question with one of the provided options: | Q:A 62-year-old woman presents for a regular check-up. She complains of lightheadedness and palpitations which occur episodically. Past medical history is significant for a myocardial infarction 6 months ago and NYHA class II chronic heart failure. She also was diagnosed with grade I arterial hypertension 4 years ago. Current medications are aspirin 81 mg, atorvastatin 10 mg, enalapril 10 mg, and metoprolol 200 mg daily. Her vital signs are a blood pressure of 135/90 mm Hg, a heart rate of 125/min, a respiratory rate of 14/min, and a temperature of 36.5°C (97.7°F). Cardiopulmonary examination is significant for irregular heart rhythm and decreased S1 intensity. ECG is obtained and is shown in the picture (see image). Echocardiography shows a left ventricular ejection fraction of 39%. Which of the following drugs is the best choice for rate control in this patient?? {'A': 'Atenolol', 'B': 'Verapamil', 'C': 'Diltiazem', 'D': 'Propafenone', 'E': 'Digoxin'}, | E: Digoxin |
Answer the following medical question with one of the provided options: | Q:A 35-year-old male presents to his primary care physician with complaints of seasonal allergies. He has been using intranasal vasoconstrictors several times per day for several weeks. What is a likely sequela of the chronic use of topical nasal decongestants?? {'A': 'Epistaxis', 'B': 'Hypertension', 'C': 'Permanent loss of smell', 'D': 'Persistent nasal crusting', 'E': 'Persistent congestion'}, | E: Persistent congestion |
Answer the following medical question with one of the provided options: | Q:A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-month history of amenorrhea, hot flashes, and increased sweating. She reports that she has been overweight all her adult life and is happy to have lost 6.8-kg (15-lb) of weight in the past 2 months. Her pulse is 110/min, and blood pressure is 148/98 mm Hg. Physical examination shows moist palms and a nontender thyroid gland that is enlarged to two times its normal size. Ophthalmologic examination shows prominence of the globes of the eyes, bilateral lid retraction, conjunctival injection, and an inability to converge the eyes. There is no pain on movement of the extraocular muscles. Visual acuity is 20/20 bilaterally. Neurologic examination shows a fine resting tremor of the hands. Deep tendon reflexes are 3+ with a shortened relaxation phase. Which of the following is the most likely cause of this patient's ocular complaints?? {'A': 'Granulomatous inflammation of the cavernous sinus', 'B': 'Abnormal communication between the cavernous sinus and the internal carotid artery', 'C': 'Glycosaminoglycan accumulation in the orbit', 'D': 'Bacterial infection of the orbital contents', 'E': 'Sympathetic hyperactivity of levator palpebrae superioris\n"'}, | C: Glycosaminoglycan accumulation in the orbit |
Answer the following medical question with one of the provided options: | Q:A 1-year-old boy presents to the emergency department with weakness and a change in his behavior. His parents state that they first noticed the change in his behavior this morning and it has been getting worse. They noticed the patient was initially weak in his upper body and arms, but now he won’t move his legs with as much strength or vigor as he used to. Physical exam is notable for bilateral ptosis with a sluggish pupillary response, a very weak sucking and gag reflex, and shallow respirations. The patient is currently drooling and his diaper is dry. The parents state he has not had a bowel movement in over 1 day. Which of the following is the pathophysiology of this patient’s condition?? {'A': 'Antibodies against postsynaptic nicotinic cholinergic ion channels', 'B': 'Autoantibodies against the presynaptic voltage-gated calcium channels', 'C': 'Autoimmune demyelination of peripheral nerves', 'D': 'Blockade of presynaptic acetylcholine release at the neuromuscular junction', 'E': 'Lower motor neuron destruction in the anterior horn'}, | D: Blockade of presynaptic acetylcholine release at the neuromuscular junction |
Answer the following medical question with one of the provided options: | Q:A 9-month-old female is brought to the emergency department after experiencing a seizure. She was born at home and was normal at birth according to her parents. Since then, they have noticed that she does not appear to be achieving developmental milestones as quickly as her siblings, and often appears lethargic. Physical exam reveals microcephaly, very light pigmentation (as compared to her family), and a "musty" body odor. The varied manifestations of this disease can most likely be attributed to which of the following genetic principles?? {'A': 'Anticipation', 'B': 'Incomplete penetrance', 'C': 'Multiple gene mutations', 'D': 'Pleiotropy', 'E': 'Variable expressivity'}, | D: Pleiotropy |
Answer the following medical question with one of the provided options: | Q:A 23-year-old man comes to the physician for evaluation of decreased hearing, dizziness, and ringing in his right ear for the past 6 months. Physical examination shows multiple soft, yellow plaques and papules on his arms, chest, and back. There is sensorineural hearing loss and weakness of facial muscles bilaterally. His gait is unsteady. An MRI of the brain shows a 3-cm mass near the right internal auditory meatus and a 2-cm mass at the left cerebellopontine angle. The abnormal cells in these masses are most likely derived from which of the following embryological structures?? {'A': 'Neural tube', 'B': 'Surface ectoderm', 'C': 'Neural crest', 'D': 'Notochord', 'E': 'Mesoderm'}, | C: Neural crest |
Answer the following medical question with one of the provided options: | Q:A 62-year-old woman comes to the physician because of coughing and fatigue during the past 2 years. In the morning, the cough is productive of white phlegm. She becomes short of breath walking up a flight of stairs. She has hypertension and hyperlipidemia. She has recently retired from working as a nurse at a homeless shelter. She has smoked 1 pack of cigarettes daily for 40 years. Current medications include ramipril and fenofibrate. Her temperature is 36.5°C (97.7°F), respirations are 24/min, pulse is 85/min, and blood pressure is 140/90 mm Hg. Scattered wheezing and rhonchi are heard throughout both lung fields. There are no murmurs, rubs, or gallops but heart sounds are distant. Which of the following is the most likely underlying cause of this patient's symptoms?? {'A': 'Chronic decrease in pulmonary compliance', 'B': 'Local accumulation of kinins', 'C': 'Mycobacterial invasion of pulmonary parenchyma', 'D': 'Progressive obstruction of expiratory airflow', 'E': 'Incremental loss of functional residual capacity\n"'}, | D: Progressive obstruction of expiratory airflow |
Answer the following medical question with one of the provided options: | Q:A 68-year-old man presents to the emergency department with leg pain. He states that the pain started suddenly while he was walking outside. The patient has a past medical history of diabetes, hypertension, obesity, and atrial fibrillation. His temperature is 99.3°F (37.4°C), blood pressure is 152/98 mmHg, pulse is 97/min, respirations are 15/min, and oxygen saturation is 99% on room air. Physical exam is notable for a cold and pale left leg. The patient’s sensation is markedly diminished in the left leg when compared to the right, and his muscle strength is 1/5 in his left leg. Which of the following is the best next step in management?? {'A': 'CT angiogram', 'B': 'Graded exercise and aspirin', 'C': 'Heparin drip', 'D': 'Surgical thrombectomy', 'E': 'Tissue plasminogen activator'}, | C: Heparin drip |
Answer the following medical question with one of the provided options: | Q:A 76-year-old African American man presents to his primary care provider complaining of urinary frequency. He wakes up 3-4 times per night to urinate while he previously only had to wake up once per night. He also complains of post-void dribbling and difficulty initiating a stream of urine. He denies any difficulty maintaining an erection. His past medical history is notable for non-alcoholic fatty liver disease, hypertension, hyperlipidemia, and gout. He takes aspirin, atorvastatin, enalapril, and allopurinol. His family history is notable for prostate cancer in his father and lung cancer in his mother. He has a 15-pack-year smoking history and drinks alcohol socially. On digital rectal exam, his prostate is enlarged, smooth, and non-tender. Which of the following medications is indicated in this patient?? {'A': 'Clonidine', 'B': 'Hydrochlorothiazide', 'C': 'Midodrine', 'D': 'Oxybutynin', 'E': 'Tamsulosin'}, | E: Tamsulosin |
Answer the following medical question with one of the provided options: | Q:A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomen and sometimes occurs after eating, especially after a big meal. He has tried to go for a walk after dinner to help with digestion, but his complaints have only increased. For the past 3 weeks he has also had symptoms while climbing the stairs to his apartment. He has type 2 diabetes mellitus, hypertension, and stage 2 peripheral arterial disease. He has smoked one pack of cigarettes daily for the past 45 years. He drinks one to two beers daily and occasionally more on weekends. His current medications include metformin, enalapril, and aspirin. He is 168 cm (5 ft 6 in) tall and weighs 126 kg (278 lb); BMI is 45 kg/m2. His temperature is 36.4°C (97.5°F), pulse is 78/min, and blood pressure is 148/86 mm Hg. On physical examination, the abdomen is soft and nontender with no organomegaly. Foot pulses are absent bilaterally. An ECG shows no abnormalities. Which of the following is the most appropriate next step in diagnosis?? {'A': 'Esophagogastroduodenoscopy', 'B': 'CT scan of the abdomen', 'C': 'Hydrogen breath test', 'D': 'Cardiac stress test', 'E': 'Abdominal ultrasonography of the right upper quadrant'}, | D: Cardiac stress test |
Answer the following medical question with one of the provided options: | Q:A 27-year-old female presents to general medical clinic for a routine checkup. She has a genetic disease marked by a mutation in a chloride transporter. She has a history of chronic bronchitis. She has a brother with a similar history of infections as well as infertility. Which of the following is most likely true regarding a potential vitamin deficiency complication secondary to this patient's chronic illness?? {'A': 'It may result in connective tissue defects', 'B': 'It may result in corneal vascularization', 'C': 'It may result in the triad of confusion, ophthalmoplegia, and ataxia', 'D': 'It may be exacerbated by excessive ingestion of raw eggs', 'E': 'It may manifest itself as a prolonged PT'}, | E: It may manifest itself as a prolonged PT |
Answer the following medical question with one of the provided options: | Q:A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does not drink any alcohol. Physical examination shows jaundice. Abdominal and neurologic examinations show no abnormalities. Serum studies show increased levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). A liver biopsy is performed and a photomicrograph after periodic acid-Schiff-staining is shown. Which of the following is the most likely additional finding in this patient?? {'A': 'Tropheryma whipplei-specific RNA on PCR', 'B': 'Bullous changes of the lung bases on chest CT', 'C': 'Beading of intra- and extrahepatic bile ducts on ERCP', 'D': 'Myocardial iron deposition on cardiovascular MRI', 'E': 'Dark corneal ring on slit-lamp examination'}, | B: Bullous changes of the lung bases on chest CT |
Answer the following medical question with one of the provided options: | Q:A 69-year-old male presents to the emergency room with back pain. He has a history of personality disorder and metastatic prostate cancer and was not a candidate for surgical resection. He began chemotherapy but discontinued due to unremitting nausea. He denies any bowel or bladder incontinence. He has never had pain like this before and is demanding morphine. The nurse administers IV morphine and he feels more comfortable. Vital signs are stable. On physical examination you note tenderness to palpation along the lower spine, weakness in the bilateral lower extremities, left greater than right. Neurological examination is also notable for hyporeflexia in the knee and ankle jerks bilaterally. You conduct a rectal examination, which reveals saddle anesthesia. Regarding this patient, what is the most likely diagnosis and the appropriate next step in management?? {'A': 'The most likely diagnosis is cauda equina syndrome and steroids should be started prior to MRI', 'B': 'The most likely diagnosis is cauda equina syndrome and steroids should be started after to MRI', 'C': 'The most likely diagnosis is cauda equina syndrome and the patient should be rushed to radiation', 'D': 'The most likely diagnosis is conus medullaris syndrome and steroids should be started prior to MRI', 'E': 'The most likely diagnosis is conus medullaris syndrome and steroids should be started after to MRI'}, | A: The most likely diagnosis is cauda equina syndrome and steroids should be started prior to MRI |
Answer the following medical question with one of the provided options: | Q:An investigator is studying the function of the lateral nucleus of the hypothalamus in an experimental animal. Using a viral vector, the genes encoding chloride-conducting channelrhodopsins are injected into this nucleus. Photostimulation of the channels causes complete inhibition of action potential generation. Persistent photostimulation is most likely to result in which of the following abnormalities in these animals?? {'A': 'Hypothermia', 'B': 'Hyperthermia', 'C': 'Polydipsia', 'D': 'Nocturnal hyperactivity', 'E': 'Anorexia'}, | E: Anorexia |
Answer the following medical question with one of the provided options: | Q:A 52-year-old woman comes to the physician because of a 6-month history of generalized fatigue, low-grade fever, and a 10-kg (22-lb) weight loss. Physical examination shows generalized pallor and splenomegaly. Her hemoglobin concentration is 7.5 g/dL and leukocyte count is 41,800/mm3. Leukocyte alkaline phosphatase activity is low. Peripheral blood smear shows basophilia with myelocytes and metamyelocytes. Bone marrow biopsy shows cellular hyperplasia with proliferation of immature granulocytic cells. Which of the following mechanisms is most likely responsible for this patient's condition?? {'A': 'Overexpression of the c-KIT gene', 'B': 'Cytokine-independent activation of the JAK-STAT pathway', 'C': 'Loss of function of the APC gene', 'D': 'Altered expression of the retinoic acid receptor gene', 'E': 'Unregulated expression of the ABL1 gene'}, | E: Unregulated expression of the ABL1 gene |
Answer the following medical question with one of the provided options: | Q:A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being treated with IV piperacillin-tazobactam. She calls the nurse to her room because she says that her heart is racing. She also demands that someone come in to clean the pile of garbage off of the floor because it is attracting flies. Her pulse is 112/min, respiratory rate is 20/min, temperature is 38.0°C (100.4°F), and blood pressure is 150/90 mm Hg. On physical examination, the patient appears sweaty, distressed, and unable to remain still. She is oriented to person, but not place or time. Palpation of the abdomen shows no tenderness, rebound, or guarding. Which of the following is the most likely diagnosis in this patient?? {'A': 'Acute cholangitis', 'B': 'Alcoholic hallucinosis', 'C': 'Delirium tremens', 'D': 'Hepatic encephalopathy', 'E': 'Thyroid storm'}, | C: Delirium tremens |
Answer the following medical question with one of the provided options: | Q:A 48-year-old woman comes to the emergency department because of a photosensitive blistering rash on her hands, forearms, and face for 3 weeks. The lesions are not itchy. She has also noticed that her urine has been dark brown in color recently. Twenty years ago, she was successfully treated for Coats disease of the retina via retinal sclerotherapy. She is currently on hormonal replacement therapy for perimenopausal symptoms. Her aunt and sister have a history of a similar skin lesions. Examination shows multiple fluid-filled blisters and oozing erosions on the forearms, dorsal side of both hands, and forehead. There is hyperpigmented scarring and patches of bald skin along the sides of the blisters. Laboratory studies show a normal serum ferritin concentration. Which of the following is the most appropriate next step in management to induce remission in this patient?? {'A': 'Pursue liver transplantation', 'B': 'Begin oral thalidomide therapy', 'C': 'Begin phlebotomy therapy', 'D': 'Begin oral hydroxychloroquine therapy', 'E': 'Begin subcutaneous deferoxamine therapy'}, | C: Begin phlebotomy therapy |
Answer the following medical question with one of the provided options: | Q:A 53-year-old man comes to the emergency department because of severe right-sided flank pain for 3 hours. The pain is colicky, radiates towards his right groin, and he describes it as 8/10 in intensity. He has vomited once. He has no history of similar episodes in the past. Last year, he was treated with naproxen for swelling and pain of his right toe. He has a history of hypertension. He drinks one to two beers on the weekends. Current medications include amlodipine. He appears uncomfortable. His temperature is 37.1°C (99.3°F), pulse is 101/min, and blood pressure is 130/90 mm Hg. Examination shows a soft, nontender abdomen and right costovertebral angle tenderness. An upright x-ray of the abdomen shows no abnormalities. A CT scan of the abdomen and pelvis shows a 7-mm stone in the proximal ureter and grade I hydronephrosis on the right. Which of the following is most likely to be seen on urinalysis?? {'A': 'Urinary pH: 7.3', 'B': 'Urinary pH: 4.7', 'C': 'Hexagon shaped crystals', 'D': 'Positive nitrites test', 'E': 'Largely positive urinary protein'}, | B: Urinary pH: 4.7 |
Answer the following medical question with one of the provided options: | Q:A 5-year-old girl is brought to the clinic by her mother for excessive hair growth. Her mother reports that for the past 2 months she has noticed hair at the axillary and pubic areas. She denies any family history of precocious puberty and reports that her daughter has been relatively healthy with an uncomplicated birth history. She denies any recent illnesses, weight change, fever, vaginal bleeding, pain, or medication use. Physical examination demonstrates Tanner stage 4 development. A pelvic ultrasound shows an ovarian mass. Laboratory studies demonstrates an elevated level of estrogen. What is the most likely diagnosis?? {'A': 'Congenital adrenal hyperplasia', 'B': 'Granulosa cell tumor', 'C': 'Idiopathic precocious puberty', 'D': 'McCune-Albright syndrome', 'E': 'Sertoli-Leydig tumor'}, | B: Granulosa cell tumor |
Answer the following medical question with one of the provided options: | Q:A 16-year-old boy is brought to the physician by his mother because she is worried about his behavior. Yesterday, he was expelled from school for repeatedly skipping classes. Over the past 2 months, he was suspended 3 times for bullying and aggressive behavior towards his peers and teachers. Once, his neighbor found him smoking cigarettes in his backyard. In the past, he consistently maintained an A grade average and had been a regular attendee of youth group events at their local church. The mother first noticed this change in behavior 3 months ago, around the time at which his father moved out after discovering his wife was having an affair. Which of the following defense mechanisms best describes the change in this patient's behavior?? {'A': 'Suppression', 'B': 'Acting out', 'C': 'Projection', 'D': 'Passive aggression', 'E': 'Regression'}, | B: Acting out |
Answer the following medical question with one of the provided options: | Q:A 63-year-old woman presents to her primary-care doctor for a 2-month history of vision changes, specifically citing the gradual onset of double vision. Her double vision is present all the time and does not get better or worse throughout the day. She has also noticed that she has a hard time keeping her right eye open, and her right eyelid looks 'droopy' in the mirror. Physical exam findings during primary gaze are shown in the photo. Her right pupil is 6 mm and poorly reactive to light. The rest of her neurologic exam is unremarkable. Laboratory studies show an Hb A1c of 5.0%. Which of the following is the next best test for this patient?? {'A': 'CT head (non-contrast)', 'B': 'Direct fundoscopy', 'C': 'Intraocular pressures', 'D': 'MR angiography of the head', 'E': 'Temporal artery biopsy'}, | D: MR angiography of the head |
Answer the following medical question with one of the provided options: | Q:An investigator is studying the modification of newly formed polypeptides in plated eukaryotic cells. After the polypeptides are released from the ribosome, a chemically-tagged protein attaches covalently to lysine residues on the polypeptide chain, forming a modified polypeptide. When a barrel-shaped complex is added to the cytoplasm, the modified polypeptide lyses, resulting in individual amino acids and the chemically-tagged proteins. Which of the following post-translational modifications has most likely occurred?? {'A': 'Acylation', 'B': 'Glycosylation', 'C': 'Phosphorylation', 'D': 'Carboxylation', 'E': 'Ubiquitination'}, | E: Ubiquitination |
Answer the following medical question with one of the provided options: | Q:A 38-year-old man presents to his physician with double vision persisting for a week. When he enters the exam room, the physician notes that the patient has a broad-based gait. The man’s wife informs the doctor that he has been an alcoholic for the last 5 years and his consumption of alcohol has increased significantly over the past few months. She also reports that he has become indifferent to his family members over time and is frequently agitated. She also says that his memory has been affected significantly, and when asked about a particular detail, he often recollects it incorrectly, though he insists that his version is the true one. On physical examination, his vital signs are stable, but when the doctor asks him where he is, he seems to be confused. His neurological examination also shows nystagmus. Which of the following options describes the earliest change in the pathophysiology of the central nervous system in this man?? {'A': 'Decreased α-ketoglutarate dehydrogenase activity in astrocytes', 'B': 'Increased extracellular concentration of glutamate', 'C': 'Increased astrocyte lactate', 'D': 'Breakdown of the blood-brain barrier', 'E': 'Increased fragmentation of deoxyribonucleic acid within the neurons'}, | A: Decreased α-ketoglutarate dehydrogenase activity in astrocytes |
Answer the following medical question with one of the provided options: | Q:A 69-year-old man is brought by his son to the emergency department with weakness in his right arm and leg. The man insists that he is fine and blames his son for "creating panic". Four hours ago the patient was having tea with his wife when he suddenly dropped his teacup. He has had difficulty moving his right arm since then and cannot walk because his right leg feels stuck. He has a history of hypertension and dyslipidemia, for which he currently takes lisinopril and atorvastatin, respectively. He is allergic to aspirin and peanuts. A computerized tomography (CT) scan shows evidence of an ischemic stroke. Which medication would most likely prevent such attacks in this patient in the future?? {'A': 'Abciximab', 'B': 'Alteplase', 'C': 'Urokinase', 'D': 'Celecoxib', 'E': 'Clopidogrel'}, | E: Clopidogrel |
Answer the following medical question with one of the provided options: | Q:A 70-year-old man presents to a medical clinic reporting blood in his urine and lower abdominal pain for the past few days. He is also concerned about urinary frequency and urgency. He states that he recently completed a cycle of chemotherapy for non-Hodgkin lymphoma. Which medication in the chemotherapy regimen most likely caused his symptoms?? {'A': 'Cytarabine', 'B': 'Methotrexate', 'C': 'Rituximab', 'D': 'Cyclophosphamide', 'E': 'Prednisone'}, | D: Cyclophosphamide |
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