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1. A 21-year-old footballer presents to A&E
with a stabbing pain above his right knee
joint. He states the pain came on suddenly
while he was sprinting. On examination he
is unable to extend the leg and he walks
with a limp. There is suprapatellar swelling
and an absent knee jerk. What is the likely
diagnosis?
A Fracture of patella
B Injury to posterior cruciate ligament
C Tear of adductor magnus muscle
D Tear of biceps femoris muscle
E Tear of quadriceps tendon
2. During strenuous exercise, what else
occurs besides tachycardia?
A Rise in Paco2
B Increased stroke volume
C Rise in mixed venous blood O2 saturation
D No change to blood pressure
E Increased renal blood flow
3. A patient is found to have
thrombophlebitis migrans. What other
condition must be considered?
A Venous insufficiency
B Diabetes mellitus
C Bronchial carcinoma
D Lyme disease
E Beckwith–Wiedemann syndrome
1E: Tear of quadriceps tendon
A 21-year-old male has sustained an injury of sudden onset, associated with swelling and an
inability to extend at the knee joint and an absent knee reflex. This is consistent with an injury
to the quadriceps group of muscles that lie in the anterior compartment of the thigh and act as
the principal extensors of the knee joint. The mechanism of injury is inconsistent with a fractured
patella.
2B: Increased stroke volume
During strenuous exercise there is an increase in heart rate, stroke volume and cardiac output.
Remember cardiac output is a function of heart rate and stroke volume. During exercise, there is
an increase in respiratory rate (hyperventilation) which will lead to a reduction in Paco2. During
exercise the oxygen demand of skeletal muscle rises, therefore leading to a reduction in mixed
venous blood oxygen concentration. Renal blood flow is autoregulated, so renal blood flow is
preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac
output and total peripheral resistance and will increase with exercise, mainly as a result of the
increase in cardiac output that occurs.
3C: Bronchial carcinoma
Thrombophlebitis migrans (or migratory thrombophlebitis) is a condition that results in recurrent
episodes of venous inflammation (phlebitis) associated with thrombosis, that occurs in different
locations (migratory). It is generally caused by inflammatory, or malignant, conditions where
the patient is tipped into a hypercoagulable state. When associated with malignant conditions
it is known as Trousseau’s syndrome and is generally associated with visceral malignancies
(adenocarcinomas), such as gastric, pancreatic, bronchial carcinomas. It is a non-metastatic (or
paraneoplastic) effect of malignancy and is related to factors secreted by tumours.
1. A 21-year-old footballer presents to A&E
with a stabbing pain above his right knee
joint. He states the pain came on suddenly
while he was sprinting. On examination he
is unable to extend the leg and he walks
with a limp. There is suprapatellar swelling
and an absent knee jerk. What is the likely
diagnosis?
A Fracture of patella
B Injury to posterior cruciate ligament
C Tear of adductor magnus muscle
D Tear of biceps femoris muscle
E Tear of quadriceps tendon
2. During strenuous exercise, what else
occurs besides tachycardia?
A Rise in Paco2
B Increased stroke volume
C Rise in mixed venous blood O2 saturation
D No change to blood pressure
E Increased renal blood flow
3. A patient is found to have
thrombophlebitis migrans. What other
condition must be considered?
A Venous insufficiency
B Diabetes mellitus
C Bronchial carcinoma
D Lyme disease
E Beckwith–Wiedemann syndrome
1E: Tear of quadriceps tendon
A 21-year-old male has sustained an injury of sudden onset, associated with swelling and an
inability to extend at the knee joint and an absent knee reflex. This is consistent with an injury
to the quadriceps group of muscles that lie in the anterior compartment of the thigh and act as
the principal extensors of the knee joint. The mechanism of injury is inconsistent with a fractured
patella.
2B: Increased stroke volume
During strenuous exercise there is an increase in heart rate, stroke volume and cardiac output.
Remember cardiac output is a function of heart rate and stroke volume. During exercise, there is
an increase in respiratory rate (hyperventilation) which will lead to a reduction in Paco2. During
exercise the oxygen demand of skeletal muscle rises, therefore leading to a reduction in mixed
venous blood oxygen concentration. Renal blood flow is autoregulated, so renal blood flow is
preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac
output and total peripheral resistance and will increase with exercise, mainly as a result of the
increase in cardiac output that occurs.
3C: Bronchial carcinoma
Thrombophlebitis migrans (or migratory thrombophlebitis) is a condition that results in recurrent
episodes of venous inflammation (phlebitis) associated with thrombosis, that occurs in different
locations (migratory). It is generally caused by inflammatory, or malignant, conditions where
the patient is tipped into a hypercoagulable state. When associated with malignant conditions
it is known as Trousseau’s syndrome and is generally associated with visceral malignancies
(adenocarcinomas), such as gastric, pancreatic, bronchial carcinomas. It is a non-metastatic (or
paraneoplastic) effect of malignancy and is related to factors secreted by tumours.
Goji Berries... yes... I tried those too.For my health conditions, Those sweet, red berries seemed to help, but only during the time when I consumed them. I don't want to take a drug for the rest of my life, so why would I want to take a natural supplement everyday for the rest of my life (although Goji berries are very tasty and are highly nourishing). To me this was not a cure either (and I'm LOOKING for the CURE).
ReplyDeleteUp to that point, I hadn't found a cure. I felt like a young jumbled mess. I continued to have extreme pain, but continued on my path to healing. I started to focus on myself and not everyone else. When I was a young adult, I took on too much responsibility out of a sense of obligation. This was no longer healthy for me, so I resigned from all my projects and groups. Those days to come were the best [and worst] days. I took a lot of time off work, yet began to feel so extremely exhausted. Many health professionals "diagnosed" me with adrenal fatigue & Hiv,Prostate Cancer so my situation was annoying then I keep searching for permanent cure online that's when I came to know of Dr Itua herbal center hands whom god has blessed with ancestral herbs and a gift to heal people with diseaseSo I made a purchase of his herbal medicines and I have been watching my health for 6 years now and I actually confirmed that his herbal medicines are a permanent cure and I'm so happy that I came to know of his herbal healings.You can contact Dr Itua herbal center Email: drituaherbalcenter@gmail.com www.drituaherbalcenter.com if you went through exactly what I go through in terms of health conditions because to be honest there is more to learn about natural herbs than medical drugs.