#MEDICINE(NEET Pattern)
Que. A lady developed breathlessness, pruritus, urticaria 1 hour after eating NSAIDS for headache. Chest examination was remarkable for rales with BP-80/50 mm Hg. All of following can be used for initial management except:
ANSWER= B. Steroids
Explain:- Mild symptoms such as pruritus and urticaria can be controlled by administration of 0.3 to 0.5 mL of l: 1000 (l mg/mL) epinephrine SC or IM.
An IV infusion should be initiated to provide a route for administration of 2.5 mL epinephrine, diluted l: 10,000, at 5- to l0-min intervals, volume expanders such as normal saline, and vasopressor agents such as dopamine if intractable hypotension occurs.
Oxygen alone via a nasal catheter or with nebulized albuterol may be helpful, but either endotracheal intubation or a tracheostomy is mandatory for oxygen delivery if progressive hypoxia develops.
Que. A 50 years old male patient came to emergency with right hemiparesis and loss of speech for 2.5 hours. BP is 180/100. What is the next best step in the management of this patient?
Explain:- CT imaging of the brain is the standard imaging modality to detect the presence or absence of intracranial hemorrhage. If the stroke is ischemic, administration of recombinant tissue plasminogen activator (rtPA) or endovascular mechanical thrombectomy may be beneficial in restoring cerebral perfusion. Medical management to reduce the risk of complications becomes the next priority, followed by plans for secondary prevention.
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