#MEDICINE (NEET PG)
A patient presented to emergency with altered sensorium was found to have irregularly irregular pulse with a pulse deficit of 20. JVP will show?
A. Cannon a waves
B. Absent a waves
C. Rapid x decent
D. Absent y descent
A patient is planned for dental procedure. In which of the following infective endocarditis prophylaxis is not indicated?
A. Atrial septal defect
B. Untreated congenital CHD
C. Prosthetic valves
D. History of endocarditis
Explain:- Drug therapy is not currently a component of the standard of care for this condition. No specific medications are indicated for patients with a secundum atrial septal defect. Bacterial endocarditis prophylaxis is required for the first 6 months following device closure or surgical closure with a patch. Preoperatively, antibiotic prophylaxis is not required in an isolated ostium secundum atrial septal defect.
A patient with chronic liver disease developed ascites with diffuse pain abdomen. Ascitic tap showed 600 polymorphic neutrophils/ml. What is the most likely diagnosis?
A. Malignant ascites
B. Tuberculosis
C. Subacute bacterial peritonitis
D. Edema
Explain:- Also called 1° bacterial peritonitis. Common and potentially fatal bacterial infection in patients with cirrhosis and ascites. Often asymptomatic, but can cause fevers, chills, abdominal pain, ileus, or worsening encephalopathy. Commonly caused by gram ⊝ organisms (eg, E coli, Klebsiella) or less commonly gram ⊕ Streptococcus. Diagnosis: paracentesis with ascitic fluid absolute neutrophil count (ANC) > 250 cells/mm3. Empiric first-line treatment is 3rd generation cephalosporin (eg, cefotaxime).
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