Questions
Ask the room.
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What Are the Common Side Effects of Artvigil 150 mg?
**Headache**
One of the most commonly reported side effects of Armodafinil is headaches. Factors such as dehydration, hunger, lack of sleep, and caffeine intake can exacerbate th…
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1ans
163
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Is it safe to take Dolo 650 (paracetamol) daily for 10+ days for chronic tension headaches, or does that raise liver concerns?
Patient reports recurring tension-type headaches almost daily for the past 2 weeks, self-medicating with one Dolo 650 tablet most evenings for relief. No fever, no other analgesics…
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527
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A 2-Year-Old Child with Progressive Abdominal Distension: What's Your Diagnosis
A 2-year-old male child presents with progressive abdominal distension for 2 months, intermittent fever, weight loss, and decreased appetite. There is no history of trauma.
On exa…
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439
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Pediatric Oncology: Can You Identify the Diagnosis?
A **3-month-old female infant** presents with fever and abdominal distension.
### Imaging Findings
**Ultrasound Abdomen**
* Left suprarenal mass measuring **52 × 50 × 39 mm**
* …
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2ans
289
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Clinical Challenge: Can You Solve This Tropical Infection?
A 54-year-old man with diabetes presents with fever, weight loss, and multiple liver abscesses after returning from Southeast Asia. Culture reveals an oxidase-positive Gram-negativ…
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376
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CT urogram showing ureterovaginal fistula, right kidney swelling and stone – what does this mean and what treatment is needed?
53‑year‑old woman who recently had a CT urogram because of urinary leakage and discomfort. The report mentions:
Mild hydroureteronephrosis of the right kidney
A thin communicati…
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1ans
278
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What is the diagnostic approach to interstitial lung disease - when is HRCT sufficient vs surgical lung biopsy needed?
60-year-old male with progressive exertional dyspnea, dry cough for 1 year. HRCT shows basal bilateral honeycombing with traction bronchiectasis. No identifiable cause. How do I ap…
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335
views
When should asthma therapy be stepped up from ICS alone to ICS/LABA, and what triggers biologics?
25-year-old with diagnosed asthma. Currently on moderate-dose ICS, still using SABA 3x/week, waking at night twice a month. What step is this and when should I add LABA vs refer fo…
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252
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How is spontaneous pneumothorax managed - needle aspiration vs chest tube, and when is surgery indicated?
25-year-old tall male, first episode of right-sided pneumothorax, 3 cm on CXR. Mildly symptomatic. Do I observe, aspirate or insert a chest tube? And at what point should VATS be c…
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236
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What is the initial management of massive hemoptysis and when is bronchial artery embolization indicated?
Patient with TB history now coughing up >200 mL blood in 24 hours. SpO2 dropping. Is this massive hemoptysis? What are the immediate airway/positioning steps and when should we pro…
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190
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How is pulmonary arterial hypertension classified and what are treatment options for WHO Group 1 PAH?
35-year-old woman with progressive exertional dyspnea, mPAP 45 mmHg on right heart catheterization, no secondary cause found. How is PAH classified and what drugs should be started…
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205
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When should BiPAP/NIV be started in COPD exacerbation with hypercapnic respiratory failure?
COPD patient ABG: pH 7.29, pCO2 68, pO2 55 on controlled O2. Currently on nebulized bronchodilators and IV steroids. Drowsy but rousable. What are the criteria for NIV initiation a…
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184
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Which severity score is better for community-acquired pneumonia - CURB-65 or PSI? And what are ICU admission criteria?
70-year-old with fever, productive cough, RR 28/min, BUN 28, confusion, SpO2 90%. How do I score severity and determine hospitalization vs ICU admission?
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164
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How do you diagnose pulmonary embolism - when is D-dimer enough vs when is CTPA needed?
35-year-old post-surgery patient with sudden onset pleuritic chest pain and tachycardia. Wells score 4. D-dimer is elevated. Should I go straight to CTPA or is VQ scan better here?
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147
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How do you approach diagnosis of a unilateral pleural effusion — when is thoracentesis mandatory?
45-year-old with unilateral dullness on percussion and reduced breath sounds at left base. CXR shows left-sided opacity. No prior known disease. How do I differentiate transudative…
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150
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What is the stepwise management of acute COPD exacerbation in the ED?
65-year-old with COPD (FEV1 40% predicted) presents with increased dyspnea, purulent sputum, and SpO2 84% on room air. RR 28/min. What are the immediate and subsequent management s…
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158
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What are the indications and absolute contraindications for thrombolytic therapy in STEMI?
STEMI patient in a hospital without PCI facility. Door-to-balloon time will exceed 120 min. Patient has no prior stroke, no active bleeding, no recent surgery. Is thrombolysis appr…
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98
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What is the management of complete (3rd degree) AV block with hemodynamic instability?
75-year-old presents with syncope. ECG: HR 38 bpm, P waves dissociated from QRS. BP 80/50. No reversible cause found. What are the immediate and definitive management steps?
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88
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How does cardiac tamponade present clinically and what is the emergency treatment?
Post-cardiac surgery patient develops hypotension, raised JVP, muffled heart sounds, and pulsus paradoxus. Echo shows pericardial effusion with RV diastolic collapse. What is the i…
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87
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What are the Modified Duke Criteria for diagnosing infective endocarditis?
Patient with fever, new murmur, and positive blood cultures for Streptococcus viridans x2. How do I apply the Duke Criteria to confirm or rule out infective endocarditis?
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66
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When is coronary angiography indicated in patients with stable angina on optimal medical therapy?
60-year-old with exertional chest pain, positive stress test, on aspirin, statin, and long-acting nitrates. Symptoms persist. Should I proceed with coronary angiography? What are t…
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64
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What are the preferred drugs for rate control in atrial fibrillation and when is rhythm control preferred?
Patient with new-onset AF, HR 130 bpm, mildly symptomatic. No structural heart disease. Should I use beta-blocker, CCB, or digoxin for rate control? When would I consider rhythm co…
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75
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How is hypertensive emergency managed differently from hypertensive urgency?
BP 210/120 mmHg with papilledema and mild confusion. No prior history. Is this a hypertensive emergency or urgency? What is the target BP reduction and timeline?
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62
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What are the current indications for ICD implantation in patients with heart failure with reduced EF?
Patient with HFrEF (EF 28%) has been on optimal medical therapy for 6 months. When is ICD indicated vs CRT-D? What EF cutoff and NYHA class criteria apply?
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How do you differentiate STEMI from NSTEMI on a 12-lead ECG?
A patient presents with chest pain. ECG shows changes in multiple leads. How do I distinguish STEMI requiring immediate cath lab activation from NSTEMI that can be managed medicall…
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75
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What is the first-line treatment for acute decompensated heart failure with pulmonary edema?
A 68-year-old patient presents with severe breathlessness, SpO2 88%, bilateral crackles, and elevated JVP. CXR shows pulmonary congestion. What is the immediate management priority…
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214
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MBBS Final Year – Obstetrics & Gynecology Discussion
Long Answer Question:
Define preeclampsia. Discuss risk factors, clinical features, complications, investigations, and management of severe preeclampsia.
Answer as you would writ…
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173
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MBBS Final Year – General Medicine Discussion
A 55-year-old male presented with fever, productive cough, breathlessness, and chest pain for 5 days. On examination, temperature is 102°F, respiratory rate 32/min, and crepitation…
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146
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ICU/Oncology Case Discussion – Radiation Oncology
A 58-year-old male, chronic smoker and tobacco chewer for more than 25 years, presented with progressive difficulty swallowing, change in voice, severe throat pain radiating to the…
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114
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How would you manage this ICU airway and ventilation emergency? Opinions from anesthesiologists and intensivists welcome.
ICU Case Discussion – Anesthesia/Critical Care
A 64-year-old male with a history of Type 2 Diabetes, COPD, and Hypertension was admitted to ICU with severe community-acquired pneu…
For peer discussion only — not a substitute for clinical judgment. Verify with authoritative sources.