Surgery collections Videos and quizez 2021

2023-02-26 20:43:02 Educational objective: A single brain abscess usually results from direct extension of an adjacent infection (eg, otitis media, sinusitis, dental infection). Viridans streptococcus and Staphylococcus aureus are the 2 most commonly isolated orqanisms. Headache, fever, focal neurologic deficits, and seizure may be present. Brain imaging (CT scan, 11/IRI) typically reveals a single ring-enhancing lesion with central necrosis. Open / Comment

2023-02-26 08:42:02 A 21-year-old man is brought to the emergency department by his family after a witnessed generalized tonic-clonic seizure. His sister says that the patient has never had a previous seizure but has had progressive headaches, fever, nasal congestion, and rhinorrhea over the last 3 weeks. He has no chronic medical problems and does not use alcohol, tobacco, or illicit drugs. Temperature is 38.9 C (102 F), blood pressure is 130/85 mm Hg, and pulse is 96/min. The patient is drowsy and postictaL CT scan of the head with intravenous contrast reveals a 3-cm ring-enhancing lesion in the left frontal lobe. There are air-fluid levels and mucosal edema in the paranasal sinuses. Rapid HIV testing is negative. Open / Comment

2023-02-25 20:42:02 Educational objective: Huntington disease is an autosornal dominant disease of CAG trinucleotide repeat expansion characterized by psychiatric symptoms, cognitive impairment, and chorea.
It is associated with preferential degeneration of GABA-producing neurons in the caudate nucleus and putarnen. Open / Comment

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https://t.me/USMLERECALLS2021/872 Open / Comment

2023-02-25 08:39:02 A 37-year-old woman comes to the office due to frequent tearfulness. The patient describes herself as "a happy person" at baseline but says that "about 6 months ago, I began to have more sad days than happy days." She frequently goes a week without leaving home and has to force
herself to eat and clean. The patient's father committed suicide at age 41, and her paternal grandfather is said to have died of a "mental disease" at age 49. The patient tearfully admits to thoughts of suicide but has no plans or intent. Temperature is 36.9 C (98.4 F), blood pressure is 121/77 mm Hg, pulse is 68/min, and respirations are 14/min. The patient has no subjective memory issues. She scores 25/30 on the Montreal Cognitive Assessment (normal: ;::26), losing points on measures of executive function. She appears restless during the examination, shifting frequently in her chair. The patient repeatedly raises her right arm in an abrupt, twisting motion that ends with smoothing her hair. Extraocular movement testing shows delayed initiation of voluntary saccades. Deep tendon reflexes are 3+ in both upper and lower extremities. Open / Comment

2023-02-24 20:38:02 Educational objective: Migraine should be suspected in patients with unilateral headaches with a pulsing or throbbing quality, particularly if accompanied by nausea/vomiting and photophobia. Patients who have frequent attacks or disabling symptoms that do not respond to abortive treatment should be considered for prophylactic treatment, including topiramate, beta blockers, or amitriptyline. Open / Comment

2023-02-24 08:37:01 A 29-year-old woman comes to the office due to frequent episodes of headache. She has moderate to severe, left-sided, throbbing pain associated with nausea and occasional vomiting. Her headache is often preceded by a tingling sensation in the right hand that gradually involves the right arm and face and is followed by numbness lasting <1 hour. She feels irritable while experiencing the headaches. The pain typically improves following several hours of rest in a dark and quiet room. The patient has had these episodes every 1-2 months for the past 5 years. She has taken as-needed sumatriptan with some relief, but the symptoms have caused her to miss several days of work. She has no other medical history and does not use tobacco, alcohol, or recreational drugs. There is a family history of depression. Vital signs are within normal limits and physical examination is normal. Open / Comment

2023-02-23 20:37:01 Educational objective: Cervical spondylotic myelopathy is common in older adults and generally presents with progressive neck pain, gait disturbances, lower motor neuron signs in the upper extremities (eg, weakness, diminished reflexes), and upper motor neuron signs in the lower extremities (eg, increased reflexes, spasticity). Open / Comment

2023-02-23 11:57:19 https://t.me/studentdoctor Open / Comment

2023-02-23 08:36:01 A 62-year-old woman comes to the office due to progressive gait unsteadiness. The patient's legs feel stiff, and she frequently stumbles and has to hold handrails while descending stairs. She also has had tingling and numbness in the hands and an occasional electric shock-like sensation in the spine. She has had no bowel or bladder incontinence. The patient has fibromyalgia and continues to have shoulder and neck pain despite a recent dosage increase in duloxetine. Other medical conditions include depression and hypothvroidism. She does not use tobacco, alcohol, or illicit drugs. Examination of the cranial nerves is normal. Upper extremity muscle strength is decreased, with mild wasting of intrinsic hand muscles. Lower extremity tone and reflexes are increased bilaterally. Sensation is grossly intact Open / Comment