Uworld | Step 1

2022-08-27 08:13:02 Open / Comment

2022-08-25 08:11:01 Open / Comment

2022-08-25 08:10:23 A 23-year-old, previously healthy man was involved in a motor vehicle collision. He lost consciousness at the scene but recovered by the time emergency medical services arrived. The patient was alert and awake in the ambulance but lost consciousness again soon after arriving at the emergency department. His breath smells of alcohol. Blood pressure is 130/90 mm Hg, pulse is 68/min, and respirations are 12/min. A bruise is noted over the left temple area. The left pupil is mildly dilated. Open / Comment

2022-06-23 20:05:35 Educational objective: Inadequate blood supply to the brain (eg, arterial thrombosis or embolism) leads to ischemic stroke. The first microscopic changes are typically seen 12-24 hours after irreversible ischemic injury and include intense eosinophilic staining of the neuronal cytoplasm (red neurons) and nuclear fragmentation. Open / Comment

2022-06-23 08:04:01 An 82-year-old man is found unresponsive by his neighbor. The patient lives alone in his suburban home. When the neighbor went to check on him, the patient was on the floor and not answering any questions. His medical history is unknown. On arrival of emergency medical services, the patient is obtunded and responds only to painful stimuli. Supportive measures are begun, including endotracheal intubation, but the patient dies en route to the hospital. Autopsy reveals extensive atherosclerotic disease involving the coronary and internal carotid arteries. Histopathologic examination of the brain in the right middle cerebral artery territory shows neurons with intensely eosinophilic cytoplasm and nuclear fragmentation. Open / Comment

2022-06-22 21:04:01 Educational objective: Superior gluteal nerve injury results in weakness and paralysis of the gluteus medius, gluteus minimus, and tensor fasciae latae muscles. This causes the pelvis to tilt downward toward the contralateral side (positive Trendelenburg sign). Patients will also lean toward the ipsilateral side when walking to help stabilize the pelvis (gluteus medius gait). Open / Comment

2022-06-22 08:04:01 Open / Comment

2022-06-22 08:03:01 A 63-year-old man comes to the physician's office due to long-standing osteoarthritis that is refractory to over-the-counter analgesics. After discussing various treatment options with his physician, the patient is referred to a surgeon for right total hip arthroplasty. His acute postoperative course is unremarkable. During a follow-up appointment, the patient reports difficulty walking despite minimal pain. On examination, he leans to his right side when walking. When asked to stand on his right leg, the patient's left hip tilts downward. Open / Comment

2022-06-21 20:03:01 Educational Objective: Acetylcholine release from presynaptic terminal vesicles at the neuromuscular junction depends upon the influx of extracellular calcium into the presynaptic terminal. Calcium influx into the nerve terminal occurs following neuronal depolarization and opening of voltage-gated calcium channels. Open / Comment

2022-06-21 08:02:02 Open / Comment