Uworld | Step 1

2021-11-21 08:31:04 Open / Comment

2021-11-21 08:30:56 A 74-year-old man with metastatic lung cancer is brought to the emergency department due to suddenonset severe headache, nausea, and vomiting. The patient was diagnosed with squamous cell lung cancer 4 months ago and was found to have metastasis to the right frontal lobe of the brain. He refused chemotherapy and radiation treatments and is receiving palliative care. Blood pressure is 142/86 mm Hg, pulse is 100/min, and respirations are 20/min. On examination, the patient is somnolent but wakes up to voice and follows instructions. Urgent CT scan of the head reveals hemorrhage within the tumor, causing significant surrounding edema; the right cingulate gyrus is seen herniating beneath the falx cerebri. Open / Comment

2021-11-20 20:30:55 Open / Comment

2021-11-20 20:29:01 A 68-year-old woman is evaluated for right lower extremity weakness while hospitalized. The patient was admitted after sustaining a right femoral neck fracture and underwent total hip arthroplasty. Her operative course was uncomplicated, but the patient experienced right leg weakness postoperatively. Since the surgery, she has had difficulty with physical therapy and reports numbness of the right leg. The patient's other medical conditions include hypertension, type 2 diabetes mellitus, a prior transient ischemic attack, and osteoarthritis. Right lower extremity examination shows weakness in dorsiflexion, plantar flexion, and knee flexion. Hip flexion and knee extension are normal. Sensation to light touch is decreased on the dorsum of the right foot and posterolateral aspect of the right calf. Ankle reflex is absent on the right. Open / Comment

2021-11-20 19:23:39 Open / Comment

2021-11-20 08:28:01 Open / Comment

2021-11-20 08:26:01 An elderly immigrant from the Middle East presents to your office complaining of numbness and tingling of his hands and feet. He was diagnosed with pulmonary tuberculosis several months ago and is currently receiving isoniazid and rifampin. Neurologic testing demonstrates sensory ataxia and decreased pain sensation in the distal extremities. Open / Comment

2021-11-19 20:22:02 Open / Comment

2021-11-19 20:21:01 A 28-year-old woman comes to the office due to pain at a previous surgery site. The patient underwent cesarean delivery a year ago and had no issues with wound healing. However, over the past 2 months, she has had intermittent sharp and burning pain at the incision site. Physical examination reveals a wellhealed, low, transverse scar. There is a small knot palpable at the left end of the scar, light touch of which elicits severe pain. Cutaneous sensory nerve injury and abnormal axonal regeneration are suspected. Open / Comment

2021-11-19 08:21:01 Open / Comment