Uworld | Step 2ck

2022-05-20 21:22:01 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

2022-05-20 07:22:01 Open / Comment

2022-05-20 07:21:01 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

2022-05-19 21:21:01 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

2022-05-19 11:20:11 Open / Comment

2022-05-19 11:19:24 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

2022-05-18 21:05:26 Educational objective: Delirium is an acute confusional state characterized by a reduced or fluctuating level of consciousness, along with inability to sustain attention, anxiety, agitation, andfor hallucinations. Common precipitating causes of delirium include infections (eg, urinary tract infection), polypharmacy, medication side effects, volume depletion, and electrolyte or metabolic disturbances. Open / Comment

2022-05-18 17:09:27 https://t.me/studentdoctor Open / Comment

2022-05-18 11:58:57 https://t.me/USMLE_AMBOSS Open / Comment

2022-05-18 07:05:23 Open / Comment