Uworld | Step 2ck

2022-04-12 07:39:01 Open / Comment

2022-04-12 07:38:01 A 35-year-old man is brought to the emergency department after being involved in a motor vehicle collision. He is unconscious. Blood pressure is 100/50 mm Hg, pulse is 100/min, and respirations are 19/min. Examination shows bilaterally reactive and nondilated pupils. He does not follow commands and makes inappropriate sounds. A CT scan of the head shows numerous minute punctate hemorrhages with blurring of the graywhite matter interface. Open / Comment

2022-04-11 20:38:01 Educational objective: Mild to moderate cancer-related pain can usually be managed with nonopioid analgesics. However, if initial interventions are not effective, intermittent doses of short-acting opioids should be offered. If the pain requires frequent dosing or if bedtime dosing does not provide relief through the night, a long-acting opioid may be added. Open / Comment

2022-04-11 07:37:02 Open / Comment

2022-04-11 07:37:01 A 71-year-old man comes to the ·office due to worsening low back pain. The patient is having significant pain with movement that is limiting his activity, as well as nocturnal pain that is disrupting his sleep. He has had no lower extremity weakness or numbness and no bladder or bowel dysfunction. He is taking ibuprofen 3-4 times a day, and it is not controlling his pain. The patient has a history of prostate cancer and takes leuprolide. He also received palliative radiotherapy for multiple lumbar spine metastases several months ago. Temperature is 37 C (98.6 F), blood pressure is 140/86 mm Hg, and pulse is 88/min. Lower extremity motor strength, deep tendon reflexes, and sensation are normal. Open / Comment

2022-04-10 20:36:01 Educational objective: Restless legs syndrome is characterized by an urge to move the legs and is accompanied by dysesthesias that are worsened by inactivity and improved with movement Symptoms are worse in the evening/night Treatment includes iron supplementation for iron deficiency, conservative measures, and pharmacotherapy with dopamine agonists (eg, pramipexole) or alpha-2-delta calcium channel ligands (eg, gabapentin). Open / Comment

2022-04-10 07:36:02 Open / Comment

2022-04-10 07:35:11 A 62-year-old man with hypertension and stage 3 chronic kidney disease complains of poor sleep. He describes the sensation of spiders crawling over both legs about 15-20 minutes after getting into bed at night Sometimes the patient has to sit up in bed and massage his legs. Walking and pacing around the bed or wiggling his legs alleviates the symptoms, but they return when he gets back in bed. His wife's sleep has deteriorated as her husband's leg movements have gotten worse. After initial evaluation, he is started on first-line pharmacotherapy for his condition. Open / Comment

2022-04-10 05:13:30 Most of the exam is repeated from recalls

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https://t.me/USMLERECALLS2021/525 Open / Comment