Uworld | Step 2ck

2022-10-10 16:06:11 https://t.me/studentdoctor Open / Comment

2022-10-10 08:15:06 Open / Comment

2022-10-10 08:14:01 A 57-year-old man comes to the emergency department with right arm and leg weakness, first noticed about 2 hours ago when he could not grip a pen. He is now unable to shake hands and walks with a mild limp. The patient has also had a mild, constant headache the past several days that he attributes to stress from a new project at work. His past medical history is significant for hypertension and hyperlipidemia, and he does not smoke or consume alcohol. His blood pressure is 180/100 mm Hg, and pulse is 80/min. There is mild asymmetry of the lower face, decreased muscle strength in the right arm, and positive Babinski sign on the right side. Sensory examination is normal. Blood glucose is 210 mg/dL ECG shows sinus rhythm with occasional premature ventricular beats. Noncontrast CT scan of the head reveals no abnormalities. Open / Comment

2022-10-09 20:14:01 Educational objective: CT scan of a diffuse axonal injury shows numerous minute punctate hemorrhages with blurring of the gray-white interface. Open / Comment

2022-10-09 08:14:01 Open / Comment

2022-10-09 08:13:02 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 gray- Open / Comment

2022-10-08 20:13:01 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

2022-10-08 08:12:01 Open / Comment

2022-10-08 08:11:01 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

2022-10-07 20:11:01 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