Uworld | Step 2ck

2022-10-07 08:11:01 Open / Comment

2022-10-07 08:10:12 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

2022-10-06 20:10:11 Educational objective: Chemotherapy-induced peripheral neuropathy typically presents as a symmetric, distal, sensory neuropathy that spreads in a stocking-glove pattern. Common causative agents include platinum-based medications (eg, cisplatin}, taxanes (eg, paclitaxel), and Vinca alkaloids (eg, vincristine Open / Comment

2022-10-06 08:10:11 Open / Comment

2022-10-06 08:09:01 A 58-year-old woman comes to the physician due to difficulty walking. Over the last several weeks she has also experienced bilateral foot numbness and tingling. She was diagnosed with advanced Hodgkin lymphoma 2 months ago and is currently undergoing chemotherapy containing bleomycin, doxorubicin, and vincristine. Her other medical problems include type 2 diabetes and hypertension. Physical examination shows bilateral weakness on dorsiflexion of the feet and loss of pain and temperature sensation affecting both toes. Knee jerk reflexes are 2+ bilaterally but ankle jerk reflexes are absent Open / Comment

2022-10-05 21:02:01 Educational objective: Migraine is an episodic neurological disorder that results in severe, unilateral, phonophobia, and nausea/vomiting;
throbbing headaches often associated with photophobia, they may be accompanied by aura (focal, reversible neurologic symptoms that precede or accompany the
headache). Estrogen-containing contraceptives are contraindicated in patients with migraine with aura due to the increased risk of ischemic stroke. Open / Comment

2022-10-05 08:01:01 Open / Comment

2022-10-05 08:01:01 An 18-year-old woman comes to the office due to recurrent headaches. In the past, the patient has had occasional headaches, especially during term exams or other stressful situations. However, over the past 3 months, she has had 4 episodes of severe headache. They are always left sided, throbbing, associated with nausea, and spontaneously resolve after 12-24 hours. The patient also reports feelings of numbness and tingling in her extremities prior to the headaches. She has no chronic medical conditions and underwent an appendectomy several years ago. The patient is sexually active with her boyfriend and began taking combined oral contraceptives 6 months ago. Vital signs are within normal limits. Physical examination, including neurological examination, shows no abnormalities. Open / Comment

2022-10-04 20:01:30 Open / Comment

2022-10-04 08:00:56 Open / Comment