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* nbme q17
 #830273  
  cosmos123 - 08/11/16 14:41
 
  A 24-year-old man is admitted to the hospital because of a 2-day history of agitation and difficulty sleeping. He has no history of serious illness. Vital signs are T 37.8 C, pulse 100/min, respirations 18/min, and BP 130/80 mm Hg. Pupils are dilated and reactive to light. During the mental status examination, the patient claims that he is God and speaks rapidly, jumping from topic to topic. Complete blood count and serum electrolyte concentrations are within the reference ranges. Toxicology screening of the urine is negative. Serum thyroid studies are pending. Ophthalmoscopic examination is shown. Which of the following is the most appropriate next step in diagnosis?

(picture of fundoscopy shown)

A) CT scan of the head
B) ECG
C) 24-Hour urine collection for porphyrin
D) Lumbar puncture
E) MRI of the brain

 
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* Re:nbme q17
#3305286
  usmdca - 08/11/16 14:43
 
  A) CT scan of the head  
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* Re:nbme q17
#3305309
  norwood - 08/11/16 16:03
 
  Aaa  
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* Re:nbme q17
#3305319
  bzd_abuser - 08/11/16 16:32
 
  A) CT scan of the head
 
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* Re:nbme q17
#3305380
  hindro - 08/12/16 00:20
 
  Head CT  
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* Re:nbme q17
#3375715
  usmle742 - 12/03/18 16:41
 
  why not MRI head  
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