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+--- Thread: Qs - munnabhai79 (/showthread.php?tid=177347)
Qs - munnabhai79 - ArchivalUser - 04-09-2007
A previously healthy 67-year-old man comes to the physician because of a 4-month history of hand weakness, intermittent tingling of the small fingers of his hands, and mild neck pain. Examination shows wasting, weakness, and fasciculations of the interossei muscles. Sensation is decreased to pinprick and vibration in the small fingers of each hand. Triceps tendon reflexes are decreased. Which of the following is the most likely diagnosis?
A ) Amyotrophic lateral sclerosis
B ) Cervical spondylosis
C ) Multiple sclerosis
D ) Myasthenia gravis
E ) Myasthenic (Lambert-Eaton) syndrome
F ) Myotonic muscular dystrophy
G ) Polymyalgia rheumatica
H ) Polymyositis
I ) Progressive neuropathic (peroneal) muscular atrophy
A 27-year-old primigravid woman at 29 weeks' gestation comes to the emergency department because of a 24-hour history of increasingly severe right-sided abdominal pain and no appetite. She has vomited twice over the past 4 hours. She has not had vaginal bleeding. Her temperature is 38.2 C (100.8 F). Examination shows exquisite tenderness of the right lateral flank and the fundus. There are no peritoneal signs. Bowel sounds are absent. The fetal heart rate is 144/min. Laboratory studies show:
Hematocrit 37%
Leukocyte count 16,000/mm3
Serum
Total bilirubin 1.1 mg/dL
Amylase 32 U/L
Lactate dehydrogenase 110 U/L
Urine WBC 3“5/hpf
Which of the following is the most likely diagnosis?
A ) Abruptio placentae
B ) Appendicitis
C ) Cholelithiasis
D ) Colitis
E ) Pyelonephritis
0 - ArchivalUser - 04-09-2007
B
E (C ?) but WBC in urine !
0 - ArchivalUser - 04-09-2007
B definetly
0 - ArchivalUser - 04-09-2007
is no 1: A ?
0 - ArchivalUser - 04-09-2007
UMN or LMN or both -- Weakness, Atrophy, Muscle Spasticity but Sensation is Intact in ALS
0 - ArchivalUser - 04-09-2007
ALS is UMN +LMN
0 - ArchivalUser - 04-10-2007
GUYS FIRST QQQQQQQQ HAS A TYPICAL PRESENTATION OF LMN .....I DON'T SEE SIGH OF UMN .....I GO FOR CERVICAL SPON ..OR MMD....................................
FOR THE 2ND QQQQQQQQQQ WBC IN URINE ....RAISED TLC ......FLANK PAIN ...GO WITH PYELO NE.....ANY COMMENT
0 - ArchivalUser - 04-10-2007
B ) Appendicitis for 2nd one.
Bowel Sounds absent too, so....
any suggestion???
0 - ArchivalUser - 04-10-2007
munnabhai do u have the ans