l18 - shuun - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6) +--- Thread: l18 - shuun (/showthread.php?tid=436839) |
l18 - shuun - ArchivalUser - 08-10-2009 A 59-year-old woman comes to the clinic complaining of pain in her hands. She states that her fingers are often numb and tingling, particularly along her thumb and first three fingers. The pain sometimes wakes her from her sleep and requires her to shake her hands until normal sensation returns. The pain, described as sharp tingling preceded by numbness, is often worse after knitting, a hobby she pursues with great vigor. Aside from this pain, she complains only of mild fatigue and being overweight. She denies any fevers, chills, visual changes, polyphagia/ polydipsia/polyuria, or other systemic symptoms. Past medical history is remarkable only for depression, irritable bowel syndrome (constipation dominant), and high blood pressure treated with a thiazide diuretic. Physical examination shows mild wasting of the bilateral thenar eminences of her palms. Tapping on her wrist increases the pain, as does prolonged flexion of her wrists. Given this patientâ„¢s presentation, an appropriate test to order when working up the primary cause of her hand pain is (A) antinuclear antibody titer (B) hemoglobin A1c level © no additional testing necessary (D) thyroid-stimulating hormone (E) urine pregnancy test easy one......... 0 - ArchivalUser - 08-10-2009 D... 0 - ArchivalUser - 08-10-2009 EEE 0 - ArchivalUser - 08-10-2009 hypothy with carpal tunnel syndrome 0 - ArchivalUser - 08-10-2009 oooops ans: DDD 0 - ArchivalUser - 08-10-2009 hahah ,-- cony, when is your exam. you may be tired for study? 0 - ArchivalUser - 08-10-2009 Meti ...................yu are ready .. D..........This patient has carpal tunnel syndrome. Although the condition is often idiopathic, it also is associated with endocrinopathies, such as hypothyroidism and acromegaly. 0 - ArchivalUser - 08-10-2009 shuun. you erote it's easy. so -- no i'm not ready |