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+--- Thread: mastiska! - ingoditrust (/showthread.php?tid=538856)
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mastiska! - ingoditrust - ArchivalUser - 10-06-2010
A 39-year-old woman who had a hysterectomy and bilateral oophorectomy 5 months earlier for heavy irregular menses comes to the office because of "strange feelings." She describes a "rising discomfort in her stomach followed immediately by feelings of rage." The episodes usually last a few minutes. She has had them in the past, but since the surgery they have increased in frequency. She has no chronic medical conditions that she is aware of and is taking estrogen replacement therapy. Physical examination is normal. The most appropriate next step is to
A. immediately send the patient to the emergency department
B. obtain a neurological consult
C. obtain a psychiatric consult
D. order a brain MRI
E. start the patient on phenytoin and see her back in 6 months
0 - ArchivalUser - 10-06-2010
A 52-year-old man comes to the emergency department because of "left arm shaking." He tells you that 2 days earlier he noted left arm paresthesias along the lateral aspect of his left arm and left 4th/5th fingers while he was reading. He thinks he may have been leaning on his left arm at the time and the symptoms resolved after 30 seconds. This morning he noted the same feelings lasting a few seconds, but then his 4th/5th fingers started shaking rhythmically, which then migrated to all his fingers, his hand, and then his arm up to his elbow. This episode lasted a total of 30 seconds. He denies any strange smells or tastes, visual changes, or weakness. Afterwards, his fingers felt "locked in position" for a few seconds. Then, he felt as if he did not have control of his hand and had difficulty donning his socks. He and his wife decided to drive to hospital and in the car he had trouble putting his seat belt into the socket. Examination and routine laboratory studies are normal. The most appropriate next step in management is to
A. discharge the patient to follow up in clinic in 2 weeks
B. obtain a brain MRI
C. obtain an electroencephalogram
D. obtain an orthopedic consult
E. order electromyography and nerve conduction studies
0 - ArchivalUser - 10-06-2010
A 21-year-old woman comes to the office because of 6 months of intermittent headaches. She reports having headaches in the past, but these are much more severe. The headaches are described as throbbing, unilateral, with associated photophobia. They are typically noticed around the time of her menses but are also exacerbated during stressful times such as her midterm exams. There is not an aura preceding any of these headaches. She has tried 200 mg of ibuprofen with minimal relief. Currently she is headache free. Physical examination is unremarkable. Her neurological examination is non-focal. The most appropriate pharmacotherapy to treat this patient's headaches is
A. amitriptyline
B. dihydroergotamine
C. indomethacin
D. sumatriptan
E. verapamil
0 - ArchivalUser - 10-06-2010
first q, b
0 - ArchivalUser - 10-06-2010
You are seeing a 28-year-old previously healthy male bodybuilder in the emergency department for headache evaluation. He tells you that he was lifting weights yesterday afternoon and then when he got home he developed a non-throbbing bifrontal headache during dinner. He took some aspirin and lay down and felt better in about 20 minutes. Then he got up and within 10 minutes of resuming normal activity the headache returned. He went to bed for the night and the headache resolved. Today the pain returned, but he feels better now that he is lying down on a stretcher. Neurologic examination is unremarkable. The most appropriate initial management of this patient's condition is
A. bed rest and hydration for 1-2 weeks
B. brain MRI
C. intravenous prochlorperazine
D. observation in the hospital
E. psychiatry consult
0 - ArchivalUser - 10-07-2010
B.......B.........D..........A
PL POST ALL ANS..THANKS.
0 - ArchivalUser - 10-07-2010
B- neuro consult
E- EMG-conduction studies
E- verapamil
B- MRI (for IC hypotension)
0 - ArchivalUser - 10-07-2010
Ans: B, E, E, C
0 - ArchivalUser - 10-07-2010
B-temporal epilepsy
B-partial seizure
C-No matter what the patient takes for relief of head ache,once she comes to you,you start her with NSAID
B-not sure,but the patient has increased intracranial htn
0 - ArchivalUser - 10-07-2010
what are the answers ingoditrust?