qqqq4 - basicq

[ArchivalUser]

A 20-year-old man comes to his primary care physician because of a headache and excessive drowsiness for the past month. The headaches are dull and diffuse without any nausea, vomiting, or visual disturbances. He denies snoring and says he sleeps well through the night. However, he now has vivid dreams. He denies using drugs, alcohol, or any other medications. On examination the physician notes a slim man who appears tired but has an otherwise unremarkable physical examination. A sleep study is unremarkable. MRI of the brain after contrast reveals abnormalities in a mass located between the thalamic bodies.

What is the most likely cause of this patient's symptoms?

1-craniopharyngioma
2-enlarged adenoids
3- excessive melatonin production
4-hyperpitutarism
5-increased intraventricular pressure

[ArchivalUser]

No sleep problems .. kind of rules out Pineal glands.. But MRI shows interthalamic mass. which points towrads Pinealoma... so signs of raised IV pressure like nausea and gait ataxia are there.... but vivid dreams are there

3. Exacessive Melatonin production?.... as drowsiness with interthalamic mass?

normal sleep study as.. melatonin doesnt effect night sleep.. But more of it causes day time somnolence? I dont know jus guessin

[ArchivalUser]

Mass between the thalamic bodies..hmm...well if he had nausea, vomiting, blurred vision, papilliedema may be I would have tempted for an ependymoma. The next best guess will be a pineal gland tumour.

wil go for C.

[ArchivalUser]

yep 33

[ArchivalUser]

333 excessive melatonin production .... melatonin acts at suprachiasmatic nucleus of thalamus