Impaired fertility in a man w/high-riding bilateral scrotal mass. Underlying cause? - Varicocele.
82 year old with decreased vision. Dilated veins,
... [Show More] widespread retinal hemorrhages intermixed with white plaques on fundoscopic exam. Diagnosis? - Central retinal vein artery occlusion.
15 year old girl on chronic steroid therapy presents with acute back pain. Most likely cause? - Osteoporotic compression fracture.
Patient with flank pain with radiation to the groin and normal vital signs. Pain relieved with morphine. Next best step? - Increase fluid intake and send home.
Terminal cancer patient that comes in with acute onset lower back pain. She is taking morphine Q4 which works for a bit but then subsides. What should you do to her regimen? - Make the morphine Q3 so she has adequate pain control.
A young infant that has bilateral retinal hemorrhages and tense fontanelle. What is the most likely cause? - Child abuse
What is the treatment for an acute gout attack? - 1. NSAIDs: Indomethacin
2. Steroids
3. Colchicine
Patient who is sick in the ICU, and has (comatose level) hypernatremia. She has a low urine specific gravity. Normal kidney function. What is the underlying cause of hypernatremia? - Diabetes Insipidus. She cannot concentrate her urine.
4 year old boy. Suddenly develops a pancytopenia, has hepatosplenomegaly and adenopathy. Some mild gingival bleeding. Next best step? - Bone marrow biopsy. This kid has ALL.
Patient has a first time positive PPD and a negative chest X-ray. What is the next best step? - This patient has latent TB. This means that he needs to be treated with INH for 9 months.
Furthermore, if he had a negative PPD. B/c this is his first time, he would come back in two weeks.
Patient that is mute. Has bilateral nystagmus, hypertonia, decreased sensation to skin prick. What is the most likely overdose? - Intoxication with PCP. Remember he does not always have to be aggressive.
Patient has a family history of ovarian cancer. What is the best thing to do if she is worried that she may get an ovarian malignancy? - Put her on OCP. They prevent risk of ovarian and endometrial cancer.
Elderly patient with increased ESR. Decreased hip motion, and a 20 degree hip flexion contracture. What is the most likely cause? - Osteoarthritis. Decrease in flexion of 115 degrees is diagnostic criteria. X-ray may show joint space narrowing.
COPD patient that is post operative day 4 complains of serosang discharge. PE shows abdominal distension, mild tenderness to the incision, and no erythema. What is the most likely diagnosis? - Wound dehiscence. Pestana says a salmon colored discharge that SOAKS the dressing on post-op day four.
A patient comes in with upper motor neuron signs along with atrophy fasiculations and LMN signs. What will the EMG show? - Fibrillation potentials in multiple sites of the muscle. UpToDate: Fibrillation potentials occur when an individual muscle fiber is denervated (eg, it is no longer innervated by its nerve terminal). The denervated muscle fiber spontaneously produces a muscle action potential, or fibrillation potential [Show Less]