CS mix 1 Flashcards
(162 cards)
1
Q
26 y/o male presents after falling and losing consciousness at work. He had rhythmic movements of the limbs, bit his tongue, and lost control of his bladder. He was subsequently confused (as witnessed by bystanders)
A
Seizure, grand mal (now called complex tonic-clonic seizure)
2
Q
55 y/o male c/o falling after feeling dizzy and unsteady. He experienced transient LOC. He has hypertension and is on numerous antihypertensive drugs
A
Drug-induced orthostatic hypotension (causing syncope)
3
Q
65 y/o male presents after falling and losing consciousness for a few seconds. He had no warning prior to passing out but recently had palpitations. His past history included CABG
A
Cardiac arrhythmia (causing syncope)
4
Q
68 y/o male presents following a 20 minute episode of slurred speech, right facial drooping and numbness, and right hand weakness. His symptoms had totally resolved by the time he got to the ER He has a history of hypertension, diabetes mellitus, and heavy smoking
A
Transient ischemic attack
5
Q
68 y/o M presents with slurred speech, right facial drooping and numbness, and right hand weakness. Babinski’s sign is present on the right. He has a history of hypertension, diabetes mellitus, and heavy smoking
A
Stroke
6
Q
33 y/o F presents with ascending loss of strength in her lower legs over the past two weeks. She had a recent URI
A
Guillain-Barre syndrome
7
Q
30 y/o F presents with weakness, loss of sensation, and tingling in her left leg that started this morning. She is also experiencing right eye pain, decreased vision, and double vision. She reports feeling “electric shocks” down her spine upon flexing her head
A
Multiple sclerosis
8
Q
55 y/o M presents with tingling and numbness in the hand and feet (glove and stocking distribution) over the past two months. He has a history of diabetes mellitus, hypertension, and alcoholism. There is decreased soft touch, vibratory, and position sense in the feet
A
Diabetic peripheral neuropathy
9
Q
40 y/o F presents with occasional double vision and droopy eyelids at night with normalization by morning
A
Myasthenia gravis
10
Q
25 y/o M presents with hemiparesis (after a tonic-clonic seizure) that resolves over a few hours
A
Todd’s paralysis
11
Q
40 y/o F c/o feeling tired, hopeless, and worthless and of having suicidal thoughts. She recently discovered that her husband is homosexual
A
Depression
12
Q
44 y/o M presents with fatigue, insomnia, and nightmares about a murder that he witnessed in a mall one year ago. Since then, he has avoided that mall and has not gone out at night
A
PTSD
13
Q
55 y/o M presents with fatigue, weight loss, and constipation. He has a family history of colon cancer
A
Colon cancer
14
Q
40 y/o F presents with fatigue, weight gain, sleepiness, cold intolerance, constipation, and dry skin
A
Hypothyroidism
15
Q
50 y/o obese F presents with fatigue and daytime sleepiness. She snores heavily and naps 3-4 times per day but never feels refreshed. She also has hypertension
A
Obstructive sleep apnea
16
Q
20 y/o M presents with fatigue, thirst, increased appetite, and polyuria
A
Diabetes mellitus
17
Q
35 y/o M policeman c/o feeling tired and sleepy during the day. He changed to the night shift last week
A
Sleep deprivation
18
Q
30 y/o M presents with night sweats and swollen glands of one month’s duration
A
Tuberculosis
19
Q
25 y/o F presents with a three-week history of falling asleep. She sleeps seven hours per night without nightmares or snoring. She recently began college and is having trouble with her boyfriend. She drinks 3-4 cups of coffee a day
A
Stress-induced insomnia
20
Q
55 y/o obese M presents with several months of poor sleep and daytime fatigue. His wife reports that he snores loudly
A
Sleep apnea
21
Q
33 y/o F c/o three weeks of fatigue and trouble sleeping. She states that she falls asleep easily but wakes up at 3 AM and cannot return to sleep. She also reports an unintentional weight loss of 3.5 kg along with an inability to enjoy the things she once liked to do
A
Insomnia related to major depressive disorder
22
Q
26 y/o F presents with sore throat, fever, severe fatigue, and loss of appetite for the past week. She also reports epigastric and LUQ discomfort. She has cervical lymphadenopathy and a rash. Her boyfriend recently experienced similar symptoms
A
Infectious mononucleosis
23
Q
26 y/o M presents with sore throat, fever, rash, and weight loss. He has a history of IV drug abuse and sharing needles
A
HIV, acute retroviral syndrome
24
Q
26 y/o F presents with fever and sore throat
A
Pharyngitis (bacterial or viral)
25
30 y/o M presents with shortness of breath, cough, and wheezing that worsen in cold air. He has had several such episodes over the past four months
Asthma
26
56 y/o F presents with shortness of breath, as well as productive cough that has occured over the past two years for at least three months each year. She is a heavy smoker
COPD--chronic bronchitis
27
58 y/o M presents with pleuritic chest pain, fever, chills, and cough with purulent yellow sputum. He is a heavy smoker with COPD
Pneumonia
28
25 y/o F presents with two weeks of a nonproductive cough. Three weeks ago she had a sore throat and a runny nose
Atypical pneumonia
29
65 y/o M presents with worsening cough over the past six months together with hemoptysis, dyspnea, weakness, and weight loss. He is a heavy smoker
Lung cancer
30
55 y/o M presents with increased dyspnea and sputum production over the past three days. He has COPD and stopped using his inhalers last week. He also stopped smoking two days ago
COPD exacerbation (bronchitis)
31
34 y/o F nurse presents with worsening cough of six weeks duration together with weight loss, night sweats, fatigue, and fever.
Tuberculosis
32
35 y/o M presents with shortness of breath and cough. He has had unprotected sex with multiple sexual partners and was recently exposed to a patient with active tuberculosis
Tuberculosis
33
50 y/o M presents with cough that is exacerbated by lying down at night and improved by propping up on three pillows. He also reports exertional dyspnea
CHF
34
60 y/o M presents with sudden onset of substernal heavy chest pain that has lasted 30 minutes and radiates to the left arm. The pain is accompanied by dyspnea, diaphoresis, and nausea. He has a history of hypertension, hyperlipidemia, and smoking
MI
35
20 y/o African-American F presents with acute onset of severe chest pain. She has a history of sickle cell disease and multiple previous hospitalizations for pain and anemia management
Sickle cell disease--pulmonary infarction
36
45 y/o F presents with a retrosternal burning sensation that occurs after heavy meals and when lying down. Her symptoms are relieved by antacids
GERD
37
34 y/o F presents with retrosternal stabbing chest pain that improves when she leans forward and worsens with deep inspiration. She had a URI one week ago
Pericarditis
38
55 y/o M presents with retrosternal squeezing pain that lasts for two minutes and occurs with exercise. It is relieved by rest and is not related to food intake
Angina
39
34 y/o F presents with stabbing chest pain that worsens with deep inspiration and is relieved by aspirin. She had a URI one week ago. Chest wall tenderness is noted
Costochondritis
40
70 y/o F presents with acute onset of shortness of breath at rest and pleuritic chest pain. She also presents with tachycardia, hypotension, tachypnea, and mild fever. She is recovering from hip replacement surgery
Pulmonary embolism
41
55 y/o M presents with sudden onset of severe chest pain that radiates to the back. He has a history of uncontrolled hypertension
Aortic dissection
42
70 y/o diabetic M presents with episodes of palpitation and diaphoresis. He is on insulin
Hypoglycemia
43
42 y/o F presents with a 7kg weight loss over the past two months. She has a fine tremor, and her pulse is 112
Hyperthyroidism
44
44 y/o F presents with weight gain of \>11 kg over the past two months. She quit smoking three months ago and is on amitriptyline for depression. She also reports cold intolerance and constipation
Smoking cessation
45
75 y/o M presents with dysphagia that started with solids and progressed to liquids. He is an alcoholic and a heavy smoker. He has had an unintentional weight loss of 7kg over the past four months
Esophageal cancer
46
45 y/o F presents with dysphagia for two weeks together with fatigue and a craving for ice and clay
Plummer-Vinson syndrome
47
48 y/o F presents with dysphagia for both solid and liquid foods that has slowly progressed in severity over the past year. It is associated with regurgitation of undigested food, especially at night
Achalasia
48
38 y/o M presents with dysphagia and pain on swallowing solids more than liquids. Exam reveals oral thrush
Esophagitis (CMV, HSV, pill-induced)
49
20 y/o F presents with nausea, vomiting (especially in the morning), fatigue, and polyuria. Her last menstrual period was six weeks ago, and her breasts are full and tender. She is sexually active with her boyfriend, and they use condoms for contraception
Pregnancy
50
45 y/o M presents with sudden onset of colicky right-sided flank pain that radiates to the testicles, accompanied by nausea, vomiting, hematuria, and CVA tenderness
Nephrolithiasis
51
60 y/o M presents with dull epigastric pain that radiates to the back, together with weight loss, dark urine, and clay-colored stool. He is a heavy drinker and smoker
Pancreatic cancer
52
56 y/o M presents with severe midepigastric abdominal pain that radiates to the back and improves when he leans forward. He also reports anorexia, nausea, and vomiting. He is an alcoholic and has spent the last three days binge drinking
Acute pancreatitis
53
41 y/o obese F presents with RUQ abdominal pain that radiates to the right scapula and is associated with nausea, vomiting, and a fever of 101.5. The pain started after she had eaten fatty food. She has had similar but less intense episodes that lasted a few hours. Exam reveals positive Murphy's sign
Acute cholecystitis
54
43 y/o obese F presents with RUQ abdominal pain, fever, and jaundice. She was diagnosed with asymptomatic gallstones one year ago
Ascending cholangitis
55
25 y/o M presents with RUQ pain, fever, anorexia, nausea, and vomiting. He has dark urine and clay-colored stool
Acute hepatitis
56
35 y/o M presents with burning epigastric pain that started 2-3 hours after meals. The pain is relieved by food and antacids
Peptic ulcer disease
57
37 y/o M presents with severe epigastric pain, nausea, vomiting, and mild fever. He appears toxic. He has a history of intermittent epigastric pain that is relieved by food and antacids. He also smokes heavily and takes aspirin on a regular basis
Peptic ulcer perforation
58
18 y/o M boxer presents with severe abdominal pain that radiates to the scapula. He had infectious mononucleosis three weeks ago
Splenic rupture
59
40 y/o M presents with crampy abdominal pain, vomiting, abdominal distension, and inability to pass flatus or stool. He has a history of multiple abdominal surgeries
Intestinal obstruction
60
70 y/o F presents with acute onset of severe, crampy abdominal pain. She recently vomited and had a massive dark bowel movement. She has a history of CHF and atrial fibrillation, for which she has received digitalis. Her pain is out of proportion to the exam
Mesenteric ischemia/infarction
61
21 y/o F presents with acute onset of severe RLQ pain, nausea, and vomiting. She has no fever, urinary symptoms, or vaginal bleeding and has never taken OCPs. Her last menstrual period was regular, and she has no history of STDs
Ovarian torsion
62
68 y/o M presents with LLQ abdominal pain, fever, and chills for the past three days. He also reports recent onset of alternating diarrhea and constipation. He consumes a low-fiber, high-fat diet
Diverticulitis
63
20 y/o M presents with severe RLQ abdominal pain, nausea, and vomiting. His discomfort started yesterday as a vague pain around the umbilicus. As the pain worsened, it became sharp and migrated to the RLQ. McBurney's and psoas signs are positive
Acute appendicitis
64
30 y/o F presents with periumbilical pain for six months. The pain never awakens her from sleep. It is relieved by defecation and worsens when she is upset. She has alternating constipation and diarrhea but no nausea, vomiting, weight loss, or anorexia
Irritable bowel syndrome
65
24 y/o F presents with bilateral lower abdominal pain that started with the first day of her menstrual period. The pain is associated with fever and a thick, greenish-yellow vaginal discharge. She has had unprotected sex with multiple sexual partners
PID
66
67 y/o M presents with alternating diarrhea and constipation, decreased stool caliber, and blood in the stool for the past eight months. He also reports unintentional weight loss. He is on a low-fiber diet and has a family history of colon cancer
Colorectal cancer
67
28 y/o M presents with constipation (very hard stool) for the past three weeks. Since his mother died two months ago, he and his father have eaten only junk food
Low-fiber diet
68
30 y/o F presents with alternating constipation and diarrhea and abdominal pain that is relieved by defecation. She has no nausea, vomiting, weight loss, or blood in her stool
Irritable bowel syndrome
69
33 y/o M presents with watery diarrhea, vomiting, and diffuse abdominal pain that began yesterday. He also reports feeling hot. Several of his coworkers are also ill.
Infectious diarrhea (gastroenteritis)--bacterial, viral, parasitic, protozoal
70
40 y/o F presents with watery diarrhea and abdominal cramps. Last week she was on antibiotics for a UTI
Pseudomembranous (Clostridium difficile) colitis
71
25 y/o M presents with watery diarrhea and abdominal cramps. He was recently in Mexico
Traveler's diarrhea
72
30 y/o F presents with watery diarrhea and abdominal cramping and bloating. Her symptoms are aggravated by milk ingestion and are relieved by fasting
Lactose intolerance
73
33 y/o M presents with watery diarrhea, diffuse abdominal pain, and weight loss over the past three weeks. He has not responded to antibiotics
Crohn's disease
74
45 y/o F presents with coffee-ground emesis for the last three days. Her stool is dark and tarry. She has a history of intermittent epigastric pain that is relieved by food and antacids
Bleeding peptic ulcer
75
40 y/o F presents with epigatric pain and coffee-ground emesis. She has a history of rheumatoid arthritis that has been treated with aspirin. She is an alcoholic
Gastritis
76
67 y/o M presents with blood in his stool, weight loss, and constipation. He has a family history of colon cancer
Colorectal cancer
77
33 y/o F presents with rectal bleeding and diarrhea for the past week. She has had lower abdominal pain and tenesmus for several months
Ulcerative colitis
78
58 y/o M presents with bright red blood per rectum and chronic constipation. He consumes a low-fiber diet
Diverticulosis
79
65 y/o M presents with painless hematuria. He is a heavy smoker and works as a painter
Bladder cancer
80
35 y/o M presents with painless hematuria. He has a family history of kidney problems
Polycystic kidney disease
81
55 y/o M presents with flank pain and blood in his urine without dysuria. He has experienced weight loss and fever over the past two months.
Renal cell carcinoma
82
60 y/o M presents with nocturia, urgency, weak stream, and terminal dribbling. He denies any weight loss, fatigue, or bone pain. He has had two episodes of urinary retention that required catheterization
Benign prostatic hypertrophy (BPH)
83
71 y/o M presents with nocturia, urgency, weak stream, terminal dribbling, hematuria, and lower back pain over the past four months. He has also experienced weight loss and fatigue.
Prostate cancer
84
18 y/o M presents with burning sensation during urination and urethral discharge. He recently had unprotected sex with a new partner
Urethritis
85
45 y/o diabetic F presents with dysuria, urinary frequency, fever, chills, and nausea over the past three days. There is left CVA tenderness on exam
Acute pyelonephritis
86
47 y/o M presents with impotence that started three months ago. He has hypertension and was started on atenolol four months ago. He also has diabetes and is on insulin
Drug-related ED
87
40 y/o F presents with amenorrhea, morning nausea and vomitting, fatigue, and polyuria. Her last menstrual period was six weeks ago, and her breasts are full and tender. She uses the rhythm method for contraception
Pregnancy
88
23 y/o obese F presents with amenorrhea for six months, facial hair, and infertility for the past three years
Polycystic ovarian syndrome
89
35 y/o F presents with amenorrhea, galactorrhea, visual field defects, and headaches for the past six months
Amenorrhea secondary to prolactinoma
90
48 y/o F presents with amenorrhea for the past six months accompanied by hot flushes, night sweats, emotional lability, and dyspareunia
Menopause
91
35 y/o F presents with amenorrhea, cold intolerance, coarse hair, weight loss, and fatigue. She has a history of abruptio placentae followed by hypovolemic shock and failure of lactation two years ago
Sheehan's syndrome
92
18 y/o F presents with amenorrhea for the past four months. She has lost 95 pounds and has a history of vigorous exercise and cold intolerance
Anorexia nervosa
93
29 y/o F presents with amenorrhea for the past six months. She has a history of occasional palpitations and dizziness. She lost her fiance in a car accident
Anxiety-induced amenorrhea
94
17 y/o F presents with prolonged, excessive menstrual bleeding occuring irregularly over the past six months
Dysfunctional uterine bleeding
95
61 y/o obese F presents with profuse vaginal bleeding over the past month. Her last menstrual period was 10 years ago. She has a history of hypertension and diabetes mellitus. She is nulliparous
Endometrial cancer
96
45 y/o G5P5 F presents with postcoital bleeding. She is a cigarette smoker and takes OCPs
Cervical cancer
97
28 y/o F who is eight weeks pregnant presents with lower abdominal pain and vaginal bleeding
Spontaneous abortion
98
32 y/o F presents with sudden onset of left lower abdominal pain that radiates to the scapula and back and is associated with vaginal bleeding. Her last menstrual period was five weeks ago. She has a history of PID and unprotected intercourse
Ectopic pregnancy
99
28 y/o F presents with a thin, grayish-white, foul-smelling vaginal discharge
Bacterial vaginosis
100
30 y/o F presents with a thick, white, cottage cheese-like, odorless vaginal discharge and vaginal itching
Vaginitis--Candidal
101
35 y/o F presents with malodorous, profuse, frothy, greenish vaginal discharge with intense vaginal itching and discomfort
Vaginitis--trichomonal
102
54 y/o F c/o painful intercourse. Her last menstrual period was nine months ago. She has hot flushes
Atrophic vaginitis
103
37 y/o F presents with dyspareunia, inability to conceive, and dysmenorrhea
Endometriosis
104
28 y/o F c/o multiple facial and bodily injuries. She claims that she fell on the stairs. She was hospitalized for some physical injuries seven months ago. She presents with her husband
Domestic violence
105
30 y/o F presents with multiple facial physical injuries. She was attacked and raped by two men
Rape
106
30 y/o F presents with wrist pain and a black eye after tripping, falling, and hitting her head on the edge of a table. She looks anxious and gives an inconsistent story
Domestic violence
107
30 y/o F secretary presents with wrist pain and a sensation of numbness and burning in her palm and the first, second, and third fingers of her right hand. The pain worsens at night and is relieved by loose shaking of the hand. There is sensory loss in the same fingers. Exam reveals positive Tinel's sign
Carpal tunnel syndrome
108
28 y/o F presents with pain in the interphalangeal joints of her hands together with hair loss and a butterfly rash on the face
SLE
109
28 y/o F presents with pain in the metacarpophalangeal joints of both hands. Her left knee is also painful and red. She has morning joint stiffness that lasts for an hour.
Rheumatoid arthritis
110
18 y/o M presents with pain in the interphalangeal joints of both hands. He also has scaly, salmon-pink lesions on the extensor surface of his elbows and knees
Psoriatic arthritis
111
65 y/o F presents with inability to use her left leg and bear weight on it after tripping on a carpet. Onset of menopause was 20 years ago, and she did not receive HRT or calcium supplements. Her left leg is externally rotated, shortened, and adducted, and there is tenderness in her left groin
Hip fracture
112
40 y/o M presents with pain in the right groin after a motor vehicle accident. His right leg is flexed at the hip, adducted, and internally rotated
Hip dislocation--traumatic
113
56 y/o obese F presents with right knee stiffness and pain that increases with movement. Her symptoms have gradually worsened over the past 10 years. She noticed swelling and deformity of the joint and is having difficulty walking
Osteoarthritis
114
45 y/o M presents with right knee pain with swelling and redness
Septic arthritis
115
65 y/o M presents with right foot pain. He has been training for a marathon
Stress fracture
116
65 y/o M presents with pain in the heel of the right foot that is most notable with his first few steps and then improves as he continues walking. He has no known trauma
Plantar fasciitis
117
55 y/o M presents with pain in the elbow when he plays tennis. His grip is impaired as a result of the pain. There is tenderness over the lateral epicondyle as well as pain on resisted wrist dorsiflexion with the elbow in extension
Tennis elbow (lateral epicondylitis)
118
27 y/o F presents with painful wrists and elbows, a swollen and hot knee joint that is painful to flexion, a rash on her limbs, and vaginal discharge. She is sexually active with multiple partners and occasionally uses condoms
Disseminated gonorrhea
119
60 y/o F presents with pain in both legs that is induced by walking and relieved by rest. She had cardiac bypass surgery six months ago and continues to smoke heavily
Peripheral vascular disease (intermittent claudication)
120
45 y/o F presents with right calf pain. Her calf is tender, warm, red, and swollen compared to the left side. She was started on OCPs two months ago for dysfunctional uterine bleeding
DVT
121
60 y/o F c/o left arm pain that started while she was swimming and was relieved by rest
Angina/MI
122
50 y/o M presents with right shoulder pain after falling onto his outstretched hand while skiing. He noticed deformity of his shoulder and had to hold his right arm
Shoulder dislocation
123
55 y/o M presents with crampy bilateral thigh and calf pain, fatigue, and dark urine. He is on simvastatin and clofibrate for hyperlipidemia
Rhabdomyolysis due to simvastatin or clofibrate
124
45 y/o F presents with low back pain that radiates to the lateral aspect of her left foot. Straight leg raising is positive. The patient is unable to tiptoe
Disk herniation
125
45 y/o F presents with low back pain that started after she cleaned her house. The pain does not radiate, and there is no sensory deficit or weakness in her legs. Paraspinal muscle tenderness and spasm are also noted
Lumbar muscle strain
126
45 y/o M presents with pain in the lower back and legs during prolonged standing and walking. The pain is relieved by sitting and leaning forward (e.g. pushing a grocery cart)
Lumbar spinal stenosis
127
17 y/o M presents with low back pain that radiates to the left leg and began after he fell on his knee during gym class. He also describes areas of loss of sensation in his left foot. The pain and sensory loss do not match any known distribution. He insists on requesting a week off from school because of his injury
Malingering
128
20 day old M presents with fever, decreased breast feeding, and lethargy. He was born at 36 weeks as a result of premature rupture of membranes
Neonatal sepsis
129
3 y/o M presents with a two-day history of fever and pulling on his right ear. He is otherwise healthy, and his immunizations are up to date. His older sister recently had a cold. The child attends a day care center
Acute otitis media
130
12 month old M presents with fever for the last two days accompanied by a maculopapular rash on his face and body. His immunizations are not up to date
Measles (or other viral exanthem)
131
4 y/o M presents with diarrhea, vomiting, lethargy, weakness, and fever. The child attends a day care center where several children have had similar symptoms
Gastroenteritis (viral, bacterial, parasitic)
132
9 y/o M presents with a two-year history of angry outbursts both in school and at home. His mother complains that he runs around "as if driven by a motor." His teacher reports that he cannot sit still in class, regularly interrupts his classmates, and has trouble making friends
ADHD
133
12 y/o F presents with two month history of fighting in school, truancy, and breaking curfew. Her parents recently divorced, and she just started school in a new district. Before her parents divorced, she was an average student with no behavioral problems
Adjustment disorder
134
15 y/o M presents with one year history of failing grades, school absenteeism, and legal problems, including shoplifting. His parents report that he spends most of his time alone in his room, adding that when he does go out, it is with a new set of friends
Substance abuse
135
5 y/o M presents with a six-month history of temper tantrums that last 5-10 minutes and immediately follow a disappointment or a discipline. He has no trouble sleeping, has had no change in appetite, and does not display these behaviors when he is at day care
Age-Appropriate behavior
136
21 y/o F presents with several episodes of throbbing left temporal pain that lasts for 2-3 hours. Prior to its onset, she sees flashes of light in her right visual field and feels weakness and numbness on the right side of her body for a few minutes. Headaches are often associated with nausea and vomiting. She has a family history of migraine
Migraine (complicated)
137
26 y/o M presents with terrible right temporal headaches associated with ipsilateral rhinorrhea and eye tearing and redness. Episodes have occured at the same time every night for the past week and last for 45 minutes
Cluster headache
138
65 y/o F presents with severe, intermittent right temporal headache, fever, blurred vision in her right eye, and pain in her jaw when chewing
Temporal ateritis (giant cell arteritis)
139
30 y/o F presents with frontal headache, fever, and nasal discharge. There is pain on palpation of the frontal and maxillary sinuses.
Sinusitis
140
50 y/o F presents with recurrent episodes of bilateral squeezing headaches that occur 3-4 times a week. She is experiencing significant stress in her life
Tension headache
141
35 y/o M presents with sudden severe headache, vomiting, confusion, left hemiplegia, and nuchal rigidity
Subarachnoid hemorrhage
142
25 y/o M presents with high fever, severe headache, confusion, photophobia, and nuchal rigidity. Kernig's and Brudzinski's signs are positive
Meningitis
143
18 y/o obese F presents with headache, vomiting, and blurred vision for the past 2-3 weeks. She is taking OCPs
Pseudotumor cerebri
144
47 y/o M c/o daily pain in the right cheek over the past month. The pain is electric in character and occurs while he is shaving. Each episode lasts 2-4 minutes
Trigeminal neuralgia
145
81 y/o M presents with progressive confusion over the past several years together with forgetfulness and clumsiness. He has a history of diabetes mellitus, hypertension, and two strokes with residual left hemiparesis. Mental status has clearly worsened after each stroke
Vascular (multi-infarct) dementia
146
84 y/o F brought by her son c/o forgetfulness (e.g forgets phone numbers, loses her way back home) along with difficulty performing some of her daily activities (e.g. bathing, dressing, managing her money, using the phone). The problem has gradually progressed over the past few years
Alzheimer's disease
147
72 y/o M presents with memory loss, gait disturbance, and urinary incontinence for the past six months
Normal pressure hydrocephalus
148
55 y/o M presents with a rapidly progressive change in mental status, inability to concentrate, and memory impairment for the past two months. His symptoms are associated with myoclonus and ataxia
Creutzfeldt-Jakob disease
149
70 y/o insulin dependent diabetic M presents with episodes of confusion, dizziness, palpitation, diaphoresis, and weakness
Hypoglycemia
150
55 y/o F presents with gradual altered mental status and headache. Two weeks ago she slipped, hit her head on the ground, and lost consciounsess for two minutes
Subdural hematoma
151
68 y/o M presents with two month history of crying spells, excessive sleep, poor hygiene, and a 7kg weight loss, all following his wife's death. He cannot enjoy time with his grandchilren and reluctantly admits to thinking he has seen his dead wife in line at the supermarket or standing in the kitchen making dinner
Normal bereavement
152
42 y/o F presents with a four-week history of excessive fatigue, insomnia, and anhedonia. She states that she thinks constantly about death. She has suffered five similar episodes in the past, the first in her 20s, and has made two previous suicide attempts. She further admits to increased alcohol use in the past month
Major depressive disorder
153
26 y/o F presents with a 3kg weight loss over the past two months, accompanied by early-morning awakening, excessive guilt, and psychomotor retardation. She does not identify a trigger for the depressive episode but reports several weeks of increasing energy, sexual promiscuity, irresponsible spending, and racing thoughts approximately six months before her presentation
Bipolar I
154
19 y/o M c/o receiving messages from his television set. He reports that he did not have many friends in high school. In college, he started to suspect his roommate of bugging the phone. In the same time frame, he stopped going to classes because he felt that his professors were saying horrible things about him that no one else noticed. He rarely showered or left his room and has recently been hearing a voice from his television telling him to "guard against the evil empire".
Schizophrenia
155
28 y/o F c/o seeing bugs crawling on her bed over the past two days and reports hearing loud voices when she is alone in her room. She has never experienced symptoms such as these in the past. She recently ingested an unknown substance
Substance-induced psychosis
156
48 y/o F presents with a one-week history of auditory hallucinations, stating, "I am worthless" and "I should kill myself". She also reports a two-week history of weight loss, early morning awakening, decreased motivation, and overwhelming feelings of guilt
Schizoaffective disorder
157
35 y/o F presents with intermittent episodes of vertigo, tinnitus, nausea, and hearing loss over the past week
Meniere's disease
158
55 y/o F c/o dizziness for the past day. She feels faint and has severe diarrhea that stated two days ago. She takes furosemide for her hypertension
Orthostatis hypotension due to dehydration (diarrhea, diuretic use)
159
65 y/o M presents with postural dizziness and unsteadiness. He has hypertension and was started on HCTZ two days ago
Drug-induced orthostatic hypotension
160
44 y/o F c/o dizziness on moving her head to the left. She feels that the room is spinning around her head. Tilt test results in nystagmus and nausea
Benign positional vertigo
161
55 y/o F c/o dizziness that started this morning. She is nauseated and has vomited once in the past day. She had a URI two days ago and has experienced no hearing loss
Vestibular neuronitis
162
55 y/o F c/o dizziness that started this morning and of "not hearing well." She feels nauseated and has vomited once in the past day. She had a URI two days ago
Labyrinthitis
