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CS mix 1 Flashcards

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)

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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)

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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)

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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

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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

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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

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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

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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

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9
Q

40 y/o F presents with occasional double vision and droopy eyelids at night with normalization by morning

A

Myasthenia gravis

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10
Q

25 y/o M presents with hemiparesis (after a tonic-clonic seizure) that resolves over a few hours

A

Todd’s paralysis

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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

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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

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13
Q

55 y/o M presents with fatigue, weight loss, and constipation. He has a family history of colon cancer

A

Colon cancer

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14
Q

40 y/o F presents with fatigue, weight gain, sleepiness, cold intolerance, constipation, and dry skin

A

Hypothyroidism

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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

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16
Q

20 y/o M presents with fatigue, thirst, increased appetite, and polyuria

A

Diabetes mellitus

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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

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18
Q

30 y/o M presents with night sweats and swollen glands of one month’s duration

A

Tuberculosis

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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

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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

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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

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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

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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

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24
Q

26 y/o F presents with fever and sore throat

A

Pharyngitis (bacterial or viral)

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25
Q

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

A

Asthma

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26
Q

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

A

COPD–chronic bronchitis

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27
Q

58 y/o M presents with pleuritic chest pain, fever, chills, and cough with purulent yellow sputum. He is a heavy smoker with COPD

A

Pneumonia

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28
Q

25 y/o F presents with two weeks of a nonproductive cough. Three weeks ago she had a sore throat and a runny nose

A

Atypical pneumonia

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29
Q

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

A

Lung cancer

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30
Q

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

A

COPD exacerbation (bronchitis)

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31
Q

34 y/o F nurse presents with worsening cough of six weeks duration together with weight loss, night sweats, fatigue, and fever.

A

Tuberculosis

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32
Q

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

A

Tuberculosis

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33
Q

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

A

CHF

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34
Q

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

A

MI

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35
Q

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

A

Sickle cell disease–pulmonary infarction

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36
Q

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

A

GERD

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37
Q

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

A

Pericarditis

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38
Q

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

A

Angina

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39
Q

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

A

Costochondritis

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40
Q

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

A

Pulmonary embolism

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41
Q

55 y/o M presents with sudden onset of severe chest pain that radiates to the back. He has a history of uncontrolled hypertension

A

Aortic dissection

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42
Q

70 y/o diabetic M presents with episodes of palpitation and diaphoresis. He is on insulin

A

Hypoglycemia

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43
Q

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

A

Hyperthyroidism

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44
Q

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

A

Smoking cessation

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45
Q

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

A

Esophageal cancer

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46
Q

45 y/o F presents with dysphagia for two weeks together with fatigue and a craving for ice and clay

A

Plummer-Vinson syndrome

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47
Q

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

A

Achalasia

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48
Q

38 y/o M presents with dysphagia and pain on swallowing solids more than liquids. Exam reveals oral thrush

A

Esophagitis (CMV, HSV, pill-induced)

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49
Q

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

A

Pregnancy

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50
Q

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

A

Nephrolithiasis

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51
Q

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

A

Pancreatic cancer

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52
Q

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

A

Acute pancreatitis

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53
Q

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

A

Acute cholecystitis

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54
Q

43 y/o obese F presents with RUQ abdominal pain, fever, and jaundice. She was diagnosed with asymptomatic gallstones one year ago

A

Ascending cholangitis

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55
Q

25 y/o M presents with RUQ pain, fever, anorexia, nausea, and vomiting. He has dark urine and clay-colored stool

A

Acute hepatitis

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56
Q

35 y/o M presents with burning epigastric pain that started 2-3 hours after meals. The pain is relieved by food and antacids

A

Peptic ulcer disease

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57
Q

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

A

Peptic ulcer perforation

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58
Q

18 y/o M boxer presents with severe abdominal pain that radiates to the scapula. He had infectious mononucleosis three weeks ago

A

Splenic rupture

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59
Q

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

A

Intestinal obstruction

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60
Q

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

A

Mesenteric ischemia/infarction

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61
Q

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

A

Ovarian torsion

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62
Q

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

A

Diverticulitis

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63
Q

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

A

Acute appendicitis

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64
Q

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

A

Irritable bowel syndrome

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65
Q

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

A

PID

66
Q

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

A

Colorectal cancer

67
Q

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

A

Low-fiber diet

68
Q

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

A

Irritable bowel syndrome

69
Q

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.

A

Infectious diarrhea (gastroenteritis)–bacterial, viral, parasitic, protozoal

70
Q

40 y/o F presents with watery diarrhea and abdominal cramps. Last week she was on antibiotics for a UTI

A

Pseudomembranous (Clostridium difficile) colitis

71
Q

25 y/o M presents with watery diarrhea and abdominal cramps. He was recently in Mexico

A

Traveler’s diarrhea

72
Q

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

A

Lactose intolerance

73
Q

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

A

Crohn’s disease

74
Q

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

A

Bleeding peptic ulcer

75
Q

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

A

Gastritis

76
Q

67 y/o M presents with blood in his stool, weight loss, and constipation. He has a family history of colon cancer

A

Colorectal cancer

77
Q

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

A

Ulcerative colitis

78
Q

58 y/o M presents with bright red blood per rectum and chronic constipation. He consumes a low-fiber diet

A

Diverticulosis

79
Q

65 y/o M presents with painless hematuria. He is a heavy smoker and works as a painter

A

Bladder cancer

80
Q

35 y/o M presents with painless hematuria. He has a family history of kidney problems

A

Polycystic kidney disease

81
Q

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.

A

Renal cell carcinoma

82
Q

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

A

Benign prostatic hypertrophy (BPH)

83
Q

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.

A

Prostate cancer

84
Q

18 y/o M presents with burning sensation during urination and urethral discharge. He recently had unprotected sex with a new partner

A

Urethritis

85
Q

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

A

Acute pyelonephritis

86
Q

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

A

Drug-related ED

87
Q

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

A

Pregnancy

88
Q

23 y/o obese F presents with amenorrhea for six months, facial hair, and infertility for the past three years

A

Polycystic ovarian syndrome

89
Q

35 y/o F presents with amenorrhea, galactorrhea, visual field defects, and headaches for the past six months

A

Amenorrhea secondary to prolactinoma

90
Q

48 y/o F presents with amenorrhea for the past six months accompanied by hot flushes, night sweats, emotional lability, and dyspareunia

A

Menopause

91
Q

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

A

Sheehan’s syndrome

92
Q

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

A

Anorexia nervosa

93
Q

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

A

Anxiety-induced amenorrhea

94
Q

17 y/o F presents with prolonged, excessive menstrual bleeding occuring irregularly over the past six months

A

Dysfunctional uterine bleeding

95
Q

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

A

Endometrial cancer

96
Q

45 y/o G5P5 F presents with postcoital bleeding. She is a cigarette smoker and takes OCPs

A

Cervical cancer

97
Q

28 y/o F who is eight weeks pregnant presents with lower abdominal pain and vaginal bleeding

A

Spontaneous abortion

98
Q

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

A

Ectopic pregnancy

99
Q

28 y/o F presents with a thin, grayish-white, foul-smelling vaginal discharge

A

Bacterial vaginosis

100
Q

30 y/o F presents with a thick, white, cottage cheese-like, odorless vaginal discharge and vaginal itching

A

Vaginitis–Candidal

101
Q

35 y/o F presents with malodorous, profuse, frothy, greenish vaginal discharge with intense vaginal itching and discomfort

A

Vaginitis–trichomonal

102
Q

54 y/o F c/o painful intercourse. Her last menstrual period was nine months ago. She has hot flushes

A

Atrophic vaginitis

103
Q

37 y/o F presents with dyspareunia, inability to conceive, and dysmenorrhea

A

Endometriosis

104
Q

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

A

Domestic violence

105
Q

30 y/o F presents with multiple facial physical injuries. She was attacked and raped by two men

A

Rape

106
Q

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

A

Domestic violence

107
Q

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

A

Carpal tunnel syndrome

108
Q

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

A

SLE

109
Q

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.

A

Rheumatoid arthritis

110
Q

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

A

Psoriatic arthritis

111
Q

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

A

Hip fracture

112
Q

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

A

Hip dislocation–traumatic

113
Q

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

A

Osteoarthritis

114
Q

45 y/o M presents with right knee pain with swelling and redness

A

Septic arthritis

115
Q

65 y/o M presents with right foot pain. He has been training for a marathon

A

Stress fracture

116
Q

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

A

Plantar fasciitis

117
Q

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

A

Tennis elbow (lateral epicondylitis)

118
Q

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

A

Disseminated gonorrhea

119
Q

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

A

Peripheral vascular disease (intermittent claudication)

120
Q

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

A

DVT

121
Q

60 y/o F c/o left arm pain that started while she was swimming and was relieved by rest

A

Angina/MI

122
Q

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

A

Shoulder dislocation

123
Q

55 y/o M presents with crampy bilateral thigh and calf pain, fatigue, and dark urine. He is on simvastatin and clofibrate for hyperlipidemia

A

Rhabdomyolysis due to simvastatin or clofibrate

124
Q

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

A

Disk herniation

125
Q

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

A

Lumbar muscle strain

126
Q

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)

A

Lumbar spinal stenosis

127
Q

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

A

Malingering

128
Q

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

A

Neonatal sepsis

129
Q

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

A

Acute otitis media

130
Q

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

A

Measles (or other viral exanthem)

131
Q

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

A

Gastroenteritis (viral, bacterial, parasitic)

132
Q

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

A

ADHD

133
Q

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

A

Adjustment disorder

134
Q

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

A

Substance abuse

135
Q

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

A

Age-Appropriate behavior

136
Q

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

A

Migraine (complicated)

137
Q

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

A

Cluster headache

138
Q

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

A

Temporal ateritis (giant cell arteritis)

139
Q

30 y/o F presents with frontal headache, fever, and nasal discharge. There is pain on palpation of the frontal and maxillary sinuses.

A

Sinusitis

140
Q

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

A

Tension headache

141
Q

35 y/o M presents with sudden severe headache, vomiting, confusion, left hemiplegia, and nuchal rigidity

A

Subarachnoid hemorrhage

142
Q

25 y/o M presents with high fever, severe headache, confusion, photophobia, and nuchal rigidity. Kernig’s and Brudzinski’s signs are positive

A

Meningitis

143
Q

18 y/o obese F presents with headache, vomiting, and blurred vision for the past 2-3 weeks. She is taking OCPs

A

Pseudotumor cerebri

144
Q

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

A

Trigeminal neuralgia

145
Q

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

A

Vascular (multi-infarct) dementia

146
Q

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

A

Alzheimer’s disease

147
Q

72 y/o M presents with memory loss, gait disturbance, and urinary incontinence for the past six months

A

Normal pressure hydrocephalus

148
Q

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

A

Creutzfeldt-Jakob disease

149
Q

70 y/o insulin dependent diabetic M presents with episodes of confusion, dizziness, palpitation, diaphoresis, and weakness

A

Hypoglycemia

150
Q

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

A

Subdural hematoma

151
Q

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

A

Normal bereavement

152
Q

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

A

Major depressive disorder

153
Q

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

A

Bipolar I

154
Q

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”.

A

Schizophrenia

155
Q

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

A

Substance-induced psychosis

156
Q

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

A

Schizoaffective disorder

157
Q

35 y/o F presents with intermittent episodes of vertigo, tinnitus, nausea, and hearing loss over the past week

A

Meniere’s disease

158
Q

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

A

Orthostatis hypotension due to dehydration (diarrhea, diuretic use)

159
Q

65 y/o M presents with postural dizziness and unsteadiness. He has hypertension and was started on HCTZ two days ago

A

Drug-induced orthostatic hypotension

160
Q

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

A

Benign positional vertigo

161
Q

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

A

Vestibular neuronitis

162
Q

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

A

Labyrinthitis

Step2 CS (4 decks)

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