Blog

The patient is a new postoperative patient. She weighs 60 kg. The nurse anticipates that the minimum acceptable amount of urine output should be:

The statements below are consistent with classic Bipolar Disorder except:

A patient comes to his primary care clinic complaining of knee pain. His blood pressure is found to be 132/80 mmHg. The nurse notes that the last time the patient visited the clinic, nine months ago, his blood pressure was 138/74 mmHg. The patient says, “I don’t understand how it could be high because I feel fine.” The best response by the nurse is:

A 54-year-old female with PMH significant for alcoholic cirrhosis and recurrent esophageal varices, who recently underwent transjugular intrahepatic portosystemic shunt (TIPS) placement, is brought to the emergency room by her daughter due to somnolence. Starting this morning, the patient has appeared sleepy, difficult to arouse, and slow to respond to questions. On physical exam, temperature is 98.6º F, BP 98/56 mmHg, pulse is 72/min, and respirations are 14/min. She repeatedly falls asleep during examination. With arms outstretched and wrists dorsiflexed, flapping of the hands is observed. Which of the following is the most appropriate treatment for this patient?

74-year-old male with PMH significant for hyperlipidemia and diabetes presents to the Emergency Department after having a syncopal episode. Over the past 2 weeks, he has experienced dizziness and blurry vision when he gets up at night to urinate. Tonight, he had similar symptoms before abruptly passing out next to his bed. There were no preceding symptoms of nausea, diaphoresis, or feeling hot or cold. The patient denies cigarette or alcohol use and reports that he was recently diagnosed with benign prostatic hypertrophy and started on a new medication. Vital signs: BP 108/70, HR 90/min, regular, RR 16/min, T 98.6F. On exam, mucous membranes are moist. Cardiac: RRRS1S2 without murmurs, rubs, or gallops. Which of the following is the most likely cause of this patient’s syncopal episode?

A 65-year-old male presents to the emergency department with low back pain. The pain started 6 hours ago when he was gardening and carrying a heavy bag. The pain is rated as 10/10 in severity and radiates down the posterior aspect of the right thigh. He reports no fevers or chills. His only medical problem is hypertension for which he takes amlodipine. The patient is a non-smoker, uses alcohol infrequently, and has never used illicit drugs. Initial vital signs: T 99.6°F, BP 140/70 mmHg, HR 90/min, and RR 20/min. Physical examination reveals 3/5 strength to hip extension, knee flexion and extension, and plantar flexion bilaterally. Sensation to pinprick is diminished over the posterolateral legs and lateral aspects of both feet. Ankle and knee reflexes are absent bilaterally. The patient’s underwear is wet and a bladder scan reveals 800 mL of urine. Which of the following is the most likely underlying diagnosis?

Huntington’s disease is a degenerative neurologic condition due to a mutation in a gene on the fourth chromosome. Based on your knowledge of the type of genetic inheritance associated with this condition, what is the likelihood that a child of a parent with Huntington’s disease will inherit the abnormal copy of the gene from that parent?

A 76-year-old female presents to the emergency department after a ground-level fall. Over the past 6 months, she has experienced progressive experienced difficulty ambulating and has trouble focusing. Two months ago, her daughter discovered that the patient had urinated on herself, after which the patient began wearing diapers. She has a history of hypertension for which she takes amlodipine. She has never smoked cigarettes and does not drink alcohol. Vital signs: T 98.6°F, BP 112/70 mmHg, HR 90/min, and RR 18/min. Physical examination reveals an elderly female with a strong urine odor. There is no papilledema on fundoscopy. Cardiac and pulmonary exam reveals no murmurs, rubs, or gallops. She has a wide-based gait and takes small, slow steps. Which of the following findings on Brain MRI is expected?

A 46-year-old G0P0 female presents to her primary care provider with insomnia. Over the past 3 months, she has experienced insomnia nearly every night, which is affecting her workplace performance. When she tries to sleep, she reports feels a “crawling” sensation deep inside her calves. She feels better when she repositions her legs, but the sensation always returns. She has no known medical problems and denies any current prescription or over the counter medications. Her menstrual cycles are described as “regular, heavy, and stable” over the past 5 years. Her last menstrual period was 3 weeks ago. She does not smoke or drink alcohol. Vital signs: T 99.6°F, BP 120/70 mmHg, HR 80/min, and RR 18/min. On physical exam, her calves are non-tender to palpation. Sensation is intact to light touch in both feet. Ankle reflexes are 2+.   Based on the suspected diagnosis, measurement of which of the following would be most appropriate to obtain in this patient?

A 68-year-old male with a past medical history of hypertension, diabetes mellitus type II, and hyperlipidemia, as well as a 30-pack-year smoking history presents to the Emergency Department with aphasia and right-sided hemiparesis. His wife reports that he was completely normal three hours ago at dinner. Vital signs are T 37C, HR 90, BP 142/91 mmHg, RR14, O2 99% on room air. On physical examination, he is unable to repeat a sentence. He is unable to express himself although he is able to follow commands. His right upper extremity and lower extremity are both weak but the weakness is more pronounced in his right arm than right leg. On examination of the head and neck, you note bilateral carotid bruits. Head CT is obtained (see image below). Which of the following statements regarding the management of this patient is TRUE?