A 21-year-old male medical student is taken to the ER by his roommates complaining of progressive weakness. The history reveals that this student had an intestinal virus with diarrhea and vomiting that resolve over 2 days. About 10 days later, he noticed tingling sensations and numbness in his feet, followed by progressive weakness. Over the last 8 days it has gotten so bad that he is having trouble standing, and walking. His physical examination shows normal cranial nerves, distal weakness of the lower extremities (about 3+/5), absent reflexes over the lower extremities, and mild decreased vibration and position sense loss. 1. What is your differential diagnosis? 2. Where is the lesion? 3. Which diagnostic test would you perform first and why? 4. What is the most likely diagnosis and why?

Nick Vastolla is a senior on his lacrosse team.  He is running down the field, with the ball in the net of his lacrosse stick, when he passes the ball to another player and is struck by the opponent’s lacrosse stick on the right forearm.  Mr. Vastolla hears a pop and feels immediate pain.  He is assisted off the field and is evaluated on the sidelines.  He has edema, localized point tenderness, and ecchymosis where the stick struck his right forearm.  The localized point tenderness is along the upper third of the ulna.  Mr. Vastolla has no deformity, but percussion and compression/squeeze test results are positive.  He is immobilized and referred for radiography, the results of which indicate an ulna fracture.  A cast that extends over the wrist and forearm is made for his arm. Based on this scenario, what do you know about Mr. Vastolla injury? ► _________________________________________ ► _________________________________________ ► _________________________________________ ►…

A major concern with the repeated administration of opioids for the treatment of pain is _______. Tachypnea Miosis Dependence Diarrhea

"BL, a 30 year old male, came in with a chief complaint of right foot swelling and redness. Upon interviewing BL, he noted an excruciating pain on the affected site upon waking up this morning, and further disclosed that he and his friends drank lots of beer and tequila last night. Upon inspecting and palpating BL's right foot, you appreciated a significant swelling of the 1st metatarsophalangeal joint which was associated with erythema (redness), warmth, and tenderness (pain). What is the correct diagnosis?"   a Osteoarthritis   b Rheumatoid arthritis   c Gouty arthrtitis   d Psoriatic arthritis

What are the predominate cells identified in the CSF when a patient has bacterial meningitis 1) Neutrophils 2) Monocytes 3) Lymphocytes 4) Macrophages

Fourth Hospitalization As you read on, you note that Vincent was hospitalized again at age 49 with dull pain in the right, upper quadrant of the abdomen, intermittent fever of 3 weeks duration, and a yellowing of the skin and the whites of the eyes. A diagnosis of "alcohol-induced hepatitis" is listed in the chart. 1. Is the diagnosis consistent with the location of the abdominal pain? Explain your answer

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Are antibiotics useful for the common cold or purulent rhinitis? Why or why not?

A 32 yr old female presented to your office complaining of abdominal pain. She states this pain started yesterday and increased over the course of a couple of hours. It is mostly in the epigastric region and does radiate at times to the RUQ. She states it has been constant since then. Currently rates it at a 7/10. She has never had pain like this before. Denies any vomiting but does complain of nausea. She denies any diarrhea or constipation. Denies any documented fevers but has felt a little chilled this am. Denies any abdominal bloating. She does state she drinks a glass of wine each evening. Denies any tobacco use or street drug use. Current labs WBC 13.2 Hgb 14.0 Hct 38.9 Plt 250 Na 142K 4.0BUN 26CR 1.2Total bilirubin 2.5 mg/dl AST 289 ALT 302Alk Phos 358 What does the AST/ALT ratio indicate for this patient  What if your AST/ALT ratio were >1. What would that suggest?

A 40-year old gentleman arrives in the emergency room with a headache, irritability, generalized muscle pain, and uncontrollable back spasms. He has become very restless and worried because he has had the back spasms all day while at work and they have become extremely painful. In his history, the man states that he runs his own business and is very busy with work. He injured himself about 10 days earlier, puncturing his left arm with a nail from an old barn he is renovating. The wound has produced moderate quantities of pus, but he has been keeping it clean. When asked, he did not remember having a tetanus shot since he was a kid. The wound was sampled for microscopic examination and cultured. It was discovered that the culture consists of rod-shaped cells that each contain an endospore. His back appears to have very tight contractions and spasms. The patient is in obvious agonizing pain. 1. What is your diagnosis here? 2. How could this have been prevented?