step2cscases

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Anonymous
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69212
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step2cscases
Updated:
2011-02-27 11:02:06
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step cases
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CS Cases
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  1. 26 y/o M presents with severe right temporal headaches associated with ipsilateral rhinorrhea, eye tearing, and redness. Episodes have occurred at the same time every night for the past week and last for 45 minutes
    Cluster headache
  2. 65 y/o F presnts with severe, intermittent right temporal headache, fever, blurred vision in her right eye, and pain in her jaw when chewing
    Temporal arteritis (giant cell arteritis)
  3. 30 y/o F pw frontal headache, fever and nasal discharge. There is pain oni palpationof the frontal and maxillary sinuses.
    Sinusitis
  4. 50 y/o F presents with recurrent episodes of bilateral squeezing headaches that occur 3-4 times per week, typically toward end of work day.
    Tension headache
  5. 35 y/o M pw sudden severe headache, vomiting, confusion, left hemiplegia and nuchal rigidity
    Subarachnoid hemorrhage
  6. 18 y/o obese female pw pulsatile headache, vomiting, and blurred vision for the past 3 weeks. She is taking OCPs
    Pseudotumor cerebri
  7. 57 y/o M pw daily pain in the right cheek over the past month. The pain is electric and stabbing in character and occurs while he is shaving. Each episode lasts 2-4 minutes
    Trigeminal neuralgia
  8. 72 y/o M pw memory loss, gait disturbance and urinary incontinence for the past 6 months
    Normal pressure hydrocephalus (NPH)
  9. 35 y/o F pw intermittent episodes of vertigo, tinnitus, nausea and hearing loss over the past week
    Meniere's disease
  10. 44 y/o F pw dizziness on moving her head to left. She feels that the room is spinning around her head. Tilt test results in nystagmus and nausea
    Benign positional vertigo
  11. 55 y/o F pw 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
  12. 55 y/o pw 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
  13. 34 y/o pw with retrosternal stabbing chest pain that improves when she leans forward and worsens with deep inspiration. She had a URI one week ago
    Pericarditis
  14. 34 y/o pw 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
  15. 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
  16. 45 yo M pw sudden onset of colicky right-sided flank pain that radiates to the testicles, accompanied by nausea, vomiting, hematuria, and CVA tenderness
    Nephrolithiasis
  17. 41 yo 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
  18. 43 yo obese F pw RUQ abdominal pain, fever and jaundice. She was diagnosed with asymptomatic gallstones one year ago.
    Ascending cholangitis
  19. 37 yo M pw 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
  20. 70 yo F pw acute onset of severe, crampy abdominal pain. She recently worried 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
  21. 60 y/o M pw 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 hyperplasia (BPH)
  22. 35 yo F presents with amenorrhea, galactorrhea, visual field deficits, and headaches for the past six months
    Amenorrhea due to prolactinoma
  23. 61 yo obese F pw profuse vaginal bleeding over the past month. Her LMP was 10 years ago. She has a history of HTN and DM. She is nulliparous.
    Endometrial cancer
  24. 28 yo F presents with a thin, grayish white, foul-smelling vaginal discharge
    Bacterial vaginosis
  25. 30 yo F presents with thick, white cottage cheese-like, odorless vaginal discharge and vaginal itching.
    Vaginitis - candidal
  26. 35 yo F presents with malodorous, profuse, frothy, greenish vaginal discharge with intense vaginal itching and discomfort
    Vaginitis - trichomonal
  27. 65 yo M pw pain in heel of 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
  28. 45 yo 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
  29. 45 yo 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
  30. 45 yo 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
  31. 3 yo M pw 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
  32. 55 yo F presents with gradual altered mental status and headache. Two weeks ago she slipped, hit her head on the ground, and lost consciousness for two minutes
    Subdural hematoma

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