A 36-year old male is complaining of left thumb pain after falling onto his left thumb, causing forced hyperabduction of his thumb. On physical examination, there is increased laxity with valgus stress testing of the left thumb. There following radiographs are obtained.
Which of the following is the most likely diagnosis?
34 - 0
A 32-year old male wants to make an appointment to see a psychiatrist because he is very concerned about how his habits are affecting his relationship. He states he is a perfectionist who feels he must have complete order and control or else things don’t go right. He states that he is a “complete stickler for the rules” and finds it very frustrating to complete a project if the rules are not strictly adhered to. He states he does not feel anxious or depressed at this time. Which of the following is the first line management of this condition?
24 - 0
A 3-year-old is brought into the pediatric clinic by his mother for the sudden onset of spontaneous grunts, blinking, and shoulder shrugging, blurting out of repetitive phrases as well as repeating intermittent obscene words. He does not have a recent history of sore throat, skin or gastrointestinal infections. Which of the following is the most likely diagnoses?
33 - 0
Which of the following is the most common associated cardiac abnormality seen in patients with coarctation of the aorta?
31 - 0
A 43-year-old female has a history of epigastric pain that is worse with food. She has had multiple ulcers in the past that took longer than 8 weeks to heal. She also complains of intermittent diarrhea that is not relieved with fasting. A secretin test is done and there is no inhibition of gastrin levels. Which of the following is the most likely diagnosis?
39 - 0
A 44 year-old man presents with hoarseness of his voice that started six weeks ago. He works as an auctioneer and the symptoms are hindering his ability to work. He denies history of upper respiratory infection or sinus drainage. He has a history of smoking one pack per day for the past 28 years. Which of the following is indicated for further evaluation?
36 - 0
A 17 year-old man is brought in via ambulance after a motorcycle collision. He was wearing a helmet. Now he has altered level of consciousness. On computed tomography scan, there is a crescent shaped extra-axial collection crossing the suture lines with increased attenuation causing effacement of the sulci and midline shift. This finding is most suggestive of which of the following:
28 - 0
A 34 year-old woman is referred by her dentist for finding of sialolithiasis of the submandibular gland. They were noted on panoramic dental radiograph. The patient denies pain but does note increased swelling when she eats or smells food. She smokes three cigarettes per day. Which of the following is the most appropriate to treat this condition?
18 - 0
A four year-old girl is brought in for upper respiratory symptoms of cough, coryza, and conjunctivitis. Examination reveals a transverse line of inflammation along the eyelid margin. Within the mouth, you notice gray-white, sand grain-sized dots on the lower mucosa opposite the lower molars. These oral lesions are descriptive of which pathognomonic finding?
33 - 0
A 58 year-old woman presents for evaluation of worsening shortness of breath. She indicates she has gained 20 pounds in the past month, and has noticed excessive swelling of her feet, ankles and calves. On examination she has +2 pitting pretibial edema. In addition to a diuretic medication, which of the following should also be started as initial therapy?
30 - 0
John Bielinski, Jr., MS PAC is a practicing emergency medicine physician assistant from Buffalo, NY and owner of CME4Life, LLC. He has been lecturing nationally for more than twenty years, teaching the topics and tactics that have proven invaluable to medical providers.
CME4Life takes medicine and makes it easy to understand. Our mission is to "Maximize the Mind." We strive to make medicine come alive, and to make clinicians more efficient and effective. We understand that not everyone learns from the traditional teaching methods so we go all out, searching for unique solutions to educate those who provide medical care.
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2 January 2010