Light microscopy of this patient's cerebrospinal fluid is most likely to reveal which of the following?
Anonymous Quiz
51%
A. Budding yeast
11%
B. Germ tubes
12%
C.Nonseptate hyphae
19%
D.Spherules with endospores
7%
E. Sporangium
Educational objective: Cryptococcus neoformans causes meningoencephalitis in patients with untreated AIDS. Diagnosis can be made by detecting the polysaccharide capsule in cerebrospinal fluid using the latex agglutination test. India ink staining of cerebrospinal fluid is also used for diagnosis and can demonstrate round or oval budding yeast.
A 48-year-old man comes to the hospital after a day of high-grade fever, progressive headache, and double vision. The patient has been having purulent nasal drainage and frontal headache for the past several days. He has a history of type 2 diabetes mellitus. His temperature is 38.9 C (102 F), blood pressure is 110/70 mm Hg, and pulse is 94/min. Physical examination shows ptosis, mydriasis, mild proptosis, and loss of the corneal reflex of the right eye. Visual acuity is normal in both eyes, but the patient is unable to move the right eye in any direction. There is decreased sensation in the right upper face.
Which of the following structures is most likely involved in this patient's presentation?
Anonymous Quiz
13%
A. Brainstem
58%
B. Cavernous sinu
6%
C.Frontal lobe of brain
12%
D. Inferior orbital fissure
4%
E.Jugular foramen
8%
F. Optic chiasmD. Inferior orbital fissure
Educational objective: Infection of the medial face, sinuses (ethmoidal or sphenoidal), or teeth may spread through the valveless facial venous system into the cavernous sinus, resulting in cavernous sinus thrombosis. Patients typically present with headache, fever, proptosis, and ipsilateral deficits in cranial nerves Ill, IV, VI, and V (ophthalmic and maxillary branches).
A 28-year-old man comes to the emergency department due to 2 weeks of headaches, fever, and episodes of inattentiveness. The patient has a history of Hodgkin lymphoma and is undergoing treatment with combination chemotherapy. Temperature is 38.2 C (100.8 F), blood pressure is 138/84 mm Hg, and pulse is 72/min. Lumbar puncture reveals an elevated opening pressure, and cerebrospinal fluid analysis shows moderately increased protein levels and low glucose levels. Light microscopy of the cerebrospinal fluid is shown in the image.
Which of the following should be included in initial treatment for this patient's current condition?
Anonymous Quiz
73%
A.Amphotericin B
3%
B.Ampicillin
11%
C. Ceftriaxone
4%
D. Ganciclovir
3%
E. Pyrimethamine
5%
F. Voriconazole
Educational objective: Patients with suspected cryptococcal meningitis can be diagnosed using India ink staining of the cerebrospinal fluid. Treatment with amphotericin B and flucytosine is required at first, followed by long-term fluconazole maintenance therapy.
A 55-year-old man with poorly controlled hypertension and type 2 diabetes mellitus comes to the emergency department due to difficulty seeing. He has had blurry vision for the last 2 weeks, and 1 day ago he suddenly noticed a shadow develop across the visual field of his left eye. The patient has no recent headache, double vision, vertigo, light sensitivity, or nausea. On examination, pupils are equal and reactive to light. There is an area of reduced vision in the left eye. Funduscopic examination reveals a flameshaped hemorrhage in the left temporal hemiretina.
The transmission of visual information through which of the following neural structures will be disrupted?
Anonymous Quiz
7%
A. Left inferior colliculus
38%
B. Left lateral geniculate body
13%
C.Left medial geniculate body
15%
D.Medial optic chiasm
9%
E. Right inferior colliculus
19%
F. Right lateral geniculate body
A 67-year-old woman with a known history of lung cancer comes to the office due to hoarseness and
difficulty swallowing. She has no disturbances in vision or hearing. On examination, there is loss of the gag reflex on the left side; when the patient is prompted to say "ah," the uvula deviates to the right side.
a right lower lobe lung mass and several osteolytic rib lesions. MRI of the head also demonstrates multiple Her left shoulder is drooped and strength is reduced during left shoulder shrug testing. Chest x-ray shows
lesions consistent with metastasis.
difficulty swallowing. She has no disturbances in vision or hearing. On examination, there is loss of the gag reflex on the left side; when the patient is prompted to say "ah," the uvula deviates to the right side.
a right lower lobe lung mass and several osteolytic rib lesions. MRI of the head also demonstrates multiple Her left shoulder is drooped and strength is reduced during left shoulder shrug testing. Chest x-ray shows
lesions consistent with metastasis.
A 67-year-old woman with a known history of lung cancer comes to the office due to hoarseness and
difficulty swallowing. She has no disturbances in vision or hearing. On examination, there is loss of the gag reflex on the left side; when the patient is prompted to say "ah," the uvula deviates to the right side.
a right lower lobe lung mass and several osteolytic rib lesions. MRI of the head also demonstrates multiple Her left shoulder is drooped and strength is reduced during left shoulder shrug testing. Chest x-ray shows
lesions consistent with metastasis.
difficulty swallowing. She has no disturbances in vision or hearing. On examination, there is loss of the gag reflex on the left side; when the patient is prompted to say "ah," the uvula deviates to the right side.
a right lower lobe lung mass and several osteolytic rib lesions. MRI of the head also demonstrates multiple Her left shoulder is drooped and strength is reduced during left shoulder shrug testing. Chest x-ray shows
lesions consistent with metastasis.
A lesion involving which of the following anatomical structures is most likely responsible for this patient's symptoms?
Anonymous Quiz
10%
A. Cerebellopontine angle
11%
B. Foramen magnum
7%
C.Foramen ovale
5%
D.Foramen rotundum
18%
E. Hypoglossal canal
49%
F. Jugular foramen
Educational objective: Lesions of the jugular foramen can result in jugular foramen (Vernet) syndrome, which is characterized by the dysfunction of cranial nerves IX, X, and XI. Symptoms include dysphagia, hoarseness, loss of gag reflex on the ipsilateral side, and deviation of the uvula toward the normal side.
π Free Trial + Special Discount on NBME Way! π
#NBME_step2ck_Qbank
Unlock your USMLE prep potential with a free trial and exclusive discounts at NBME Way. Limited spots!
β Quick sign-up at
https://nbmeway.com/nbme/signup.php
β Expert resources
β Maximize your scores
Secure your success - enroll now and elevate your study game!
Need help? Chat with us on Telegram: @nbmeway
#USMLEPrep #NBMEWay #StudySmart
#NBME_step2ck_Qbank
Unlock your USMLE prep potential with a free trial and exclusive discounts at NBME Way. Limited spots!
β Quick sign-up at
https://nbmeway.com/nbme/signup.php
β Expert resources
β Maximize your scores
Secure your success - enroll now and elevate your study game!
Need help? Chat with us on Telegram: @nbmeway
#USMLEPrep #NBMEWay #StudySmart
Forwarded from LECTURIO USMLE |STEP 1
This media is not supported in your browser
VIEW IN TELEGRAM
π Free Trial + Special Discount on NBME Way! π
#NBME_step2ck_Qbank
β Quick sign-up at
https://nbmeway.com/nbme/signup.php
#USMLEPrep #NBMEWay #StudySmart
#NBME_step2ck_Qbank
β Quick sign-up at
https://nbmeway.com/nbme/signup.php
#USMLEPrep #NBMEWay #StudySmart
Forwarded from USMLE RECALLS STEP 1 2and 3 2024
βοΈFor details and membership
contact:
@usmle_recall
ππππππππ
https://www.tg-me.com/USMLERECALLS2021/872
Please open Telegram to view this post
VIEW IN TELEGRAM
Forwarded from USMLE RECALLS STEP 1 2and 3 2024
πRecalls will save you time to focus on the remaining questions
βοΈBelieving in yourself is the first secret to success
In the end we regret the chances we didn't takeπ
Happy learning to u allπΉ
βοΈFor details and membership
contact:
@usmle_recall
Join now
https://www.tg-me.com/USMLERECALLS2021/1537
Please open Telegram to view this post
VIEW IN TELEGRAM