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A 38-year-old accountant comes to your clinic for evaluation of a
headache. The throbbing sensation is located in the right temporal
region and is an 8 on a scale of 1 to 10. It started a few hours ago, and
she has noted nausea with sensitivity to light; she has had headaches
like this in the past, usually less than one per week, but not as severe.
She does not know of any inciting factors. There has been no change
in the frequency of her headaches. She usually takes an over the-
counter analgesic, and this results in resolution of the headache.
Based on this description, what is the most likely diagnosis of the type
of headache?
A) Tension
B) Migraine
C) Cluster
D) Analgesic rebound --- correct precise answer ---B
A 29-year-old computer programmer comes to your office for
evaluation of a headache. The tightening sensation is located all over
the head and is of moderate intensity. It used to last minutes, but this
time it has lasted for 5 days. He denies photophobia and nausea. He
,spends several hours each day at a computer monitor/keyboard. He
has tried over-the-counter medication; it has dulled the pain but not
taken it away. Based on this description, what is your
most likely diagnosis?
A) Tension
B) Migraine
C) Cluster
D) Analgesic rebound --- correct precise answer ---A
Which of the following is a symptom involving the eye?
A) Scotomas
B) Tinnitus
C) Dysphagia
D) Rhinorrhea --- correct precise answer ---A
A 49-year-old administrative assistant comes to your office for
evaluation of dizziness. You elicit the information that the dizziness is
a spinning sensation of sudden onset, worse with head position
changes. The episodes last a few seconds and then go away, and they
are accompanied by intense nausea. She has vomited one time. She
denies tinnitus. You perform a physical examination of the head and
neck and note that the patient's hearing is intact to Weber and Rinne
,and that there is nystagmus. Her gait is normal. Based on this
description, what is the most likely diagnosis?
A) Benign positional vertigo
B) Vestibular neuronitis
C) Ménière's disease
D) Acoustic neuroma --- correct precise answer ---A
A 55-year-old bank teller comes to your office for persistent episodes
of dizziness. The first episode started suddenly and lasted 3 to 4
hours. He experienced a lot of nausea with vomiting; the episode
resolved spontaneously. He has had five episodes in the past 1½
weeks. He does note
some tinnitus that comes and goes. Upon physical examination, you
note that he has a normal gait. The Weber localizes to the right side
and the air conduction is equal to the bone conduction in the right ear.
Nystagmus is present. Based on this description, what is the most
likely diagnosis?
A) Benign positional vertigo
B) Vestibular neuronitis
C) Ménière's disease
D) Acoustic neuroma --- correct precise answer ---C
, A 73-year-old nurse comes to your office for evaluation of new onset
of tremors. She is not on any medications and does not take herbs or
supplements. She has no chronic medical conditions. She does not
smoke or drink alcohol. She walks into the examination room with
slow movements and shuffling steps. She has decreased facial mobility
and a blunt expression,
without any changes in hair distribution on her face. Based on this
description, what is the most likely reason for the patient's
symptoms?
A) Cushing's syndrome
B) Nephrotic syndrome
C) Myxedema
D) Parkinson's disease --- correct precise answer ---D
A 29-year-old physical therapist presents for evaluation of an eyelid
problem. On observation, the right eyeball appears to be protruding
forward. Based on this description, what is the most likely diagnosis?
A) Ptosis
B) Exophthalmos
C) Ectropion
D) Epicanthus --- correct precise answer ---B