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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{AZ}}
|QuestionAuthor={{AZ}}
|Prompt=A 18-year-old African american male comes to the office for the evaluation of pain in his right hip that started 7 weeks ago. The pain has gradually progressed, and now it limits his daily activities. He has sickle cell disease and was hospitalized 4 months ago due to a painful crisis that was successfully treated with hydration, oxygen,  and analgesics. His temperature is 37.4C (99F), blood pressure is 120/90 mmHg, pulse is 90/min, and respirations are 14/min. Physical examination reveals no local tenderness, but there is restriction of abduction and internal rotation of the hip. What is the most likely diagnosis?
|ExamType=USMLE Step 2 CK
|Explanation=.
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|SubCategory=Neurology
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Neurology
|Prompt=A 40 year old man has been brought to the office by his family for noticeable decrease in his functional status over the last few months. He has a down syndrome and has been semi-independent all his adult life. For the last 6 years, he has been in vocational training, where he has been coping well till 8 months ago, when he started to be so forgetful and losing orientation of time and place around him. He has been rounding around the neighbor’s residence. His family reports that he lost his vocabulary when he speaks. His laboratory tests do not reveal any abnormalities. What is the clinical pattern consistent with the patient symptoms?
|Explanation='''Educational Objective:'''


'''Educational Objective:'''
|AnswerA=Huntington dementia
Avascualr necrosis should be considered in patients with multiple attacks of sickle cell crisis.
|AnswerA=Femoral fracture
|AnswerAExp='''Incorrect'''-[[]]
|AnswerAExp='''Incorrect'''-[[]]
|AnswerB=Joint effusion from septic arthritis
|AnswerB=Parkinson dementia
|AnswerBExp='''Incorrect'''-[[]].
|AnswerBExp='''Incorrect'''-[[]].
|AnswerC=Avascular necrosis
|AnswerC=Vascular dementia
|AnswerCExp='''Correct'''-[[]]
|AnswerCExp='''Incorrect'''-[[]]
|AnswerDExp='''Incorrect'''-[[]].
|AnswerD=Alzheimer type senile dementia
|AnswerE=Osteomyelitis caused by Staphylococcus
|AnswerDExp='''Correct'''-[[]].
|AnswerE=Dementia due to renal failure
|AnswerEExp='''Incorrect'''-[[]]
|AnswerEExp='''Incorrect'''-[[]]
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=Drug induced myopathy, Steroid induced myopathy
|WBRKeyword=Dementia, Parkinson's disease,  
|Approved=No
|Approved=No
}}
}}

Revision as of 01:20, 27 January 2014

 
Author [[PageAuthor::Ahmed Zaghw, M.D. [1]]]
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::Internal medicine
Sub Category SubCategory::Neurology
Prompt [[Prompt::A 40 year old man has been brought to the office by his family for noticeable decrease in his functional status over the last few months. He has a down syndrome and has been semi-independent all his adult life. For the last 6 years, he has been in vocational training, where he has been coping well till 8 months ago, when he started to be so forgetful and losing orientation of time and place around him. He has been rounding around the neighbor’s residence. His family reports that he lost his vocabulary when he speaks. His laboratory tests do not reveal any abnormalities. What is the clinical pattern consistent with the patient symptoms?]]
Answer A AnswerA::Huntington dementia
Answer A Explanation [[AnswerAExp::Incorrect-[[]]]]
Answer B AnswerB::Parkinson dementia
Answer B Explanation [[AnswerBExp::Incorrect-[[]].]]
Answer C AnswerC::Vascular dementia
Answer C Explanation [[AnswerCExp::Incorrect-[[]]]]
Answer D AnswerD::Alzheimer type senile dementia
Answer D Explanation [[AnswerDExp::Correct-[[]].]]
Answer E AnswerE::Dementia due to renal failure
Answer E Explanation [[AnswerEExp::Incorrect-[[]]]]
Right Answer RightAnswer::C
Explanation [[Explanation::Educational Objective:

Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Dementia, WBRKeyword::Parkinson's disease
Linked Question Linked::
Order in Linked Questions LinkedOrder::