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(Created page with "{{WBRQuestion |QuestionAuthor=Sapan Patel, M.B.B.S. |ExamType=USMLE Step 3 |MainCategory=Primary Care Office, Emergency Room |SubCategory=Head and Neck, Neurology |MainCategor...")
 
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|QuestionAuthor=Sapan Patel, M.B.B.S.
|QuestionAuthor=Sapan Patel, M.B.B.S.
|ExamType=USMLE Step 3
|ExamType=USMLE Step 3
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|MainCategory=Primary Care Office, Emergency Room
|MainCategory=Primary Care Office, Emergency Room
|SubCategory=Head and Neck, Neurology
|SubCategory=Head and Neck, Neurology
|Prompt=A 67-year-old man presents with a 3-day history of severe dizziness. The symptoms are exacerbated by turning his head and relieved by lying still. He reports nausea and vomiting for the first 2 days of his illness, but successfully eats breakfast on the day he is seen in clinic. He denies hearing loss and tinnitus. His past medical and surgical histories are unremarkable. He has no previous exposure to ototoxic drugs and denies further neurologic symptoms. Physical examination reveals an obviously uncomfortable white male in a wheelchair.Otologic examination is without abnormality. Weber testing with a 512 Hz tuning fork is to midline. Romberg testing indicates right-sided pathology. Cranial nerve examination is normal except left beating nystagmus. Vertigo is experienced after the Dix-Hallpike maneuver. Nystagmus is observed after a few seconds of lying down during the maneuver.The patient is treated with diazepam (Valium,) q 8 hours, which, on follow up, has relieved his symptoms.
What is the most likely diagnosis?
|RightAnswer=C
|RightAnswer=C
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 18:24, 26 August 2013

 
Author PageAuthor::Sapan Patel, M.B.B.S.
Exam Type ExamType::USMLE Step 3
Main Category
Sub Category SubCategory::Head and Neck, SubCategory::Neurology
Prompt [[Prompt::A 67-year-old man presents with a 3-day history of severe dizziness. The symptoms are exacerbated by turning his head and relieved by lying still. He reports nausea and vomiting for the first 2 days of his illness, but successfully eats breakfast on the day he is seen in clinic. He denies hearing loss and tinnitus. His past medical and surgical histories are unremarkable. He has no previous exposure to ototoxic drugs and denies further neurologic symptoms. Physical examination reveals an obviously uncomfortable white male in a wheelchair.Otologic examination is without abnormality. Weber testing with a 512 Hz tuning fork is to midline. Romberg testing indicates right-sided pathology. Cranial nerve examination is normal except left beating nystagmus. Vertigo is experienced after the Dix-Hallpike maneuver. Nystagmus is observed after a few seconds of lying down during the maneuver.The patient is treated with diazepam (Valium,) q 8 hours, which, on follow up, has relieved his symptoms.

What is the most likely diagnosis?]]

Answer A AnswerA::
Answer A Explanation AnswerAExp::
Answer B AnswerB::
Answer B Explanation AnswerBExp::
Answer C AnswerC::
Answer C Explanation AnswerCExp::
Answer D AnswerD::
Answer D Explanation AnswerDExp::
Answer E AnswerE::
Answer E Explanation AnswerEExp::
Right Answer RightAnswer::C
Explanation [[Explanation::

Educational Objective:
References: ]]

Approved Approved::Yes
Keyword
Linked Question Linked::
Order in Linked Questions LinkedOrder::