A 9-year-old girl presents with precocious puberty and episodes of uncontrollable laughter. Which of the following mass lesions might explain her symptoms?
Endocrinology • General Medicine + 1 more
The parents of a 10-year-old boy bring their child in to see you. The child has been diagnosed with cerebral palsy, and the parents do not really understand what this means. As part of your explanation, you tell them that cerebral palsy is a static encephalopathy because
Pediatrics • Developmental-Behavioral Pediatrics
A 36-year-old woman has tunnel vision in which she reports the same size area of perception regardless of how far from the testing screen the examination is performed. This history often indicates which of the following?
Ophthalmology • Ophthalmic Pathology
A 23-year-old woman complains of 2 days of visual loss associated with discomfort in the right eye. She appears otherwise healthy, but her family reports recurrent problems with bladder control over the prior 2 years, which the patient is reluctant to discuss. On neurologic examination, this young woman exhibits dysmetria in her right arm, a plantar extensor response of the left foot, and slurred speech. The most informative ancillary test would be
Ophthalmology • Ophthalmic Pathology + 2 more
A 32-year-old woman has an MRI done because of a first seizure. No etiology for the seizure is found, but there is the incidental finding of an aneurysm. The aneurysm is 5 mm and affects the posterior communicating artery. It is very close to the third cranial nerve. The initial sign of pressure on the third nerve is usually impaired
Neurology • Endovascular Surgical Neuroradiology
A 33-year-old operating room nurse accidentally has blood splashed in her eyes during a procedure. The surgical resident who examines her immediately afterward notices that she has 2-mm anisocoria and sends her to the emergency room. She feels well, is alert and talkative, and has no motor dysfunction. On examination, the emergency room physician recognizes that the iris of the eye with the smaller pupil is pale blue, while that of the other eye is brown. The etiology of the woman’s anisocoria is probably
Emergency Medicine • General Medicine
A 28-year-old man presents with right eye pain and blurry vision developing over 3 days. After examination and further history, a diagnosis of papillitis is made. How can papillitis be distinguished from the papilledema of increased intracranial pressure?
Ophthalmology • General Medicine
A 45-year-old man has noticed over the past 6 months that his sense of smell is not as sensitive as it used to be. On examination he has unilateral anosmia, ipsilateral optic atrophy, and contralateral papilledema. He most likely has which of the following?
A 58-year-old man with type 2 diabetes presents with the acute onset of double vision. Examination reveals a deficit of the third cranial nerve. A third-nerve palsy associated with diabetes mellitus is usually characterized by
General Medicine • Endocrinology + 2 more