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1. Idiopathic skeletal hyperostosis: 56-year-old man with stitt neck and diflculty
swallowing. Lateral view of the cervical spine with flowing osteophytes indenting the esophagus.
What is the most likely diagnosis?
2. Rheumatoid Arthritis: What is a the most likely diagnosis shown on XR?
3. Detailed MOI Hx. Assess midline tenderness, upper extremity
strength, sen- sation and vision: A 27-year-old male with no significant past medical
history comes into primary care clinic with the complaint of neck pain after a motor vehicle accident
2 days ago. He was hit from behind while stopped at a traflc light. He was evaluated at the scene by
emergency personnel and was not thought to be seriously injured. He has had pain in his neck since
the accident.
How do you evaluate this patient?
4. Cervical Spondylosis w/ radicular component: A 71-year-old female with past
medical history of hypertension (HTN), coronary artery disease (CAD), and degenerative disc disease
comes in with chronic neck pain for 6 weeks. The history and physical exam is notable for report of
radiating shooting pain down her right arm and reduced range of motion in her neck. No weakness in
her upper extremities and reflexes are symmetric.
What is the most likely diagnosis?
5. Burst Fracture: What kind of fracture is in this?
6. Brachial plexus injury: A 32-year-old woman delivered a large (4800-g) baby vaginally after
a somewhat diflcult labor. Her prenatal course was complicated by diabetes, which developed during
, B4E1 - STUDY CASES QUIZZES WITH RESOLVED
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pregnancy. At delivery, the infant's head emerged, but the shoulders were stuck behind the maternal
symphysis pubis, requiring the obstetrician
, B4E1 - STUDY CASES QUIZZES WITH RESOLVED
UPGRADED ACCURATE ANSWERS.GET IT 100% ACCURATE
to execute maneuvers to release the infant's shoulders and complete the delivery. The infant was noted
to have a good cry and pink color but was not moving its right arm.
What is the most likely diagnosis?
7. Allopurinol: A 58-year-old man presents for follow-up of gout. He has had multiple episodes of
gouty arthritis, primarily in the great toe. Each episode has been successfully treated with oral anti-
inflammatory medications. He takes no medications regularly and has a normal examination today.
Laboratory studies following his last episode showed an elevated uric acid level and normal renal
function. A 24-hour urine collection showed normal excretion of uric acid.
What medication should this patient be prescribed?
8. Acute low back pain d/t muscle strain: A previously healthy 48-year-old man
presents to his primary care oflce with severe low back pain that began the previous day after he
helped his daughter move into her college dorm. He denies any trauma or previous back injury. He
describes the pain as generally "achy" and sometimes characterized as being "sharp" when he moves
suddenly. The pain is located in his lower back and radiates down the back of both legs to the middle
of his posterior thighs. He denies any bladder or bowel incontinence or weakness in his legs. He denies
fever, chills, weight loss, or malaise. He finds it very diflcult to stand for prolonged periods of time
because he cannot find a comfortable position. He states that this is the worst back pain he has ever
experienced. It has not been relieved with acetaminophen or ibuprofen. His past medical history is
significant for hypertension, and his only medication is lisinopril daily. He does not smoke or use illicit
drugs and only drinks alcohol on occasion. On physical examination, he is well developed, overweight, and
in moderate discomfort. His vitals are within normal limits. On neuromuscular examination, he has
moderate tenderness bilaterally in his lumbar paraspinous muscles, and his lumbar flexion and
extension are limited by pain. Strength and sensation are within normal limits and are symmetrical
bilaterally. He has normal and symmetric knee and ankle deep tendon reflexes. Straight leg raise
testing is negative bilaterally, and gait is within normal limits.
What is the most likely diagnosis?
9. Acute gout of knee: A 45-year-old man presents to your oflce complaining of left knee pain
that started last night. The pain started suddenly after dinner and was severe within a span of 3 hours.
He denies any trauma, fever, systemic symptoms, or prior similar episodes. He takes hydrochlorothiazide
(HCTZ) for his hypertension. He states that he drank "a lot" of wine last night with dinner.
UPGRADED ACCURATE ANSWERS.GET IT 100% ACCURATE
1. Idiopathic skeletal hyperostosis: 56-year-old man with stitt neck and diflculty
swallowing. Lateral view of the cervical spine with flowing osteophytes indenting the esophagus.
What is the most likely diagnosis?
2. Rheumatoid Arthritis: What is a the most likely diagnosis shown on XR?
3. Detailed MOI Hx. Assess midline tenderness, upper extremity
strength, sen- sation and vision: A 27-year-old male with no significant past medical
history comes into primary care clinic with the complaint of neck pain after a motor vehicle accident
2 days ago. He was hit from behind while stopped at a traflc light. He was evaluated at the scene by
emergency personnel and was not thought to be seriously injured. He has had pain in his neck since
the accident.
How do you evaluate this patient?
4. Cervical Spondylosis w/ radicular component: A 71-year-old female with past
medical history of hypertension (HTN), coronary artery disease (CAD), and degenerative disc disease
comes in with chronic neck pain for 6 weeks. The history and physical exam is notable for report of
radiating shooting pain down her right arm and reduced range of motion in her neck. No weakness in
her upper extremities and reflexes are symmetric.
What is the most likely diagnosis?
5. Burst Fracture: What kind of fracture is in this?
6. Brachial plexus injury: A 32-year-old woman delivered a large (4800-g) baby vaginally after
a somewhat diflcult labor. Her prenatal course was complicated by diabetes, which developed during
, B4E1 - STUDY CASES QUIZZES WITH RESOLVED
UPGRADED ACCURATE ANSWERS.GET IT 100% ACCURATE
pregnancy. At delivery, the infant's head emerged, but the shoulders were stuck behind the maternal
symphysis pubis, requiring the obstetrician
, B4E1 - STUDY CASES QUIZZES WITH RESOLVED
UPGRADED ACCURATE ANSWERS.GET IT 100% ACCURATE
to execute maneuvers to release the infant's shoulders and complete the delivery. The infant was noted
to have a good cry and pink color but was not moving its right arm.
What is the most likely diagnosis?
7. Allopurinol: A 58-year-old man presents for follow-up of gout. He has had multiple episodes of
gouty arthritis, primarily in the great toe. Each episode has been successfully treated with oral anti-
inflammatory medications. He takes no medications regularly and has a normal examination today.
Laboratory studies following his last episode showed an elevated uric acid level and normal renal
function. A 24-hour urine collection showed normal excretion of uric acid.
What medication should this patient be prescribed?
8. Acute low back pain d/t muscle strain: A previously healthy 48-year-old man
presents to his primary care oflce with severe low back pain that began the previous day after he
helped his daughter move into her college dorm. He denies any trauma or previous back injury. He
describes the pain as generally "achy" and sometimes characterized as being "sharp" when he moves
suddenly. The pain is located in his lower back and radiates down the back of both legs to the middle
of his posterior thighs. He denies any bladder or bowel incontinence or weakness in his legs. He denies
fever, chills, weight loss, or malaise. He finds it very diflcult to stand for prolonged periods of time
because he cannot find a comfortable position. He states that this is the worst back pain he has ever
experienced. It has not been relieved with acetaminophen or ibuprofen. His past medical history is
significant for hypertension, and his only medication is lisinopril daily. He does not smoke or use illicit
drugs and only drinks alcohol on occasion. On physical examination, he is well developed, overweight, and
in moderate discomfort. His vitals are within normal limits. On neuromuscular examination, he has
moderate tenderness bilaterally in his lumbar paraspinous muscles, and his lumbar flexion and
extension are limited by pain. Strength and sensation are within normal limits and are symmetrical
bilaterally. He has normal and symmetric knee and ankle deep tendon reflexes. Straight leg raise
testing is negative bilaterally, and gait is within normal limits.
What is the most likely diagnosis?
9. Acute gout of knee: A 45-year-old man presents to your oflce complaining of left knee pain
that started last night. The pain started suddenly after dinner and was severe within a span of 3 hours.
He denies any trauma, fever, systemic symptoms, or prior similar episodes. He takes hydrochlorothiazide
(HCTZ) for his hypertension. He states that he drank "a lot" of wine last night with dinner.
