A 45-year-old female complains of feeling extremely anxious, ...

[haleyc112]

A 45-year-old female complains of feeling extremely anxious, fatigued, and has a loss of enjoyment of previously engaging activities. She has a difficult time arising from bed in the morning to go to work.
 
  She has lost her appetite, cannot sleep, and has trouble thinking straight. On physical examination, there are no significant findings. These signs and symptoms are characteristic of:
  A. The presence of a malignancy
  B. Clinical depression
  C. Hypothyroidism
  D. Adrenal insufficiency

Question 2

An 88-year-old female is accompanied by her daughter to the emergency department. The daughter explains that her mother was having her hair washed at the beauty salon, then complained of dizziness and fainted.
 
  The 88-year-old patient has a history of hypertension for which she takes a beta blocker. Otherwise she was in her usual state of health until this incident. On examination, she has no neurological deficits. Which of the following conditions should be considered?
  A. Benign positional vertigo
  B. Wertebrobasilar insufficiency
  C. Labyrinthitis
  D. Dehydration

[stillxalice]

Answer to Question 1

ANS: A
Patients who are overweight and sedentary, with a positive family history, are at high risk for developing Type 2 DM. Polydipsia, polyphagia, and polyuria are the hallmark signs of diabetes, but fatigue, weight loss, and blurred vision are often the symptoms that bring patients into the office.

Answer to Question 2

ANS: B
Vertebrobasilar insufficiency is seen mostly in the elderly and is exacerbated by extension of the neck or changes in head position. There is temporary interruption of circulation in the posterior brain due to vertebral artery occlusion. Benign paroxysmal positional vertigo, or cupulolithiasis, is the most common vestibular disorder, resulting from otolithic crystals/particles detaching from the utricle membrane and migrating to the semicircular canal. It can occur spontaneously with motion or position change or as a result of vascular or labyrinth trauma. Characterized by sudden-onset dizziness lasting less than 30 seconds and following a head position change, cupulolithiasis may be accompanied by nystagmus. It usually subsides but may recur at any time. Labyrinthitis is caused by the invasion of the ear by bacteria or a virus. The bacterial version is more serious because it may lead to meningitis. Prompt treatment with antibiotics is necessary. Labyrinthitis is characterized by severe vertigo, nystagmus, and hearing loss. Suppurative labyrinthitis may be secondary to bacterial otitis media or other bacterial infection. Serous labyrinthitis can be secondary to a variety of viral illnesses, including measles, mumps, chickenpox, influenza, mononucleosis, and adenovirus.

[haleyc112]

Thank you

[stillxalice]

No problemo