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  #1  
Old 08-26-2012
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A 6 year old boy is brought to the ER with a 2 day history of difficult walking.He is dragging his right leg and seems to have weakness in his right arm.He also complain of headache.The family just emigrated from eastern europe .According to his parents ,the child suffers from delayed growth compared to his peers and does not like to engage in active play.his lips and fingers turn blue when he cries.His vitals signs today are a BP 100/70 mmHg pulse 90/min Temp 102 F and RR of 22/min.Which of the following is most likely responsible for his current complaints?

A,Glycogen storage disease
B.Demyelinating disorder
C.Lipid storage disorder
D.malignancy
E.Brain abscess
F.malformation fo the central nervous system
G.Anterior horn cell disease
H.Slow virus infection

Please add reasoning
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Old 08-26-2012
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Originally Posted by step_enhancer View Post
A 6 year old boy is brought to the ER with a 2 day history of difficult walking.He is dragging his right leg and seems to have weakness in his right arm.He also complain of headache.The family just emigrated from eastern europe .According to his parents ,the child suffers from delayed growth compared to his peers and does not like to engage in active play.his lips and fingers turn blue when he cries.His vitals signs today are a BP 100/70 mmHg pulse 90/min Temp 102 F and RR of 22/min.Which of the following is most likely responsible for his current complaints?

A,Glycogen storage disease
B.Demyelinating disorder
C.Lipid storage disorder
D.malignancy
E.Brain abscess
F.malformation fo the central nervous system
G.Anterior horn cell disease
H.Slow virus infection

Please add reasoning
ans is H ........ pt has emigrated from europe and the child may not have been vaccinated for measles ...... leading to Subacute sclerosing panencephalitis (SSPE )
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ans is H ........ pt has emigrated from europe and the child may not have been vaccinated for measles ...... leading to Subacute sclerosing panencephalitis (SSPE )
sorry the ans is E .... just did this one online ........

i always considered that usmle guys consider everyone out side usa unimmunized and with infections .....

this time it was infection not immunization.......

did not pay attention to fever , did not know how it was related to blue hands ..... so its cong heart disease with right to left shunt leading to brain abscess .......
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sorry the ans is E .... just did this one online ........

i always considered that usmle guys consider everyone out side usa unimmunized and with infections .....

this time it was infection not immunization.......

did not pay attention to fever , did not know how it was related to blue hands ..... so its cong heart disease with right to left shunt leading to brain abscess .......
some uworld qs make me want to pull my hair off and precipitate trichotillomania

no way around them
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some uworld qs make me want to pull my hair off and precipitate trichotillomania

no way around them

but you must be handling it better after brainstorming qs from kaplan q bank ......
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but you must be handling it better after brainstorming qs from kaplan q bank ......
Kaplan qbank Qs are kind of memory based and less application based/2-3 step questions.Also the options were not so closely related as uworld's .In kaplan qbank its like either u know or not .in uworld even if u know the topic the answer choices will make u jump from a building .

this question i feel is very usmle style ,the answer choices r not tricky but the stem itself fails you from making a understanding about whats happening.
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hi guys

I dont think this question is that hard if you consider the 3 extremely important clues they give.
1) 2 days (extremely acute, only infection or abscess could do this, i doubt malignancy would behave like this).
2) Lips and fingers blue when crying (prof TOF)
3) Fever

All of this point to brain abcess

Subacute sclerosing panencephalitis is not this focal
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Subacute sclerosing panencephalitis...boards love to make ppl from eastern europe seem unvaccinated.
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Subacute sclerosing panencephalitis...boards love to make ppl from eastern europe seem unvaccinated.
but the answer is brain abscess ..... and is logical with fever and cong heart disese increasing risk of septic emboli to brain .....
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correct ans is E. very similar q I just read in MTB 2.
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Originally Posted by XpaezX View Post
hi guys

I dont think this question is that hard if you consider the 3 extremely important clues they give.
1) 2 days (extremely acute, only infection or abscess could do this, i doubt malignancy would behave like this).
2) Lips and fingers blue when crying (prof TOF)
3) Fever


All of this point to brain abcess

Subacute sclerosing panencephalitis is not this focal
Answer is E.Brain abscess

Congenital heart disease with right to left shunt (like TOF) can lead to brain abscess
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Old 08-27-2012
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Quote:
Originally Posted by XpaezX View Post
hi guys

I dont think this question is that hard if you consider the 3 extremely important clues they give.
1) 2 days (extremely acute, only infection or abscess could do this, i doubt malignancy would behave like this).
2) Lips and fingers blue when crying (prof TOF)
3) Fever

All of this point to brain abcess

Subacute sclerosing panencephalitis is not this focal
agreed wow thats tricky typical..
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