Day 27
Diagnose the case, Give the investigations, suggest the management and select the rubrics

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1.  You are a male doctor and a female patient comes to your clinic wearing revealing clothes. She comes up very close to the doctor and starts asking personal questions in a seductive tone.What would be the appropriate response? a. Refuse to examine her. b. Call in a nurse c. Use open-ended questioning technique d. Ask about her personal life e. Refer her to another doctor. Justify
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2.  A 40-year-old woman complains of episodes of severe unilateral, stabbing facial pain that is intermittent for several hours, and then disappears for several days. Physical examination is entirely normal. Which of the following is the most likely diagnosis? 
(A) trigeminal neuralgia (B) herpes zoster 
(C) acoustic neuroma (D) Bell’s palsy 
(E) diabetic neuropathy 

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3.  A teenager has a long history of “daydream- ing” in school. EEG reveals evidence of a generalized seizure disorder, but there has never been a history of convulsive muscular activity. 
(A)  simple partial seizure 
(B)  complex partial seizures 
(C)  tonic-clonic (grand mal) seizures 
(D)  absence (petit mal) seizures 
(E)  myoclonic seizures 
(F)  status epilepticus
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4. A chronic alcoholic has been diagnosed with Korsakoff syndrome (a severe inability to form new memories and a variable inability to recall remote memories). Where in the brain is the damage causing this memory loss likely located? a. Angular gyrus b. Mammillary bodies c. Hypothalamus d. Globus pallidus e. Arcuate fasciculus Explain your answer
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5. A 4-year-old boy is brought to the emergency room by his mother secondary to a fracture of his left femur. The mother states that the boy fell down the stairs at home, and that he has “always been clumsy.” X-rays of the boy’s leg confirm the fracture, and physical examination reveals bruises of various ages on the boy’s chest and abdomen. Which of the following should the physician do first? a. Arrange for a comprehensive psychiatric evaluation of the child b. Ensure the child’s safety c. Report the case to the appropriate child-family social service department d. Order a complete skeletal survey (x-rays) of the child e. Request social work intervention. Give the rationale
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