Vitamin B12 (cyanocobalamin) supplementation She has no history of serious illness….Īnswer: F. McGraw-Hill Education.Īn 82-year-old woman comes to the office because of a 1-month history of increasing numbness in her feet. First Aid for the USMLE Step 2 CK, eleventh edition (11th ed.). Le, T., Bhushan, V., Ascha, M., Bhardwaj, A., Boushra, M., & Griffin, D.Here, pain + hematuria + hydronephrosis screams “stone,” and CT is the top for stone detection. Test-taking tip: On USMLE, the clinical scenario’s specifics guide the test choice. Voiding cystourethrography: Assesses vesicoureteral reflux. Ultrasonography of the spinal column: For spinal dysraphism. Radionuclide cystography & Retrograde pyelography: Evaluates vesicoureteral reflux and urinary tract, respectively, but not ideal for stone detection. MAG-3 renal scan: Differentiates obstructive vs. Captopril renography: For renal artery stenosis. Associate sudden flank pain with hematuria to ureteral stones.Ureteral stones can present with colicky pain and hematuria, often showing radiographic evidence of hydronephrosis.For USMLE/NBME, recognize that CT of the abdomen and pelvis is the gold standard for detecting and localizing ureteral stones.In acute lumbar pain, vomiting, hematuria, and unilateral hydronephrosis with hydroureter, the child likely has a ureteral stone.A 6-year-old boy is brought to the emergency department by his mother because of the acute onset 1 hour ago of severe right-sided lumbar pain and three episodes of emesis….
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