An 18-Year-Old Woman with a History of Acne Comes to Her

question 438

Multiple Choice

An 18-year-old woman with a history of acne comes to her primary care physician because of headaches for the past 3 months.  The headaches are holocranial and pulsatile in quality.  They are worsened by lying flat and improved by sitting up.  She also experiences blurry vision and a "whooshing sound" occurring with the headaches.  She denies photophobia, fever, nausea, and vomiting during the headaches.  The headaches occur daily and fluctuate in intensity.  Her current medications include isotretinoin for her acne.  She has no known drug allergies.  She does not use alcohol, tobacco, or illicit drugs. 
Her blood pressure is 130/70 mm Hg and pulse is 70/min.  Her BMI is 34 kg/m². 
Which of the following should be closely examined during the neurologic evaluation of this patient?

• A)Finger-to-nose and heel-to-shin maneuvers
• B)Myotatic stretch reflexes
• C)Optic fundi
• D)Pain and temperature sensations
• E)Tandem gait

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Definitions:

Fuzzy Trace Theory

States that memory is best understood by considering two types of memory representations: (1) verbatim memory trace; and (2) fuzzy trace, or gist. According to this theory, older children’s better memory is attributed to the fuzzy traces created by extracting the gist of information.

Verbatim Memory Trace

The detailed and precise recall of exact details, such as words or images, from memory.

Grist

Material or ideas ready to be used or turned into something valuable.

Three-dimensional

Pertaining to or having length, width, and depth.