Jose, a 16-year-old male, presents himself to your clinic with his mother. She tells you he was playing in a football game last night and was hit hard by another player and was knocked out. When he woke up he didn't know where he was or who his parents were. He was taken to the hospital where it was shown that his heart rate was 54 beats per minute and his blood pressure was 88/54. Shortly after vital signs were taken, Jose began to vomit.What is the treatment?   Bed rest.   Mild analgesics.   Gradual return to daily activities.   All of the above are part of the treatment plan for a cerebral concussion.

Lucas, a 16-year-old male, presents himself to your clinic with his mother. She tells you he was playing in a rugby game last night and was hit hard by another player and was knocked out. When he woke up he couldn't feel his legs.What is the diagnosis? Group of answer choicesAcute Bacterial MeningitisCerebral ConcussionParaplegiaSubdural Hematoma

A 45-year-old man comes to the emergency department due to a 1-day history of constant upper abdominal pain, nausea, and several episodes of vomiting.  The pain is partially relieved by sitting up or bending forward.  He has also had mild shortness of breath.  The patient's other medical history includes hyperlipidemia and hypertension.  He uses tobacco and alcohol.  There is a family history of coronary artery disease and hypertension.  Temperature is 38.1 C (100.6 F), blood pressure is 110/70 mm Hg, pulse is 114/min, and respirations are 22/min.  There is dullness to percussion and decreased breath sounds at the left lung base.  Abdominal examination shows epigastric tenderness.  Laboratory results are as follows:Hematocrit 44%Leukocytes 16,000/mm3Calcium 7.8 mg/dLGlucose 250 mg/dLWhich of the following plays a principal role in initial management of this patient's current condition? A.Antiplatelet agents B.Broad-spectrum antibiotics C.Calcium gluconate D.Exploratory laparotomy E.Insulin infusion F.Isotonic crystalloids G.Proton pump inhibitors

A 47-year-old man with no significant medical history presents to the Emergency Department after suffering his first seizure. He says that he has had headaches for the past week and has not felt himself. He lives with his family in California, and his mother recently moved in with him after immigrating to the United States from El Salvador. He is afebrile with normal vital signs, and a brief screening physical examination is normal. He is currently alert and oriented to person, place, and time.  What is the most appropriate treatment for this patient?

A 54-year-old man is brought to the emergency department after his family found him on the floor and unresponsive at home.  The patient has a history of hypertension but is not adherent with medical treatment.  He smokes cigarettes and uses cocaine.  Temperature is 36.6 C (97.9 F), blood pressure is 176/98 mm Hg, pulse is 58/min, and respirations are 12/min and irregular.  The patient is unresponsive to deep sternal rub.  The right pupil is widely dilated and unresponsive to light.  There is intermittent extended posturing of the left arm and leg.  Deep tendon reflexes are 4+ in the left extremities, and Babinski sign is present on the left side.  Which of the following is the most likely cause of this patient's current condition? A.Basal ganglia hemorrhage B.Cerebellar hemorrhage C.Medullary ischemic infarction D.Midbrain ischemic infarction E.Occipital cortex ischemic infarctionProceed To Next Item

An 83-year-old man is transferred to the hospital from his nursing home due to hypotension and confusion. He was previously well until yesterday morning, when the nursing staff observed that he seemed lethargic and spent the day in bed. Later that night, the staff tried to communicate with him but he was not oriented to place or time. His medical history is significant for hypertension, COPD, paroxysmal atrial fibrillation, and urinary incontinence requiring a urethral catheter. He is compliant with medications, has no recent medication changes, and has no sick contacts. On examination, his temperature is 35.4°C, his blood pressure is 68/44 mmHg, his heart rate is 88 beats per minute, and his respiratory rate is 18 breaths per minute. He is lethargic with flat neck veins; his cardiac examination is normal. His lungs are clear to auscultation, and there is no significant abdominal tenderness. His neurologic examination is normal, and his extremities are warm and well perfused. His laboratory values are significant for a leukocyte count of 13,500/mm3 and a serum lactate of 3.9 mmol/L (normal range 0.6 to 2.3 mmol/L). A urinalysis shows significant pyuria. A chest x-ray shows hyperinflated lungs but no focal opacities. Which of the following is the most appropriate next step in management?