Topic: Subarachnoid Hemorrhage
Subject: Medicine
A 36-year-old female presents with the sudden onset of severe headache, nausea, and photophobia. Her level of consciousness is progressively diminishing. Which one of the following would be the most appropriate next step?
Head CT without contrast
Head CT with contrast
Head MRI
Lumbar puncture
Correct Answer :
A. Head CT without contrast
The first study ordered in any patient with suspected subarachnoid hemorrhage should be a head CT without contrast. It will reveal subarachnoid hemorrhage in 100% of cases within 12 hours of the bleed, and it is useful for identifying other sources for the headache, for predicting the site of the aneurysm, and for predicting cerebral vasospasm and poor outcome. As blood is cleared from the affected area, CT sensitivity drops to 93% within 24 hours, and to 50% at 7 days. Patients with a positive CT result for subarachnoid hemorrhage should proceed directly to angiography and treatment. Patients with a suspected subarachnoid hemorrhage who have negative or equivocal results on head CT should have a lumbar puncture. MRI and CT with contrast are not used for the diagnosis of acute subarachnoid hemorrhage.
Related Questions
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Subject: Medicine
A 63-year-old retired teacher shared with his primary care physician (PCP) during a routine office visit that he has noticed increasing difficulty with his memory. Otherwise he is in good health and requiring no medication.
Which one of the following psychological tests is a valuable screening device to be used by primary care physicians in this type of situation?
MMPI
WAIS
Thematic Apperception Test
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Subject: Medicine
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Ethosuximide
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Monocular visual loss
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Alzheimers disease
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Subject: Medicine
A 57-year-old white male with coronary artery disease suffered a cardiac arrest while jogging 10 days ago. He was resuscitated after 45 minutes but has remained unresponsive and on a ventilator since then.
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Subject: Medicine
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Subject: Medicine
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Alprazolam (Xanax)
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Confusion
Sweating
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Subject: Medicine
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Cigarette smoking
Excessive alcohol use
Hypertension
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Subject: Medicine
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Subject: Medicine
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