A 26-year-old woman comes to the office due to blurry vision in her left eye. She first noticed a "smudge" in the center of her left vision 2 days ago. The patient had been using the computer more than normal to study for an examination and thought that this might be the cause. She
ceased using the computer, but the smudge gradually enlarged to involve almost the entire left visual field. She also reports that colors appear "washed out." The patient has mild left ocular discomfort with eye movement. She has no chronic medical problems. Temperature is 36. 7 C {98 F), blood pressure is 124/82 mm Hg, and pulse is 78/min. Visual acuity is 20/200 in the left eye and 20120 in the right. When light is moved from the right eye to the left, the left pupil dilates. Muscle strength, deep tendon reflexes, and sensation are normal. Funduscopic examination is unremarkable.

?Usmle recalls November 2022?

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USMLE RECALLS STEP 1 AND 2 2022

***🟢***60% of the exam is repeated ***💃*** ***➡️***Study smarter not harder***💪*** ***🆘***A moment of hesitation may cause u lifetime of regrets Happy learning to u all***🌹*** ***☎️***For details and membership contact: @usmle\_recall

Educational objective: Bell palsy (cranial nerve VII palsy) presents with acute-onset, progressive, unilateral facial weakness involving the upper and lower face. A prodrome of auricular pain may be present Therapy is with glucocorticoids, and some studies recommend the addition of acyclovir or valacyclovir.

?Usmle recalls November 2022?

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USMLE RECALLS STEP 1 AND 2 2022

***🟢***60% of the exam is repeated ***💃*** ***➡️***Study smarter not harder***💪*** ***🆘***A moment of hesitation may cause u lifetime of regrets Happy learning to u all***🌹*** ***☎️***For details and membership contact: @usmle\_recall

A 48-year-old man comes to the emergency department due to facial drooping. The patient says he had mild left ear discomfort in the morning, and while driving to work he had difficulty closing the left eye against the light Four hours later, he was unable to sip drinks through a straw, and a colleague remarked that his face appeared droopy. He has had no upper or lower limb weakness or numbness, headache, fever, dizziness, or hearing loss. The patient was recently diagnosed with hypertension and hyperlipidemia, which he is managing with lifestyle modification. He smokes cigarettes and drinks alcohol daily, and says he is trying to cut down on both. Temperature is 37 C (98.6 F), blood pressure is 142186 mm Hg, and pulse is 84fmin. On physical examination, there is left facial asymmetry with drooping of the left corner of the mouth and flattening of the nasolabial fold. He is unable to fully close the left eye. Extraocular movements are intact, and pupils are briskly reactive. Bilateral hand grips are equal, and there is no pronator drift. The patient is able to lift his lower extremities against resistance, and gait is normal. Sensation to light touch and pain is intact on the left side of the face.

Educational objective: The behavioral variant of frontotemporal dementia (FTD) is characterized by early personality changes, compulsive behaviors, and executive dysfunction; memory difficulties tend to develop later in the disease course. FTD has an early age of onset (ie, 50s-60s) and a strong hereditary component

A 67-year-old man comes to the ·office with his wife due to increasing difficulty performing his job over the past year. He has become more irritable at work and has gotten into arguments with his boss for the first time in 20 years. His office has become increasingly cluttered as he refuses to throw things out, and he has forgotten to submit numerous recent assignments. His wife describes him as withdrawn, emotionally detached, and "not the man I married." She says, "Recently, he wants to eat the same meal every day and has lost interest in golf, which used to be one of his favorite pastimes." The patient has a history of hypertension and hyperlipidemia. He has a 30-pack-year smoking history. The patient scores 25/30 on the Montreal Cognitive Assessment (normal: ~6). The remainder of the physical examination is normal.