This document contains 15 case studies presenting with various neurological symptoms. The case studies are seeking to test knowledge of diseases such as multiple sclerosis, meningitis, Guillain-Barré syndrome, and more. Diagnostic methods and treatments are discussed. Key information includes symptoms, diagnostic testing results, medical histories, and questions regarding diagnosis and management.
1. The patient is a 70-year old woman who presents with jerky movements of her right hand for the past four months and a history of diabetes. After examination and investigations, the neurologist suspects Parkinson's disease.
2. As the SHO, your task is to explain the diagnosis of Parkinson's disease to the patient, answer her questions, and discuss the prognosis, treatment options, and social impacts of the disease.
3. It is important to explain the illness in layman's terms, discuss the likely progression, available medical and surgical treatments, and how the disease may affect her daily activities and family relationships.
This document contains 10 medical case studies presenting patients with various signs, symptoms, medical histories and examination findings. Each case study includes multiple choice questions testing understanding of anatomy, physiology and pathophysiology. The case studies cover topics such as diabetes, thyroid disorders, osteoporosis, osteoarthritis, infertility, meningitis, stroke, myasthenia gravis and trauma injuries.
This document discusses somatoform disorders, which are psychiatric disorders characterized by physical symptoms that cannot be fully explained by a medical condition. It defines several types of somatoform disorders, including somatization disorder, conversion disorder, pain disorder, hypochondriasis, and body dysmorphic disorder. It provides diagnostic criteria and characteristics of each disorder. It also discusses approaches to diagnosis, treatment involving CBT and referral to mental health professionals, and follow-up care.
This document describes the case of a 46-year-old male patient presenting with weakness, wasting, and numbness in both upper and lower limbs over the past year. Electrodiagnostic testing revealed abnormal findings consistent with a multifocal demyelinating sensorimotor neuropathy. Based on the asymmetric progression and electrodiagnostic results, the patient was diagnosed with Lewis-Sumner syndrome, a chronic relapsing demyelinating polyneuropathy.
Patients’ assessment of the applicability of ultrasound in BrazilNeil Muralee
This study assessed patients' knowledge of ultrasound (US) and its use in rheumatic diseases. 70 patients with rheumatic diseases attended an educational lecture on US. They completed questionnaires before and after the lecture. The questionnaires asked about their disease and knowledge of US and its clinical applications. After the lecture, there was a significant increase in patients answering "yes" to questions about knowing what arthritis is, knowing what a US exam is, US helping in disease diagnosis, and US helping understand what's happening in their joints. The study found that while most patients knew what US was, they were less familiar with its applicability to articular diseases, and the lecture helped increase their understanding of US's positive impact.
The document discusses the concept of suppression in homeopathy and how it can occur when the correct simillimum is not found or the cardinal principles are not followed strictly. Suppression occurs when the disease is weakened in one area but ends up strengthening in another, more important system. This happens through the 7 layers of suppression which track the progression of disease from skin to nervous system based on embryological development. Identifying and understanding the layers of suppression is important for homeopaths to avoid suppressive treatments and ensure cure by following Hering's law of cure.
This document contains 15 case studies presenting with various neurological symptoms. The case studies are seeking to test knowledge of diseases such as multiple sclerosis, meningitis, Guillain-Barré syndrome, and more. Diagnostic methods and treatments are discussed. Key information includes symptoms, diagnostic testing results, medical histories, and questions regarding diagnosis and management.
1. The patient is a 70-year old woman who presents with jerky movements of her right hand for the past four months and a history of diabetes. After examination and investigations, the neurologist suspects Parkinson's disease.
2. As the SHO, your task is to explain the diagnosis of Parkinson's disease to the patient, answer her questions, and discuss the prognosis, treatment options, and social impacts of the disease.
3. It is important to explain the illness in layman's terms, discuss the likely progression, available medical and surgical treatments, and how the disease may affect her daily activities and family relationships.
This document contains 10 medical case studies presenting patients with various signs, symptoms, medical histories and examination findings. Each case study includes multiple choice questions testing understanding of anatomy, physiology and pathophysiology. The case studies cover topics such as diabetes, thyroid disorders, osteoporosis, osteoarthritis, infertility, meningitis, stroke, myasthenia gravis and trauma injuries.
This document discusses somatoform disorders, which are psychiatric disorders characterized by physical symptoms that cannot be fully explained by a medical condition. It defines several types of somatoform disorders, including somatization disorder, conversion disorder, pain disorder, hypochondriasis, and body dysmorphic disorder. It provides diagnostic criteria and characteristics of each disorder. It also discusses approaches to diagnosis, treatment involving CBT and referral to mental health professionals, and follow-up care.
This document describes the case of a 46-year-old male patient presenting with weakness, wasting, and numbness in both upper and lower limbs over the past year. Electrodiagnostic testing revealed abnormal findings consistent with a multifocal demyelinating sensorimotor neuropathy. Based on the asymmetric progression and electrodiagnostic results, the patient was diagnosed with Lewis-Sumner syndrome, a chronic relapsing demyelinating polyneuropathy.
Patients’ assessment of the applicability of ultrasound in BrazilNeil Muralee
This study assessed patients' knowledge of ultrasound (US) and its use in rheumatic diseases. 70 patients with rheumatic diseases attended an educational lecture on US. They completed questionnaires before and after the lecture. The questionnaires asked about their disease and knowledge of US and its clinical applications. After the lecture, there was a significant increase in patients answering "yes" to questions about knowing what arthritis is, knowing what a US exam is, US helping in disease diagnosis, and US helping understand what's happening in their joints. The study found that while most patients knew what US was, they were less familiar with its applicability to articular diseases, and the lecture helped increase their understanding of US's positive impact.
The document discusses the concept of suppression in homeopathy and how it can occur when the correct simillimum is not found or the cardinal principles are not followed strictly. Suppression occurs when the disease is weakened in one area but ends up strengthening in another, more important system. This happens through the 7 layers of suppression which track the progression of disease from skin to nervous system based on embryological development. Identifying and understanding the layers of suppression is important for homeopaths to avoid suppressive treatments and ensure cure by following Hering's law of cure.
A 40-year-old woman presented with a butterfly rash on her face, arthralgia, alopecia, and fatigue but no fever. The most likely diagnosis is systemic lupus erythematosus (SLE) given the clinical presentation of rash and joint pain. SLE is an inflammatory autoimmune disorder that can affect multiple organ systems including skin, joints, brain, heart, lungs, liver, and kidneys. Laboratory tests ordered would include CBC, ESR, CRP, autoantibodies such as ANA, anti-dsDNA, and complement levels. Initial treatment would include NSAIDs, antimalarial drugs, and short courses of oral corticosteroids depending on organ involvement
Discussion #1· What is the CC in the case studies What are im.docxcuddietheresa
Discussion #1
· What is the CC in the case studies? What are important questions to ask the patients to formulate the history of present illness and what did the patients tell you?
The CC in the first case study with Mr. Morales is diabetes management post heart attack and open-heart surgery a month ago. The important questions to ask is to find more information regarding current diabetes management and compliance to management. Open ended question allows practitioner to draw information from the patient (Dunphy, Winland-Brown, Porter, & Thomas, 2019). Starting with the question tell me more allows patient to elaborate more. Questions regarding blood glucose monitoring, medications, and compliance with medications would give insight of current diabetes management. Patient was saying his job as the reason for not being able to see provider at clinic and also not being able to check his blood sugar. Cost of testing strips. Patient has been checking his blood sugar since his heart attack, but worried he won’t be able to once the testing strip runs out. Mr. Morales also provides list of medications currently taken. Blood glucose readings are above 200 on days he didn’t take his insulin shot.
The CC in the second case study with Mr. Kaleb is rhinorrhea for 3-4 days. The use of mnemonics “OLDCARTS”, practitioner can get more information from the patients of present illness. The seven attributes of a symptom are critical to help understand presented illness which are Onset, Location, Duration, Character, Aggravating/alleviating Factors, Radiation, and Timing (Bickley & Szilagyi, 2017). The mnemonics “OLDCARTS” help provider ask the proper question to elaborate present illness. I would ask if there if there is anything that makes the symptom better or worse? If there are any other symptoms like shortness of breath and associated with current symptoms. Patient answered questions with medications that he tried for symptom relieves although non-effective. Mr. Kaleb have no shortness of breath and “feeling warm the first day but now I just have the chills occasionally.”
· What components of the physical exams are important to review in the cases? What are pertinent positive and negative physical exam findings to help you formulate your diagnosis?
The physical exams that are important to review in Mr. Morales case are his vital signs and cardiac based on his recent heart attack. Extremities, neurologic, fundoscopic, and foot exam are important to assess in patient with diabetes. Patient continue with high blood pressure reading 150/90 indicates need for hypertension management. Positive findings of microaneurysm on bilateral eyes, hard exudates on the left are signs of diabetic retinopathy. Diabetic foot exam finds decreased sensation to monofilament and vibration to the mid-shin, onychomycosis, and +1 dorsal pedis and posterior tibialis pulses bilaterally. Exam was negative for foot ulcers. Findings suggest patient have neuropathy to his lower extr ...
"Time course evaluation & treatment of post-TBI brain tumor with correspondin...Maggie Jan
This case report describes a patient who developed a brain tumor seven years after sustaining traumatic brain injuries from military service. The patient presented with visual field loss, headaches, and hormonal imbalances. Imaging revealed a pituitary tumor compressing the optic chiasm, consistent with the patient's bitemporal hemianopsia. The patient was started on medication to shrink the tumor and address mood and hormonal issues. Visual fields were tracked over a year of treatment, showing changes corresponding to tumor size. While the relationship between traumatic brain injury and later brain tumor is unclear, addressing the tumor helped manage overlapping symptoms from both conditions.
The document discusses delirium in elderly patients, including risk factors, presentation, diagnosis, management, and case studies. Delirium is a medical emergency caused by multiple factors and requires identifying and treating the underlying medical conditions. It can have serious consequences like increased mortality if not properly diagnosed and managed.
This document contains questions and answers related to pediatric imaging, cardiology, gastroenterology, hematology, neurology and other topics. It includes radiological images and questions about diagnoses, management, and embryology. The document is a study guide for the OSCE pediatrics exam covering various pediatric body systems and conditions assessed through imaging modalities like X-ray, CT and MRI.
The document contains summaries of 20 OSCE pediatric stations including questions on Down syndrome with esophageal atresia, typhoid vaccination recommendations, hemoglobin disorders, muscular dystrophies, transverse myelitis, Ehlers Danlos syndrome, pulmonary sequestration, Reiter's syndrome, enterobiasis, cleidocranial dysplasia, Wilson's disease, spinal cord injuries, Meckel's scan, congenital hypothyroidism, hemophilia A, neurocysticercosis and their diagnoses and management. The stations cover ethics, clinical examination, choice of investigations, interpretations of tests and forming differential diagnoses.
The document discusses fibromyalgia as a chronic pain condition affecting 10 million people in the US that causes whole body pain, fatigue, and cognitive issues. It outlines the challenges patients face in getting diagnosed due to a lack of physician education and training, and discusses treatment approaches like medication, exercise, and self-management techniques. The goal is to increase awareness of fibromyalgia and help patients better understand the condition through a documentary and other outreach efforts.
The document discusses fibromyalgia as a chronic pain condition affecting 10 million people in the US that causes whole body pain, fatigue, and cognitive issues. It outlines the challenges patients face in getting diagnosed due to a lack of physician education and training, and discusses treatment approaches like medication, exercise, and self-management techniques. The goal is to increase awareness of fibromyalgia and help patients better understand the condition through a documentary and other outreach efforts.
Mistakes in Epilepsy Care - Orrin Devinsky, MDNYU FACES
The document discusses common mistakes made in epilepsy care, including diagnostic bias, failure to consider mood disorders or how disorders may evolve over time, overreliance on prior diagnoses, and failure to consider quality of life from the patient's perspective rather than just medical factors. It also notes how doctors and patients can be influenced by anecdotes rather than statistics and the importance of humility, open-mindedness, and reassessing risks and benefits over time based on new evidence rather than established viewpoints.
Paroxysmal sympathetic hyperactivity (PSH) is a type of sympathetic hyperactivity that occurs after acute brain damage from events like traumatic brain injury, stroke, or meningitis. It results from the loss of inhibitory pathways from cortical areas to sympathetic centers in the brainstem. This leads to episodic increases in heart rate, blood pressure, respiratory rate, temperature, and motor activity. Treatment involves resting in the intensive care unit and using medications like morphine or clonidine to reduce sympathetic nervous system stimulation and lower blood pressure and heart rate. One case example described episodes of fever, tachycardia, and hypertension in a man after a head injury that were successfully treated with clonidine.
Dartmouth Summer Institute for Informed Pt Choice (Let Patients Help Decide W...e-Patient Dave deBronkart
This document discusses the importance of patient engagement and empowerment in healthcare. It argues that patients are the largest, yet most neglected, healthcare resource worldwide. While patients are the ultimate stakeholders, they are often excluded from discussions about their own care. The document advocates for letting patients help decide what healthcare outcomes and goals are most important. It presents examples of how greater patient access to medical information and engagement in their own care led to better outcomes.
This document discusses several ethical dilemmas that can arise at the end of life. It describes situations involving conflicts between clinicians and families over appropriate care, as well as conflicts within clinical teams. It also addresses issues around withdrawing or withholding treatment, physician assisted suicide, palliative sedation, and ensuring comfort at end of life. The document emphasizes the importance of open communication, establishing goals of care based on patient values and preferences, and providing care aimed at both cure and comfort.
This document discusses medical errors and misdiagnosis. It notes that one in five medical errors are potentially serious or fatal, and that the most common reasons for medical malpractice claims are surgery errors and diagnostic errors. Diagnostic errors account for many preventable deaths annually in the US. Some of the leading causes of misdiagnosis discussed include lack of healthcare professionals, poor teamwork and follow up, human cognitive factors, and too much focus on one exam finding. The document also provides strategies to reduce errors such as thorough history taking, physical exams, using diagnostic aids, and always following up on concerning symptoms.
Right Temporal Lobe Meningioma presenting as postpartum depression: A case re...Apollo Hospitals
Meningiomas are tumors which arise from arachnoid cells and can occur both in the brain and spinal cord. Meningiomas can present with psychiatric symptoms (such as depression, anxiety disorders, or personality changes) in the absence of any neurologic signs or symptoms.
A lecture by Dr Imran Waheed, Consultant Psychiatrist, outlining the approach towards the diagnosis and management of schizophrenia, with particular reference to primary care. Delivered in March 2013 in Birmingham, UK.
This document provides an overview of multiple sclerosis (MS) and myasthenia gravis (MG). For MS, it discusses that the cause is unknown but may involve viruses, genetics or an autoimmune response. Symptoms involve the brain and spinal cord and include numbness, weakness, and vision issues. Diagnosis involves MRI, spinal fluid analysis and evoked potentials. Nursing goals include managing symptoms, preventing complications and maintaining mobility. For MG, it describes it as an autoimmune disorder causing muscle weakness. Symptoms include weakness of eye muscles and swallowing. Diagnostic tests include Tensilon test and electromyography. Treatment focuses on anticholinesterase medications.
Medillectual juniors 2017 (Prelims and Mains)Quitzkrieg
Medical Quiz; A part of Quitzkrieg 2017, the annual AIIMS Delhi Quiz fest under Pulse 2017. QMs: Sneha Mohan, Srividya, Lajja, Dev (and also, Satwik and Utkarsh)
This document reviews central sensitization syndrome and how to initially evaluate patients presenting with fibromyalgia. Central sensitization is a condition where the central nervous system amplifies sensory input across organ systems, resulting in increased pain perception. Many chronic pain conditions like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome overlap due to shared symptoms of central sensitization. The evaluation of fibromyalgia should involve focused history taking including symptom onset, pain behaviors, emotional responses, comorbid psychiatric disorders, and past treatments. Identifying features of central sensitization can improve the efficiency and accuracy of the clinical evaluation.
Week 2 Discussion History of present illness.docxwrite22
The document discusses two patient case studies:
1) Mr. Morales presented with diabetes management issues after a recent heart attack. Key information to obtain included medication compliance and blood sugar monitoring. Exam findings showed diabetic retinopathy and neuropathy. The primary diagnosis was type 2 diabetes.
2) Mr. Kaleb presented with rhinorrhea and cough. Differential diagnoses included viral upper respiratory infection, allergic rhinitis, and acute bronchitis. Exam ruled out fever and infection. The final diagnosis was viral upper respiratory infection.
This document provides a case study on bipolar disorder. It begins with objectives to define bipolar disorder, discuss concepts of nursing care, examine the brain's anatomy and physiology related to neurotransmitters, understand pharmacological treatments, and apply assessments and interventions. It then provides background on bipolar disorder prevalence and characteristics. The rationale for choosing this case and significance of studying it are discussed. The scope focuses on nursing and pharmacological management, with limitations due to confidentiality. Dorothea Orem's Self-Care Model is identified as the conceptual framework. Literature on the history and classifications of bipolar disorder is reviewed. The clinical summary provides demographic data and applies developmental theories to the case.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
A 40-year-old woman presented with a butterfly rash on her face, arthralgia, alopecia, and fatigue but no fever. The most likely diagnosis is systemic lupus erythematosus (SLE) given the clinical presentation of rash and joint pain. SLE is an inflammatory autoimmune disorder that can affect multiple organ systems including skin, joints, brain, heart, lungs, liver, and kidneys. Laboratory tests ordered would include CBC, ESR, CRP, autoantibodies such as ANA, anti-dsDNA, and complement levels. Initial treatment would include NSAIDs, antimalarial drugs, and short courses of oral corticosteroids depending on organ involvement
Discussion #1· What is the CC in the case studies What are im.docxcuddietheresa
Discussion #1
· What is the CC in the case studies? What are important questions to ask the patients to formulate the history of present illness and what did the patients tell you?
The CC in the first case study with Mr. Morales is diabetes management post heart attack and open-heart surgery a month ago. The important questions to ask is to find more information regarding current diabetes management and compliance to management. Open ended question allows practitioner to draw information from the patient (Dunphy, Winland-Brown, Porter, & Thomas, 2019). Starting with the question tell me more allows patient to elaborate more. Questions regarding blood glucose monitoring, medications, and compliance with medications would give insight of current diabetes management. Patient was saying his job as the reason for not being able to see provider at clinic and also not being able to check his blood sugar. Cost of testing strips. Patient has been checking his blood sugar since his heart attack, but worried he won’t be able to once the testing strip runs out. Mr. Morales also provides list of medications currently taken. Blood glucose readings are above 200 on days he didn’t take his insulin shot.
The CC in the second case study with Mr. Kaleb is rhinorrhea for 3-4 days. The use of mnemonics “OLDCARTS”, practitioner can get more information from the patients of present illness. The seven attributes of a symptom are critical to help understand presented illness which are Onset, Location, Duration, Character, Aggravating/alleviating Factors, Radiation, and Timing (Bickley & Szilagyi, 2017). The mnemonics “OLDCARTS” help provider ask the proper question to elaborate present illness. I would ask if there if there is anything that makes the symptom better or worse? If there are any other symptoms like shortness of breath and associated with current symptoms. Patient answered questions with medications that he tried for symptom relieves although non-effective. Mr. Kaleb have no shortness of breath and “feeling warm the first day but now I just have the chills occasionally.”
· What components of the physical exams are important to review in the cases? What are pertinent positive and negative physical exam findings to help you formulate your diagnosis?
The physical exams that are important to review in Mr. Morales case are his vital signs and cardiac based on his recent heart attack. Extremities, neurologic, fundoscopic, and foot exam are important to assess in patient with diabetes. Patient continue with high blood pressure reading 150/90 indicates need for hypertension management. Positive findings of microaneurysm on bilateral eyes, hard exudates on the left are signs of diabetic retinopathy. Diabetic foot exam finds decreased sensation to monofilament and vibration to the mid-shin, onychomycosis, and +1 dorsal pedis and posterior tibialis pulses bilaterally. Exam was negative for foot ulcers. Findings suggest patient have neuropathy to his lower extr ...
"Time course evaluation & treatment of post-TBI brain tumor with correspondin...Maggie Jan
This case report describes a patient who developed a brain tumor seven years after sustaining traumatic brain injuries from military service. The patient presented with visual field loss, headaches, and hormonal imbalances. Imaging revealed a pituitary tumor compressing the optic chiasm, consistent with the patient's bitemporal hemianopsia. The patient was started on medication to shrink the tumor and address mood and hormonal issues. Visual fields were tracked over a year of treatment, showing changes corresponding to tumor size. While the relationship between traumatic brain injury and later brain tumor is unclear, addressing the tumor helped manage overlapping symptoms from both conditions.
The document discusses delirium in elderly patients, including risk factors, presentation, diagnosis, management, and case studies. Delirium is a medical emergency caused by multiple factors and requires identifying and treating the underlying medical conditions. It can have serious consequences like increased mortality if not properly diagnosed and managed.
This document contains questions and answers related to pediatric imaging, cardiology, gastroenterology, hematology, neurology and other topics. It includes radiological images and questions about diagnoses, management, and embryology. The document is a study guide for the OSCE pediatrics exam covering various pediatric body systems and conditions assessed through imaging modalities like X-ray, CT and MRI.
The document contains summaries of 20 OSCE pediatric stations including questions on Down syndrome with esophageal atresia, typhoid vaccination recommendations, hemoglobin disorders, muscular dystrophies, transverse myelitis, Ehlers Danlos syndrome, pulmonary sequestration, Reiter's syndrome, enterobiasis, cleidocranial dysplasia, Wilson's disease, spinal cord injuries, Meckel's scan, congenital hypothyroidism, hemophilia A, neurocysticercosis and their diagnoses and management. The stations cover ethics, clinical examination, choice of investigations, interpretations of tests and forming differential diagnoses.
The document discusses fibromyalgia as a chronic pain condition affecting 10 million people in the US that causes whole body pain, fatigue, and cognitive issues. It outlines the challenges patients face in getting diagnosed due to a lack of physician education and training, and discusses treatment approaches like medication, exercise, and self-management techniques. The goal is to increase awareness of fibromyalgia and help patients better understand the condition through a documentary and other outreach efforts.
The document discusses fibromyalgia as a chronic pain condition affecting 10 million people in the US that causes whole body pain, fatigue, and cognitive issues. It outlines the challenges patients face in getting diagnosed due to a lack of physician education and training, and discusses treatment approaches like medication, exercise, and self-management techniques. The goal is to increase awareness of fibromyalgia and help patients better understand the condition through a documentary and other outreach efforts.
Mistakes in Epilepsy Care - Orrin Devinsky, MDNYU FACES
The document discusses common mistakes made in epilepsy care, including diagnostic bias, failure to consider mood disorders or how disorders may evolve over time, overreliance on prior diagnoses, and failure to consider quality of life from the patient's perspective rather than just medical factors. It also notes how doctors and patients can be influenced by anecdotes rather than statistics and the importance of humility, open-mindedness, and reassessing risks and benefits over time based on new evidence rather than established viewpoints.
Paroxysmal sympathetic hyperactivity (PSH) is a type of sympathetic hyperactivity that occurs after acute brain damage from events like traumatic brain injury, stroke, or meningitis. It results from the loss of inhibitory pathways from cortical areas to sympathetic centers in the brainstem. This leads to episodic increases in heart rate, blood pressure, respiratory rate, temperature, and motor activity. Treatment involves resting in the intensive care unit and using medications like morphine or clonidine to reduce sympathetic nervous system stimulation and lower blood pressure and heart rate. One case example described episodes of fever, tachycardia, and hypertension in a man after a head injury that were successfully treated with clonidine.
Dartmouth Summer Institute for Informed Pt Choice (Let Patients Help Decide W...e-Patient Dave deBronkart
This document discusses the importance of patient engagement and empowerment in healthcare. It argues that patients are the largest, yet most neglected, healthcare resource worldwide. While patients are the ultimate stakeholders, they are often excluded from discussions about their own care. The document advocates for letting patients help decide what healthcare outcomes and goals are most important. It presents examples of how greater patient access to medical information and engagement in their own care led to better outcomes.
This document discusses several ethical dilemmas that can arise at the end of life. It describes situations involving conflicts between clinicians and families over appropriate care, as well as conflicts within clinical teams. It also addresses issues around withdrawing or withholding treatment, physician assisted suicide, palliative sedation, and ensuring comfort at end of life. The document emphasizes the importance of open communication, establishing goals of care based on patient values and preferences, and providing care aimed at both cure and comfort.
This document discusses medical errors and misdiagnosis. It notes that one in five medical errors are potentially serious or fatal, and that the most common reasons for medical malpractice claims are surgery errors and diagnostic errors. Diagnostic errors account for many preventable deaths annually in the US. Some of the leading causes of misdiagnosis discussed include lack of healthcare professionals, poor teamwork and follow up, human cognitive factors, and too much focus on one exam finding. The document also provides strategies to reduce errors such as thorough history taking, physical exams, using diagnostic aids, and always following up on concerning symptoms.
Right Temporal Lobe Meningioma presenting as postpartum depression: A case re...Apollo Hospitals
Meningiomas are tumors which arise from arachnoid cells and can occur both in the brain and spinal cord. Meningiomas can present with psychiatric symptoms (such as depression, anxiety disorders, or personality changes) in the absence of any neurologic signs or symptoms.
A lecture by Dr Imran Waheed, Consultant Psychiatrist, outlining the approach towards the diagnosis and management of schizophrenia, with particular reference to primary care. Delivered in March 2013 in Birmingham, UK.
This document provides an overview of multiple sclerosis (MS) and myasthenia gravis (MG). For MS, it discusses that the cause is unknown but may involve viruses, genetics or an autoimmune response. Symptoms involve the brain and spinal cord and include numbness, weakness, and vision issues. Diagnosis involves MRI, spinal fluid analysis and evoked potentials. Nursing goals include managing symptoms, preventing complications and maintaining mobility. For MG, it describes it as an autoimmune disorder causing muscle weakness. Symptoms include weakness of eye muscles and swallowing. Diagnostic tests include Tensilon test and electromyography. Treatment focuses on anticholinesterase medications.
Medillectual juniors 2017 (Prelims and Mains)Quitzkrieg
Medical Quiz; A part of Quitzkrieg 2017, the annual AIIMS Delhi Quiz fest under Pulse 2017. QMs: Sneha Mohan, Srividya, Lajja, Dev (and also, Satwik and Utkarsh)
This document reviews central sensitization syndrome and how to initially evaluate patients presenting with fibromyalgia. Central sensitization is a condition where the central nervous system amplifies sensory input across organ systems, resulting in increased pain perception. Many chronic pain conditions like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome overlap due to shared symptoms of central sensitization. The evaluation of fibromyalgia should involve focused history taking including symptom onset, pain behaviors, emotional responses, comorbid psychiatric disorders, and past treatments. Identifying features of central sensitization can improve the efficiency and accuracy of the clinical evaluation.
Week 2 Discussion History of present illness.docxwrite22
The document discusses two patient case studies:
1) Mr. Morales presented with diabetes management issues after a recent heart attack. Key information to obtain included medication compliance and blood sugar monitoring. Exam findings showed diabetic retinopathy and neuropathy. The primary diagnosis was type 2 diabetes.
2) Mr. Kaleb presented with rhinorrhea and cough. Differential diagnoses included viral upper respiratory infection, allergic rhinitis, and acute bronchitis. Exam ruled out fever and infection. The final diagnosis was viral upper respiratory infection.
This document provides a case study on bipolar disorder. It begins with objectives to define bipolar disorder, discuss concepts of nursing care, examine the brain's anatomy and physiology related to neurotransmitters, understand pharmacological treatments, and apply assessments and interventions. It then provides background on bipolar disorder prevalence and characteristics. The rationale for choosing this case and significance of studying it are discussed. The scope focuses on nursing and pharmacological management, with limitations due to confidentiality. Dorothea Orem's Self-Care Model is identified as the conceptual framework. Literature on the history and classifications of bipolar disorder is reviewed. The clinical summary provides demographic data and applies developmental theories to the case.
Similar to Neurology osce for undergraduate part 1 (20)
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
2. The content of this presentation is only for
educational purposes
Mohammed H. Hilow - medical studnet
3. 23 years old university student presented with sudden onset left side
weakness for 1 day of the upper limb started in the hand then spread
to involve all the limb. The patient has flu few days before the attack.
The patient has no LOC, no difficulty of swallowing, no dysphagia, no
seizure and no headache or dizziness. MRI showing below.
Questions :
1- What is the DDX ?
2- What is the likely diagnosis and why ?
3- What is the treatment of this patient ?
Mohammed H. Hilow - medical studnet
4. • DDX : MS, ADEM
• Likely DX: MS (age >20 and periventricular lesions)
• Tx: this patient is in acute attack the treatment of choice is steroid
pulse therapy or Plasmophoresis
Answer
Mohammed H. Hilow - medical studnet
5. A 29 yrs old knowing case of MS. She is on
Avonex(IF beta1a) 30mg I.M. weekly. She is
planning to have a baby but she is very worry
about how the disease might affect her pregnancy.
Questions:
1- Can MS patients get pregnant? If yes, When ?
2- Dose the MS attacks frequency change during and after pregnancy ?
3- Can she continue using the same drug during pregnancy? If no what
are the alternatives?
Mohammed H. Hilow - medical studnet
6. • MS doesn’t affect fertility. Patient allowed to be pregnant if in the last
year has two or less attacks.
• During pregnancy the MS attacks decrease, but in puerperium the
attacks increase and DMD should be started 2 months before delivery
(some textbooks after delivery)
• No, it is teratogenic. Alternatives are either using steroids during the
second trimester or using Capoxone (articles might mention other
drugs)
Answer
Mohammed H. Hilow - medical studnet
7. 17 yrs old female presented with gradual visual loss preceded
by pain in her right eye aggravated by movement. O/E the
patient has central scotoma and sluggish pupillary reflex in the
right eye. Fundoscopy show no changes.
Questions
1- What is the likely diagnosis?
2- What is the next step in approaching this patient?
3- What is the treatment?
4- Is it necessary to follow up this patient why and how ?
Mohammed H. Hilow - medical studnet
8. • Optic neuritis
• Send patient for MRI(Post Gd MRI). Around 20% of MS present as
optic neuritis and 50% of MS patient develop Optic neuritis during the
disease course.
• Treatment with methylprednisolone I.V
• Yes, this patient is female and below 35 yrs these increase here risk
to develop MS after optic neuritis. Follow up every 6 months with
MRI.
Answer
Mohammed H. Hilow - medical studnet
9. Questions
1- What is the name of this sign?
2- Which of the pictures (1 or 2 ) is positive ? Describe each picture.
3- What are the causes of positive sign ?
4- When it considered as pseudo sign ?
1 2
Mohammed H. Hilow - medical studnet
10. • Babinski sign
• 1 is negative ( there is planter flexion) 2 is positive (upward or platner
extension with fanning)
• Cause of +ve sign:
• UMNL(CVA)
• Children <1 year
• Coma
• Post ictal satge
• Pseudo-babinski sign: occur in patient with choreoathetosis where
the up going toe is due to hyperkinesia
Answer
Mohammed H. Hilow - medical studnet
11. Questions
1- What is the sign in the picture ?
2- When it considered positive ?
3- causes of positive sign?
Mohammed H. Hilow - medical studnet
12. • Hoffman’s sign(equivalent of the Babinski sign)
• Considered positive if the index finger flexed and the thumb
adducted and flexed.
• Causes of +ve sign:
• UMNL
• Agitation
• Hyperthyroidism
Answer
Mohammed H. Hilow - medical studnet
13. Examiner hand
Questions
1- What is the sign in the picture ?
2- When it considered positive ?
3- causes of positive sign?
Mohammed H. Hilow - medical studnet
14. • Wartenberg sign(Babinski of the upper limb)
• It is positive when the thumb is adducted and flexed
Answer
Mohammed H. Hilow - medical studnet
15. Questions
1- Findings ?
2- what is the diagnosis ?
3- What is the likely cause and why ?
4- What are the other causes and how
to differentiate
Mohammed H. Hilow - medical studnet
16. • The left eye complete ptosis and deviation downward outward
• 3rd nerve palsy
• Medical cause - the pupils size are equal
• Surgical causes such as posterior communicating artery aneurysm – in
surgical cause the pupil dilated (mydriasis)
Answer
Mohammed H. Hilow - medical studnet
17. Questions
1- Findings ?
2- what is the diagnosis ?
3- What are the causes ?
4- What is the cause if this patient has
bilateral papilledema?
5- what are the false localizing signs ?
Mohammed H. Hilow - medical studnet
18. • The left eye deviated medially
• 6th CN palsy
• SOL, IIH, Vascular
• Increased ICP-e.g IIH
• Neurological signs have been described as ‘false localizing’ if
they reflect dysfunction distant or remote from the expected
anatomical locus of pathology and hence challenging the
traditional clinicoanatomical correlation paradigm. They include
• 3rd, 4th, 5th, 6th CN palsy and papilledema.
Answer
Mohammed H. Hilow - medical studnet
19. 50 years old female presented with left side mouth
deviation developed over the last week with inability
to close the eye.
You treated the patient after diagnosing her.
3 months later she complain of mouth twitching in
the left cornear when she closes her eye.
Questions
1- What is your diagnosis?
2- Is it upper or lower motor neuron lesion and
why?
3- What is your explanation to her presentation
after 3 months?
Mohammed H. Hilow - medical studnet
21. Questions
1- What is the diagnosis ?
2- what are the causes ?
Mohammed H. Hilow - medical studnet
22. Questions
1- Describe the findings and what is the Dx?
2- Treatment ?
3- complications ?
Mohammed H. Hilow - medical studnet
23. 29 years old female referred to you from the ophthalmology clinic. The
patient has diplopia and ptosis. Patient complain that she feels very
tired at the end of the day.
Questions
1- What are the clinical tests to diagnose this patient ?
2- What other tests you will order?
3- Is imaging important and why?
Mohammed H. Hilow - medical studnet
24. • Ice-pack test for ptosis, Sustained upgaze (60 to 180 seconds),
Sustained abduction of the arms (120 seconds), Counting aloud (1 to
50)
• Edrophonium or neostigmine test, AchR Antibody, Anti-MuSk and/or
LPRP4 antibody, Decrement test, Single fiber EMG
• Yes, important as 75% of patients has either thymus gland hyperplasia
or thymoma these patient may benefit from thymoectomy. (CT or
MRI)
Answer
Mohammed H. Hilow - medical studnet
25. The young female showing in the picture below complains of
weakness that become more severe at the end of the day.
Questions
1- What are the findings in the picture
2- Does pregnancy affect her disease? How ?
3- Treatment lines for this patient?
Few months later the patient presented with
Weakness and she was taking her Drugs as
doctor told her. She has same symptoms of her presentation in addition
to her UTI symptoms.
4- What is the possible cause of this patient deterioration?
Mohammed H. Hilow - medical studnet
26. A young man was found unconscious in his office 1 hr ago.
Questions
1- What is the first thing to do?
2- What you would look for to differentiate between metabolic and
structural coma ?
3- What is the test showing below?
Mohammed H. Hilow - medical studnet
27. Questions for each drug in the pictures
1- Mechanism of action of this drug?
2- Side effects ?
3- Indications ?
Mohammed H. Hilow - medical studnet
28. Questions
1- Mechanism of action of this drug?
2- Side effects ?
3- Indications ?
4- What is the end dose phenomenon ?
5- What is the on-Off phenomenon
Mohammed H. Hilow - medical studnet
29. Answer
• 4- The wearing-off effect (also called end-of- dose akinesia):
each dose improves mobility for 1-2 hours but akinesia
rapidly returns.
• 5- The on-off effect: ‘off’ periods of marked akinesia alternate
with ‘on’ periods of improved mobility.
Mohammed H. Hilow - medical studnet
30. Diabetic 60 yrs old man awakens with left side weakness.
Examination indicates relatively symmetric upper motor
neuron pattern of weakness involving the face, arm, and leg.
There are no sensory abnormalities, No dysphagia, no
dysarthria, no dysphagia, no LOC, no Abnormal movement.
Questions:
1- What is the diagnosis?
2- Which structure involved?
3- What are the types of weakness?
Mohammed H. Hilow - medical studnet
31. Answer
• CVA
• Internal capsule
• Proximal, distal, pyramidal and segmental
Mohammed H. Hilow - medical studnet
32. Questions
1- describe what is showing in the picture?
2- What is the diagnosis?
3- Which muscles spared ?
4- what are the causes ?
Mohammed H. Hilow - medical studnet
33. Answer
• Claw hand
• Ulnar nerve palsy
• Thenar muscles and two lateral lumbrical muscles.
• Causes: cubital tunnel syndrome, damage to the nerve
Mohammed H. Hilow - medical studnet
34. Questions
1- Name the showing investigation?
2- Indications other than seizure/epilepsy?
3- What are the common patterns showing in epilepsy?
Mohammed H. Hilow - medical studnet
35. Questions
1- Name the showing investigations ?
2- Mention 3 indications ?
3- picture 2 – what is the test? What is the likely diagnosis?
2
1
Mohammed H. Hilow - medical studnet
36. Questions
1- Name the showing sign
2- Describe findings
3- Mention other signs you will find in this patient ?
Mohammed H. Hilow - medical studnet
37. Answer
• Valley sign
• Good bulk of deltoid and infraspinatus and wasting of other
surrounding muscles
• Calf pseudohypertrophy and Gower’s sign
Mohammed H. Hilow - medical studnet
38. Questions
1- What is the showing sign?
2- Causes of positive sign ?
3- Other signs might be positive
Mohammed H. Hilow - medical studnet
39. Answer
• brudzinski sign
• Meningeal irritation (meningitis, SAH)
• Kernig sign, neck stiffness, cheeck sign
Mohammed H. Hilow - medical studnet