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Re: CASES
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Re: CASES - June 11, 2005 3:18:00 AM
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Dr.Wagner
Posts: 1242
Joined: January 24, 2003
From: Indianapolis
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The first patient is absolutely Multiple Sclerosis. She presented with a primary complaint of "dizzyness" to my ED. In reality she did not have the eye pain the day of the exam, but had it earlier. I added it to make the diagnosis easier. I wanted to hear as big of a differential as possible to get out people out of their comfort zone. Optic Neuritis is impossible to see on eye exam except for an afferent pupilary defect. Which likely would have muddied the waters a bit.
Patient 2 was indeed carbon monoxide poisoning. I gave alot of hints. THis is a very real deal that could present anywhere. In the winter it must be on your differential...and to be honest this is what my stepfather died from. Gotta think of it.
Patient 3, well she can't drive herself home. So she must have a driver. You should also contact her primary care physician. As for the constipation, recommend a stool softener.
Anyway, the idea for these was to broaden the differential...to get people thinking PAST 'vestibular', Greg did a great job. These were real cases.
_____________________________
Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: CASES - June 11, 2005 7:49:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
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[QUOTE]Optic Neuritis is impossible to see on eye exam except for an afferent pupilary defect. Which likely would have muddied the waters a bit.[/QUOTE]I recall optic neuritis being described as a 'really white optic nerve'..." Is this truly difficult to pick up on funduscopic exam?
Thank you again for the cases, and I appreciate the way that you dealt with my answer to number 3.
This is the Socratic method of teaching that IMO is the best way to learn these things. You will be a fantastic resource to your PT students.
_____________________________
Greg Priest, DC, DABCO
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Re: CASES - June 11, 2005 6:33:00 PM
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jbeneciuk
Posts: 112
Joined: November 26, 2004
From: Jacksonville, FL
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Dr. Wagner:
Thanks again for the case studies....it was a good learning experience...and I get your point now !!
Keep them coming if you can.
JBeneciuk
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