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Unformatted text preview: Prepared by R Hayek These case studies are for revision and represent examples of old exam questions. Case You are having a gathering of friends, and during dinner one of the guests, a 36 year old man begins to experience a severe headache. This is associated with nausea, vomiting and neck stiffness. He has no focal neurological findings but has marked nuchal rigidity. 1. What is the most likely diagnosis at this early stage? (apart from the food) 2. What is the most likely mechanism for your answer in (1) and why? 3. What could be used to differentiate between your answer to (1) and meningitis? 4. What treatment recommendations do you have for this patient? 5. Describe the patho-anatomic changes that produce arteriovenous malformations 6. Differentiate between a pathological headache verses non pathological headache. (Utilize a differential diagnosis flow chart to highlight your answer). Case An 12 year old female presents to the outpatients clinic escorted by her mother suffering from acute back pain as a result of netball game 2 days earlier. They reported that her low back pain started about 2 hours after the game. The patient could not walk unsupported, she claimed that she could not fully place her left heel on the ground and as a result she could only walk by placing the tip of her left foot onto the ground. 1) What is your differential diagnosis? 2) Do you have any serious concerns about this patients presentation? What are they? Continued On examination of the lower limb the patient had difficulties in extending her left knee fully and had extensive associated left hamstring contractures along with reduced left vibratory sense of the left foot and ankle and left L4 deep tendon reflex reduction. 3) What are the most likely tissues responsible for the above presentation, of contracture, loss of position sense and apparent reduction in reflexes? 4) Organize your list in question 3 and justify on the merit of: Severity Complexity Approach to therapy Long term disability of such presentations. Continued 1 Prepared by R Hayek The patient had altered pain perception particularly from the right lower leg, however, pain perception was normal at all levels above T12. 5) Discuss the neurological mechanisms that may lead to this type of presentation. 6) Discuss the differential diagnosis of question 5 by utilizing clinical examination procedures (i.e.: ortho/neuro/chiro etc). This may be presented in the form of a differential diagnosis tree (Flow Chart). 7) What is the most likely diagnosis? OLD Exam Questions for revision. Case A 69 year old patient presents to you with thoracic and cervical pain that seem to be slowly increasing in the last 2 weeks. His history reveals that a motor vehicle accident was sustained 4 weeks earlier on his way home after a bowling game....
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This note was uploaded on 07/15/2011 for the course ECO 2023 taught by Professor Mr.raza during the Summer '10 term at FAU.
- Summer '10