DIAG 2740 Chapter 12 Case Studies

DIAG 2740 Chapter 12 Case Studies - Chapter 12 Cases Case...

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Chapter 12 Cases Case #1 Anosmia and Visual Impairment Minicase A 51 year old man began having difficulty reading over the course of 5-6 weeks. He saw his doctor, and on review of systems it was noted that he had lost his sense of smell about 3 years earlier, On exam, he had a visual acuity of 20/20 in the right eye and 20/40 in the left eye. He was unable to smell coffee or soap in either nostril. Localization and differential diagnosis 1. On the basis of the signs and symptoms shown above in bold, where is the lesion? 2. What is a likely diagnosis? (add papilledema and headache with this case) Case # Cheek Numbness and a Bulging Eye Minicase A 51 year old woman saw an ophthalmologist because she noticed that her left eye seemed to be bulging out increasingly for the past 3-4 years, and she had recently developed left sided headaches. Exam was normal except for an outward bulging of her left eye (proptosis) and decreased sensation to touch and pin prick over the left cheek. Localization and differential diagnosis 1. Which division of which cranial nerve provides sensation to the cheek? 2. What kind of lesion is suggested by the slowly developing left proptosis over the course of several years, together with the cheek sensory deficit and left sided headache? Case #3 Jaw Numbness and Episodes of Loss of Consciousness Minicase A 24 year old woman was admitted to the cardiology service after an episode of syncope. Upon further probing, it was found that the patient had had three prior episodes of loss of consciousness over recent years, during which she was unresponsive for a few minutes, had some poorly described shaking movements, and was then confused for up to thirty minutes. On review of systems, the patient described a patch of numbness over her left jaw that had been present for approximately 2 years. Exam was normal except for decreased light touch, pin prick, and temperature sensation in the left jaw and lower face.
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Localization and differential diagnosis 1. On the basis of the signs and symptoms shown above in bold, which cranial nerve is involved? Case #4 Isolated Facial Weakness Minicase A 26 year old woman developed pain behind her left ear one evening. When she looked in the mirror the next morning she noticed that her left face was drooping. In addition her left ear was more sensitive to loud sounds. She saw her physician, who gave her some medication for the pain , but over the next 2 days her left eye developed a scratchy” painful sensation, so she came to emergency room. Exam was notable for marked left facial weakness, including the forehead. Taste was not tested. The remainder of the exam was normal. Localization and differential diagnosis
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This note was uploaded on 11/23/2011 for the course DIAG 2740 taught by Professor Markamos during the Winter '11 term at Life Chiropractic College West.

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DIAG 2740 Chapter 12 Case Studies - Chapter 12 Cases Case...

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