DIAG 2740 Chapter 16 Case Studies

DIAG 2740 Chapter 16 Case Studies - Chapter 16 Cases Case...

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Chapter 16 Cases Case #1 Unilateral Flapping and Arm Flinging Minicase A 65 year old HIV-positive man began having involuntary flinging movements of the right arm and leg, which became progressively worse over the course of the last month, making gait and the use of the right hand difficult. On exam, he had continuous, wild uncontrollable flapping and circular movements of the right arm, and occasional jerky motions of the right leg, with an unsteady gait, falling to the right. The remainder of the exam was unremarkable. Localization and differential diagnosis 1. On the basis of the signs and symptoms shown in bold above, where is the lesion? 2. Given immune system compromise, which is a likely cause of the deficits? Case #2 Irregular Jerking Movements and Marital Problems Chief Complaint A 35 year old man a recent history of jerking movements went with his wife to see a psychiatrist for marital problems. History The wife reported that during recent months her husband had been having occasional, irregular jerking movements of the head, trunk, and limbs. At night he sometimes would grind his teeth in his sleep, grip his wife’s hand tightly without knowing it, or swallow noisily. The husband denied having any involuntary movements but said they could be there. He did admit to occasional stumbling, having recently fallen down a flight of stairs. However, he denied that this represented any significant change in his gait over recent years. He worked as a salesman in a small business and denied any depression or problems due to intellectual function or psychiatric problems. In the army he was a high 70s golfer. At the time of consultation he was shooting 120, but he attributed his decrease in performance to practicing golf less often than previously. His wife felt something was wrong and urged him to seek medical attention, and his refusal led to bitter arguments. Family History
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DIAG 2740 Chapter 16 Case Studies - Chapter 16 Cases Case...

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