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What Causes Bruises On The Legs And Arms Along With Concentration Difficulty?
Question: My friend is a 28 year old male came who has bruising on his arms and legs. His eyes had bags under them. He stated when he’s at work he has “decreased ability to concentrate, pay attention and solve problems.” His wife is constantly around with him and mentioned that she did not want him to work at all and be a stay at home househusband.” He came to me because he was having seizures and heard a physician and a chiropractor may help him.
After FURTHER questioning he was in a domestic violence situation to which his significant other had, in self defense, pushed my friend so he took a bad fall down a few stairs hitting his head.
1) What are 5 most relevant questions I could ask him initially?
2) Based on above, what is the diagnostic hypothesis?
3) List all pertinent examination finding that one might, could, would, should find upon examination of someone with this disorder.
4) List what types of further work-up might, could, would, should be done in cases or suspected cases of this disorder.
5) What is the management for this disorder.
6) Make sure you include medical, chiropractic, other alternatives, etc.
7) Make sure you include short and long term goals
8) Based upon the information you have thus far, what are the anatomical sites involved in this patient?(Be as specific as possible)
9) Explain the pathophysiology of this condition
10) What would be short term & long term goals?
After FURTHER questioning he was in a domestic violence situation to which his significant other had, in self defense, pushed my friend so he took a bad fall down a few stairs hitting his head.
1) What are 5 most relevant questions I could ask him initially?
2) Based on above, what is the diagnostic hypothesis?
3) List all pertinent examination finding that one might, could, would, should find upon examination of someone with this disorder.
4) List what types of further work-up might, could, would, should be done in cases or suspected cases of this disorder.
5) What is the management for this disorder.
6) Make sure you include medical, chiropractic, other alternatives, etc.
7) Make sure you include short and long term goals
8) Based upon the information you have thus far, what are the anatomical sites involved in this patient?(Be as specific as possible)
9) Explain the pathophysiology of this condition
10) What would be short term & long term goals?
Brief Answer:
Answers to your questions are below
Detailed Answer:
Hi,
Thanks for your query.
Sorry for the delay in my response.
1) What are 5 most relevant questions I could ask him initially?
---Whether there is any motor weakness ?
How frequent are the seizures ?
Are there any behavioral changes ?
Did he have a head injury in past ?
Does he suffer from any other medical condition ?
Is he on any medications ?
2) Based on above, what is the diagnostic hypothesis?
-- Need to rule out Cognitive dysfunction disorders
3) List all pertinent examination finding that one might, could, would, should find upon examination of someone with this disorder.
-- Head injuries, physical marks of abuse, Motor skills, Gait and Counselling to learn about thought process.
4) List what types of further work-up might, could, would, should be done in cases or suspected cases of this disorder.
-- Mental tests like XXXXXXX Mental State Examination (MMSE), Situational judgment tests (SJTs) or Inventories (SJIs) and Inductive reasoning test.
5) What is the management for this disorder.
-- Cognitive behavioral therapy.
6) Make sure you include medical, chiropractic, other alternatives, etc.
-- Role of Chiropractic is uncertain. It depends on presence of any sort of physical defects. An integrated approach by a Psychiatrist and a neurologist would be essential.
7) Make sure you include short and long term goals
-- Short term goals - Diagnosis and treatment
long term - Regular counselling sessions and repeat the above mentioned tests.
8) Based upon the information you have thus far, what are the anatomical sites involved in this patient?(Be as specific as possible)
--Couldn't be specific with such a short history. Frontal brain defects should be looked for.
9) Explain the pathophysiology of this condition
-- Condition needs to be diagnosed yet. Causes of such problems could be worsening of previous medical conditions, abuse of medications or drugs, alcohol or drug withdrawals, mental illness, severe pain, immobilization, sleep deprivation and hypnosis
10) What would be short term & long term goals?
-- Already explained.
Hope, I answered your query.
Wish you good health.
Regards,
Answers to your questions are below
Detailed Answer:
Hi,
Thanks for your query.
Sorry for the delay in my response.
1) What are 5 most relevant questions I could ask him initially?
---Whether there is any motor weakness ?
How frequent are the seizures ?
Are there any behavioral changes ?
Did he have a head injury in past ?
Does he suffer from any other medical condition ?
Is he on any medications ?
2) Based on above, what is the diagnostic hypothesis?
-- Need to rule out Cognitive dysfunction disorders
3) List all pertinent examination finding that one might, could, would, should find upon examination of someone with this disorder.
-- Head injuries, physical marks of abuse, Motor skills, Gait and Counselling to learn about thought process.
4) List what types of further work-up might, could, would, should be done in cases or suspected cases of this disorder.
-- Mental tests like XXXXXXX Mental State Examination (MMSE), Situational judgment tests (SJTs) or Inventories (SJIs) and Inductive reasoning test.
5) What is the management for this disorder.
-- Cognitive behavioral therapy.
6) Make sure you include medical, chiropractic, other alternatives, etc.
-- Role of Chiropractic is uncertain. It depends on presence of any sort of physical defects. An integrated approach by a Psychiatrist and a neurologist would be essential.
7) Make sure you include short and long term goals
-- Short term goals - Diagnosis and treatment
long term - Regular counselling sessions and repeat the above mentioned tests.
8) Based upon the information you have thus far, what are the anatomical sites involved in this patient?(Be as specific as possible)
--Couldn't be specific with such a short history. Frontal brain defects should be looked for.
9) Explain the pathophysiology of this condition
-- Condition needs to be diagnosed yet. Causes of such problems could be worsening of previous medical conditions, abuse of medications or drugs, alcohol or drug withdrawals, mental illness, severe pain, immobilization, sleep deprivation and hypnosis
10) What would be short term & long term goals?
-- Already explained.
Hope, I answered your query.
Wish you good health.
Regards,
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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