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CCS neuro - svenska101
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05-23-2009, 07:39 PM
Is the following list sufficient for possible CCS cases from neuro
TIA Migraine Parkinson Dementia Seizures Headache Myasthenia Gravis Multiple Sclerosis any input appreciated
05-23-2009, 07:41 PM
I think we need to add spinal cord problems like trauma, though it could be in the trauma section.
05-23-2009, 07:43 PM
gullian burrie syndrome
meningitis subdural hematoma
05-23-2009, 07:47 PM
oh yes I forgot to mention few more
Low Back Pain Spinal cord compression (very important one) Subarachnoid hemorrhage Subdural hemorrhage Vertigo AMS (Altered mental status changes) zkadhem what about like some other neurological dx like ALS etc
05-23-2009, 07:51 PM
yeh, everything is possible and I think in neurology cases the approach is not much complicated.
05-23-2009, 07:53 PM
ok svenska101,
How will you manage a patient who is 50 years old male came to your office complaining of tremor? vital signs are normal. No Hx of DM or HTN.
05-23-2009, 08:26 PM
(zkadhem 2 scenarios)
HPI no current medications Vitals normal (no orthostasis) Complete physical exam results show (s/s suggestive of parkinson dis) (bradykinesia, rigidity,micrographia etc) mental status normal no hallucinations order these tests as routine and schedule the pt to return in 7 days BMP UA TSH CT head seum ceruloplasmin 24 hr urine copper on follow up visit interval history vitals results are normal order bromocriptine po (although one can also order ropinirole po) send the pt home counsell medication compliance diet low protein exercise if pt smokes or drinks (then smoking cessation etc) dx parkinson dis ----------------------------------------------------------------------------------------------------------- Consider hospitalizing patients with Parkinson's disease who have any of the following conditions Hallucinations Delirium Profound fluctuations in mobility Mania Depression Frequent or serious falls Infection (e.g., urinary tract infection, aspiration pneumonia) ------------------------------------------------------------------------------------------------------------ Second scenario same pt more than 50 years with some tremor involving hands but spares legs in office vitals stable, no DM, no HTN but drinks and reports that his tremor improves when he is drinking complete physical exam results normal except only tremor order routine BMP UA propanolol po send the patient home re schedule after 15 days Pt returns after 2 weeks interval hx pt reports improvement in his tremor continue the beta blocker case ends dx benign essential tremor ------------------------------------------------------------ |
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) I think you have listed everything