1) What differential diagnoses should be considered for this individual?
When addressing this question, the provider may feel overwhelmed with volume and possibility. Consequently, a thorough knowledge of disease pathology, presentation, and an understanding of the establishment and ranking of the most likely differential diagnoses is of immense importance. Like with any presenting complaint, the history and physical should serve as the guidepost for the differential diagnosis. Every disease presents with certain makers, some obvious, some frustratingly vague, but it is incredibly important to approach every case with the same technique and precision.
As a provider it is important to begin with what is known. Consequently, the provider …show more content…
2) She does not exhibit any rheumatologic symptomatology.
3) She is currently afebrile.
4) Her neck is non-tender and supple, with full range of motion.
5) Severely diminished deep tendon reflexes.
6) She displays normal affect, without any history of depression, anxiety, or mental instability.
The purpose of this recap is to assist with and encourage the use of a methodical approach to the patient, by compounding what is known and forming a list of the most likely differential diagnoses. The providers who cared for this patient utilized this process, and concluded that the following diagnoses were the most likely:
1) Guillain-Barre syndrome
2) Multiple Sclerosis
3) Lyme Disease
4) Conversion Disorder
Diagnosis Rules-In Rules-Out
Guillain-Barre Syndrome Recent febrile illness, likely viral. Positive for bilateral weakness, numbness, paresthesia, finger dysesthesia. Severe hyporeflexia or areflexia. Lack of well demarcated sensory level (Andari, 2016). No evidence of damage to cranial nerves, particularly cranial nerve 7. Relatively rapid progression, 5 days since illness as opposed to several weeks (Andari, …show more content…
In addition, autonomic dysfunction may be severe enough to require intensive care unit (ICU) monitoring. Thus, many patients with GBS are initially admitted to the ICU for close monitoring of respiratory, cardiac, and hemodynamic function. Less severely affected patients can be managed in intermediate care units, and mildly affected patients can be managed on the general ward with telemetry, along with monitoring of blood pressure and vital capacity every four hours.
When addressing this question, the provider may feel overwhelmed with volume and possibility. Consequently, a thorough knowledge of disease pathology, presentation, and an understanding of the establishment and ranking of the most likely differential diagnoses is of immense importance. Like with any presenting complaint, the history and physical should serve as the guidepost for the differential diagnosis. Every disease presents with certain makers, some obvious, some frustratingly vague, but it is incredibly important to approach every case with the same technique and precision.
As a provider it is important to begin with what is known. Consequently, the provider …show more content…
2) She does not exhibit any rheumatologic symptomatology.
3) She is currently afebrile.
4) Her neck is non-tender and supple, with full range of motion.
5) Severely diminished deep tendon reflexes.
6) She displays normal affect, without any history of depression, anxiety, or mental instability.
The purpose of this recap is to assist with and encourage the use of a methodical approach to the patient, by compounding what is known and forming a list of the most likely differential diagnoses. The providers who cared for this patient utilized this process, and concluded that the following diagnoses were the most likely:
1) Guillain-Barre syndrome
2) Multiple Sclerosis
3) Lyme Disease
4) Conversion Disorder
Diagnosis Rules-In Rules-Out
Guillain-Barre Syndrome Recent febrile illness, likely viral. Positive for bilateral weakness, numbness, paresthesia, finger dysesthesia. Severe hyporeflexia or areflexia. Lack of well demarcated sensory level (Andari, 2016). No evidence of damage to cranial nerves, particularly cranial nerve 7. Relatively rapid progression, 5 days since illness as opposed to several weeks (Andari, …show more content…
In addition, autonomic dysfunction may be severe enough to require intensive care unit (ICU) monitoring. Thus, many patients with GBS are initially admitted to the ICU for close monitoring of respiratory, cardiac, and hemodynamic function. Less severely affected patients can be managed in intermediate care units, and mildly affected patients can be managed on the general ward with telemetry, along with monitoring of blood pressure and vital capacity every four hours.