Differential:
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Presentation:
Malingering
26 yo M presents after falling and
Hypoglycemia
losing consciousness at work. He had
rhythmic movements of the limbs, bit
Workup:
his tongue, and lost control of his
CBC
bladder. He was subsequently
Electrolytes, glucose
confused after regaining
Urine toxicology
consciousness (as witnessed by his
EEG
colleagues)
MRI—brain
CT—head
LP—CSF analysis
ECG
, Differential:
Tuberculosis
Pneumonia
Presentation: Lung abscess
34 yo F nurse presents with Vasculitis
worsening cough of 6 weeks' Lymphoma
duration accompanied by weight Metastatic cancer
loss, fatigue, night sweats, and fever. HIV/AIDS
She has a history of contact with Sarcoidosis
tuberculosis patients at work.
Workup:
CBC
PPD/QuantiFERON Gold
, Differential:
Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
Vestibular neuronitis
Labyrinthitis
Presentation: Benign positional vertigo
55 yo F c/o dizziness for the past day. Vertebrobasilar insufficiency
She feels faint and has severe
diarrhea that started 2 days ago. She Workup:
takes furosemide for hypertension. Orthostatic vital signs
CBC
Electrolytes
Rectal exam, stool for occult blood
Stool leukocytes
, Differential:
Cardiac arrhythmia (causing syncope)
Severe aortic stenosis
Syncope (other causes)
Presentation:
Seizure
65 yo M presents after falling and
Pulmonary embolism
losing consciousness for a few
seconds. He had no warning before
Workup:
passing out but recently had
ECG
palpitations. His history includes a
Holter monitoring
coronary artery bypass graft.
CBC
Electrolytes, glucose
Echocardiography
CT—head
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Presentation:
Malingering
26 yo M presents after falling and
Hypoglycemia
losing consciousness at work. He had
rhythmic movements of the limbs, bit
Workup:
his tongue, and lost control of his
CBC
bladder. He was subsequently
Electrolytes, glucose
confused after regaining
Urine toxicology
consciousness (as witnessed by his
EEG
colleagues)
MRI—brain
CT—head
LP—CSF analysis
ECG
, Differential:
Tuberculosis
Pneumonia
Presentation: Lung abscess
34 yo F nurse presents with Vasculitis
worsening cough of 6 weeks' Lymphoma
duration accompanied by weight Metastatic cancer
loss, fatigue, night sweats, and fever. HIV/AIDS
She has a history of contact with Sarcoidosis
tuberculosis patients at work.
Workup:
CBC
PPD/QuantiFERON Gold
, Differential:
Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
Vestibular neuronitis
Labyrinthitis
Presentation: Benign positional vertigo
55 yo F c/o dizziness for the past day. Vertebrobasilar insufficiency
She feels faint and has severe
diarrhea that started 2 days ago. She Workup:
takes furosemide for hypertension. Orthostatic vital signs
CBC
Electrolytes
Rectal exam, stool for occult blood
Stool leukocytes
, Differential:
Cardiac arrhythmia (causing syncope)
Severe aortic stenosis
Syncope (other causes)
Presentation:
Seizure
65 yo M presents after falling and
Pulmonary embolism
losing consciousness for a few
seconds. He had no warning before
Workup:
passing out but recently had
ECG
palpitations. His history includes a
Holter monitoring
coronary artery bypass graft.
CBC
Electrolytes, glucose
Echocardiography
CT—head
