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SMUGrinch
10-30-2005, 09:32 PM
a 15 y.o. asian male is brought into your office by his uncle. The boy complains of having "dizzy spells" and a "lump in his throat" during these episodes. He states he's been having these as long as he can remember. Your PE is unremarkable and the VS shows 98/62, 69 (HR). He gets the attack while in your office, he connect him to your portable ECG machine and this is what you see:
(the second attachment)
After the episode you see this:
(the first attachment)
Hint: shortned PR-interval

Diagnosis and treatment please?
SMUGrinch
10-31-2005, 08:44 AM
a 62 year old male comes to your office with a c/c of a single episode of syncope yesterday. The episode happened upon arising in the morning. Your PE is unremarkable with a BP 126/80. You notice on his chart his diagnoses included BPH, HTN, DMII, cataract, eczema, and ringworm. You look at his medication list which reveals:
Glucovance, hytrin, lac-hydrin lotion, enelapril, humulog, lotrimin, and asa.
The glucovance, enaliprin, and hytrin are new drugs
What is THE MOST LIKELY CAUSE OF THIS SINGLE SYNCOPAL EPISODE.
bchamp1281
11-01-2005, 02:02 PM
Is the answer to #2 a TIA (transient ichemic attack)?

I may be thinking to deeply on this one ...
SMUGrinch
11-01-2005, 03:26 PM
Is the answer to #2 a TIA (transient ichemic attack)?

I may be thinking to deeply on this one ...

It's not the answer I'm looking for but I can absolutely see how you can possibly be thinking that. That would definetly be a differential diagnosis. Great try though.
:D
charger5001
11-01-2005, 11:13 PM
....Seizure?
SMUGrinch
11-01-2005, 11:15 PM
....Seizure?

Nope...look at the meds he's on...
;)
charger5001
11-01-2005, 11:19 PM
Acute MI ?
SMUGrinch
11-01-2005, 11:21 PM
Acute MI ?

Are you talking about the 1st or second one? Either way it's not correct...If you want the answer I can PM you
ES21
11-01-2005, 11:23 PM
Id like the answer... for #1 and #2
SMUGrinch
11-02-2005, 12:05 AM
Id like the answer... for #1 and #2
sent in pm