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Geratric Cases
These are background cases that support questions with the QBank. Each question can refer back to a case. Click here to add a new case.
Title | Question Case | Actions |
|---|---|---|
| 65 year-old male presents with a history of numbness, tingling and pain | 65 year-old man presents with a couple of month history of numbness and tingling and pain which began in his toes and has progressed to mid-foot. He describes a pins and needles sensation with some burning pain. He has also been tripping on his feet somewhat, and his gait has become unsteady.Neurologic Examination: Normal strength throughout except mild weakness on ankle dorsiflexion and toe extension. Diminished pinprick to the ankles with diminished but present vibration and proprioception at the toes. Reflexes are normal in the arms, diminished at the knees, and absent at the ankles. | edit, delete |
| 65 year-old male with history of tremors in his hands | A 65 year-old right-handed white male with a 3-year history of tremors in his hands when he is sitting, watching TV. The tremor started on the left initially, but now there is a slight tremor on the right. His wife reports that he is walking more slowly and shuffles his feet. His handwriting has also gotten smaller.Neurologic Examination:Mental Status: Slow to answer. Hypophonic voice.Cranial nerves: Masked face. Normal extraocular movement. | edit, delete |
| 65 year-old man with diabetes and COPD | A 65 year-old man with diabetes and chronic obstructive pulmonary disease (COPD) is admitted with a COPD exacerbation and started on steroids. When his blood sugars become elevated, insulin is added to his medication regimen. A pressure ulcer develops on his heel and he has difficulty walking. Upon discharge from the hospital, he will need home health services. | edit, delete |
| 66 year-old male with a fracture | A 66 year-old man has been instructed to keep his weight off his left lower leg after sustaining a fracture. He comes to you for advice on how to do this. He is in good physical condition. | edit, delete |
| 70 year-old male awoke with right-sided weakness and expressive aphasia | A 70 year-old right handed white male awoke with right-sided weakness and expressive aphasia. He presented to the ER within 45 minutes of discovering the weakness. He has never had a similar event.Physical Examination:Mental status: Awake, alert, and oriented. His comprehension is intact, but he is having difficulty expressing himself with word-finding difficulty.Cranial nerves: Right lower facial weakness. Eyes deviated to the left. Right superior quadrantanopia. All other cranial nerves are intact.Motor: Dense right-sided hemiplegia. | edit, delete |
| 70 year-old manle with a history of hypertension and diabetes | 70 year-old man with a history of hypertension and diabetes develops sudden onset of double vision and pain over the right temple. Neurologic examination reveals mild ptosis of the right eye, failure of the right eye to adduct and impaired upgaze on the right. The pupils are reactive. | edit, delete |
| 87 year-old female who presents to the ER with a large sore on her right upper back | 87 year-old female was seen in the ER with a large sore on her right upper back. There is no history of trauma. The ulcer has over the past week gotten larger. She has been having low grade temperature, some tenderness and erythema, but little drainage. Size is about 3x3 cm. The patient is wheelchair and bedridden and is able to get into a shower with maximal assistance every day, but does not bathe herself. There are no other signs of skin problems. | edit, delete |
| BT is an 85 year-old male who has been admitted to the hospital for repair of a hip fracture | BT is an 85 year-old male who has been admitted to the hospital for repair of a hip fracture he sustained while playing golf. He has a history of hypertension and hypercholesterolemia, both of which are treated. On review of systems, he admits to “memory problems” and difficulty sleeping at night. The day after admission he undergoes total hip replacement. Blood loss is estimated at 300cc with two units of blood transfused during the surgery. He seems to recover well the next day after surgery, is talking with his family about “getting back on the course". | edit, delete |
| CB is a 67 year-old female who presents to your office - 2 weeks later | Two weeks later, you receive CB’s test results. Her pap test and mammogram are once again normal. Her TSH is 0.27 (0.35-5.5 miU/ml). DEXA scan results in T score of –2.0 at the femoral neck. FOB (fecal occult blood) tests are negative. You are concerned about her risk for osteoporosis, so you ask the patient to come in for a follow up visit. | edit, delete |
| CB is a 67 year-old female who presents to your office - Alzheimer’s disease | Pretend for a minute that five years have gone by and give CB an additional diagnosis of moderately advanced Alzheimer’s disease. Her husband is also a resident of the same nursing home where he lives because of coronary disease, osteoarthritis of the knee, and a slight stroke. He could no longer take care of his wife at home so their children arranged for them to stay together in the nursing facility. They are observed to be romantic with each other. | edit, delete |