Case studies with working and differential diagnosis

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CC:  Nausea, vomiting and extreme dizziness

Patient reports that over the last year she has experiences episodes of extreme dizziness leading to nausea and vomiting.  When asked if she has any additional symptoms, she states she suffers from unsteadiness, diarrhea and ringing in the ears.  When asked is she has noticed any pattern regarding her condition (i.e., how it starts, what stops it, how it changes over time), the patient says that she has noticed fullness in the ear before the dizziness begins.  She denies any hearing impairment but says the attacks can last up to 12 hours.  She is willing to do or try anything for them to stop because it affects her ability to work.

Working diagnosis : Meniere disease 

Differential diagnosis : otitis media,

Benign paroxysmal positional vertigo

External otitis (acute)

Need to do :

1. You must complete all three case studies.  In order for your work to be considered complete and eligible for full points, you will need to follow all of these instructions.

2. From the conditions that we have covered this term, choose one working diagnosis and three other differential diagnoses, for a total of four diagnoses, that you will discuss for each case. Clearly state what you think the best diagnosis is for each. Using narrative format (i.e., written in paragraph form with complete sentences), discuss the following:

• Which risk factors, signs, symptoms, labs, etc., led you to choose each diagnosis?

• Drawing on the risk factors, signs, symptoms, labs, etc., explain why the working diagnosis was ruled in and why the differentials were ruled out.

• As a general rule of thumb, each case should be about 2 pages long; it is possible for them to be shorter or longer depending on individual style and each case’s details.

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