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A 28 years old woman presents with intermittent jaw pain and clicking noise in the jaw joint when she chews or talks. She says the pain is worse in the morning when she awakens, but decreases as the day progresses. She complains of being unable to open her mouth as wide as she used to. She also complains of periodic headaches in temporal regions. On examination she has tenderness to palpation in the region anterior to the tragus of the ear. A clicking of the mandibular joint is palpated as the patient opens and closes her mouth. What potential sequelae do you need to be concerned about?

December 27, 2020 7:26 am Published by

Recurrent pain, pulpitis and tooth wear as a result of bruxism

A 28 years old woman presents with intermittent jaw pain and clicking noise in the jaw joint when she chews or talks. She says the pain is worse in the morning when she awakens, but decreases as the day progresses. She complains of being unable to open her mouth as wide as she used to. She also complains of periodic headaches in temporal regions. On examination she has tenderness to palpation in the region anterior to the tragus of the ear. A clicking of the mandibular joint is palpated as the patient opens and closes her mouth. What are the most important differential diagnoses?

December 27, 2020 7:25 am Published by

Of the relevant differential diagnoses, it is important to rule out temporal arteritis.

A 28 years old woman presents with intermittent jaw pain and clicking noise in the jaw joint when she chews or talks. She says the pain is worse in the morning when she awakens, but decreases as the day progresses. She complains of being unable to open her mouth as wide as she used to. She also complains of periodic headaches in temporal regions. On examination she has tenderness to palpation in the region anterior to the tragus of the ear. A clicking of the mandibular joint is palpated as the patient opens and closes her mouth. What is the most likely diagnosis?

December 27, 2020 7:24 am Published by

Temporomandibular joint syndrome

A 27 years old man develops a sudden onset of headache shortly after taking cocaine in a nightclub. He collapses with a right-sided hemiplegia, and his level of consciousness rapidly deteriorates. On arrival, he is in coma, extending to pain, with no eye opening and no verbal response. His left pupil is fixed and dilated. What are the most important differential diagnoses?

December 27, 2020 7:22 am Published by

Of the relevant differential diagnoses, it is important to rule out stroke, cerebral aneurysm or hemorrhage and cavernous hemangioma.

A 78 years old woman presents with confusion, agitation, and visual hallucinations. She has become progressively confused over the past 2 years and has had trouble managing her affairs, including shopping and paying bills. It is unclear when her confusion started. Initially, she was having trouble following conversations and got lost on several occasions. Her memory, which was previously good, has begun to deteriorate. At night, she sees children playing in her house and has called the police on several occasions. She gets angry easily and has been paranoid about her relatives and their intentions. Her behavior tends to fluctuate from day to day. She started to shuffle about 6 months ago and had difficulty getting out of chairs, and getting dressed to go out seemed to take hours. On one occasion, she fell and was taken to the emergency department but was subsequently discharged with no diagnosis given. What potential sequelae do you need to be concerned about?

December 27, 2020 7:20 am Published by

Substance abuse, depression and suicide

A 78 years old woman presents with confusion, agitation, and visual hallucinations. She has become progressively confused over the past 2 years and has had trouble managing her affairs, including shopping and paying bills. It is unclear when her confusion started. Initially, she was having trouble following conversations and got lost on several occasions. Her memory, which was previously good, has begun to deteriorate. At night, she sees children playing in her house and has called the police on several occasions. She gets angry easily and has been paranoid about her relatives and their intentions. Her behavior tends to fluctuate from day to day. She started to shuffle about 6 months ago and had difficulty getting out of chairs, and getting dressed to go out seemed to take hours. On one occasion, she fell and was taken to the emergency department but was subsequently discharged with no diagnosis given. What are the most important differential diagnoses?

December 27, 2020 7:19 am Published by

Of the relevant differential diagnoses, it is important to rule out brain tumor, cerebrovascular insufficiency and substance abuse (intoxication or... View Article

A 78 years old woman presents with confusion, agitation, and visual hallucinations. She has become progressively confused over the past 2 years and has had trouble managing her affairs, including shopping and paying bills. It is unclear when her confusion started. Initially, she was having trouble following conversations and got lost on several occasions. Her memory, which was previously good, has begun to deteriorate. At night, she sees children playing in her house and has called the police on several occasions. She gets angry easily and has been paranoid about her relatives and their intentions. Her behavior tends to fluctuate from day to day. She started to shuffle about 6 months ago and had difficulty getting out of chairs, and getting dressed to go out seemed to take hours. On one occasion, she fell and was taken to the emergency department but was subsequently discharged with no diagnosis given. What is the most likely diagnosis?

December 27, 2020 7:18 am Published by

Lewy body disease

A 25 years old woman presents with increasing headache for 3 to 4 weeks together with confusion, nausea and vomiting, and diplopia for 1 week. On examination she is drowsy, but is able to cooperate with the medical examination. On neurologic examination she has a left 6th cranial nerve palsy, and range of motion in her neck is decreased due to pain and stiffness. The only other pertinent findings are reduced visual acuity and slight photophobia. What potential sequelae do you need to be concerned about?

December 27, 2020 7:17 am Published by

Shock, seizures and permanent cognitive or neurological deficits