Thank you for your participation!
Your Score is: / 50
Correct List of Differential Diagnoses: / 30
Correct Order of Differential Diagnoses: / 20
Our Differential:
Your Differential:
Our Diagnosis:
Primary Determinant:
Exam Results
Exam: normal vision of 20/20, no relative afferent pupil defect. Ocular motility normal. Intraocular pressure 13 mmHg OU. Dilated fundus exam showed normal retina, macula and optic nerves
Further exam: when pressing on her globe, the retinal artery collapsed in the right eye with very little digital pressure on the eye, and the left eye’s central retinal artery did not collapse until moderate digital pressure was given
Testing: fluorescein angiogram showed delayed patchy choroidal filling in the right eye during the early phase and delayed filling of the central retinal vein (delayed arterial- venous filling time of greater than 4 seconds).
Preparation Planning : Case Review #31921374
Malmö, Sweden
October 2023
Assignment Instructions
Purpose
The purpose of this assignment is to work through one case at a time of a patient presenting with Transient Visual Loss. The differential diagnosis you provide will be graded and the score reported anonymously to the instructor. The goal of this exercise is to enhance classroom discussion and your answers may be presented in the class as talking points.
How to Complete the Assignment
The assignment requires you to investigate the patient history and additional patient results to determine a differential diagnosis. The elements of the history can be requested in any order you think is appropriate. You will be required to select each element of the history you think is most relevant to the patient’s chief complaint in a step-by-step manner, then you will be given the patient history for your inquiry, and then you will then reorder the Ranked Diagnosis elimating possbilities by clicking the trash can You will then repeat the process to determine other parts of the history that you think are the most relevant, until you are ready to submit your refined differential diagnosis of probable entities, ranked in order of their likelihood. You may enter your differential diagnosis at any time by clicking the "Differential Diagnosis" button. Once the diagnosis is submitted the assignment is complete and no further action is required until attending the lecture, where each case will be discussed as a group interaction.
Scoring
- The Student begins with a maximum 50 points
- 30 points are awarded for having all CORRECT Diagnoses present in your Differential
- Points will be deducted for selecting an incorrect diagnosis
- 20 points are awarded for having all Diagnoses in the CORRECT order of most to least likely
- Points are awarded for having each Diagnosis the CORRECT order
After the Lecture
You will be provided with a link to review the suggested way to work through the case along with keys points for evaluating each piece of the information from the patient history.
Case Review #31921374
Patient Presentation
80-year-old white female that has noticed repeated episodes of sudden darkening of vision.
Click on the Cards Below to Learn More
Bilateral vs Unilateral
Bilateral vs Unilateral
Unilateral, right eye only for each episode
Duration
Duration
Each episode has a duration of less than a minute.
Activity during the episode
Activity during the episode
Episodes of darkening of vision occurred while standing upright from sitting position or when she bends over to pick up laundry from the floor and rises to standing position.
Pattern of visual loss
Pattern of visual loss
Repeated episodes of Negative visual phenomenon (darkening of vision), entire vision in the right eye only.
Other Symptoms
Other Symptoms
10 lb. (4.5kg) weight loss in the last 6 months, flu-like symptoms and mild low-grade fever. Has been having some hip and neck pain the last 3 months. She went to her hairdresser 3 weeks ago and was experiencing some pain during her comb-out after a shampoo. She also has had two episodes of horizontal diplopia lasting less than a minute in the last 2 weeks.
Current Medication
Current Medication
The patient is on anti-hypertensive medications for high blood pressure.
How to "Score" Point
- The Student begins with a maximum 50 points
- 30 points are awarded for having all CORRECT Diagnoses present in your Differential
- Points will be deducted for selecting an incorrect diagnosis
- 20 points are awarded for having all Diagnoses in the CORRECT order of most to least likely
- Points are awarded for having each Diagnosis the CORRECT order
Patient Presentation
80-year-old white female that has noticed repeated episodes of sudden darkening of vision.
Click on the Cards Below to Learn More
Bilateral vs Unilateral
Bilateral vs Unilateral
Unilateral, right eye only for each episode
Duration
Duration
Each episode has a duration of less than a minute.
Activity during the episode
Activity during the episode
Episodes of darkening of vision occurred while standing upright from sitting position or when she bends over to pick up laundry from the floor and rises to standing position.
Pattern of visual loss
Pattern of visual loss
Repeated episodes of Negative visual phenomenon (darkening of vision), entire vision in the right eye only.
Other Symptoms
Other Symptoms
10 lb. (4.5kg) weight loss in the last 6 months, flu-like symptoms and mild low-grade fever. Has been having some hip and neck pain the last 3 months. She went to her hairdresser 3 weeks ago and was experiencing some pain during her comb-out after a shampoo. She also has had two episodes of horizontal diplopia lasting less than a minute in the last 2 weeks.
Current Medication
Current Medication
The patient is on anti-hypertensive medications for high blood pressure.
How to "Score" Point
- The Student begins with a maximum 50 points
- 30 points are awarded for having all CORRECT Diagnoses present in your Differential
- Points will be deducted for selecting an incorrect diagnosis
- 20 points are awarded for having all Diagnoses in the CORRECT order of most to least likely
- Points are awarded for having each Diagnosis the CORRECT order