PHYSICAL EXAM AND LABORATORY RESULTS
Physical Exam: The patient is of a slightly muscular build and
tends to avoid eye contact. The hed and neck exam is unremarkable. Lungs
are clear to auscultation and the heart has a regular rate and rhythm with
no murmurs. The neurological exam
reveals an exaggerated left knee jerk reflex. No other abnormalities are
noted.
Laboratory: SMAC-20, CBC, VDRL, phenytoin and carbamazepine levels
are within normal limits. A PPD skin test is positive at 20mm. The CXR is
normal. Review the stool exam and CAT scan of the hea
d.
With image of stool specimen,
Can you identify the organism?
With image of CAT scan,
What is the likely diagnosis in this patient?
Assignment
- Develop a comprehensive list of problems to be addressed in the
patient management and counseling plan.
Clinical Students Only:How important do you think compliance with
prescribed treatment will be in this case? What special provisions should
be made to maximize compliance?
- Review the diagnosis and management plan.