Case #9:
A 36 year old man is seeing his physician because he is becoming increasingly weak. He reports that the weakness progresses throughout the day. He has a desk job and can hardly keep his eyes open and head up by the end of the day. Other history is unremarkable. Cranial nerve examination shows weak facial muscles, inability to repeat movements, and bilateral ptosis. The patient’s shoulders droop with a very poor posture.
1. What is the likely diagnosis?
2. What is the pathogenesis of this disease?
3. What other deficits might present if untreated?
4. Why do the symptoms seem to worsen later in the day?
5. What other conditions should be ruled out?
6. What treatment should be sought?
Case #10:
Tim and Leanne are rushed to the hospital after a car accident. Tim was driving as the car was hit in the driver side door. He sustained a broken humerus from the direct impact. His arm was immobilized and he is resting in his room. Leanne, who was in the front passenger seat sustained a ruptured spleen and four adjacent broken ribs on the left side. Her wounds are from striking the middle console of the car. She is in the ICU with her chest wrapped.
1. What are the factors that affect wound production?
2. Which factor is the main difference causing Tim and Leanne to have such different injuries?
3. What is the mechanism that caused the rupturing of Leanne’s spleen?
4. What is the name of the condition in which several adjacent ribs is broken?
5. Due to her broken ribs, what is Leanne at risk of developing?
6. If Leanne’s lung is bruised, what other condition may develop?
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