Consultant. Vol. 49 No. 4

Pages: 1 2

What’s Your Diagnosis?
Sharpen Your Physical Diagnostic Skills

Something Wrong on the Face of an Old Man

By HENRY SCHNEIDERMAN, MD—Series Editor | April 1, 2009

Dr Schneiderman is vice-president for medical services and physician-in-chief, Hebrew Health Care, West Hartford, Conn, and president of its Connecticut Geriatric Specialty Group. He is professor of medicine (geriatrics) and associate professor of pathology, University of Connecticut Health Center in Farmington and clinical professor, nursing, Yale University. He is a recipient of the American Geriatrics Society Clinician of the Year award and received the Laureate award of the Connecticut chapter of the American College of Physicians.

This article was originally presented as an independent educational activity under the direction of CME LLC. The ability to receive CME credits has expired. The article is now presented here for your reference. CME LLC is no longer responsible for the presentation of the article.

HISTORY

A 76-year-old man is seen because of redness below the right eye. Has long-standing “lazy eye” on the left, which is chronically deviated outward. Has lived in nursing home for some years due to self-care deficit from memory loss. No recent eye surgery, conjunctivitis, sinus infection, or periocular trauma.

PHYSICAL EXAMINATION

Man who does not effectively communicate how much of his moderate discomfiture is psychological versus physical. Temperature, 37.3°C (99.2°F); heart rate, 84 bpm and regular; BP, 126/84 mm Hg; respirations, 20 per minute and not labored. Face as shown. Visual function seems preserved within limits of his replies. Full ocular range of motion. Each pupil constricts on direct illumination and consensually on shining flashlight beam into opposite eye.

What’s Your Diagnosis?

(answer on next page)

Pages: 1 2

by Jaco Fishenfeld | March 08, 2011 9:01 PM EST

very good teaching

by Gary Melvin Gorlick | February 18, 2011 5:23 PM EST

An excellent discussion and teaching case.

by Yusharn Wang | January 31, 2011 3:49 AM EST

Looks like an early form of cellulitis.

by JISHA JOHN | November 20, 2010 6:55 AM EST

Pre septal cellulitis

by JISHA JOHN | November 20, 2010 6:50 AM EST

Bells palsy

Article Comment Pages: 1 2 3 Next

TOPIC INDEX

Developmental/Genetic

Nutritional/Metabolic

FROM PHYSICIANS PRACTICE

Key Differences between FQHCs and RHCs
Chastity Werner, RHIT, June 13, 2013
FQHCs and RHCs take up a unique niche among physician practices. And that affects compensation and billing.

Improving Care Coordination in Your Practice
Susanne Madden, June 12, 2013
Practices are feverishly working to control the rising costs of healthcare - effective care coordination can help.

Refunding Overpayments: Two Options for Medical Practices
Ericka L. Adler, June 12, 2013
Medicare and Medicaid providers must return overpayments once identified. Here are two different refund approaches for practices to consider when necessary.

Four Easy Ways to Boost Patient Time of Service Collections
Aubrey Westgate, June 12, 2013
Simple ways your medical practice staff can increase the likelihood patients will pay when presenting for appointments.

iPad Alternatives for Mobile Physicians
Marisa Torrieri, June 11, 2013
As more physicians are seeing the merits of media tablets, the market is expanding, too.

Something Wrong on the Face of an Old Man

Join the Conversation