Answer to Question #210121 in Biochemistry for Whatever

Question #210121

A female in her sixties (Mrs J) makes an appointment with her GP because she has been suffering with pains in her legs and having difficulty walking. She is also having problems with her vision. She presents as overweight, bordering on obese. When questioned about her appetite she mentions that she seems to feel thirsty a lot of the time. The GP takes a blood sample and asks the patient to provide an MSU urine specimen. After using a dipstick on both samples, the GP arranges for the patient to attend the clinic for a glucose tolerance test.

Question 3

Describe the profile for this patient and suggest the clinical implications.

Expert's answer
  1. the profile for this patient and suggest the clinical implications Dropped head syndrome (DHS) is defined as weakness of the neck extensor muscles causing a correctable chin-on-the-chest deformity. Here we report the case of a patient with severe pain from lower leg ischemia showing DHS whose symptoms were attenuated by pain relief after amputation of the severely ischemic lower leg. To our knowledge this is the first report indicating that severe pain can cause DHS. A 64-year-old Asian woman was referred to our department with a 1-month history of DHS. She also suffered from severe right foot pain because of limb ischemia. She began to complain of DHS as her gangrenous foot pain worsened. She had neck pain and difficulty with forward gaze. We found no clinical or laboratory findings of neuromuscular disorder or isolated neck extensor myopathy. We amputated her leg below the knee because of progressive foot gangrene. Her severe foot pain resolved after the surgery and her DHS was attenuated. Severe pain can cause DHS. If a patient with DHS has severe pain in another part of the body, we recommend considering aggressive pain relief as a treatment option.
  2. Alkaptonuria: A rare&nbsp;<span class="hlt" style="color: rgb(153, 0, 0);">cause</span>&nbsp;of recurrent&nbsp;<span class="hlt" style="color: rgb(153, 0, 0);">severe</span>&nbsp;back&nbsp;<span class="hlt" style="color: rgb(153, 0, 0);">pain</span>&nbsp;in the emergency department
  3. Directory of Open Access Journals (Sweden)
  4. MSeidahmed
  5. 2012-09-01
  6. Full Text Available We report a 45 year-old male patient who presented to the emergency department of Hamad General Hospital with recurrent severe low back pain. Clinical examination revealed characteristic deposition of blue-brownish pigment in the sclera and ear. X-ray revealed diffuse intervertebral disc calcification. Alkaptonuria was suspected and the diagnosis was confirmed by detection of high levels of homogentisic acid in the urine.
  7. Periarticular Morphine-Induced Sphincter of Oddi Bradycardia in an Awake Patient Under Spinal Anesthesia: An Important Diagnostic Consideration.
  8. (United States)
  9. Koumpan, Yuri; Engen, Dale; Tanzola, Robert; Saha, Tarit
  10. 2016-10-01
  11. Sphincter of Oddi spasm from opioids has been documented, presenting as severe epigastric pain and potentially overlooked in a differential diagnosis. We present a case of sphincter of Oddi spasm from periarticular morphine in a patient under spinal anesthesia, causing severe distress and treated effectively with glucagon. It is important for anesthesiologists using opioids to consider it as a cause of perioperative pain and be familiar with treatment as it may be refractory by conventional use of opioids for pain relief. It is also important to consider the systemic effects of periarticular absorption, as evident by our case.
  12. Treatment of cancer
  13. International Nuclear Information System (INIS)
  14. Nakano, Masao
  15. 1979-01-01
  16. Relief of pain caused by cancerous invasion is one of the most important role of radiotherapy. Telecobalt has improved the palliative effects for cancer pain, because of its sufficient depth dose. Supervoltage x-ray generated from Linac has expanded indications of treatment for cancer pain by the shortening of treatment time due to high dose rate. Intraoperative electron beam therapy is useful in the case of carcinoma of the pancreas suffering severe pain. Fast neutron therapy is clearly more effective than supervoltage x-ray for pain caused by the invasion of radioresistant cancer. Pelvic angiography is useful for diagnosis

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