Examining the Sensory System
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Skull Fracture
This is a non-contrast cranial CT from a patient who sustained a fall injury, landing on the back of the head. The CT here shows the cranium utilizing the “bone window”. One can appreciate that the details of the skull bone is shown in greater detail. In contrast, the contents within the skull as well…
Thymoma
In this contrast thoracic CT scan of a middle-aged woman with newly diagnosed seropositive generalized myasthenia gravis, an abnormal thymic lesion (present in the anterior mediastinal compartment) could be seen (Figure 1). The patient was referred to the Cardiothoracic Surgeons where she received a thymectomy via an open sternotomy. The thymic specimen was sent for histo-pathological…
Creutzfeld-Jakob Disease
Creutzfeld-Jakob Disease (CJD) are prion diseases and can be subdivided into sporadic (account for 85% of cases), genetic (15% of cases) and acquired forms (<1% cases). CJD is rare with an incidence of 1-1.5 per million population per year with a peak age of onset of 55-75years. It is a common cause of rapidly progressive dementia. However, other symptoms including myoclonus, visual or…
Contraindications of a Lumbar Puncture
A lumbar puncture (LP) is contraindicated in the following scenarios: Patients with bleeding diathesis, e.g. severe coagulopathy (INR >1.4) and thrombocytopenia (platelet <50 x 109/L). If coagulopathy or thrombocytopenia is not corrected prior to the procedure, spinal hematomas resulting in spinal cord compromise may result. Patients with increased intracranial pressure due to an intracranial lesion…
General Examination
Before touching the patient, it is important and good practice to stand back and spend some time in performing a thorough general examination of the patient. Unfortunately, students often rush into touching the patient, hence often neglecting crucial signs which may lead to the diagnosis. An approach to the general examination of a patient presenting…
