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Title | Creator | History |
51 |
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Never Too Young or Too Old | Bart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael Levy | An 81-year-old woman with history of ocular myasthenia gravis presented with sequential bilateral vision loss. Six days before presentation, she discovered that vision of her left eye was reduced to light perception. She did not have any eye pain, pain with eye movement, headache, scalp tenderness, ... |
52 |
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Sometimes a Biopsy is Best | Kevin Chodnicki; Natalie Wolkow; Michael Yoon; Bart Chwalisz | A 30 -year-old pregnant woman without significant medical or ocular history presented with decreased right eye vision. In her 2nd trimester, she was diagnosed with Lyme disease with a bulls-eye rash and positive Lyme antibodies; she was treated with two weeks of amoxicillin. At 33 weeks pregnant she... |
53 |
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From Brainstem to Stern (Video) | Neena Cherayil; Angela Viane; Grant Liu; Ali Hamedani | A previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa... |
54 |
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Smoke Gets in Your Eyes (PDF) | Tatiana Bakaeva; John Gittinger, Jr | A 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She ... |
55 |
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From Brainstem to Stern (Slides) | Neena Cherayil; Angela Viane; Grant Liu; Ali Hamedani | A previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa... |
56 |
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Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Slides) | Jorge Kattah; Scott Eggers; Sarah Bach | A 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a... |
57 |
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Look in the Back (Slides) | Tatiana Deveney; Aristides Capizzano; Jonathan Trobe | A 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio... |
58 |
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Tumefictive MS (Slides) | Anthony Brune III; Hemant Parmar; Sandra Camelo-Piragua; Lindsey De Lott | A 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten... |
59 |
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Bones of the Past (Slides) | Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto Rapalino | A 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se... |
60 |
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Not All Men with Thick Skulls Have High Testosterone (Slides) | Prem Subramanian | A 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai... |
61 |
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Not All Men with Thick Skulls Have High Testosterone (PDF) | Prem Subramanian | A 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai... |
62 |
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A Myel-In, a Long Way to Go (PDF) | Aishwarya Pareek; Timothy Lotze; Gail Demmler; Brandon Tran; William Whitehead; Carrie Mohila; Veeral Shah | A 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s... |
63 |
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A Par 3 Macular Hole? (Slides) | Archana Srinivasan; Jerald Gong; Mark Moster | A 78-year old woman with 3-week history of sudden onset 'visual blur' OU and difficulty reading was evaluated by her ophthalmologist and suspected to have macular hole secondary to posterior vitreous detachment and vitreomacular traction (VMT). Her past medical history was significant for hypertensi... |
64 |
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Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Slides) | David DeLeon; Mariel Rojas; Francisco Sanchez; Rosa Tang; Julie Patel; Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
65 |
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Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (PDF) | David DeLeon; Mariel Rojas; Francisco Sanchez; Rosa Tang; Julie Patel; Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
66 |
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From Brainstem to Stern (PDF) | Neena Cherayil; Angela Viane; Grant Liu; Ali Hamedani | A previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa... |
67 |
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Tissue Is the Issue (PDF) | Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc Dinkin | The pathologic specimen demonstrated atypical histiocytic proliferation and infiltration with abundant cytoplasm, CD68+, S100+, consistent with Rosai Dorfman (RDD). The patient had been treated with steroids with a partial response and disease stabilization with radiation therapy with subsequent pro... |
68 |
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Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (PDF) | Zeeshan Haq; Jeremy Tanner; Christine Glastonbury; Cathryn Cadwell; Brooks Crawford; Elan Guterman; Maulik Shah; Megan Richie; Nailyn Rasool | A 72-year-old man with chronic sinusitis, obstructive sleep apnea, and recent extensive travel presented with right-sided headaches, vision changes, and allergy symptoms. A head CT demonstrated a sinus infection and he was treated with amoxicillin-clavulanate; and prednisone. His headache persisted ... |
69 |
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Are We 'Tilting At Windmills'? (Video) | Michael Vaphiades | A 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred... |
70 |
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Are We 'Tilting At Windmills'? (Slides) | Michael Vaphiades | A 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred... |
71 |
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Smoke Gets in Your Eyes (Video) | Tatiana Bakaeva; John Gittinger, Jr | A 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She ... |
72 |
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Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (Video) | Zeeshan Haq; Jeremy Tanner; Christine Glastonbury; Cathryn Cadwell; Brooks Crawford; Elan Guterman; Maulik Shah; Megan Richie; Nailyn Rasool | A 72-year-old man with chronic sinusitis, obstructive sleep apnea, and recent extensive travel presented with right-sided headaches, vision changes, and allergy symptoms. A head CT demonstrated a sinus infection and he was treated with amoxicillin-clavulanate; and prednisone. His headache persisted ... |
73 |
|
Tumefictive MS (Video) | Anthony Brune III; Hemant Parmar; Sandra Camelo-Piragua; Lindsey De Lott | A 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten... |
74 |
|
Bones of the Past (Video) | Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto Rapalino | A 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se... |
75 |
|
Not All Men With Thick Skulls Have High Testosterone (Video) | Prem Subramanian | A 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai... |