| Mrs. Jamison, one of your favorite patients, is a 68 YO woman with a history only of rheumatoid arthritis. She presents to your office for her yearly physical. After briefly talking about her children and grandchildren (and seeing their pictures in her wallet), you settle down to trying to cover a year's worth of prevention and intervention in the 15 minutes alloted. |
After covering issues regarding prevention and Review of Systems, you proceed to the
Physical Exam. Regarding HEENT, you start with her eyes.
Question 1: With an older patient, for what are you looking
which are particularly common?
Answer to Question 1
After covering issues regarding prevention and Review of Systems, you proceed to the
Physical Exam. Regarding HEENT, you start with her eyes.
Question 2: Her retinal exam is shown below. About what, if
anything, are you concerned?
Answer to Question 2
Question 3: You continue your exam, and find no other
ocular abnormalities by observation or palpation. What follow-up questions would you want
to ask her?
Answer to Question 3
She indicates that she thinks her eyes are "getting old" and that she often sees
"halos" around objects, but that that has been gradually coming on for months.
She denies any headaches or eye pain.
Question 4: What type of glaucoma is she most likely to
have? What about her history and physical is consistent or inconsistent with this
diagnosis?
Answer to Question 4
Question 5: What else should you check in your physical
exam?
Answer to Question 5
Question 6: What are the classes of drugs that can be used
for glaucoma?
Answer to Question 6
End of Case 3
Start Case 4
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