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A patient comes in with sweating, tremors, palpitations, and tachycardia. They complain of headache and dizziness and occasional blurred vision. Family reports that they have had slurred speech and difficulty concentrating. What is your work-up and how do you treat the top DDx?

a) Hypoglycemia; administer glucose
b) Panic attack; provide reassurance
c) Migraine; administer analgesics
d) Alcohol intoxication; monitor and provide supportive care

1 Answer

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Final answer:

The patient's symptoms could indicate hypoglycemia, which would be diagnosed through a blood glucose test and treated with glucose administration. Differential diagnoses include a panic attack, migraine, or alcohol intoxication, each requiring different management approaches. A thorough medical work-up is necessary to confirm the diagnosis.

Step-by-step explanation:

When a patient presents with symptoms such as sweating, palpitations, tachycardia (increased heart rate), tremors, headache, dizziness, blurred vision, slurred speech, and difficulty concentrating, a differential diagnosis must be considered. The top differential diagnoses (DDx) for these symptoms could be hypoglycemia, panic attack, migraine, alcohol intoxication, and others such as hyperinsulinism or neurological conditions.

The diagnostic work-up for these symptoms should include obtaining a thorough patient history, physical examination, and appropriate laboratory tests, such as a blood glucose level which would confirm hypoglycemia if the levels are low. In the event that hypoglycemia is diagnosed, the immediate treatment would be to administer glucose. For a panic attack, reassurance and potentially anxiolytics may be offered, while migraines would be treated with analgesics, and alcohol intoxication would require monitoring and supportive care.

User Gurkha
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