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A student is frustrated because she feels she is not getting all she needs from her professor's last lecture. The professor started fine discussing a complicated pathologic process, then drifted off course mispronouncing words. She remembered previous episodes over the past couple of months of him occasionally using the wrong words to describe common things, though he would quickly recover, but this day was worse and the episode lasted longer.


The next class was cancelled because the professor ended going to the hospital later that day. The teacher had initially thought he was experiencing a drop in blood pressure because he just started an ACE inhibitor. He also has been following all the diet recommendations for his Type II Diabetes. However he does smoke and is a social drinker. His Glucose was 155 mg/dL with a HbA1c of 9.5%; LDL cholesterol 160mg/dL. Vital signs are as follows: Oral temperature - T 97.7; Heart rate 72bpm; Blood pressure 150/90; Respiratory rate 20 bpm; and SpO2 95% on room air.


1. Is this an emergency?


2. What tests are likely to be done at the hospital?


3. What are the tests likely to reveal what is going on? And what area of the body is most likely affected?


4. What interventions will need to be done?


5. What lifestyle changes should this teacher be advised to avoid future episodes?

Answer :

Yes, this may be considered an emergency given the professor's neurological symptoms and the need for urgent medical attention.

Neurological examination, blood tests, electrocardiogram (ECG), brain imaging (MRI/CT scan), etc., are likely to be done at the hospital.

The tests are likely to reveal abnormal glucose control, elevated LDL cholesterol levels, and potential neurological abnormalities affecting the brain.

Interventions may include adjusting medication, initiating lifestyle changes, and potentially prescribing antiplatelet or anticoagulant medication based on the diagnosis.

The teacher should be advised to quit smoking, limit alcohol intake, follow a diabetic diet, engage in regular exercise, and adhere to prescribed medications to prevent future episodes or complications.

1. The professor's symptoms, such as drifting off course, mispronouncing words, and longer-lasting episodes, along with the cancellation of the next class and the professor's visit to the hospital, suggest a potential medical emergency. These symptoms may indicate a neurological issue that requires immediate medical attention.

2. Given the professor's symptoms and medical history, several tests are likely to be conducted at the hospital. These may include a neurological examination to assess cognitive function and coordination, blood tests to evaluate glucose control and cholesterol levels, an electrocardiogram (ECG) to assess heart function, and brain imaging such as an MRI or CT scan to investigate any structural abnormalities in the brain.

3. The tests are likely to reveal high blood glucose levels (indicated by a glucose level of 155 mg/dL and HbA1c of 9.5%), elevated LDL cholesterol levels (160 mg/dL), and potential neurological abnormalities affecting the brain. The specific area of the brain affected will depend on the underlying cause of the symptoms, which further diagnostic tests can help determine.

4. The interventions will depend on the underlying diagnosis. Treatment may involve adjusting the dosage or type of medication, initiating lifestyle changes such as diet modifications and regular exercise, and potentially prescribing antiplatelet or anticoagulant medication if necessary.

5. To avoid future episodes or complications, the professor should be advised to make certain lifestyle changes. These may include quitting smoking to improve overall health, limiting alcohol intake, following a diabetic diet to better manage glucose levels, engaging in regular exercise to promote cardiovascular health, and adhering to prescribed medications to maintain optimal control of diabetes and cholesterol levels. These lifestyle changes can help minimize the risk of future episodes and promote overall well-being.


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