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Suggest Treatment For Bruising On Arms And Legs

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Posted on Thu, 19 Mar 2015
Question: My friend is a 28 year old male came who has bruising on his arms and legs. His eyes had bags under them. He stated when he’s at work he has “decreased ability to concentrate, pay attention and solve problems.” His wife is constantly around with him and mentioned that she did not want him to work at all and be a stay at home househusband.” He came to me because he was having seizures and heard a physician and a chiropractic may help him.
My questions are:
!) What are 5 most relevant questions I could ask him initially?
2) Based on above, what is the diagnostic hypothesis?
3) Of the hypothesis, what is the 5 most likely (with rationale)
4) What are 5 most relevant exam procedures? (i.e. possible positives and what it indicates)

If further information is needed, please provide follow-up questions so to come up with a working differential diagnoses (and rationale).

What would be a care plan?


doctor
Answered by Dr. Pankaj Borade (7 hours later)
Brief Answer:
seizures that requires urgent attention and investigation, ?medical ?psychiatric condition

Detailed Answer:
Dear,
welcome to HCM
From the complaints you have given here of your friend, it appears that has bruising on arms and legs the cause for this is unknown. Secondly, he is complaining of not able to concentrate, poor attention, and in ability to solve problems. his eyes had bags under them.
well, his picture is suggestive of conditions like, trauma, medical condition, renal problem, drug use disorder, psychiatric condition.
A Proper and detailed history about any medical condition like renal disorder, hypertension, trauma, drug use behaviour, quarrels, confirmation of the seizure episodes with its duration and progression, any medications taking for it,etc. will be needed.
Certain investigations can be indicated like CT BRAIN, blood complete profile, a renal function test, liver function test, x rays of arm and legs, etc

If currently he is having seizures it is an emergency and needs to e taken to hospital. The cause for his seizure needs to be investigated for.
I suggest you to take him to local physician or hospital as soon as possible.

welcome for further suggestions
Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Pankaj Borade (46 minutes later)
NOTE: Is traumatic brain injury, most likely from domestic violence ruled out, perhaps with secondary non-epileptic seizures?
a)     List ALL pertinent examination findings that one might, could, would, should find upon examination of someone with this disorder.
b) List what types of FURTHER work-up might, could, would, should be done in cases or suspected cases of this disorder.
c) What is the management for this disorder?
d) Make sure you include medical, chiropractic, other alternatives, etc.
e) Make sure you include short and long term goals
f) Based upon the information you have thus far, what are the anatomical sites involved in this patient? (Be as specific as possible)
g) Explain the pathophysiology of this condition
h) What would be a care plan?


doctor
Answered by Dr. Pankaj Borade (4 hours later)
Brief Answer:
Few suggestions

Detailed Answer:
I need to know
1) how did he get the bruising?
2) any history of trauma, injury to brain, accident,?
3) history of any substance or drug intake?

My suggestion to you
1) baseline Complete haemogram profile, renal function test, liver function test.
2) brain EEG to rule out seizure episode.
3) X Ray arm and leg to rule out any fracture
4) a psychiatrist consultation for mentioned complaints or poor attention at work.

Welcome for further suggestions
Regards
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Pankaj Borade

Psychiatrist

Practicing since :2011

Answered : 571 Questions

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Suggest Treatment For Bruising On Arms And Legs

Brief Answer: seizures that requires urgent attention and investigation, ?medical ?psychiatric condition Detailed Answer: Dear, welcome to HCM From the complaints you have given here of your friend, it appears that has bruising on arms and legs the cause for this is unknown. Secondly, he is complaining of not able to concentrate, poor attention, and in ability to solve problems. his eyes had bags under them. well, his picture is suggestive of conditions like, trauma, medical condition, renal problem, drug use disorder, psychiatric condition. A Proper and detailed history about any medical condition like renal disorder, hypertension, trauma, drug use behaviour, quarrels, confirmation of the seizure episodes with its duration and progression, any medications taking for it,etc. will be needed. Certain investigations can be indicated like CT BRAIN, blood complete profile, a renal function test, liver function test, x rays of arm and legs, etc If currently he is having seizures it is an emergency and needs to e taken to hospital. The cause for his seizure needs to be investigated for. I suggest you to take him to local physician or hospital as soon as possible. welcome for further suggestions Regards