A fifty-five year old retired Navy Master Chief is brought into the ER by his yo

Question

A fifty-five year old retired Navy Master Chief is brought into the ER by his young girlfriend. She states that her boyfriend has had an increase in lapses of memory and he is “ walking funny” despite no recent trauma. While you are talking to the girlfriend, the patient interjects and states that he has been experiencing a lot of numbness in his fingers and lower extremities. Physical examination is significant for ataxia and Argyll Robertson pupil.

- Which laboratory test is used as a screening test for this condition? Which laboratory test is specific and will confirm the presence or absence of this condition?

- What procedure would you request be performed on this patient? The procedure is performed. For this condition, what would you expect to be the “typical” results?

Explanation / Answer

a) by the above information it is known that it is a neurosyphilis, it is bacterial infection of the brain or spinal cord, The laboratory test for ataxia the screening tests are medical test , blood test, and urine test, and imaging studies like CTscan or MRI to check if there is any shrinkage of the cerebellum or tumor or clot that affects the cerebellum, and lumbar puncture and genetic testing for confirmation for presences or absences of this condition. the screening test for argyll robertson pupil are rapid plasma reagin (rpr) and venereal disease research laboratory(vdrl) the confirmatory test is pupil better respond to accommodation as compare to stimulus of light b)pencilin is used to treat 1)aqueous pencillin or2)one day intramuscular injection.the regimen lasts 10 to 14 days , the antibiotics probenecid and ceftriaxone are often used along with penicillin, during recovery blood tests are performed at 3 and 6 months and then every year for three years following the treatment and cerebrospinal fluid should be monitored every six months.the treatment will treat the infection but the damage which is already done cannot be repaired, in mild cases antibiotics leads to perfect health but in other severe cases it probobaly improve but does not give perfect health.

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