St Thomas University Differential Diagnosis of Ocular Symptoms Medical Case Study

Question Description

A 79-year-old male remarks on his first visit that he has noticed a gradual decrease in vision in both his eyes since last year. His old medical record has not yet arrived at your office. He states that since he moved from Florida a year ago, he has not had an eye examination and does not yet know an ophthalmologist. He is having difficulty carrying on his activities of daily living that involve his sight. He states that he cannot recognize people at some distance until they come quite close and he is often frightened by his perception of strangers speaking to him. Watching television and reading are becoming increasingly difficult for him. He states that glare is a problem and notes that a few times he almost tripped over something on the floor. He still drives his car in the local community. He asks if you think he may have a cataract. He says his wife had two cataracts in the past and he remembers her complaining of vision problems which have now resolved.

Vital Signs: BP 128/84; HR 82; RR 18; BMI 24.

Chief Complaint: Decrease in my vision; glare is very bothersome!

Discuss the following:

1) What additional subjective data are you seeking to include past medical history, social, and relevant family history?
2) What additional objective data will you be assessing for?
3) What are the differential diagnoses that you are considering?
4) What laboratory tests will help you rule out some of the differential diagnoses?
5) What radiological examinations or additional diagnostic studies would you order?
6) What treatment and specific information about the prescription that you will give this patient?
7) What are the potential complications from the treatment ordered?
8) What additional laboratory tests might you consider ordering?
9) What additional patient teaching may be needed?
10) Will you be looking for a consult?

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.

Grading Rubric

Your assignment will be graded according to the grading rubric.

Discussion Rubric
Criteria	Ratings	Points
Identification of Main Issues, Problems, and Concepts	5 points Distinguished Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.	4 points Excellent Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.	2 points Fair Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.	1 points Poor Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.	5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines	3 points Distinguished Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.	2 points Excellent Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.	1 point Fair Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.	0 point Poor Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.	3 points
Response to Posts of Peers	2 points Distinguished Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.	1 points Fair Student constructively responded to one other post and either extended, expanded or provided a rebuttal.	0 point Poor Student provided no response to a peer’s post.	2 points

Discussion Rubric

Criteria

Ratings

Points

Identification of Main Issues, Problems, and Concepts

5 points
Distinguished

Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.

4 points
Excellent

Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.

2 points
Fair

Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.

1 points
Poor

Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.

5 points

Use of Citations, Writing Mechanics and APA Formatting Guidelines

3 points
Distinguished

Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

2 points
Excellent

Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.

1 point
Fair

Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.

0 point
Poor

Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.

3 points

Response to Posts of Peers

2 points
Distinguished

Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.

1 points
Fair

Student constructively responded to one other post and either extended, expanded or provided a rebuttal.

0 point
Poor

Student provided no response to a peer’s post.

2 points

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