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A seven year old female presents to your office with a 1 mos history of staring episodes.
Mom states she has noticed the episodes a few times a week at home but thought she just wasn't paying attention. Mom is concerned because her teacher has also noticed the staring episodes at school. The episodes last only 5-10 seconds, but the patient doesn't respond to her name being called. Her only past medical history include one febrile seizure at 13 mos of age and asthma diagnosed three years ago.
Her exam and vital signs are unremarkable.
Questions
1. What other pertinent history would you want to know about this patient? What additional questions would you ask?
2. What are some key areas you would examine on this patient and why?
3. What laboratory or diagnostic tests would you order/consider for this patient and why? Provide rationale.
4. List three potential diagnoses for this provide and provide rationale for each one. Why did you choose them? Why did you rule them in or out? List the diagnoses in order from 1-3 with the first diagnosis being your primary diagnosis.
5. Discuss the treatment plan for your primary diagnosis. What medications would you prescribe? Any OTC remedies? Any referrals? Discuss education and follow-up for this patient.
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