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For junior #Doctors
Think of common causes before the rare ones
1. 19-yr old was brought with history of muscle pains, cramps and spasm for three months. He was evaluated by neurologist (located in a smaller town). NCV/EMG, serum CPK & thyroid profile were done and were normal.
Think of common causes before the rare ones
1. 19-yr old was brought with history of muscle pains, cramps and spasm for three months. He was evaluated by neurologist (located in a smaller town). NCV/EMG, serum CPK & thyroid profile were done and were normal.
2. The local neurologist suspected a diagnosis of neuromyotonia (<200 cases have been reported worldwide), and referred for testing of anti voltage-gated potassium channel (VGKC) complex antibody.
However, I wanted to look for a fairly common cause first.
However, I wanted to look for a fairly common cause first.
3. Ordered for vitamin D testing, which was reported as 9 ng/mL (normal level >30 ng/mL).
Started him on vitamin D supplements, advised him to adequately expose skin to sunlight; and engage in regular physical exercises.
Started him on vitamin D supplements, advised him to adequately expose skin to sunlight; and engage in regular physical exercises.
4. Take home message for my junior colleagues:
Always think of common causes first, before chasing a rare diagnosis- true for exams as well as medical practice.
#MedTwitter #MedEd
Always think of common causes first, before chasing a rare diagnosis- true for exams as well as medical practice.
#MedTwitter #MedEd
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