dr.wad
Forum Senior
Topics: 3
Posts: 335
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You are a physician practicing in a small community in the Rocky Mountains near Aspen, Colorado. A 33-year-old female comes to your office for evaluation of a bilateral tingling sensation in the fingertips. She describes the sensation as affecting all the fingers on both hands. She has no medical problems and takes no medications. She is a vegetarian and is visiting the area from San Diego, California. She denies any other symptoms, including headache, nausea, vomiting, shortness of breath, and urinary frequency. On physical examination the patient has a normal sensory examination, including reaction to light touch and pinprick and vibratory sensation. She is able to stand normally with the arms extended and the eyes closed. A cerebellar examination reveals normal finger-to-nose testing and no dysdiadochokinesis. Her gait is normal, including tandem gait, toe walking, and heel walking. What would you recommend as the next step?
A. Blood tests for serum vitamin B12
B. Fasting blood glucose level
C. Reassurance
D. Serologic testing for syphilis
E. Treatment with acetazolamide for altitude sickness
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| gingko
Forum Senior
Topics: 13
Posts: 226
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C..
probably the respiratory alkalosis is causing some hypocalcemic symptoms..no need for acetazolamide yet without any other evidence of acute mountain sickness..will gradually adapt..if there were a choice, i would advise to ascend slowly to a higher altitude if she plans to go to a higher altitude
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| cool doctor
Forum Junior
Topics: 1
Posts: 226
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yop C
darkhorse posted this Q like a month ago
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