1/16/2024 0 Comments Nick fink barefootFor the last 10 years, he has lived in a rural, wooded area in a home he built. The patient's medical history is remarkable for a flu-like illness approximately 4 months ago characterized by 3 to 4 days of fever, cough, diarrhea, and myalgias, which resolved spontaneously.įurther questioning reveals the patient has been a carpenter since completing high school 17 years ago. Except as noted, the review of systems is otherwise negative. No ataxia, dysphagia, visual symptoms, or bowel or bladder incontinence have been noted, and he has not complained of headaches, back or neck pain, or confusion. In the past 2 to 3 weeks, the tingling has taken on a progressively painful, burning quality and he has noted weakness in gripping tools. His symptoms began approximately 3 months ago, with the insidious onset of numbness and tingling in his toes and fingertips, progressing slowly in the ensuing weeks to involve the feet and hands in a symmetric “stocking-glove” fashion. Taken together, these indexes should help the reader recognize the many opportunities for enhancing knowledge, skills, and abilities in environmental medicine, and integrating an enhancement of environmental medicine in medical education.Ī 35-year-old carpenter with peripheral neuropathy and skin lesionsĪ 35-year-old, fair-skinned male is referred to your clinic for evaluation. Index 3 presents the case studies in terms of sentinel pathophysiological conditions, and Index 4 presents the case studies according to common clinical signs, symptoms, and presenting complaints. Creative teachers and students, however, may find these case studies helpful in other educational settings and courses/clerkships as well. Index 2 presents the case studies in terms of the most common medical school courses and clerkships where they might be used. Index 1 lists the case studies according to agent or condition (in alphabetical order). They were selected for their clinical interest with respect to environmental factors and health, relevance to particular courses and clerkships in medical school, and illustrative potential for teaching medical school students about the impact of the environment on health.įour indexes are included in this appendix to help guide the reader in the use of the case studies. This appendix contains 55 case studies from peer reviewed literature, including journal articles and educational material developed by the Agency for Toxic Substances and Disease Registry (ATSDR).
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