WALC Week 8 Winner: Danielle Theis!

Every Wednesday, the Student Success Center holds a
Weekly Anatomical Language Challenge (WALC).

This week's winner is: 

Danielle Theis!

Congratulations on winning WALC for the fourth week in a row!

This challenge series will be held weekly throughout the semester to give students a chance to showcase their anatomical knowledge for a chance to win prizes!

Mystery Case Monday: Drive-thru Salads & Diarrhea

Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.

This week's hypothetical patient has been experiencing watery diarrhea with frequent (often explosive) bowel movements, bloating, fatigue, and nausea over the last week and a half. The patient's physician did a physical examination and order an analysis of our patient's stool. The physician informed the patient that there has been a local outbreak of people exhibiting similar symptoms and that they would be testing the patient's stool for a specific pathogen. Like many other patients with similar symptoms, this patient reported eating a salad from a local fast-food chain a few weeks ago. The lab found relatively large oocysts that demonstrated a blue autofluorescence under ultraviolet epiflouorescence microscopy. These results confirmed the presence of the suspected pathogen. The physician prescribed trimethoprim-sulfamethoxazole and told the patient to rest and get plenty of fluids.

Thought Questions:

What is the most likely diagnosis for this patient?

How would a stool examination confirm this diagnosis?

What are the anatomical structures involved in this clinical issue?

What are the physiological impacts of being infected with this pathogen?

Why did the physician recommended for our patient to rest and get plenty of fluids?

Leave your comments below and check back on Friday to see how our hypothetical patient was diagnosed!

Closed Case Friday: Up, Up, & Away

Earlier this week, we gave you a hypothetical patient with the following case:

This week, our hypothetical patient is a 30-year-old female who traveled from her home in the Black Hills to hike around Denali National Park and Preserve in Alaska. While there, she decided to hike the centerpiece of the park, Denali (formerly known as Mount McKinley). This is the highest mountain peak in North America with a summit at 20,310 ft above sea level. As she made her ascent, she started to experience increasingly severe headaches. She had trouble sleeping along the way and started feeling nauseous, which led to her eating less and less as she traveled. When she reached 14,000 ft, she stopped at the medical camp on the mountain to see a doctor about her symptoms. Upon physical examination, her lungs were clear to auscultation, her neurological exam was normal, and her oxygen saturation was at 84% while breathing ambient air (which is normal). The doctor recommended for her to consider descending, but she refused. She agreed to stay at the camp overnight and was given acetaminophen for her headaches and anti-emetics for her nausea. The doctor also gave her diamox to take twice a day to help her acclimatize. After a few days, she was forced to stop at the 17,000 ft medical camp because she was having trouble walking and her headache was worse despite the medication. She also reports having vomited a few times before stopping at the camp. The doctor at the 17,000 ft medical camp gave her dexamethasone and ordered her to descend and to be admitted to the hospital.

Today, we reveal that our hypothetical patient was diagnosed as having: 

Acute Mountain Sickness that progressed to High Altitude Cerebral Edema

Acute Mountain Sickness (AMS) is a common form of altitude sickness that often manifests as dizziness, headaches, muscle aches, and nausea. The can come from ascending too quickly, which doesn't allow your body to acclimatize appropriately to the new environment at higher elevations. Fast ascent can cause hypoxia and related conditions as gas exchange rates between your lungs and your blood becomes less efficient. Younger people and people who live at lower elevations are more likely to experience altitude sickness when climbing mountains. Symptoms typically don't arise until a day or two after you have been exposed to new elevations. In some cases, AMS can be treated with medications to help your body adjust to these changes and to subdue headaches/nausea. Allowing more time for acclimatization can also be helpful. In more severe forms of AMS, patients should get to a lower elevation before the altitude sickness progresses to a more serious form, such as High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE). AMS is diagnosed using a variety of scoring systems.

High Altitude Cerebral Edema (HACE) is a severe form of altitude sickness that occurs due to fluid in the brain. This is a life-threatening condition that requires immediate medical attention. It is typically treated with the steroid dexamethason and patients who develop HACE must descend to an elevation below 4,000 ft above sea level. Supplemental oxygen is often provided during descent. If not treated immediately, HACE can be fatal within 24 hours, so patients with HACE are usually assisted in making a rapid descent. Some patients enter into comas without treatment. Most patients who are treated and taken to a lower elevation quickly recover in a few days, but some may need weeks to recover. MRI and CT scans are used to monitor patient progress.

AMS and more severe forms of altitude sickness, like HACE and HAPE, can be prevented by using medications to help with acclimatization and ascending slowly to allow for the body's systems to adjust to the changes in elevation. Some cultures, such as the indigenous peoples who live in the Andes, have chewed coca leaves (the plant used in cocaine production) to alleviate the symptoms of altitude sickness.

Thanks for joining us for this week's Mystery Case and we hope to see you next week!

WALC Week 7 Winner: Danielle Theis!

Every Wednesday, the Student Success Center holds a
Weekly Anatomical Language Challenge (WALC).

This week's winner is: 

Danielle Theis!

Congratulations on winning WALC for the third week in a row!

This challenge series will be held weekly throughout the semester to give students a chance to showcase their anatomical knowledge for a chance to win prizes!

Mystery Case Monday: Up, Up, & Away

Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.

This week, our hypothetical patient is a 30-year-old female who traveled from her home in the Black Hills to hike around Denali National Park and Preserve in Alaska. While there, she decided to hike the centerpiece of the park, Denali (formerly known as Mount McKinley). This is the highest mountain peak in North America with a summit at 20,310 ft above sea level. As she made her ascent, she started to experience increasingly severe headaches. She had trouble sleeping along the way and started feeling nauseous, which led to her eating less and less as she traveled. When she reached 14,000 ft, she stopped at the medical camp on the mountain to see a doctor about her symptoms. Upon physical examination, her lungs were clear to auscultation, her neurological exam was normal, and her oxygen saturation was at 84% while breathing ambient air (which is normal). The doctor recommended for her to consider descending, but she refused. She agreed to stay at the camp overnight and was given acetaminophen for her headaches and anti-emetics for her nausea. The doctor also gave her Diamox to take twice a day to help her acclimatize. After a few days, she was forced to stop at the 17,000 ft medical camp because she was having trouble walking and her headache was worse despite the medication. She also reports having vomited a few times before stopping at the camp. The doctor at the 17,000 ft medical camp gave her dexamethasone and ordered her to descend and to be admitted to the hospital.


Thought Questions:

What is the most likely diagnosis for this patient?

Which diagnostic tests would confirm this diagnosis?

What are the anatomical structures involved in this clinical issue?

What are the potential underlying causes for this condition?

What is a good recommended course of treatment for our hypothetical patient?

Leave your comments below and check back with us on Friday to see how our hypothetical patient was diagnosed!

Case Closed Friday: To Sleep, Perchance to Dream

Earlier this week, we gave you a hypothetical patient with the following case:

This week, our hypothetical patient is a 7-year-old girl whose parents brought her into the clinic because she has gained an unusual amount of weight and has been excessively tired during the day, which has caused her to frequently fall asleep at school. When she first wakes up from these episodes, she is unable to speak or move her arms or legs for several minutes. This, in addition to her reports of waking up in the middle of the night and frequently experiencing nightmares, has caused the patient to fear falling asleep.

Today, we reveal that our hypothetical patient was diagnosed as having: 

Narcolepsy

This chronic neurodegenerative disease is relatively rare and can be challenging to diagnose, particularly in cases with patients that do not present with the classic symptoms of excessive daytime sleep and cataplexy. Misdiagnosis among children with narcolepsy can disrupt normal growth patterns and have life-threatening consequences. Narcolepsy is caused by autoimmune dysfunction that destroys neurons that produce hypocretin, a chemical in the brain that prevents REM sleep from occurring indiscriminately and sustains alertness. This disease is often diagnosed through physical examination, reviewing medical history, and conducting sleep studies. Children with narcolepsy usually have shortened average sleep latency on EEGs and sleep onset REM periods. These issues can be detected using video-EEGs, nocturnal polysomnography (PSG), and Multiple Sleep Latency Tests (MSLTs). Narcolepsy is typically treated with a combination of medications and behavioral modifications. Counseling is recommended, particularly for patients with trauma-triggered clinical manifestations of the disease. Changes to diet and sleep patterns as well as noticing, anticipating, and reducing triggers can help improve patient quality of life.

Thanks for joining us for this week's Mystery Case and we hope to see you next week!

WALC Week 6 Winner: Danielle Theis!

Every Wednesday, the Student Success Center holds a
Weekly Anatomical Language Challenge (WALC).

This week's winner is: 

Danielle Theis!

Congratulations on winning WALC for the second week in a row!

This challenge series will be held weekly throughout the semester to give students a chance to showcase their anatomical knowledge for a chance to win prizes!

Mystery Case Monday: To Sleep, Perchance to Dream

Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.

This week, our hypothetical patient is a 7-year-old girl whose parents brought her into the clinic because she has gained an unusual amount of weight and has been excessively tired during the day, which has caused her to frequently fall asleep at school. When she first wakes up from these episodes, she is unable to speak or move her arms or legs for several minutes. This, in addition to her reports of waking up in the middle of the night and frequently experiencing nightmares, has caused the patient to fear falling asleep.



Thought Questions:

What is the most likely diagnosis for this patient?

Which diagnostic tests would confirm this diagnosis?

What are the anatomical structures involved in this clinical issue?

What are the potential underlying causes for this condition?

What is a good recommended course of treatment for our hypothetical patient?

Be sure to leave your comments below and check back at the end of the week to see what our hypothetical patient had and what caused it!

Case Closed Friday: Weather Changes Moods

Earlier this week, we gave you a hypothetical patient with the following case:

This week, our hypothetical patient is a 33-year-old woman who is a professor at SDSM&T. Three years ago, she moved to Rapid City, SD, from her hometown, Sarasota, FL. A few months into her first semester, she began feeling unusually depressed and lethargic. She had not experienced these symptoms in the past and had difficulty in processing these feelings. She began sleeping more than usual and felt more irritable than was normal for her. After her first year of teaching, she stopped having these feelings and assumed that her issues were related to adjusting to her new home. However, her symptoms reappeared during the fall semester of her second year and again subsided by the end of the spring semester. She is now in her third year and is again experiencing feelings of lethargy, depression, and excessive sleeping. She is having increasing difficulty in concentrating and has gained 25 pounds since moving to South Dakota.

Today, we reveal that our hypothetical patient was diagnosed as having: 

Seasonal Affective Disorder (SAD)

While it's pretty normal to experience the "winter blues" or days of feeling "down", people with SAD experience these feelings for extended periods of time and lose their motivation to do things that they normally enjoy. These prolonged feelings of depression and lethargy often lead to disruptions in sleep patterns and eating behaviors. Many patients find concentrating to be increasingly difficult and may begin to feel more easily agitated. Some patients turn to alcohol or other substances for comfort or relaxation. Some cases also involve thoughts of suicide. Most cases occurs during late fall or early winter and subside during the spring and summer; however, some people have summer-onset SAD. SAD is often accompanied by changes in appetite and subsequent changes to a person's weight. Winter-onset SAD is more commonly associated with increases in cravings resulting in weight gain, while summer-onset SAD is more frequently associated with a loss of appetite and subsequent weight loss. Like many psychological disorders, the causes for SAD are not fully understood. Disruptions in normal levels of serotonin (mood-related neurotransmitter) and melatonin (sleep-related hormone) likely play a role in the manifestation of SAD. Changes in exposure to sunlight can also lead to depression by disrupting the body's circadian rhythms. People with family histories or personal medical histories of depression are at risk for the development of SAD. SAD also appears to occur more frequently in populations living further away from the equator. SAD is diagnosed through a combination of physical examinations, lab tests, and psychological evaluations. It is often treated with light therapy first and can begin working within a few days of treatment. If a patient's case is more severe, antidepressants and/or psychotherapy may be prescribed. Other forms of therapy that are effective for some cases include relaxation techniques, such as yoga, tai chi, or meditation, music therapy, and art therapy. Regular exercise and exposure to natural sunlight are helpful both in treating and in preventing SAD in at-risk individuals.

Thanks for joining us for this week's Mystery Case and we hope to see you next week!

Student Spotlight: Matthew Howard

Here at SDSM&T we have a growing and thriving community of pre-health students. Today, we are shining a spotlight on Matthew Howard. Matt is a Mechanical Engineering major. Pre-Medicine has been his pathway here at SD Mines and he has been applying for various medical schools. (In fact, he just recently had his first interview!) We caught up with Matt to ask him about his pre-health journey and how he is preparing for a career in healthcare.

Have you done any shadowing yet? What did you learn from those experiences? 

I have shadowed several doctors over a wide range of specialties including a dermatologist, an orthopedic surgeon, a family practice physician, and a gastroenterologist. While there were considerable differences in the types of problems that each specialty faced, it was the similarities that most impressed me. One surgeon in particular that I shadowed made sure to emphasize that, no matter what specialty you are in, you have to be a doctor first and a specialist second. Those words have stayed with me as I have shadowed other doctors, and I have tried to pay special attention to the common themes that constitute being a doctor, such as genuinely caring for the overall well-being of the patient and treating them with respect and dignity.  

Have you done any research? 

I have not done any dedicated research, but I have worked on various design projects during my time here. I am currently on a multidiscipline senior design team that is working on developing a wearable, flexible array of strain sensors (based on polymer strain sensors developed by Dr. Zhu’s lab) that can be used to track a person’s hand movements. Research is definitely something that I am interested in doing in the future, and one of the primary criteria I looked for when choosing which schools to apply to was the available opportunities for research.

What kinds of volunteering do you do?

Most of the volunteering that I do is through my involvement with my church. I have taught AWANA classes (a children’s Bible study club), ushered, helped with Vacation Bible School (a summer church camp/class), served food, helped with setup/teardown of concerts, and more. I am also usually involved in one or more political campaigns every election cycle.

How did you prepare for taking the MCAT?

During the spring semester leading up to it (I took it in June) I watched some Khan Academy videos whenever I had some spare time. Once classes were done for the semester I spent about four weeks reading through some Kaplan prep books that I borrowed from a friend. For the final two weeks I did a full-length practice exam every other day and then reviewed them the next day.

What do you do when you aren’t studying?

I enjoy hiking, dirtbiking, mountain biking, and skiing. Anything to get outside and enjoy the Hills. I also enjoy reading, usually novels. 

How do you manage stress?

For me, the key to staying stress-free is staying organized and having a definite plan for how I am going to accomplish everything that I need to accomplish. 

What advice do you have for our freshman pre-health students?

Spend enough time in your chosen field to make sure that is where you want to spend your career, and don’t be afraid to switch up your path if you find something you enjoy doing more.

WALC Week 5 Winner: Danielle Theis!

Every Wednesday, the Student Success Center holds a
Weekly Anatomical Language Challenge (WALC).

This week's winner is: 

Danielle Theis!

This challenge series will be held weekly throughout the semester to give students a chance to showcase their anatomical knowledge for a chance to win prizes!

Pet Therapy Kicks Off Midterms Stress Relief Events at the SSC

To help our students de-stress, the Student Success Center
will be hosting stress-relief activities every day this week. 

Several studies have shown that interacting with animals can help relieve mental stress. Today, SD Mines students tested those results personally by playing with four, sweet kittens and an excited puppy in the Student Success Center. These animals were kindly brought in by the Humane Society of the Black Hills and they provided some much-appreciated pet therapy for SDSM&T students.

Buster (who will be up for adoption next week) brought lot of energy to share with his new friends!

These four ladies took over the corner with our famous orange couch.

Queen Kitty of the Orange Couch rules over her kingdom.

Warm kitty, soft kitty, little ball of fur...

Happy kitty, sleepy kitty, purr, purr, purr....

Puppy poses for a picture while getting the belly rubs.

All worn out from a hard day's work!

Be sure to drop by the Student Success Center all week for other stress-relief activities! 

Mystery Case Monday: Weather Changes Moods

Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.

This week, our hypothetical patient is a 33-year-old woman who is a professor at SDSM&T. Three years ago, she moved to Rapid City, SD, from her hometown, Sarasota, FL. A few months into her first semester, she began feeling unusually depressed and lethargic. She had not experienced these symptoms in the past and had difficulty in processing these feelings. She began sleeping more than usual and felt more irritable than was normal for her. After her first year of teaching, she stopped having these feelings and assumed that her issues were related to adjusting to her new home. However, her symptoms reappeared during the fall semester of her second year and again subsided by the end of the spring semester. She is now in her third year and is again experiencing feelings of lethargy, depression, and excessive sleeping. She is having increasing difficulty in concentrating and has gained 25 pounds since moving to South Dakota.

Thought Questions:

What is the most likely diagnosis for this patient?

Which additional diagnostic tests would confirm this diagnosis?

What are the anatomical structures involved in this clinical issue?

What are the potential underlying causes for this condition?

What is a good recommended course of treatment for our hypothetical patient?

Be sure to leave your comments below and check back at the end of the week to see what our hypothetical patient had and what caused it!

Case Closed Friday: Eye Have a Problem

Earlier this week, we gave you a hypothetical patient with the following case:

This week, our hypothetical patient is a 65-year-old woman experiencing decreased bilateral vision over the past month. She was told by her doctors that this was secondary to early age-related macular degeneration. She reports difficulty reading, loss of depth perception, and dimness of her vision in addition to having dull headaches that began about 6 months ago. She did not have any ocular pain or new flashes, floaters, or diplopia. The patient denied the use of tobacco or alcohol and did not have any family history of ocular issues. She is currently being treated with Seroquel for her bipolar disorder. Upon examination the patient demonstrated an inability to see anything in the outer half of both her left and right visual fields. Slit lamp biomicroscopy demonstrated that the macular and retinal nerve fiber layer OCT were normal in both eyes. A Humphrey visual field (HVF) 30-2 was performed.

Today, we reveal that our hypothetical patient was diagnosed as having: 

Bitemporal Hemianopsia

This could have been confirmed by the results of the HVF test. This condition is characterized by the loss of vision in the temporal visual field and is often due to compression of the nasal fibers on the optic chiasm. (Remember that the fibers of the optic chiasm cross one another, thus pressure on the nasal fibers of the chiasm affects the temporal visual field or peripheral vision.) There are many things that can cause this compression, but it most often results from intracranial tumors. It can also be caused by demyelinating diseases, inflammatory diseases, or ocular aneurysms. MRIs can help to reveal these underlying causes. Courses of treatment begin with identifying the underlying cause of the bitemporal hemianopsia. Depending upon the cause, a patient may undergo hemianopsia rehabilitation, such as training the eyes to search into the area of field that is missing, patching one eye, adding a stereo-typoscope device, or surgical interventions to deal with tumors.

This case study was loosely based on an actual case. Check it out here:
https://www.healio.com/ophthalmology/retina-vitreous/news/print/ocular-surgery-news/%7Bf470a7f9-ea6a-4d7b-aa89-445bc8341b7c%7D/woman-presents-with-progressive-decreasing-vision-in-both-eyes-and-new-onset-headaches 

Thanks for joining us for this week's Mystery Case and we hope to see you next week!

WALC Week 4 Winners: Emily, Kate, & Kaylee!

Every Wednesday, the Student Success Center holds a
Weekly Anatomical Language Challenge (WALC).

This week's winners are: 

Kate Dickinson
Emily Hein
Kaylee Wilson

This week, we had a 3-way tie! Keep up the good work, ladies!

This challenge series will be held weekly throughout the semester to give students a chance to showcase their anatomical knowledge for a chance to win prizes!

Featured Faculty: Dr. Kayla Pritchard

Here at the South Dakota School of Mines & Technology we have many excellent faculty who serve as academic advisors for our pre-health students. Today, we are featuring Dr. Kayla Pritchard from the Department of Social Sciences. Dr. Pritchard holds an A.A. from McCook Community College, as well as a B.A., an M.A., and a Ph.D. from the University of Nebraska-Lincoln. She earned her Ph.D. in Sociology with a specialization in Women's and Gender Studies. We spoke with Dr. Pritchard to learn more about her work here at SDSM&T.

What kinds of courses do you teach here at SDSM&T?

I teach all of the sociology courses here at SD Mines. My planned upper-level courses for the next two semesters are SOC 492 Health and Society (spring 2019) and SOC 411 Licit and Illicit Drugs (fall 2019). These may be of interest to pre-health students!

What is your research focus? How have you involved SDSM&T students in your research?

Right now, my research focus has been on experiences in motherhood and mental health outcomes for women in different motherhood experiences. I currently have a paper under review that analyzed differences in psychological distress and life satisfaction among women. I have also recently conducted 31 interviews with double mothers (women who have both biological and stepchildren) and am in the process of data analysis. I worked with a student to transcribe the interviews (and was able to pay her out of a grant I received). 

For which pre-health pathways do you advise SDSM&T students?

I advise students going into a variety of health fields, from medical school, physical/occupational therapy school, chiropractic school, dental school, and even public health programs.

Who is your favorite scientist and why are they your favorite?

My favorite scientist is Charlotte Perkins Gilman. While she may not be a scientist in the traditional sense (and I firmly believe that definition should expand), she was innovative and persuasive. Her book Women and Economics (1898) argued for incorporating women into analyses of economic productivity. She wrote about reorganizing housework and childcare and counting them as economic factors. She wrote and published her own periodical for years in the 1910s. She wrote short stories and novels – students might be familiar with The Yellow Wallpaper, a story about a woman driven mad by the dismissals of her health complaints by her doctor. My favorite work of hers, though, is Herland, a novel of a civilization comprised entirely of women discovered by three men. Gilman was a social science phenom, crossing the boundaries between sex/gender, economics, family policy, and healthcare. 

What techniques do you use to manage your time and stress levels?

No one ever feels like they ever fully master managing their time and stress levels, but it is essential to figure out what works for you. For me, I’ve found that lists of tasks (in order of priority) are really useful. I have to write things down or I forget them, so sticky notes are my friend. I am most productive in the mornings so I try to carve out time then. I also try to use physical space to represent tasks that I need to accomplish (piles of papers to grade, papers to read for research, sticky notes of reminders). However, you also have to step away from work, physically and mentally. I like to hike and be outdoors with my family. I like to escape into a show on Netflix (right now its American Horror Story or Crazy Ex-Girlfriend). Good friends to whom you can vent and laugh are a great resource. The trick it to find out what works for you and schedule it like you would any other important thing.

What advice do you have for students struggling to stay motivated in difficult courses?

For a student in a difficult course, I would remind them first of why they’re in the course in the first place. It is a means to achieve their larger goals. The course is temporary and it may be worth fighting through if it helps the student get where they want to be. Second, I would recommend a study group so students can help push each other forward. Lastly, I would remind the student of the tutoring and supplemental instruction available if grades were a concern of theirs and it was affecting motivation. There are a lot of resources and support available on campus. College is hard. We need to recognize that. But it can also be very enjoyable. Look at a difficult class as a challenge and make plans to conquer it. The view from the top is probably worth it.

Mystery Case Monday: Eye Have a Problem

Today is the first of many Mystery Case Mondays here at The Atrium! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.

This week, our hypothetical patient is a 65-year-old woman experiencing decreased bilateral vision over the past month. She was told by her doctors that this was secondary to early age-related macular degeneration. She reports difficulty reading, loss of depth perception, and dimness of her vision in addition to having dull headaches that began about 6 months ago. She did not have any ocular pain or new flashes, floaters, or diplopia. The patient denied the use of tobacco or alcohol and did not have any family history of ocular issues. She is currently being treated with Seroquel for her bipolar disorder. Upon examination the patient demonstrated an inability to see anything in the outer half of both her left and right visual fields. Slit lamp biomicroscopy demonstrated that the macular and retinal nerve fiber layer OCT were normal in both eyes. A Humphrey visual field (HVF) 30-2 was performed.

Thought Questions:

What is the most likely diagnosis for this patient?

Which additional diagnostic tests would confirm this diagnosis?

What are the anatomical structures involved in this clinical issue?

What are the potential underlying causes for this condition?

What is a good recommended course of treatment for our hypothetical patient?

Be sure to leave your comments below and check back at the end of the week to see what our hypothetical patient had and what caused it!