Question

Patient scenario

Mr. Singh is a 38-year old who practices power lifting 4 times per week. Usually Mr. Singh can “grip it and rip it” when performing 113 kg deadlifts but recently he has been having difficulty gripping the bar and experiencing fatigue and tingling in his hands. Mr. Singh’s trainer, Josephine, recommends he take a week off of working out before pushing his body any further. Dan returns to the gym a week later and attempts to bench press at a lighter weight to get warmed up. Josephine has to quickly spot him in a missed attempt. Mr. Singh becomes despondent and admits something might be wrong because he is still experiencing tingling, pain and weakness in his hands and now his feet as well.

Discussion Question:  Research Mr. Singh's symptoms and determine a differential diagnosis by listing at least two different possible conditions that match some or all of Mr. Singh's symptoms. Justify why you selected each of the conditions on your list.

Write a detailed answer to the discussion question. Your post must be at least 3-4 sentences per differential diagnosis

Answer 1

The symptoms of Mr. Singh is defined as peripheral neuropathy. Various medical condictions account for peripheral neuropathy include  diabetes, chemo-induced neuropathy inflammatory infections, hereditary disorders, auto-immune diseases, protein disorders, toxic neuropathy, malnutrition, kidney failure and chronic alcoholism.

Diabetic peripheral neuropathy is the most common cause of peripheral neuropathy. Due to nerve damage especially to the feet and arms due to excess blood sugar level and triglycerise level could potentially damage nerves. It causes tingling, burning, pain, numbness and fatigue.

Inflammatory neuropathies is another differential diagnosis for Mr.singh's condition caused by infections or an autoimmune process. It occurs when immune system attcks the nerves usually in case of certain  viral and bacterial infections such as  HIV, Lyme disease, shingles, Epstein-Barr , Hepatitis B and C, West Nile and cytomegalovirus. It accompanied with sensory symptoms like burning, tingling or numbness and muscle weakness usually in the arms or legs or more widespread.

Chronik renal failure and hypothyroidism are also can be differentially diagnosed for Mr.Singh's symptoms.