b'SCIENTIFIC ASSEMBLY PACEP 2022 CPC HIGHLIGHTWhat is the Diagnosis? CPC CASE The CaseBilateral Hand Numbness & Tingling STUDY THE CASE 68 year-old male presented to the ED with bilateral hand numbnessand tingling which started earlier that morning after taking a bath.He described his hands as weak, clumsy and he was unable to grasp objects.He was having trouble with ADLs, like zipping his pants.A special thank you toPertinent negatives: difficulty speaking, facial droop, vision changes, legRachel Ibrahim, MD for submitting this case, Penn State Health Emergency Medicine weakness, bowel/bladder incontinence, CP, SOB, headache, neck pain,which won the 2022trauma, carpal tunnel syndrome, myalgia, fever. CPC competition! About Us:Pertinent positive: patient had first COVID vaccine 2 weeks ago (Moderna)Penn State Health is a multi-hospital health system serving patients and communities across central Pennsylvania. We are the Vital signs: Temp 36.7, BP 147/79, HR 68, RR 20, SpO2 100% on RAonly medical facility in Pennsylvania to be accredited as a Level I pediatric trauma center and Level I adult trauma center. The system includes Penn State Health Milton S. Hershey Medical Center, Penn State Health Childrens Hospital, and Penn State Physical exam pertinent findings: Cancer Institute based in Hershey, Pa.; Penn State Health Hampden Medical Center in Enola, Pa.; Penno Right hand: weakness in ulnar, radial and median nerve distributionsState Health Holy Spirit Medical Center in Camp Hill, Pa.; Penn State Health St. Joseph Medical Center in JOIN OURReading, Pa.; Penn State Health Lancaster Pediatric Center in Lancaster, Pa.; Penn State Health LancasterTEAM o Left hand: motor function in radial nerve distribution better than Medical Center (opening fall 2022); and more than 3,000 physicians and direct care providers at moreEMERGENCY right, weakness in ulnar and median nerve distributionthan 126 outpatient practices in 94 locations. Additionally, the system jointly operates various healthMEDICINEOPPORTUNITIES oSensory: subjective sensory changes in both hands, decreased care providers, including Penn State Health Rehabilitation Hospital, Hershey Outpatient Surgery Center,AVAILABLE sensation to light touchHershey Endoscopy Center, Horizon Home Healthcare and the Pennsylvania Psychiatric Institute.o Reflexes: Mild hyporeflexia in right upper extremityWe foster a collaborative environment rich with diversity,Benefit highlights include:MRI Brain and cervical spine: unremarkable, unrelated chronic findingsshare a passion for patient care, and have a space for those Competitive salary with sign-on bonuswho share our spark of innovative research interests. Our Comprehensive benefits and retirement packagePatient was admitted to hospitalhealth system is expanding and we have opportunities in both Relocation assistance & CME allowance The patients symptoms persisted overnight and the next morning academic hospital as well community hospital settings.Attractive neighborhoods in scenic Central Pennsylvania the patient reported tingling sensation in the left lower extremity and progressed up his left leg to the point where he was barely able to lift itoff bed.What test will make the diagnosis?What is the final diagnosis?see conclusion on page 23FOR MORE INFORMATION PLEASE CONTACT:Heather Peffley, PHR CPRP - Penn State Health Lead Physician Recruiter hpeffley@pennstatehealth.psu.eduPACEP News | Spring 2023 19Penn State Health is fundamentally committed to the diversity of our faculty and staff.We believe diversity is unapologetically expressing itself through every persons perspectives and lived experiences.We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.'