This document provides information about a 52-year-old male patient diagnosed with Stage IV malignant melanoma. It includes his personal and family medical history, physical examination findings, diagnostic workup revealing metastases to lymph nodes and bones, and proposed homeopathic treatment plan. The patient has a non-healing ulcer on his right thumb and swelling in his right axilla, with a family history of melanoma. Diagnostic testing confirmed metastatic melanoma and the patient was given Merc sol, Silicea, and Hydrocotyle to address his symptoms based on the totality of the case.
Kimura disease is a rare chronic inflammatory disorder of unknown etiology. It usually presents as subcutaneous mass in the head and neck region and is frequently associated with regional lymphadenopathy or salivary gland involvement.It is rare in India, only 200 cases have been reported worldwide since its histopathological diagnosis.
This document provides guidance for conducting a clinical assessment of the thyroid gland. It outlines the steps to take a comprehensive history, including initial etiquettes, personal details, chief complaint, pain assessment, past history, drug history, family history, and social history. Systems to review related to endocrine diseases are also listed. The physical exam section describes examination of general observations, eyes, hands, chest/abdomen, and lower limbs. Key endocrine symptoms and signs are highlighted.
Sadia, a 10-year old girl, presented with pain and swelling in her left leg for 3 months and difficulty walking for 1 month. She also had a new painless swelling near her left eye. Initial workup found a mass in her left leg and another in her left eye area. Biopsies of the masses found features suggestive of Ewing sarcoma and metastatic neuroblastoma. Further imaging and testing confirmed the diagnosis of metastatic neuroblastoma with a primary tumor in her left leg and metastases in her left eye area.
This case study describes 49-year-old Mr. Dhatchanamoorthy who presented with fever, cough, vomiting and breathlessness. He was diagnosed with pulmonary tuberculosis and a history of diabetes. He lives in a nuclear family in a rural village in a house with adequate ventilation and sanitation. Medical examination found him moderately nourished with signs of left lung consolidation. Sputum examination confirmed active tuberculosis bacteria. He was started on antitubercular treatment and advised on nutrition, hygiene and follow-up to support his recovery.
SOAP NOTE
Name: C.M.
Date: 04/08/2016
Time: 10:55
Pt. Encounter #
Age: 52
Sex: Female
SUBJECTIVE
CC:
“My hands are swollen and painful”
HPI:
This is a 51-year-old female who comes to the office with complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. Also, she report weight loss, anorexia, aching, and stiffness. Morning stiffness lasts for as long as 1 to 2 hours.
Medications:
1. Diovan 80mg po daily
2. Singular 10mg po at bed time
3. Tylenol 500mg 1 tab po every 6 hours x pain
4. Albuterol 2 puff every 6 hours as needed
PMH
Allergies: NKA
Medication Intolerances: None
Chronic Illnesses/Major traumas: Hypertension, Asthma.
Hospitalizations/Surgeries: Hysterectomy 5 years ago.
Family History
Mother diagnosed with: Asthma, Hypothyroidism, Rheumatoid Arthritis
Father diagnosed with: HTN, Dementia
Sister diagnosed with: HTN
Social History
Patient has a high school education. She works as a mail carrier for the post office for 15 years. She has been widowed for the last two years. Currently, she lives alone in a rented apartment. She has two living children, who all live close by and have families of their own. She reports her family is supportive and denies any needs at this time. She has adequate shelter and food. She denies any leisure activities. She refuses to practice exercises. She just goes to the local church on Sunday. She eats a diet low sodium. She denies substance use, ETOH, tobacco, marijuana or illicit drugs.
ROS
General
Weight loss and fatigue
Decreased energy level
Cardiovascular
Denies chest pain, palpitations, PND, orthopnea, edema
Skin
Denies delayed healing, rashes, bruising, bleeding or skin discolorations, any changes in lesions or moles
Respiratory
Denies cough, wheezing, dyspnea at this time
Eyes
Corrective lenses
Gastrointestinal
Denies abdominal pain, N/V/D, constipation, hepatitis, hemorrhoids, eating disorders, ulcers, black tarry stools
Ears
Denies ear pain, hearing loss, ringing in ears, discharge
Genitourinary/Gynecological
Denies urgency, frequency burning, change in color of urine, vaginal discharge or STDS. Hysterectomy 5 years ago. Last mammography 1 years ago.
G2, P2, A0
Nose/Mouth/Throat
Denies sinus problems, dysphagia, nose bleeds or discharge, dental disease, hoarseness, and throat pain
Musculoskeletal
Localized symptoms in hand joints: pain, tender, swollen, and decrease range of motion.
Breast
SBE every month, denies lumps, bumps or changes
Neurological
Denies syncope, seizures, transient paralysis, weakness, paresthesias, black out spells
Heme/Lymph/Endo
Denies HIV status, bruising, blood transfusion hx, night sweats, swollen glands, increase thirst, increase hunger, cold or heat intolerance
Psychiatric
Denies depression, anxiety, sleeping difficulties, suicidal ideation/attempts, previous dx
OBJECTIVE
.
It is a planned professional conversation that enables the patient to communicate their symptoms , feeling and fear to the clinician, so that the nature of the patient’s real and suspected illness and mental attitudes may be determined.
This case presentation describes a 35-year-old female who presented with generalized swelling over her body for 20 days and abdominal pain for 1 day. Her history and examination findings were consistent with hypothyroidism, nephrotic syndrome, and systemic lupus erythematosus. Laboratory tests confirmed Hashimoto's thyroiditis, lupus nephritis with nephrotic range proteinuria, and positive ANA, anti-dsDNA, and anti-thyroglobulin antibodies. She was started on prednisone and thyroxine therapy and admitted for further management including a renal biopsy.
A 17-year-old male presented with a 3-month history of low-grade fever, left neck swelling, weight loss, and night sweats. Examination found a 5x4 cm left neck swelling and a 2 cm posterior neck swelling. Investigations including CBC, LFTs, ESR, and CT scans were normal. Excision biopsy of the cervical node was performed. The differential diagnoses included tuberculosis, metastasis, reactive lymphadenitis, lymphoma, and various infectious etiologies. The pathology was consistent with Hodgkin lymphoma, a cancer of the lymphatic system. The case presentation discussed the characteristics, subtypes, diagnostic workup, treatment including radiotherapy, and prognosis of Hodgkin lymphoma.
Kimura disease is a rare chronic inflammatory disorder of unknown etiology. It usually presents as subcutaneous mass in the head and neck region and is frequently associated with regional lymphadenopathy or salivary gland involvement.It is rare in India, only 200 cases have been reported worldwide since its histopathological diagnosis.
This document provides guidance for conducting a clinical assessment of the thyroid gland. It outlines the steps to take a comprehensive history, including initial etiquettes, personal details, chief complaint, pain assessment, past history, drug history, family history, and social history. Systems to review related to endocrine diseases are also listed. The physical exam section describes examination of general observations, eyes, hands, chest/abdomen, and lower limbs. Key endocrine symptoms and signs are highlighted.
Sadia, a 10-year old girl, presented with pain and swelling in her left leg for 3 months and difficulty walking for 1 month. She also had a new painless swelling near her left eye. Initial workup found a mass in her left leg and another in her left eye area. Biopsies of the masses found features suggestive of Ewing sarcoma and metastatic neuroblastoma. Further imaging and testing confirmed the diagnosis of metastatic neuroblastoma with a primary tumor in her left leg and metastases in her left eye area.
This case study describes 49-year-old Mr. Dhatchanamoorthy who presented with fever, cough, vomiting and breathlessness. He was diagnosed with pulmonary tuberculosis and a history of diabetes. He lives in a nuclear family in a rural village in a house with adequate ventilation and sanitation. Medical examination found him moderately nourished with signs of left lung consolidation. Sputum examination confirmed active tuberculosis bacteria. He was started on antitubercular treatment and advised on nutrition, hygiene and follow-up to support his recovery.
SOAP NOTE
Name: C.M.
Date: 04/08/2016
Time: 10:55
Pt. Encounter #
Age: 52
Sex: Female
SUBJECTIVE
CC:
“My hands are swollen and painful”
HPI:
This is a 51-year-old female who comes to the office with complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. Also, she report weight loss, anorexia, aching, and stiffness. Morning stiffness lasts for as long as 1 to 2 hours.
Medications:
1. Diovan 80mg po daily
2. Singular 10mg po at bed time
3. Tylenol 500mg 1 tab po every 6 hours x pain
4. Albuterol 2 puff every 6 hours as needed
PMH
Allergies: NKA
Medication Intolerances: None
Chronic Illnesses/Major traumas: Hypertension, Asthma.
Hospitalizations/Surgeries: Hysterectomy 5 years ago.
Family History
Mother diagnosed with: Asthma, Hypothyroidism, Rheumatoid Arthritis
Father diagnosed with: HTN, Dementia
Sister diagnosed with: HTN
Social History
Patient has a high school education. She works as a mail carrier for the post office for 15 years. She has been widowed for the last two years. Currently, she lives alone in a rented apartment. She has two living children, who all live close by and have families of their own. She reports her family is supportive and denies any needs at this time. She has adequate shelter and food. She denies any leisure activities. She refuses to practice exercises. She just goes to the local church on Sunday. She eats a diet low sodium. She denies substance use, ETOH, tobacco, marijuana or illicit drugs.
ROS
General
Weight loss and fatigue
Decreased energy level
Cardiovascular
Denies chest pain, palpitations, PND, orthopnea, edema
Skin
Denies delayed healing, rashes, bruising, bleeding or skin discolorations, any changes in lesions or moles
Respiratory
Denies cough, wheezing, dyspnea at this time
Eyes
Corrective lenses
Gastrointestinal
Denies abdominal pain, N/V/D, constipation, hepatitis, hemorrhoids, eating disorders, ulcers, black tarry stools
Ears
Denies ear pain, hearing loss, ringing in ears, discharge
Genitourinary/Gynecological
Denies urgency, frequency burning, change in color of urine, vaginal discharge or STDS. Hysterectomy 5 years ago. Last mammography 1 years ago.
G2, P2, A0
Nose/Mouth/Throat
Denies sinus problems, dysphagia, nose bleeds or discharge, dental disease, hoarseness, and throat pain
Musculoskeletal
Localized symptoms in hand joints: pain, tender, swollen, and decrease range of motion.
Breast
SBE every month, denies lumps, bumps or changes
Neurological
Denies syncope, seizures, transient paralysis, weakness, paresthesias, black out spells
Heme/Lymph/Endo
Denies HIV status, bruising, blood transfusion hx, night sweats, swollen glands, increase thirst, increase hunger, cold or heat intolerance
Psychiatric
Denies depression, anxiety, sleeping difficulties, suicidal ideation/attempts, previous dx
OBJECTIVE
.
It is a planned professional conversation that enables the patient to communicate their symptoms , feeling and fear to the clinician, so that the nature of the patient’s real and suspected illness and mental attitudes may be determined.
This case presentation describes a 35-year-old female who presented with generalized swelling over her body for 20 days and abdominal pain for 1 day. Her history and examination findings were consistent with hypothyroidism, nephrotic syndrome, and systemic lupus erythematosus. Laboratory tests confirmed Hashimoto's thyroiditis, lupus nephritis with nephrotic range proteinuria, and positive ANA, anti-dsDNA, and anti-thyroglobulin antibodies. She was started on prednisone and thyroxine therapy and admitted for further management including a renal biopsy.
A 17-year-old male presented with a 3-month history of low-grade fever, left neck swelling, weight loss, and night sweats. Examination found a 5x4 cm left neck swelling and a 2 cm posterior neck swelling. Investigations including CBC, LFTs, ESR, and CT scans were normal. Excision biopsy of the cervical node was performed. The differential diagnoses included tuberculosis, metastasis, reactive lymphadenitis, lymphoma, and various infectious etiologies. The pathology was consistent with Hodgkin lymphoma, a cancer of the lymphatic system. The case presentation discussed the characteristics, subtypes, diagnostic workup, treatment including radiotherapy, and prognosis of Hodgkin lymphoma.
GR AFHS Diff Venous Stasis Derm from Cellulitis.-w-o CH.pptxAFHSResources
This document summarizes a discussion on differentiating venous stasis dermatitis from cellulitis in older adults. It presents a case study of a 78-year-old woman with itchy patches on her lower legs. The discussion emphasizes key differences between venous stasis dermatitis and cellulitis, including symptoms, course of illness, and risk factors. It recommends assessing and addressing the patient's condition through the 4Ms framework - focusing on what matters to the patient, optimizing medications, screening for mental status issues, and promoting mobility. The goal is to properly diagnose venous stasis dermatitis, educate the patient, and develop a personalized care plan centered on her priorities, health, and lifestyle.
A 75-year-old male presented with constipation and abdominal bloating. Diagnostic workup revealed colonic adenocarcinoma. He underwent sigmoidectomy and Hartmann's procedure. Pathology confirmed well-differentiated colonic adenocarcinoma. Risk factors for the patient included age, smoking history, and family history of colon cancer. Treatment guidelines include surgical resection and chemotherapy depending on stage.
This case presentation discusses Acute Lymphocytic Leukemia (ALL) in a 15-year-old male patient. It provides details on the patient's history, physical exam findings, ALL disease profile, diagnostic tests, treatment including chemotherapy, and nursing management. The nursing process is applied, with nursing diagnoses of fatigue, increased temperature, nutrition imbalance, and anxiety. Discharge planning includes education on nutrition, medication, hygiene, rest, and complication prevention.
Gynecological Oncology Navigation by Penny Daugherty, RN, MS, OCN, ONN-CGPennyDaughertyRNMSOC
This session defines the various diagnoses classified as gynecological malignancies and address the discreet nuances of each disease, as well as recognition and management of specific side effects associated with individual syndromes. Conventional and targeted therapies are reviewed as well as discussions assisting patients in the selection of integrative approaches to care.
This document provides a summary of a client's medical information, including diagnoses, signs and symptoms, and medications. The client has several chronic conditions including frontal lobe dementia, osteoarthritis, hypothyroidism, hyperlipidemia, and hemorrhoids. The learner applied clinical skills and decision making in delivering person-centered care that respected the client's culture, encouraged independence, and strengthened self-care abilities.
This document provides information on taking a case history for dental patients. It discusses the importance of the case history, outlines the key components that should be covered, and explains the purpose and importance of each component. These include gathering information on the chief complaint, medical history, dental history, social history, and performing an extraoral and intraoral examination. Taking a thorough case history is important for diagnosis, treatment planning, and managing the patient properly.
This document provides information on taking a case history for dental patients. It defines a case history and lists its objectives, which include establishing a relationship with the patient, providing information for diagnosis and treatment decisions. The components of a case history are outlined, including general information, chief complaint, medical and dental history, and examinations. Details are given on collecting information for each component, such as symptoms, medications, habits, and family history. Taking a thorough case history is important for understanding the patient's condition and developing an appropriate treatment plan.
This document presents a case report of a 35-year-old man who presented with fever, night sweats, cough, pallor, fatigue, sore throat, anorexia, lymphadenopathy, hepatosplenomegaly, and bone tenderness over 4 months. Initial biopsy suggested Hodgkin's lymphoma but review suggested non-Hodgkin's lymphoma. Further workup found pancytopenia, lymphoblasts on peripheral smear, and nodular lymphoma infiltration on bone marrow biopsy, consistent with a diagnosis of both NHL and autoimmune hemolytic anemia. The diagnostic challenges and treatment considerations for NHL and its association with autoimmune diseases like AIHA are discussed.
This case report describes a 51-year-old female patient who complained of a localized gingival growth for over 2 years. After examination and biopsy, the patient was diagnosed with pyogenic granuloma. The lesion was treated with intralesional injections of the sclerosing agent sodium tetradecyl sulfate at multiple sites over several sessions, resulting in complete regression of the lesion without complications. Sclerosing agents like sodium tetradecyl sulfate are an effective first-line treatment for small vascular lesions like pyogenic granuloma due to their simplicity, low cost, and ability to resolve lesions without surgery or hospitalization in many cases.
This document provides a case study of a 64-year-old male patient who presented with stiffening of the extremities. The patient has a history of hypertension, diabetes, and thyroid cancer. Physical assessment revealed weakness on the right side of the body. Diagnostic tests showed signs of inflammation and slightly abnormal thyroid and kidney function. A CT scan found lesions in the brain consistent with ischemic stroke. The case study aims to educate nursing students on assessing and caring for patients with ischemic stroke through knowledge of pathophysiology, appropriate interventions, and developing rapport with patients.
This document contains medical information about a 55-year-old male patient presenting with a 1-year history of an ulcer on his penis, as well as swelling and pain in his groin region and scrotum over the past 8-6 months. Physical examination revealed the penile and groin ulcers, as well as swollen lymph nodes and scrotal enlargement. Biopsy of the penile ulcer showed well-differentiated squamous cell carcinoma. Imaging and tests identified secondary infection with Pseudomonas bacteria and scrotal elephantiasis. The patient was diagnosed with advanced penile cancer complicated by infection and elephantiasis, requiring total penectomy and lymph node dissection for treatment.
- This document appears to be a medical report for a 42-year-old Filipino female patient presenting with carious teeth.
- The clinical examination revealed a pigmented lesion on the buccal mucosa that was diagnosed as oral lichen planus based on its characteristics and histology.
- Oral lichen planus is an autoimmune condition more common in middle-aged females. The patient's case was asymptomatic reticular type. Follow up was planned every 6 months to 1 year.
The document provides information on the process of endodontic diagnosis. It discusses the importance of diagnosis and outlines the key stages: collecting patient information, questioning the patient, performing clinical tests, correlating findings, and formulating a diagnosis. A thorough clinical examination involves inspecting and palpating extraorally and intraorally, as well as examining tooth mobility, percussion, and periodontal probing to evaluate any signs of infection or pathology. The neurophysiology of dental pulp and pain transmission pathways are also summarized. The goal of diagnosis is to determine the nature of any dental disease by comprehensively gathering subjective and objective clinical findings.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document provides information about oral cancer including its definition, risk factors, warning signs and symptoms, areas of highest risk, precancerous conditions, diagnosis process, clinical features, treatment options, prevention methods, potential complications, and important points. Oral cancer is defined as a malignant tumor that develops in the oral cavity. It discusses that tobacco use, alcohol consumption, sunlight exposure, age, gender, nutrition, infections, and chronic irritation are major risk factors. Diagnosis involves examining the medical history, clinically examining the oral cavity and neck, and potentially conducting radiological or biopsy if abnormalities are detected. Treatment depends on the cancer's location and severity but may involve surgery, radiation therapy, chemotherapy, or combinations. Prevention focuses on lifestyle
A 4-year-old Egyptian boy presented with sudden onset left cheek swelling for 1 day. Examination revealed a diffuse 5x6cm swelling on the left cheek that was painful and itchy. Laboratory tests were normal. The diagnosis was an insect sting based on the history and examination findings. The swelling was treated with cold compression, antihistamines, and analgesics.
History taking as foundation of clinical diagnosisDrVinutaPatil
This document discusses the importance of history taking in clinical diagnosis. It states that obtaining an accurate history is the critical first step in determining the etiology of a patient's problem, and that 70% of diagnoses can be made based on history alone. It outlines the key components of a patient history, including chief complaint, history of present illness, past medical history, family history, social history, and a systematic review of other body systems. Taking a thorough history is important for reaching a provisional diagnosis, developing a differential diagnosis, and planning an effective treatment approach.
This case presentation discusses a 30-year old female patient with diabetic foot ulcer on the right foot. She has a history of type 2 diabetes for 9 years and a burn on her right great toe that developed into an ulcer and was later amputated. Her laboratory investigations show hyperglycemia, proteinuria, and pseudomonas infection in the foot ulcer culture. Her treatment includes antibiotics, insulin, oral hypoglycemics, wound dressing, and patient education on foot care and diabetes management to prevent recurrence.
The document provides details about taking a thorough case history for periodontal patients. It emphasizes that case history recording is the first and most important step, as it allows for correct diagnosis and treatment planning. The case history should include chief complaint, history of present illness, past medical/dental history, family history, personal habits, general examination, and intraoral and extraoral examinations. Taking a comprehensive case history provides important insights into the patient's condition and relevant social, medical, and dental factors.
This document provides guidance on taking a surgical history. It emphasizes the importance of history for diagnosis, communication and documentation. The key components of a surgical history include personal history, chief complaint, present history, past history, and family history. Personal history involves gathering information on name, age, sex, occupation, habits, etc. The chief complaint is the patient's main problem in their own words. The present history analyzes the chief complaint and reviews other body systems. Past history looks at prior relevant events. Family history identifies familial or hereditary conditions. Proper history taking establishes trust and aids in individualizing patient care.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
GR AFHS Diff Venous Stasis Derm from Cellulitis.-w-o CH.pptxAFHSResources
This document summarizes a discussion on differentiating venous stasis dermatitis from cellulitis in older adults. It presents a case study of a 78-year-old woman with itchy patches on her lower legs. The discussion emphasizes key differences between venous stasis dermatitis and cellulitis, including symptoms, course of illness, and risk factors. It recommends assessing and addressing the patient's condition through the 4Ms framework - focusing on what matters to the patient, optimizing medications, screening for mental status issues, and promoting mobility. The goal is to properly diagnose venous stasis dermatitis, educate the patient, and develop a personalized care plan centered on her priorities, health, and lifestyle.
A 75-year-old male presented with constipation and abdominal bloating. Diagnostic workup revealed colonic adenocarcinoma. He underwent sigmoidectomy and Hartmann's procedure. Pathology confirmed well-differentiated colonic adenocarcinoma. Risk factors for the patient included age, smoking history, and family history of colon cancer. Treatment guidelines include surgical resection and chemotherapy depending on stage.
This case presentation discusses Acute Lymphocytic Leukemia (ALL) in a 15-year-old male patient. It provides details on the patient's history, physical exam findings, ALL disease profile, diagnostic tests, treatment including chemotherapy, and nursing management. The nursing process is applied, with nursing diagnoses of fatigue, increased temperature, nutrition imbalance, and anxiety. Discharge planning includes education on nutrition, medication, hygiene, rest, and complication prevention.
Gynecological Oncology Navigation by Penny Daugherty, RN, MS, OCN, ONN-CGPennyDaughertyRNMSOC
This session defines the various diagnoses classified as gynecological malignancies and address the discreet nuances of each disease, as well as recognition and management of specific side effects associated with individual syndromes. Conventional and targeted therapies are reviewed as well as discussions assisting patients in the selection of integrative approaches to care.
This document provides a summary of a client's medical information, including diagnoses, signs and symptoms, and medications. The client has several chronic conditions including frontal lobe dementia, osteoarthritis, hypothyroidism, hyperlipidemia, and hemorrhoids. The learner applied clinical skills and decision making in delivering person-centered care that respected the client's culture, encouraged independence, and strengthened self-care abilities.
This document provides information on taking a case history for dental patients. It discusses the importance of the case history, outlines the key components that should be covered, and explains the purpose and importance of each component. These include gathering information on the chief complaint, medical history, dental history, social history, and performing an extraoral and intraoral examination. Taking a thorough case history is important for diagnosis, treatment planning, and managing the patient properly.
This document provides information on taking a case history for dental patients. It defines a case history and lists its objectives, which include establishing a relationship with the patient, providing information for diagnosis and treatment decisions. The components of a case history are outlined, including general information, chief complaint, medical and dental history, and examinations. Details are given on collecting information for each component, such as symptoms, medications, habits, and family history. Taking a thorough case history is important for understanding the patient's condition and developing an appropriate treatment plan.
This document presents a case report of a 35-year-old man who presented with fever, night sweats, cough, pallor, fatigue, sore throat, anorexia, lymphadenopathy, hepatosplenomegaly, and bone tenderness over 4 months. Initial biopsy suggested Hodgkin's lymphoma but review suggested non-Hodgkin's lymphoma. Further workup found pancytopenia, lymphoblasts on peripheral smear, and nodular lymphoma infiltration on bone marrow biopsy, consistent with a diagnosis of both NHL and autoimmune hemolytic anemia. The diagnostic challenges and treatment considerations for NHL and its association with autoimmune diseases like AIHA are discussed.
This case report describes a 51-year-old female patient who complained of a localized gingival growth for over 2 years. After examination and biopsy, the patient was diagnosed with pyogenic granuloma. The lesion was treated with intralesional injections of the sclerosing agent sodium tetradecyl sulfate at multiple sites over several sessions, resulting in complete regression of the lesion without complications. Sclerosing agents like sodium tetradecyl sulfate are an effective first-line treatment for small vascular lesions like pyogenic granuloma due to their simplicity, low cost, and ability to resolve lesions without surgery or hospitalization in many cases.
This document provides a case study of a 64-year-old male patient who presented with stiffening of the extremities. The patient has a history of hypertension, diabetes, and thyroid cancer. Physical assessment revealed weakness on the right side of the body. Diagnostic tests showed signs of inflammation and slightly abnormal thyroid and kidney function. A CT scan found lesions in the brain consistent with ischemic stroke. The case study aims to educate nursing students on assessing and caring for patients with ischemic stroke through knowledge of pathophysiology, appropriate interventions, and developing rapport with patients.
This document contains medical information about a 55-year-old male patient presenting with a 1-year history of an ulcer on his penis, as well as swelling and pain in his groin region and scrotum over the past 8-6 months. Physical examination revealed the penile and groin ulcers, as well as swollen lymph nodes and scrotal enlargement. Biopsy of the penile ulcer showed well-differentiated squamous cell carcinoma. Imaging and tests identified secondary infection with Pseudomonas bacteria and scrotal elephantiasis. The patient was diagnosed with advanced penile cancer complicated by infection and elephantiasis, requiring total penectomy and lymph node dissection for treatment.
- This document appears to be a medical report for a 42-year-old Filipino female patient presenting with carious teeth.
- The clinical examination revealed a pigmented lesion on the buccal mucosa that was diagnosed as oral lichen planus based on its characteristics and histology.
- Oral lichen planus is an autoimmune condition more common in middle-aged females. The patient's case was asymptomatic reticular type. Follow up was planned every 6 months to 1 year.
The document provides information on the process of endodontic diagnosis. It discusses the importance of diagnosis and outlines the key stages: collecting patient information, questioning the patient, performing clinical tests, correlating findings, and formulating a diagnosis. A thorough clinical examination involves inspecting and palpating extraorally and intraorally, as well as examining tooth mobility, percussion, and periodontal probing to evaluate any signs of infection or pathology. The neurophysiology of dental pulp and pain transmission pathways are also summarized. The goal of diagnosis is to determine the nature of any dental disease by comprehensively gathering subjective and objective clinical findings.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document provides information about oral cancer including its definition, risk factors, warning signs and symptoms, areas of highest risk, precancerous conditions, diagnosis process, clinical features, treatment options, prevention methods, potential complications, and important points. Oral cancer is defined as a malignant tumor that develops in the oral cavity. It discusses that tobacco use, alcohol consumption, sunlight exposure, age, gender, nutrition, infections, and chronic irritation are major risk factors. Diagnosis involves examining the medical history, clinically examining the oral cavity and neck, and potentially conducting radiological or biopsy if abnormalities are detected. Treatment depends on the cancer's location and severity but may involve surgery, radiation therapy, chemotherapy, or combinations. Prevention focuses on lifestyle
A 4-year-old Egyptian boy presented with sudden onset left cheek swelling for 1 day. Examination revealed a diffuse 5x6cm swelling on the left cheek that was painful and itchy. Laboratory tests were normal. The diagnosis was an insect sting based on the history and examination findings. The swelling was treated with cold compression, antihistamines, and analgesics.
History taking as foundation of clinical diagnosisDrVinutaPatil
This document discusses the importance of history taking in clinical diagnosis. It states that obtaining an accurate history is the critical first step in determining the etiology of a patient's problem, and that 70% of diagnoses can be made based on history alone. It outlines the key components of a patient history, including chief complaint, history of present illness, past medical history, family history, social history, and a systematic review of other body systems. Taking a thorough history is important for reaching a provisional diagnosis, developing a differential diagnosis, and planning an effective treatment approach.
This case presentation discusses a 30-year old female patient with diabetic foot ulcer on the right foot. She has a history of type 2 diabetes for 9 years and a burn on her right great toe that developed into an ulcer and was later amputated. Her laboratory investigations show hyperglycemia, proteinuria, and pseudomonas infection in the foot ulcer culture. Her treatment includes antibiotics, insulin, oral hypoglycemics, wound dressing, and patient education on foot care and diabetes management to prevent recurrence.
The document provides details about taking a thorough case history for periodontal patients. It emphasizes that case history recording is the first and most important step, as it allows for correct diagnosis and treatment planning. The case history should include chief complaint, history of present illness, past medical/dental history, family history, personal habits, general examination, and intraoral and extraoral examinations. Taking a comprehensive case history provides important insights into the patient's condition and relevant social, medical, and dental factors.
This document provides guidance on taking a surgical history. It emphasizes the importance of history for diagnosis, communication and documentation. The key components of a surgical history include personal history, chief complaint, present history, past history, and family history. Personal history involves gathering information on name, age, sex, occupation, habits, etc. The chief complaint is the patient's main problem in their own words. The present history analyzes the chief complaint and reviews other body systems. Past history looks at prior relevant events. Family history identifies familial or hereditary conditions. Proper history taking establishes trust and aids in individualizing patient care.
Similar to Case of Right Ungal Malignant Melanoma (20)
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
1. PRESENTATION BY: Mohammed Huzaifa Saud
4th BHMS
UNDER THE GUIDANCE OF: Dr Jyothirmai Maam
HOD & Professor Preventive and Social Medicine
Govt Homoeopathic Medical College & Hospital,
Bangalore
2. Individual Profile:
• Name: Gyan Bahadur Rana
• Age: 52yrs
• Sex: Male
• Religion: Buddhist
• Caste: Not known
• H/O Migration: Nil
• Education: SSLC
• Occupation: Street Food Vendor
• Income: 10000/ month
• Language Known: Bangla, Hindi
• Blood Group: O +ve
• Marital Status: Married
• Address: Toto Para, Jalpaiguri, West Bengal- 735220
3. Important Health Events:
• Long Hospital Stay: 4 months in Alcohol Rehabilitation Centre
(10yr)
• Operations: Matricectomy on Right Thumb .(Complete Extirpation
of the nail matrix, resulting in permanent nail loss.) 10/12/2021
• Injuries/Burn/Accidents: Minor Accident (Scar Mark on left
forearm)
• Regular Medication: 1. Tab. Telma 40mg
2. Tab. Teniva Forte
3. Tab. Rosuva 20mg
• Suicide Attempt: Nil
• Poisoning: Nil
• Others: Nil
4. Family Structure:
No of Males: 2
No of Females: 2
Total: 4
Family Type: Nuclear Family
Sl.
no
Name Age Sex
Marital
Status
Education
Occupatio
n
Incom
e
Medicosocial
status
1
Mr. Gyan Bahadur
Rana
52ys M SSLC
Street
Food
Vendor
10000/
month
DM, HTN,
Cancer
2 Mrs. Ajitmaya Rana
37yr
s
F Married SSLC
House
wife
-
DM, HTN
3 Mr. Abhimanyu Rana
15yr
s
M Unmarried 9th std Student - -
4 Ms. Nagma Rana
20yr
s
F Unmarried Bsc 2nd yr Student - -
FAMILY PROFILE
5. Per capita monthly income = Total Family income
No. of members
2500= 10000/4
According to modified BG Prasad Classification
1733-2886/- is mentioned as Middle Class.
Social Class
Modified BG
Prasad 2015
Upper Class >5775
Upper Middle
Class
2887-5774
Middle Class 1733-2886
Lower Middle
Class
866-1732
Lower Class <866
Socioeconomic Class
6. Clinical Details of the Patient
Presenting Complaints:
1. C/O Pain and Swelling in Right Axillary region since 5 months.
2. C/O Non Healing Ulcer on Right Thumb since 9 months.
H/O Presenting Complaints:
Gradual Onset & Gradual Progression
Location Sensation Modality Concomitant
Right Axillary
Region
Swelling and Painfull
< Pressure
< Morning
No Amel
-
Right Thumb Ulcer Bleeds to touch - -
7. Past History:
1. Acute Liver Disease
Time of illness- 10 yrs ago
Hospitalization – Was in Rehab Center for 4 months
Treatment- Allopathic Treatment
2. Matricectomy on Right Finger.
Time of illness- 2 weeks 10/12/2021
Hospitalization – Was admitted for 2 days
Treatment- Allopathic Treatment
Similar Case in Family:
Elder Brother Died due to Malignant Melanoma 8yrs ago.
Epidemological History:
8. Lifestyle:
• Diet: Mixed
• Appetite: Good, prefer warm food
• Hunger: Normal
• Thirst: 2 lts/day , moderate
• Desire: Sweet 2+
• Perspiration: NS
• Urine: 2-3/0-1 D/N, passes without difficulty
• Bowel: 2 times a day , Satisfactory
• Sleep: Sound & Refreshing Sleep
• Habits: Chronic Alcoholic , 1 Quater / day
Habit of Chewing Betel nut
• Thermals: Chilly
9. General Physical Examination
• Built: Obese
• Height: 5ft
• Weight: 93kg
• Nourishment: Well nourished
• Anemia: NAD
• Cyanosis: NAD
• Jaundice: NAD
• Lymphadenopathy: Right Axillary Lymphadenopathy
• Edema: NAD
Vitals Signs:
PR: 70 bpm
RR: 16 cpm
BP: 130/90
mmHg
Temp: Afebrile
10. Systemic Examination
EXAMINATION OF SKIN & NAILS:
• Inspection: Non Healing Ulcer on Right Thumb
• Palpation: Bleeds on Touch
Crust on Skin, painful only on touch.
• Scraping: Nil Hutchinson's sign
Non Healing Ulcer
11. 13/8/22
1. FNAC from Right Axillary
Lump:
Positive for Metastatic
Deposits of Malignant
Melanoma.
Lab Investigations:
12. 19/8/22
2. PET CT Scan:
Metastatic Subungual Malignant
Melanoma; ill defined lesion in right
thumbnail bed likely representing
primary site.
13. 19/8/22
3. Nail Wedge Biopsy:
Poorly differentiated Malignant Neoplasm
4. IHC (Immuno Histochemistry):
The neoplastic cells are Positive for
S100,MelanA & HMB45.
14. Right Ungual Melanoma with Axillary Lymphadenopathy
Hutchinson's sign Axillary Lymphadenopathy
pTNM Stage IV
Clinical Diagnosis
Non Healing Ulcer
15. pTNM Stage IV
TNM Staging: Tis N1 M1a
Tis : Melanoma in situ
N1 : 1 Tumor involved LN
M1a : Distant metastasis to
skin, soft tissue including
muscle & Bones.
As mentioned in PET Scan Primary Site in
this case is likely to be Right Thumb Nail
bed.
17. Dynamic Disease
Chronic Disease
Disease with fully developed symptoms
Miasmatic
Complex
Syco - syphilitic
Classification of Disease according to Dr.Hahnemann
18. Common Symptoms
• Ulcer on Right thumb
Uncommon Symptoms
• Pain & swelling in axilla
region.
• < Pressure
< Morning
• Non Healing Ulcer on Right
thumb.
• Desire Sweets, prefer Warm
foods.
Analysis of Case
19. • Optimistic
• Courageous
• Mentally strong
• Desire Sweets
• Prefer warm food.
• Pain & swelling in Axilla
• Non healing ulcer on right
thumb
• Ulcer bleeds on touch
Physical Generals
Mental Generals Particulars
Evaluation of Case
20. Reportorial Totality
• EXTREMITIES – ULCERS – Fingers – Nails
• CHEST – AXILLA ; complaint of – right
• GENERALS – Food and Drinks – sweets – desire
• MIND – COURAGEOUS
• MIND – OPTIMISTIC
• SKIN – CANCER - melanoma
21. Final Prescription
• Merc sol 200 X 3days
5-5-5
• Silicea 6x
2-2-2
• Hydrocotyle Q
10-0-10 drops
Advice:
1. Avoid Alcohol intake.
2. Use Sun Screen & avoid UV Exposure.
22. Agent Factor Host Factor
Biological – Family History of
Malignant Melanoma
Mechanical – Repeated hit on
the Right Thumb.
Inheritance – Family History of
Malignant Melanoma. Elder
Brother died with same
condition.
Others – Chronic Alcoholic.
Environmental Factor Social Factor
Occupational Environment –
Street Food Vendor (Sells
Momo's n Noodles). Repeated
hit on the Right Thumb.
Habits – Chronic Alcoholic.
1 Quater / day
Habit of Chewing Betel
nut
Identification of the Factors Responsible for / Influencing the
Present Condition:
23. Levels of Prevention
Levels of Prevention Which level has failed?
How could have been
prevented?
Primary
Health
promotion
Periodical Check-up.
By quitting alcohol.
Specific
protection
Excessive consumption of Alcohol.
Secondary
Early detection
& proper
treatment
Inspite of knowing that his brother
has been diagnosed with Malignant
melanoma and died because of it, pt
didn’t get screening done.
As early symptoms appeared
(Hutchison Sign), he could
have underwent screening for
Ca marker HMB45.
Tertiary
Disability
limitation
As PET Scan shows the Metastatic
deposits in Right Iliac bone and in
Femur, there are high chance of
necrosis.
-
Avoid UV exposure , Use
• Prevention of MM is easier than treating it:
1. Photoprotection
2. Self examination: Especially those at risk (H/o Skin Cancers.)
24. Assesment of Knowledge, Attitude and Practice (KAP) towards
the Disease
Particulars Knowledge
Attitude
(beliefs and
custom)
Practice
Cause
Treatment
Prevention
Health service
Others
Patient had
acknowledge his
condition as his
brother suffered
from the same
condition and
had died.
Patient is
mentally strong
& optimistic yet
with a Happy –
go – lucky
attitude.
This condition
was caused by
the long practice
of drinking
alcohol.
25. MALIGNANT MELANOMA
Melanoma is a type of cancer that arises from pigmented cells called
melanocytes. It most often occurs in melanocytes in the skin’s top layer.
26. Causes & Risk Factors
Risk factors for melanoma include both
intrinsic (genetic and phenotype) and extrinsic (environmental or exposure)
factors:
• Sun exposure.
• Pigmentary characteristics.
• Multiple nevi.
• Family and personal history of melanoma.
• Immunosuppression.
• Environmental exposures.
27. Hidden Melanoma
• Melanoma under a nail: There are three ways in which this may present:
1. The development of pigmented band in the nail, granulation tissue may
appear some year laterat the edge of the nail, and pigment band may
become wider.
2. Chronic paronychia affecting single nail.
3. Development of warty growth of nail bed with shedding of nail.
• Melanoma in the mouth, digestive tract, urinary tract or vagina.
• Melanoma in the eye.
28. A. Asymmetry: One side is not like the other.
B. Border: The edges are irregular or ragged.
C. Color: It has color variations, such as shades of brown or black,
sometimes with patches of pink, red or white
D. Diameter: It’s more than 6 millimeters across (the size of a pencil
eraser),
though it can be smaller.
E. Evolving: The mole may change in size, color or shape.
Clinical Features
29. Stage Information for Melanoma
Tis, N0, M0 Tis = Melanoma in
situ.b,c
N0 = No regional
metastases detected.
M0 = No evidence
of distant
metastasis.
pTNM Stages 0
30. pTNM Stages IA and IB
IA T1a, N0, M0 T1a = <0.8
mm/without
ulceration.
N0 = No regional
metastases detected.
detected.
IB T2a, N0, M0 T2a = >1.0–2.0
mm/without
ulceration.
N0 = No regional
metastases detected.
M0 = No evidence of
distant metastasis.
M0 = No evidence of
distant metastasis.
31. pTNM Stages II
IIA T2b, N0, M0 T2b = >1.0–2.0
mm/with
ulceration.
N0 = No regional
metastases detected.
M0 = No evidence of
distant metastasis.
32. IV Tis = Melanoma in
situ.
T1a = <0.8
mm/with
ulceration.
N1 = 1 Tumor
involved LN
pTNM Stage IV
M1a = Distant
metastasis to skin, soft
tissue including muscle,
and/or nonregional
lymph nodes
33. Treatment Options for Melanoma
Stage 0 melanoma Excision
Stage I melanoma
Excision +/− lymph node
management
Stage II melanoma
Excision +/− lymph node
management
Stage III melanoma
Excision +/− lymph node
management
Stage IV melanoma
Intralesional therapy
Immunotherapy
Signal transduction inhibitors
Chemotherapy
Palliative local therapy