Case Study of Patient "H"
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case study of patient "H" ALL input is greatly wanted and appreciated. Would like to know if our study groups "patient" diagnosis and prognosis and order of events coincide.
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This document summarizes the case of a 31-year-old male who presented with fever for 40 days. An echocardiogram showed multiple mobile vegetations on his tricuspid valve. Blood cultures grew Staphylococcus aureus. He was diagnosed with infective endocarditis and underwent treatment with antibiotics and surgical repair of his tricuspid valve. Infective endocarditis is an infection of the heart valves or endocardium that is commonly caused by bacteria entering the bloodstream. It typically involves the valves and can cause local destruction, embolic events, and heart failure if not treated properly.
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The first document describes two emergency cases seen at the hospital on October 6th, 2022. The first case involves a 37-year-old man brought to the emergency department for worsening lethargy and abdominal pain. On examination, he appears weak with low blood pressure and pale conjunctiva. The second case involves a 3-year-old girl brought to the emergency department for intermittent abdominal pain and vomiting blood. On examination, she appears weak with a palpable mass in her right lower abdomen. The tutor leads a discussion on identifying and discussing the problems in these cases chronologically while considering all possible diagnoses. References are also provided for some laboratory results.
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2) During an attempt to place an IV line for a CT scan, the patient became unresponsive. Resuscitation was required.
3) A CT scan showed an intraventricular hemorrhage. The patient's condition deteriorated and she eventually passed away despite recommendations for surgical decompression.
4) There were several delays in care including protecting the patient's airway, obtaining the CT scan, communicating the critical results, following up on results, and initiating treatments for brain edema.
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- A 52-year-old female presented with a 1-month history of cough and fevers after being treated for breast cancer. She was admitted to the hospital with worsening shortness of breath.
- On admission, she had abnormal lab results including elevated white blood cell count. A chest CT showed abnormalities. Antibiotics were started but she continued to spike fevers.
- Sputum cultures grew gram-positive cocci. Bronchoscopy with biopsy showed inflammatory infiltrate but did not reveal a definitive diagnosis. Further diagnostic testing was done on hospital day 5.
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This document summarizes a case of a 13-year-old male who presented with abdominal pain, fever, dyspnea, and loose stools. Imaging showed acute pulmonary thromboembolism and splenic venous infarcts. Laboratory tests found leukocytosis, severe thrombocytopenia, and signs of disseminated intravascular coagulation. The patient was diagnosed with acute myeloid leukemia, likely acute promyelocytic leukemia, which was causing secondary thrombosis. Due to bleeding risks, heparin treatment was not possible and the patient received platelet and plasma transfusions before transfer for further management and treatment with all-trans retinoic acid therapy.
Instructions· This week’s case study will introduce concepts r.docx
Instructions
· This week’s case study will introduce concepts related to the pulmonary system and shock states. Read the scenario and thoroughly complete the questions. Some of the answers will be short answers and may not require a lot of details. For example: what is the most common organism to cause a hospital acquired infection? The answer is pseudomonas aeruginosa. Answers to questions that relate to the pathogenesis of a disease must include specific details on the process. For example: How does hypoxia lead to cellular injury? Simply writing that a lack of blood flow, causes a lack of oxygen available to the cell and the cell cannot function without oxygen is not sufficient. This type of response is NOT reflective of an advanced understanding of the concept or graduate level work. This answer should discuss the cascade of events leading to the lack of oxygen and how it specifically impairs cellular function. All answers to these type of questions should address the effects at the cellular level, then the effects on the organ and then the body as a whole. Additionally describing the normal anatomical and/or physiologic processes underlying the pathogenesis will be necessary to thoroughly answer the question.
It is very likely that you will need to reference multiple sources to answer the questions thoroughly. Your text book will not necessarily have all the answers. Only professional sources may be used to complete the assignment. These include text books, primary and secondary journal articles from peer reviewed journals, government and university websites, and publications from professional societies who establish disease management guidelines and recommendations. Sources such as Wikipedia or other generic websites are not considered professional references and should not be used to complete the case studies.
· Reason for Consultation:
Desaturation to 64% on room air 1 hour ago with associated shortness of breath.
History of Present Illness:
Mrs. X is 73-year-old Caucasian female who was admitted to the general surgery service 3 days ago for a leaking j-tube which was surgically replaced 2 days ago. This morning at 07:30, the RN reported that the patient was sleeping and doing fine, then the CNA made rounds at 0900 and Mrs. X was found to be mildly dyspneic. Vital signs were checked at that time and were; temperature 38.6, pulse 120, respirations 20, blood pressure 138/38. O2 sat was 64% on room air. The general surgeon was notified by the nursing staff of the hypoxia, an order for a chest x-ray and oxygen therapy were given to the RN. The O2 sat is maintaining at 91-92% on 4L NC. The patient was seen and examined at 10:10 a.m. She reported that she has had mild dyspnea for 2 days that has progressively gotten worse. She does not use oxygen at home. Her respiratory rate at the time of this visit was 20 and she feels short of breath. She has felt this way in the past when she had pneumonia. She is currently undergoing radiatio.
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This document summarizes the case of a 31-year-old male who presented with fever for 40 days. An echocardiogram showed multiple mobile vegetations on his tricuspid valve. Blood cultures grew Staphylococcus aureus. He was diagnosed with infective endocarditis and underwent treatment with antibiotics and surgical repair of his tricuspid valve. Infective endocarditis is an infection of the heart valves or endocardium that is commonly caused by bacteria entering the bloodstream. It typically involves the valves and can cause local destruction, embolic events, and heart failure if not treated properly.
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The first document describes two emergency cases seen at the hospital on October 6th, 2022. The first case involves a 37-year-old man brought to the emergency department for worsening lethargy and abdominal pain. On examination, he appears weak with low blood pressure and pale conjunctiva. The second case involves a 3-year-old girl brought to the emergency department for intermittent abdominal pain and vomiting blood. On examination, she appears weak with a palpable mass in her right lower abdomen. The tutor leads a discussion on identifying and discussing the problems in these cases chronologically while considering all possible diagnoses. References are also provided for some laboratory results.
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1) A 50-year-old female with a history of metastatic colon cancer presented with abdominal distension and vomiting.
2) During an attempt to place an IV line for a CT scan, the patient became unresponsive. Resuscitation was required.
3) A CT scan showed an intraventricular hemorrhage. The patient's condition deteriorated and she eventually passed away despite recommendations for surgical decompression.
4) There were several delays in care including protecting the patient's airway, obtaining the CT scan, communicating the critical results, following up on results, and initiating treatments for brain edema.
CPC
- A 52-year-old female presented with a 1-month history of cough and fevers after being treated for breast cancer. She was admitted to the hospital with worsening shortness of breath.
- On admission, she had abnormal lab results including elevated white blood cell count. A chest CT showed abnormalities. Antibiotics were started but she continued to spike fevers.
- Sputum cultures grew gram-positive cocci. Bronchoscopy with biopsy showed inflammatory infiltrate but did not reveal a definitive diagnosis. Further diagnostic testing was done on hospital day 5.
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This document summarizes a case of a 13-year-old male who presented with abdominal pain, fever, dyspnea, and loose stools. Imaging showed acute pulmonary thromboembolism and splenic venous infarcts. Laboratory tests found leukocytosis, severe thrombocytopenia, and signs of disseminated intravascular coagulation. The patient was diagnosed with acute myeloid leukemia, likely acute promyelocytic leukemia, which was causing secondary thrombosis. Due to bleeding risks, heparin treatment was not possible and the patient received platelet and plasma transfusions before transfer for further management and treatment with all-trans retinoic acid therapy.
Instructions· This week’s case study will introduce concepts r.docx
Instructions
· This week’s case study will introduce concepts related to the pulmonary system and shock states. Read the scenario and thoroughly complete the questions. Some of the answers will be short answers and may not require a lot of details. For example: what is the most common organism to cause a hospital acquired infection? The answer is pseudomonas aeruginosa. Answers to questions that relate to the pathogenesis of a disease must include specific details on the process. For example: How does hypoxia lead to cellular injury? Simply writing that a lack of blood flow, causes a lack of oxygen available to the cell and the cell cannot function without oxygen is not sufficient. This type of response is NOT reflective of an advanced understanding of the concept or graduate level work. This answer should discuss the cascade of events leading to the lack of oxygen and how it specifically impairs cellular function. All answers to these type of questions should address the effects at the cellular level, then the effects on the organ and then the body as a whole. Additionally describing the normal anatomical and/or physiologic processes underlying the pathogenesis will be necessary to thoroughly answer the question.
It is very likely that you will need to reference multiple sources to answer the questions thoroughly. Your text book will not necessarily have all the answers. Only professional sources may be used to complete the assignment. These include text books, primary and secondary journal articles from peer reviewed journals, government and university websites, and publications from professional societies who establish disease management guidelines and recommendations. Sources such as Wikipedia or other generic websites are not considered professional references and should not be used to complete the case studies.
· Reason for Consultation:
Desaturation to 64% on room air 1 hour ago with associated shortness of breath.
History of Present Illness:
Mrs. X is 73-year-old Caucasian female who was admitted to the general surgery service 3 days ago for a leaking j-tube which was surgically replaced 2 days ago. This morning at 07:30, the RN reported that the patient was sleeping and doing fine, then the CNA made rounds at 0900 and Mrs. X was found to be mildly dyspneic. Vital signs were checked at that time and were; temperature 38.6, pulse 120, respirations 20, blood pressure 138/38. O2 sat was 64% on room air. The general surgeon was notified by the nursing staff of the hypoxia, an order for a chest x-ray and oxygen therapy were given to the RN. The O2 sat is maintaining at 91-92% on 4L NC. The patient was seen and examined at 10:10 a.m. She reported that she has had mild dyspnea for 2 days that has progressively gotten worse. She does not use oxygen at home. Her respiratory rate at the time of this visit was 20 and she feels short of breath. She has felt this way in the past when she had pneumonia. She is currently undergoing radiatio.
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Name Add name hereHIM 2214 Module 6 Medical Record Abstractin.docx
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Instructions: In this medical record abstracting assignment you will first need to download and the records (history & physical, surgery consultation, operative report, pathology report and discharge summary) for a patient with digestive system problems. (Recommend reading them in the order listed).
Save your answers to the following related questions in this document and submit them for this module's assignment.
1. Define the terms diverticulosis and diverticulitis.
2. What is the pathophysiology of diverticulitis?
3. What is a hiatal hernia?
4. Describe some of the signs or symptoms a person with a hiatal hernia might have.
5. What is a pulmonary embolus?
6. What was the etiology (cause) of the pulmonary embolus for this patient?
7. What is gastritis?
8. Which problem is likely a contributor to the patient’s Type II diabetes mellitus?
9. What was the purpose of the barium enema?
10. What does the abbreviation HEENT stand for?
11. What is thrombophlebitis?
12. What is a surgical resection?
13. Define anastomosis.
14. What is ferrous gluconate and what is it used to treat?
15. What condition is the drug Darvocet used to treat?
16. What are electrolytes?
17. What is exogenous obesity?
18. Where is the femoral pulse found/taken?
19. Where is the popliteal pulse found/taken?
20. What is hepatosplenomegaly?
21. Which condition(s) is/are the drug Humulin used to treat?
22. What is an adenocarcinoma?
23. Which condition(s) is/are the drug Lanoxin used to treat?
24. What is the purpose of ordering the blood test PTT?
25. What is a colon stricture?
26. What is/are the etiologies associated with colorectal cancer?
27. What is the medical term for gallstones?
28. Which condition(s) is the drug Zantac used to treat?
29. What does the pathology report indicate about the spread of the carcinoma in this patient?
30. What is the etiology of Type II diabetes mellitus?
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Academic arguments are not about ranting, screaming or otherwise increasing conflict, but in fact are the opposite: They attempt to help the other person understand what the author believes to be right (opinion) based on the evidence presented (authority, logic, facts).
For your topic for your final paper, what kinds of arguments can you develop for your claim (thesis, main idea)?
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Record Number:
005
Age:
67
Gender:
Male
Length of Stay:
3 days
Service:
Inpatient Hospital Admission
Disposition:
Home
Discharge Summary
Patient is a 67-year-old male. He saw the doctor recently with abdominal pain and constipation. A barium enema showed diverticulosis and perhaps a stricture near the sigmoid and rectal junction. He was scoped by the doctor, who saw a stricture at that point and sa ...
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1. A man with fatigue, rash and anal fistula was diagnosed with syphilis based on a positive RPR test.
2. A man with weight loss, cough and fever was initially treated for pneumonia but was ultimately diagnosed with acute pancreatitis based on elevated amylase and lipase levels.
3. A man with syncope was initially suspected to have seizures but autopsy revealed pulmonary embolisms, consistent with factor V Leiden deficiency found post-mortem.
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2. Examination found the patient mildly anemic with multiple joint deformities and scarring on her legs. Colonoscopy found ulceration and bleeding in the colon consistent with ulcerative colitis.
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This document describes the case of a 77-year-old man who presented with fever, left leg swelling and redness, and altered mental status. He had a history of diabetes and was initially treated for cellulitis with antibiotics but his condition deteriorated with confusion and delirium. He developed septic shock and refractory hypotension despite supportive management and antibiotics. He had multiple organ dysfunction and died after cardiac arrest despite resuscitative efforts. The case discusses the patient's hospital course, clinical findings, investigations and management of sepsis.
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Instructions: In this medical record abstracting assignment you will first need to download and the records (history & physical, surgery consultation, operative report, pathology report and discharge summary) for a patient with digestive system problems. (Recommend reading them in the order listed).
Save your answers to the following related questions in this document and submit them for this module's assignment.
1. Define the terms diverticulosis and diverticulitis.
2. What is the pathophysiology of diverticulitis?
3. What is a hiatal hernia?
4. Describe some of the signs or symptoms a person with a hiatal hernia might have.
5. What is a pulmonary embolus?
6. What was the etiology (cause) of the pulmonary embolus for this patient?
7. What is gastritis?
8. Which problem is likely a contributor to the patient’s Type II diabetes mellitus?
9. What was the purpose of the barium enema?
10. What does the abbreviation HEENT stand for?
11. What is thrombophlebitis?
12. What is a surgical resection?
13. Define anastomosis.
14. What is ferrous gluconate and what is it used to treat?
15. What condition is the drug Darvocet used to treat?
16. What are electrolytes?
17. What is exogenous obesity?
18. Where is the femoral pulse found/taken?
19. Where is the popliteal pulse found/taken?
20. What is hepatosplenomegaly?
21. Which condition(s) is/are the drug Humulin used to treat?
22. What is an adenocarcinoma?
23. Which condition(s) is/are the drug Lanoxin used to treat?
24. What is the purpose of ordering the blood test PTT?
25. What is a colon stricture?
26. What is/are the etiologies associated with colorectal cancer?
27. What is the medical term for gallstones?
28. Which condition(s) is the drug Zantac used to treat?
29. What does the pathology report indicate about the spread of the carcinoma in this patient?
30. What is the etiology of Type II diabetes mellitus?
· Academic arguments are designed to get someone to agree with the author, who may use pathos (emotion), logos (logic and facts) and ethos (authority and expertise) to persuade.
Academic arguments are not about ranting, screaming or otherwise increasing conflict, but in fact are the opposite: They attempt to help the other person understand what the author believes to be right (opinion) based on the evidence presented (authority, logic, facts).
For your topic for your final paper, what kinds of arguments can you develop for your claim (thesis, main idea)?
Health Record Face Sheet
Record Number:
005
Age:
67
Gender:
Male
Length of Stay:
3 days
Service:
Inpatient Hospital Admission
Disposition:
Home
Discharge Summary
Patient is a 67-year-old male. He saw the doctor recently with abdominal pain and constipation. A barium enema showed diverticulosis and perhaps a stricture near the sigmoid and rectal junction. He was scoped by the doctor, who saw a stricture at that point and sa ...
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The document describes the rules and format for an integrated medical quiz finals round consisting of 12 total questions divided into 2 questions per team. Teams have 1 minute to answer each question they receive before it bounces to the next team, and can pounce within 30 seconds to steal a question. Correct answers earn points while incorrect answers during a pounce result in negative points, with scores announced at the end.
The document provides the details of a quiz competition involving 12 total medical questions that will be divided among teams to answer within time limits, with opportunities to earn or lose points depending on correct or incorrect responses when pouncing to answer another team's question. S
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This document provides clinical materials for self-learning in clinical medicine. It includes 12 clinical cases with descriptions, examination findings, imaging results, and summaries. The objective is to examine each case carefully and analyze the findings to aid in learning. Suggestions and feedback can be provided to the author via email. The author acknowledges and thanks the patients, teachers, and colleagues who contributed to developing this resource.
vasculitis.pptx
Waseem, a 27-year-old technician, presents with a 5-year history of skin rashes and 1-year history of joint pains. Recently he has developed a cough and hemoptysis. Examination finds a vesicular rash on his lower limbs and he is cANCA positive. Investigations reveal granulomatosis with polyangitis (GPA, formerly Wegener's granulomatosis). As GPA can be fatal if untreated, induction therapy with corticosteroids and cyclophosphamide is planned to induce remission, followed by rituximab to maintain remission.
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• Esophageal foreign body
• Mucus plugging
• Pneumonia
• Atelectasis
• Bronchiolitis
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Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
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This document discusses a case of retroperitoneal fibrosis in a 42-year-old female patient. It provides details of her medical history and treatments over the past 2 years for her condition. Imaging showed retroperitoneal fibrosis encasing the right ureter. She underwent right ureterolysis with uretero-ureterostomy and omental wrapping. Post-operatively, her drain output was serous and she was discharged after ensuring no collections were present. Retroperitoneal fibrosis is defined as an inflammatory fibrotic process in the retroperitoneum commonly causing ureteral compression. It most often presents with back or flank pain and can be idiopathic or associated with various causes. Management involves
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1. A man with fatigue, rash and anal fistula was diagnosed with syphilis based on a positive RPR test.
2. A man with weight loss, cough and fever was initially treated for pneumonia but was ultimately diagnosed with acute pancreatitis based on elevated amylase and lipase levels.
3. A man with syncope was initially suspected to have seizures but autopsy revealed pulmonary embolisms, consistent with factor V Leiden deficiency found post-mortem.
4. A woman with Parkinson-like symptoms visiting from Paris after using ecstasy was found to have a meningi
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A 59-year-old man with a history of ESRD on dialysis presented with neck swelling and sore throat and was found to have Lemierre's syndrome based on CT findings of retropharyngeal fluid and internal jugular vein thrombosis, and was treated with IV antibiotics and underwent a prolonged hospital course complicated by hypotension, coagulopathy, and metastatic adenocarcinoma before passing away.
A case presentation on Peripheral Arterial Occlusive disease
Case presentation at Civil hospital,Ahmedabad. A case of lower limb arterial occlusive disease due to atherosclerosis.
Dr htar htar meq compilation
This patient presents with a 3 month history of right leg pain on walking that resolves with rest. Examination finds the right leg cooler with sparse hair and thin skin. All pulses are absent below the femoral pulse. Doppler ultrasound finds softer signals in the right leg arteries and an ankle brachial pressure index of 0.6 on the right and 0.8 on the left. The patient has risk factors of smoking and diabetes. The clinical diagnosis is peripheral arterial disease and the patient is advised on lifestyle changes and medication while further investigation and monitoring is recommended.
‘A 45 years old lady presented with bloody diarrhoea & multiple joint pain (S...
1. Dr. Farhana Faruque presented on the case of 45-year-old Mrs. Rokeya Begum who was admitted with bloody diarrhea for 15 years, abdominal pain for 15 years, and joint pain and swelling in her hands and feet for 13 years.
2. Examination found the patient mildly anemic with multiple joint deformities and scarring on her legs. Colonoscopy found ulceration and bleeding in the colon consistent with ulcerative colitis.
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- 1. Patient is diagnosed with having a malfunctioning tricuspid valve. Pre-op lab work states bacterial pneumonia, antibiotics ordered, week later, notified antibiotics were wrong ones and needed to be changed. Heart surgery 3 weeks later. Slight pneumonia remaining. Patient remains somewhat ill after surgery. Follows up with out patient care for heart. 3 months later complaining of indigestion and upset stomach and sore throat. Patient waits a week, tips of ears few fingers and toes turning purple. Some small ulcers on body, slight fever, weak, feet hurt and right eye is bloody in appearance, both eyes glassy. At hospital is sent to regional hospital where he is admitted. Within 6 hours he is placed on ventilator and tests run. Following day is placed on dialysis. Within 3 days of admittance is given slim chance of survival. Hands and feet and tips of ears are now charcoal black, and the sores are now larger and appear as if eating at the flesh. Family is now told that he will not survive, if he were by chance to survive, he would lose both legs both hands, genitals, right eye and no eyesight in left eye and would be on dialysis the rest of his life. Patients chart states: Hospital Problem List (principal) shock circulatory (HCC) priority high Acute kidney injury (HCC) priority high acute Purpura fulminans (HCC) priority high Endocarditis h/o tricuspid valve replacement, bioprostheticvalve thrombocytopenia (HCC) Sepsis (HCC) Acute respiratory failure (HCC) Hypocalcemia
- 2. Hyponatremia Dry gangrene (HCC) S/p bilateral above the knee amputation (HCC) NON-hospital Problem List Acute bacterial endocarditis Endocarditis of tricuspid valve s/p tvr (tricuspid valve replacement) abnormal ct of liver pulmonary embolism (HCC) What was the initial causing factor? And how did these problems evolve one from the other. Initial diagnosis: D.I.C. with underlying cause of MRSA, . Is this correct? Treated with dialysis, amputations of legs and hands, antibiotics and dialudid. All heart medicine has been stopped. Is treatment correct? What is prognosis?