A Study On Infectious Disease

EMERGENCY SERVICES ADMISSION REPORT Patient Name: Benjamin Engelhart Patient ID: 112592 DOB 10/5/---- AGE: 46 SEX: Male Date of Admission 11/14/---- Emergency Room Physician: Alex McClure, MD Admitting Diagnosis: Acute Appendicitis HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

Case Study 43 Choledocholithiasis Scenario T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips

is worn in Jeff’s room. D) Non-sterile gloves are necessary to deliver the meal and prevent the spread of TB.

Vital Sign Increase/Decrease/Normal Respiration Rate + Heart Rate + Blood Pressure - Body Temperature + 2. If you were the doctors on the scene, what diagnosis would you give this patient? (You may use the internet to help diagnose the patient.)

Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.

D- The patient arrived on time for her session and reports being stable on dose and haven't used any illicit drugs. This writer advised the patient that this writer was in fact in receipt of missed phone call about coming to the session at 10:30 am rather than 10 am due to her mother in the process of selling the house. This writer addressed with the patient about letter from CHR from her counselor, Jade Bray stating about the patient non-compliance with her appointment due transportation barrier. According to the patient, she is going through hardship as her mother is no longer taking her to her appointment as the patient says, " She's tired of bringing me everyone, Charlene. She complains about bringing me here and does not understand why I can't even get a bottle...:Like c'mon. What do I have to do?" This writer explained to the patient about TEAM decision, at which the patient disagree with the decision. This writer asked the patient about her "judgement." According to the patient, she feels she is making judgement by not engaging any further altercation with patient at the clinic, dosing daily, coming to her counseling session, and trying to get help from Chrysalis for

SURGICAL HISTORY History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

CYANOTIC: A patient who has cyanosis, or a slight bluish discoloration of the skin due to the presence of abnormal amounts of reduced hemoglobin in the blood JAUNDICE: A yellow discoloration of the skin GASTROSCOPY: A scope for inspecting the stomach COLONOSCOPY: An endoscope to inspect the colon (large intestines) ANGIOSCOPE: Views the heart

a strong odor, and several lab tests on admission. The results were as follows: Laboratory Test Results Complete metabolic panel (CMP): Within normal limits except for the following results: Urine culture and sensitivity results are pending. 1. What condition do the assessment findings and lab reports point toward? 2. The medical director makes rounds and writes orders to start an IV of D51/2 NS at 75 m/hr

S- 3671 dispatched to a m pt C/O of abdominal pain and black stool. Pt is a 49 y/o m whose C/C is abdominal and lower back pain. Pt also states that he is experiencing cramping around his left ribcage. Pt states that he has been experiencing N/V/D for the past four days. Pt also states that his bm's have produced black, watery stool since the monday prior to the incident date. Pt is able to provide EMS personnel with a detailed medical Hx that includes HIV, acid reflux, and recently diagnosed COPD. Pt also states that he recently stopped smoking cigarettes. Pt is also able to provide EMS personnel with a list of medications that he is currently taking that includes Duloxetine, Stribild, Ranitidine, Aripiprazole, oxycodone, and proair. Pt states that he has not taken any of his prescribed medications for the past four days prior to the incident date. Pt states that he has allergies to Kaletra and gabapentin. Pt states that his primary

The staff assesses Jt and then asks his mother about his allergies and medical history. They then ask what medication he takes. She states he has environmental allergies so he always takes Equate Allergy and Sinus Headache. She says he takes two tablets every 4 hrs. She then proceeds to tell the staff that the dentist who removed his wisdom teeth prescribed him Percocet 5/325mg 1 tab every 4 hrs for his pain, which he has been taking routinely. The

The origin of nosocomial infections can be attributed to the following: - Bacterial flora already present in the patient; - Microorganisms from the environment through transmission from: carriers colonized at admission, admitted to wards without undergoing surveillance, isolation or eradication of the germ(s); patients who have developed the infection but who have not been isolated;contact with contaminated objects and surfaces; medical personnel, usually via their hands; invasive procedures such as the installation or maintenance of a device(1).

D-The patient reports she is stable on her current dose and haven't experienced any withdrawals and/or cravings. The patient further mentioned that work is going okay, but still exploring other job opportunities. This writer provided positive feedback towards the patient's recovery process. In addition, the patient reports she has to do a pneumonia test as it was suggested by her PCP today. This writer requested for the patient to detailed if she's experiencing any symptoms and would like to consult with the clinic medical doctor. Based on the patient, she reports she was experiencing some backaches, but now, feels okay. During the remainder of the session, the patient discussed her plans for the Easter holiday and also shared with this writer that today is her son birthday.

Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow-up visit after his discharge from the hospital on 08/08/2017. He was admitted on 08/04/2017 due to normocytic anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis. The esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in the antrum, and small hiatal hernia. He had a colonoscopy which revealed internal hemorrhoids. Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus, hypertension, stable chronic kidney disease stage III, and bilateral impacted cerumen. It was noted that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes at a time for 1

Weekends in the emergency department often bring about long hours performing arduous duties. On a saturday night with midnight approaching, entered a seventeen year old boy in obvious despair. The young man presented doubled over in agony along with active vomiting. Having encountered this scenario many times before, my immediate thought was appendicitis. There are many clinical markers that can lead one to suspect appendicitis, yet one seemingly odd test comes to mind initially more than any other. When I encounter a patient potentially experiencing appendicitis, I will ask them to hop on one foot. After receiving a befuddled stare and asked to repeat the request, the patient apprehensively responds. If they are able to complete the task, then it’s not appendicitis; However, if they are unable to complete this task then appendicitis is likely the culprit of this relentless lower pain. Although this is not a typical test involved while triaging patients with abdominal pain, It comes from something I was taught by a preceptor years ago. I have added this test to every patient encountered with signs and symptoms of appendicitis, and it has predicted the outcome nearly every time. Asking this seventeen year old to do this resulted in the usual confusing look with delayed response. To my surprise, he was able to complete the task with little to no change in pain. After completing this exercise, I began thinking of all other possibilities that would lead to the boys pain.