Anemia Case Study Answers

My patient is a 58-year-old female, who presents with controlled type II diabetes, hypertension, and possibly thyroid tumors that have been there for a few years. She is under the care of a physician for her diabetes and associated controlled hypertension. I recommended several times that she see her physician after feeling the tumors around her neck and thyroid. Her medical history also indicates that she had rheumatic fever twelve to thirteen years ago, has arthritis in her knees, and occasional headaches. She is 5”3 and weighs 216 pounds. Her blood pressure was 126/80, pulse was 88 BPM, respirations were 20, and her temperature was 98.2 Fahrenheit. She doesn’t smoke and I made sure that she had eaten lunch and wasn’t hungry. She is currently on 100 mg Metformin for her diabetes, 120 mg. Lisinopril for hypertension, 40 mg. of Lovastatin to lower cholesterol, 80 mg. of Aspirin to prevent cardiovascular disease, and daily insulin. Reviewing her medical HX, I was informed that she usually checks her blood glucose daily, but had recently run out of strips, so it had been a

She converses appropriately. Blood pressure 92/60 supine. Blood pressure decreased to 72/50 standing. Pulse is 90 and regular. Weight 113 pounds. She has a normal appearance of her face and does not have a masked appearance of her face. She has good strength throughout her face. She has good strength of her extremities. She has only minimal cogwheel rigidity at the left wrist, but no cogwheel rigidity at the right wrist. She has no tremor of her hands. She moves her extremities freely and with normal speed. She is able to rise on her own from a sitting to a standing position, only minimal bradykinesia of standing. She walks fairly freely and there is a normal cadence of her gait. She did not have dyskinetic movements of her extremities. She is able to walk, including turning without losing her balance. She does not shuffle her feet when walking. She does not have en bloc turning. She has good posture stability

SW is a 65 year old white female who is 5’8” tall and who weighs 155 lbs. Her IBW is 140 lbs. and she has an IBW % of 110.71. She went to emergency department on February 1, 2015 complaining of shortness of breath and coughing since November, 2014. Her medical diagnosis includes multi-drug resistant organism, diabetes, COPD, and lung cancer. Her laboratory result shows that she has an elevated WBC of 17.4 on February 2nd and it increased to a critical level of 32.2 the next day. An elevated WBC usually means an infection is happening in the body. Her RBC is elevated at 6.19 which could mean hemoconcentration or it could be due to her COPD. Her decreased MCH of 25.0 & 24.8, her Neutrophils of 13.8 and her elevated RDW of 18.2 & 18.4 could mean that she’s having some iron deficiency anemia. Her laboratory also shows that her albumin is low which can be from prolonged immobilization, decreased nutritional status or worse it could be due to her lung cancer. Her low Sodium of 132 and Chloride at 93 may be due to her diet or medication side effects. Her serum glucose at 118 is elevated which can be from her diabetes or from stress of being in the hospital. Her Platelet count of 405 is normal and her BUN of 5 is also within range. Her arterial blood gas is showing compensated imbalances. Her pH is 7.35 which is normal on the low side. Her PaCo2 is 65.2 which is very elevated, her PaO2 is 66.4 which is very low, her HCO3 is also very elevated at 35.3.

A 67 year old female Caucasian patient comes in to the clinic complaining of decreased vision, affecting the left eye more than the right. She is being treated for hypertension, cholesterol, and diabetes. Her distance vision is 20/25 OD and 20/40 OS and her near vision is 20/25 OD and 20/50 OS. Her prescription was found to be -11.00-1.00X180 OD and -13.50-1.50X015 OS, which is classified as high myopia. A 1+ nuclear sclerosis was found in the right eye. A 2+ nuclear sclerosis and a paracentral subcapsular cataract were found in the left eye. Due to these findings, it was determined that glasses could not fully fix the patients vision. This lead to a referral to a retinal specialist and a cataract surgeon. No other abnormalities were noted on the initial examination. The patient then came back when the cataract surgery was performed on the left eye and the visual acuity improved to 20/25 at distance and 20/25- at near OS. All things concerning the surgery seemed normal for a day after the IOL placement. Six months later, the

A scleral depression and dilated fundus examination were performed. Opthalmoscopic examination of the retina and vessels of the left eye show a vitreous detachment.

This is 38 year old Female. Patient reports chronic back pain. Dull aching pain, taht radiates down to her legs. Patient denies chest pain, SOB, N/V/D, or fever. Patient reports deressive moods, denies thoughts of sucide or homicide. Patient reports intermitten hadache, and she's been taking BC powder OCT.

Considering Ms. A’s signs and symptoms, including the laboratory results, she has iron deficiency anemia. To be able to diagnose Ms. A’s condition, the physician has to perform a physical examination for signs of iron-deficiency anemia. These exams include checking the color and complexion of the skin, gum, and nailbeds to see if they are pale. Listening to the heart for rapid and irregular heartbeats, auscultation of the lungs for fast and uneven breathing, and palpation of the abdomen to check for the size of the liver and spleen are three more test that is done to diagnose iron deficient patients. Also, pelvic and rectal examination to check for internal bleeding.

A clinical study presented in the 119th annual meeting of the American Academy of Ophthalmology by Dr Donald Tan of the Singapore National Eye Center and his colleagues

Fellow eye is affected weeks or months after the involvement of the first eye. In acute stages, disc hyperemia and telangiectatic microangiopathy are evident. In chronic cases, severe optic atrophy supervenes. However, it is associated with brisk pupillary light reflexes.(12)

Symptoms: the whole eye is popped out from its socket, as if under pressure (not just swollen).

Patient MJ came in to the emergency department frustrated speaking in Russian. A translator was quickly requested and MJ expressed complaints of sudden swelling of the neck, and stated that he’s been feeling “butterfly in my stomach” all week long. Upon admission assessment, patient reported that he has not been feeling himself lately, lost a 15lbs in span of one month despite great appetite. Additionally, couldn’t sleep at night anymore because of his increased anxiety, and nighttime sweating. The admitting nurse also noted visible sweating, tremor, irritability, during the assessment and his vital sign was 99.4F 18R 120HR 144/92BP 99O2. Patient reported pain level of 2 from 1/10 scale for his throat discomfort. The assessment findings were tachycardia, diaphoresis, hypertension, and slight protrusion of the eyes.

On September 21, 2016, I reviewed Mrs. S’s chart prior to meeting with her. She is an 80-year-old female who is a resident at the Artman Luthern Home. She has no known drug allergies. Her past medical history includes; thrombocytopenia, hypothyroidism, unspecified dementia with behavioral disturbances, hypertension, difficulty walking, UTI, history of a fall, and artificial openings of the urinary tract.

At today's visit, she is accompanied by her daughter. She is awake, alert. The daughter reports that the patient has a fair appetite. She states that the patient has an unsteady gait and she uses a walker. The patient denies, pain, shortness of breath and chest pain. No new concerns reported at this time. The daughter reports that the patient continues to needs assistance with her ADLS, but appears stable at this time.

Ms. A has noticed increased shortness of breath, and low levels of energy and enthusiasm especially during her menses. During a golf tournament, she became light-headed. She presented in the emergency clinic today with an elevated heart and respiratory rate, and low blood pressure. She reports history of menorrhagia and dysmenorrhea for 10-12 years. She takes 1,000 mg of aspirin every 3-4 hours for 6 days during her period and during the summer while playing golf for joint stiffness. This paper will explore the patient’s diagnosis, classify the anemia, and give the rationale for the diagnosis.

Anemia and bleeding disorders are common conditions that affect the human blood. Anemia involves a decrease in both hemoglobin concentration and the number of erythrocytes in the blood. As a result, the condition causes a decrease in the blood’s oxygen carrying capacity. On the other hand, bleeding disorders involve heavy and continuous loss of blood. They are often classified into coagulation disorders and platelet disorders. In the current study, two different cases of anemia and bleeding disorder were investigated.