Biopsy Case Summary

GROSS DESCRIPTION: Exam of the specimen designated “left fallopian tube” reveals the presence of a fallopian tube measuring 6 cm in length and 2.3 cm in average diameter. Sectioning of the tube shows it to be

Dr. Jones found the lump and it he had been unlike anything he had seen before, it was shiny and purple “(like “grape Jell-O,” he wrote later.)” It was “a tumor that would leave her five children motherless and change the future of medicine.”

In this case study the patient’s regular physician referred her to a clinic to have a mole examined. The patient’s mole is located on the left upper quadrant of her abdomen. That means the mole is below her left breast. Given a more descriptive detail of the mole location; it is in the anterior truck position in the front of Mrs. Miller body. Mrs. Miller mole is inferior to the thoracic and superior to the pelvis in the abdominal region. Which means the mole is above her umbilical region. To examine the patient she must lie in a supine position laying face upward (Patton & Thibodeau, 2014, pg. 8-11). During the operation, the physician notices a similar mole in the occipital region of Mrs. Miller body. The occipital region is located on the back of lower skull. Mrs. Miller has to be placed in a prone position to be scanned. Mrs. Miller body will be laying face downward. (Patton & Tibodeau, 2014, pg 9&15).

Janet Tomcik, age 31, was assign to participate in the Department of Rehabilitation and Correction center in the state of Ohio on April 28, 1989 for having burglar tools in her custody. The policy of the institutes states every new inmate must have a physical examination to record current medical status. Ms. Tomcik had her medical assessment done on May 26, 1989 by Dr. Evans. The next day she inspected her own breasts and found a pea size lump in the right one. She notified medical personal but she did not receive a re-examination until June 21 by a nurse who stated the mass was large.

The mother claimed her son a brain tumor that didn't exist, making him appear to be suffering from the deadly disease by shaving his head and eyebrows in a scheme to cash in on his illness by posting the photos on two GoFundMe pages she setup for her "sick son."

Background: A 36year old Caucasian male who is a construction worker presented to his physician's office complaining of several moles on his scalp and face that were “changing.” The client noticed a color change on the moles and states "they've increased in size". The borders on the facial moles are irregular. In addition; he states "the mole on his scalp is the worst". One half does not look equal to the other half. The client states "the moles are very bothersome and they itch a lot".

A 25-year-old female presents to your clinic for evaluation of a mass in the vulvar area. This has been present for the last 1 week and tender to touch, there is no fever and no chills. Upon exam, you noticed that there is a medially protruding mass in the introitus area around a radius of 1.5 cm and tender to touch with some induration around the area. You advised the patient that the most likely diagnoses in this case are:

Dr. Gray was a physician who was taking care of one of his partner’s patients while the partner, Dr. Leavitt, was away. One morning a sixty-year-old man who was a previous patient of Dr. Leavitt, Mr. Karnofsky, came in to the office wheezing and coughing. After the description of all of Mr. Karnofsky’s symptoms, Dr. Gray sent him for an x-ray, which revealed cancer. Dr. Gray had not seen any notes in the patient’s chart of anything previously abnormal, but according to the radiologist who took the x-ray, a previous x-ray eighteen months before had found a lung nodule in the same lung that currently showed cancer. The radiology section of Mr. Karnofsky’s chart did hold of record of the nodule and the recommendation for repeat x-rays, but Dr. Leavitt had ignored or not seen them and had not told the patient. The

Mrs. Sheena a 69-year-old religious Jewish lady, admitted in internal medicine ward with abdominal pain and intestinal obstruction. She was diagnosed with breast cancer that had metastasized to the liver and bone. She was treated with a combination of anticancer drugs without response. Her family consisted of five children, four of whom were married with children and grandchildren. One of the patient's daughters, a 37-year-old single woman, had been diagnosed with stage II breast cancer. After a lumpectomy, she refused chemotherapy because of her desire to have a child. She only told her oldest brother about her illness; it was their secret. Mrs. Sheena’s mother and two of her sisters died because of breast cancer.

needed expeditiously. He was screened early and caught the diagnosis of ear cancer before the

Taylor, a 7 year-old suffering from ewing sarcoma wished to be a singer. She always looks at the glass with it being half full. “I actually really like not having hair,” Taylor says. “It’s so much easier to get ready and you can never get your hair pulled.” She’s been through surgery and radiation. Volunteers helped Taylor’s wish come true. They helped her record in a recording studio, helped her do a photoshoot, and even at a local restaurant, the owner offered to host her album release party.

The MO seemed happy with my diagnosis and care plan, though he did highlight the importance of practicing the physical examination skills in order to become a more competent practitioner. Overall I feel gaining knowledge and skills in translating a patients’ history and physical examination results, has enabled me to become more confident in making a diagnosis and has improved my decision making skills.

Upon receipt of the biopsy result, the physician counseled with Mr. Cato and conveyed that the lesion was indeed malignant melanoma. Initially Mr. Cato was distraught as he was unsure what this diagnosis meant, and he feared he could not afford whatever treatments might be necessary to eradicate the malignancy. At a follow-up appointment, Mr. Cato was educated as to the severity of his diagnosis and the expensive surgical procedure needed to excise the melanoma. The physician was fully aware of Mr. Cato’s financial situation, and immediately began to formulate a plan to prolong this man’s life. After exhausting all of his options to find inexpensive treatment, the doctor took it upon himself

Hazel Grace Lancaster is a sixteen year old girl who is diagnosed with stage 4 Thyroid cancer with metastasis forming in her lungs, but has managed to live with

* Prior to performing A.’s physical assessment, I gathered information over her diagnosis tonsillectomy, adenoidectomy, and vitiligo and any passed medical problems to be aware of. I then introduced myself to A. and her family and asked her if she wanted her grandparents to stay in the room during her physical assessment. I then explained the process of starting at her head and working downward to her feet by providing privacy throughout the whole assessment. First I started, by observing her appearance and behavior and how well A. communicated with me, A.’s behavior was calm, cooperative and appropriate for her age. I assessed PERRLA in both eyes, her pupils were a 3, equal, round, reactive to light and accommodated. I assessed her mucus membranes which were pink and moist along with assessing her throat by looking at the back of throat and checking for bleeding , whitish area, and odor. I then asked her if she had any frequent swallowing and trickling of blood in her throat. A. stated she did not have any frequent swallowing or blood in her throat just some soreness and discomfort in her throat. A.’s throat had white areas on both sides where the tonsils were removed with no bleeding. I auscultated her heart and lungs, and heard S1S2 and her