Calhoun Eye Case Study

He admits to a 25 pound weight gain over the last few months. The patient was

The Client’s mother died at 45 years old from typhoid fever and her sister had breast cancer in 2013 and had double mastectomy. Client’s father died at 40 years old from unknown cause. Client’s maternal grandfather died at 90 years old from stroke and he passed away in the

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

The patient was referred for a new itchy and tender bilateral groin lesions that the patient says will drain pus. He also has multiple other complaints. He gives a history of being allergic to DOXYCYCLINE. As previously stated, he has tender sites which can drain pus off and on in his groin for years. There is also history of facial acne and scalp acne since his late teens. He took Accutane during his 20s with improvement by history. He flared and repeated Accutane about one year after completing the first course by his history. He is bathing with unscented Dove and uses cocoa butter lotion. He also has a second problem of itching over his back, shoulders, and arms, and legs

BB’s skin presents as pink, warm and dry. No obvious signs or symptoms of abnormal bruising or lesions present however, the patient states that the skin has of late has

Eye Vision Inc, a long-standing medical device manufacturer, has signed a contract to sell Holland Hospital the Clear View Laser and a two-year separately priced maintenance plan for $1 million and $0.2 million respectively. On a when-and-if available bais, Eye Vision Inc. will provide software updats that is embedded with the Laser to maintainance purchasor. The software has never been sold without Laser for its functional necessity. In this memo, as explained below, we conclude that:

Medical Update: Client has no current medical issues. CM observed that the client is having problem with the eyes. CM on numerous occasions referred the client to Laser Eyes but the client was no show.

PHYSICAL EXAMINATION: HEENT: Tympanic membranes and external auditory canals are within normal limits. Throat is clear with no gingival lesions. He is ______________. No obvious proliferate retinopoathy. NECK: No carotid bruit. No thyroid enlargement. LUNGS: Clear to auscultation. HEART: No S3, S4 or murmurs. ABDOMEN: Soft with no organomegaly. Normal bowel sounds. FEET: Good dorsalis and posterior tibial pulses bilaterally. Left foot has no abrasions, lesions, sores or ulcers. Right foot shows obvious deformity from previous break. He has an area located between his second and third metatarsal head that has clearly been an abscess that has broken through. He also has an obvious foot ulcer located over the instep of his right foot, full thickness. There is tracking to the broken foot, to which the ulcer area is connected and there is a question of osteomyelitis in this area.

Patient is a 9 year old adolescent male, presents with a 2 day history of itching encrusted sores especially around the mouth area. Parent is using OTC antibiotic ointment with no improvement, no recent history of fever. Parent states that pat recently visited a petting zoo

Mr. .J. is a 30 year old Caucasian male presented to the Emergency Department with symptoms of myalgia, fever, rash, swollen glands, leukopenia, and thrombocytopenia. Mr. J. reported fever and sore throat started about a week ago and the rash presented today. Mr. J. stated “I thought I had the flu but I am not feeling any better and now I have a rash, that’s why I decided to come to the E.D.”. (Health and Human Services panel, 2013)

Extraocular muscles are intact. Conjunctivae are without erythema. No drainage or discharge from the eyes. There is no involvement of the eyelid and the nearest lesion is approximately 1.5 to 2 cm lateral to the left eye. He does have multiple vesicular lesions, some of which he has rubbed and no longer have the vesicle and appear to be just almost shallow ulcerations. This extends along the temporal area, on the left side into the ear canal itself and I do see similar lesions in the ear. Again, many of which have been ruptured and there is dried blood all through the canal as well. There is no other abnormality noted. There is no wax. I can see the TM. It does not appear to be involved. There is no involvement behind the ear. No pain at the mastoid process. Mucous membranes are moist. There is no mucosal lesions. No

Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician

Pupils equal and round, reactive to light. Wears glasses, had injury to eye in 2008 where traumatic Cataract removed and lens was implanted.

General Appearance: The patient is 36-year-old Caucasian woman who is in no apparent distress. Patient is alert and oriented to person, place, time and situation, cooperative, well-nourished, well-groomed, and dressed appropriately for the weather. Hygiene is excellent

“Quality means consistence conformance to costumer expectations” (Slack, Chambers & Johnston 2010 pg 40) Quality for the London eye could mean designing a structure that provides a bird’s eye view of London. Quality could also mean a high design of their processes, including ensuring that all 32 capsules are cleaned, staff are well trained in health and safety and are always professional at all times. Quality also means the London eye is safe and reliable. Quality also means that the timed admissions booking systems (TABS) is on time. Quality could also mean error free processing for their timed admissions system. Quality means that all parts for the London eye is made to specification and the assembly is