Collapse Case Studies

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

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

A (assessment): Ms. O’Reilly’s vital signs are temperature of 37.5 C, pulse of 112, blood pressure of 102/52, and respirations of 24. Her respirations are still deep but have a regular rhythm. She has a CBS of 8.1 and regular insulin running as per orders. The lab work shows uncompensated metabolic acidosis with no hypoxia. Ms. O’Reilly’s neurological status has improved with a GSC of 13. Her dehydration is being treated with NS containing 40mEQ KCL/L running at 200ml/hr and potassium levels maintained at 4.

The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.

The Collapse: The Accidental Opening of the Berlin Wall by Mary Elise Sarotte explains the causes and events leading up the opening of the Berlin Wall. By first describing the state of Eastern Europe, Sarotte leads the reader into descriptive chapters about the people and events that lead up to November 9, 1989. The story of the opening of the Berlin Wall, or the Iron Curtain as some call it, is compelling told by using a profusion of sources and actions that all play a major role in this watershed moment in history.

Childhood illnesses include measles, mumps, rubella, and chickenpox. She has fallen many times however, has never broken any bones. Serious traumas include three concussions. Has had many surgeries including tonsils removed, gastric bypass, right hip replacement, 2 bilateral knee surgeries, cataracts removed, back surgery and is waiting for shoulders to be replaced. Reports sinus infections in the spring and fall due to pollen and mold. These symptoms are similar to the ones she is experiencing now. Several years ago, she traveled around the world for 7 months and was in England for the Mad Cow Disease outbreak.

On December 2nd around 10:30 a.m., a building in downtown Sioux Falls, South Dakota collapsed. Fear stuck the hearts of many as they heard the deafening collapse of a downtown building on 10th Street and Phillips Avenue. Many first responders and police quickly moved to try and find survivors. Hundreds of people waited for survivors to be pulled out from the debris. Cheers erupted when three hours after the collapse, firefighters found Emily Fodness alive underneath the rubble. Sadly, Ethan McMahon, a construction worker, was found dead underneath the rubble almost five and a half hours after Emily was rescued. Hultgren Construction is under investigation for causing the collapse.

At today’s visit she is accompanied by her daughter and friends. She is awake, alert and oriented. She complains of abdominal pain that is a 10/10. The pain is a deep cramping pain

Seven people were killed when high winds toppled the stage at the Indiana State Fair right before a concert begins. “The Indiana Occupational Safety and Health Administration (IOSHA) on Wednesday issued a scathing report about last summer’s deadly stage collapse” (Puente, 2012). IOSHA fined three organizations for failure to do their job and keep the public safe.

The most likely diagnosis for this severe abdominal pain located within her right lower quadrant and amongst her right side would be an acute appendicitis due to inflammation of the appendix.

There are two possible causes for this condition that are revealed in the case study. The first cause is that the patient was sick with the flu during which she was vomiting multiple times each day and unable to keep down any foods or liquids, resulting in her becoming dehydrated. This dehydrated state reduces the amount of plasma in the blood stream, causing an alkalemia effect (WHO, 2010). This is further exasperated by the loss of gastric secretions, which are very high in hydrochloric acid. This hydrochloric acid typically enters the bloodstream in small amounts, encouraging the necessary homeostatic state for proper blood

one placid evening, April and Amber were having a good time , suddenly Amber was collapsed they rushed her to the hospital. The doctor discovered that Amber has a very serious illness that needs to be treated right away. The doctor tried to condole April about Amber's condition, so April called her amiable grandmother and spoke to her about Amber's condition. she was really upset about the sad news. The only thing she could do is support her with the money to get the treatment she needs. So, she asked April if she could stop by her house and give her the money. While going home April met her friends to go out and decided to be desirous with the money and have a good time. She spent all her sister's treatment money on her selfish needs and

Should she become more symptomatic in the near future, it would be reasonable to perform bronchoscopy for AFB cultures and should those results be positive, I believe further consideration for Mycobacterium avium complex infection therapy would then be warranted. She does have some plural thickening as noted on her CT scan in May and I have ordered a six-month repeat CT scan for follow up. It is interesting to note that she does have some nodular disease that are both tree and bud as well as in a bronchovascular distribution, which calls to question the possibility of sarcoidosis as well. However, she does not have any significant mediastinal or hilar

Also, I am offended that you believe I am trying to earn a passing grade without doing the course work. It is impossible to receive a passing grade without doing the work. The work has to be available in order for me to complete it.

Collapsing is a common presenting complaint in emergency rooms and can be caused by diseases affecting many different body systems, including cardiovascular, pulmonary, neurological, musculoskeletal and systemic diseases. When an animal presents with a history of collapsing, appropriately defining the presenting complaint is essential to initiate the correct diagnostic pathway. In this lecture, I will discuss how to initially approach the collapsing dogs and cats by constructing a list of differential diagnosis based on the history and physical examination findings, how to initiate a correct diagnostic pathway, and initial treatment plans based on the affected body systems. I will first emphasize the importance of ruling out potentially life-threatening