Multiple Myeloma Case Studies

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.

PAST MEDICAL/SURGICAL HISTORY: As above. SOCIAL HISTORY: Status post heavy smoking, 50+-pack-year history. He quit 10 years ago. Status post alcohol abuse, quit 3 or 4 years ago. He lives by himself and no longer drives but has 2 daughters here in Miami who take him where he needs to go. FAMILY HISTORY: Patient’s wife died 14 years ago of COPD due to lifelong smoking. Brother has diabetes mellitus. Unremarkable family history otherwise. REVIEW OF SYSTEMS: No fever, no nausea, no vomiting. Patient has incontinence of bowel. No shortness of breath, no chest pain, no palpitations. PHYSICAL EXAMINATION: Well-developed, well-nourished white male who is alert and oriented x3. Wears bilateral hearing aids. Afebrile with blood pressure 130/70. NECK: No carotid bruits. LUNGS: Clear to auscultation bilaterally. HEART: S1, S2 normal. No murmur. No S3 or S4. ABDOMEN: Soft, nontender. No arterial bruits. No masses, no organomegaly. EXTREMITIES: No edema. No pulses present in the lower extremities. The right great toe is absent. The left great toe shows a 2 x 1 cm deep ulcer with redness around the toe with pus extruding. PLAN 1. Get consult with Dr. Beth Brian, Infectious Disease. 2. Follow up with Dr. Hirsch, Orthopedics. (Continued)

The claimant is a 48-year-old male who fell off a ladder while working and fell 15 feet backward striking his head, sustaining an acute right subdural hematoma, multiple rib fractures, and left-sided nondisplaced clavicle fracture. He was admitted to the hospital on 11/27/2017 and was discharged to home on 12/05/2017.

Dimmesdale who is one of the main character in the Scarlet letter by Nathaniel hawthorne, appeared to be sick and haved sinned. Dimmesdale and hester prynne both have commit the sin adultery. Hester was punished but Dimmesdale had hid his sin for only Hester knew until her husband came and found out.

Osteosarcoma(OS) is a primary malignant tumor of bone which is characterized by the formation of osteoid tissue. Although it is the most common malignancy of long bones after multiple myeloma [2], it is a relatively rarer entity in the craniofacial region. About 6% of Oss arise in the jaws .The estimated incidence of the new cases of Jaw OS (JOS) per year is 0 .07 in 100,000. (1) The etiology of OS is unknown, but some risk factors such as a previous history of ionizing radiation, alkylating agent, retinoblastoma and benign bone lesions such as paget disease and fibro osseous dysplasia have been associated with the development of head and neck OS.(2-4) JOS occur with a peak in the third through fifth decades of life. The mean age is

Multiple myeloma (also plasma cell myeloma also known as MM, myeloma, plasma cell myeloma, or as Kahler's disease) is a progressive hematologic (blood) disease. It is a cancer of the plasma cell, an important part of the immune system that produces immunoglobulins (antibodies) to help fight infection and disease.

At the height of the transition of Philadelphia’s economy from agricultural to industrial, Philadelphia experienced a period of economic prosperity for almost all its citizens. Businesses were booming, new projects and development were established, the banking and commerce industries soared and a record number of jobs were created enabling the city to reach full employment rate, something that the city has yet to experience since. Citizens were confident in the government and financial institutions were equally confident in their citizens as evident by lax lending habits. As all good things typically come to an end, Philadelphia had an economic turn for the absolute worse. In 1920, the stock market crashed with several major bank failures and employment rate plummeted. The city then went through the worse financial time in the history of the U.S. known as the Great Depression. Citizens looked to their government for ways and means of ending the suffrage wreaking havoc on a once thriving and prosperous city. The significant increase in unemployment rate resulted in citizens losing trust and hope in the Republican Party, the party in power at the time. The New Deal initiative was then developed under President Roosevelt, which slowly ushered in the recovery of the economy and the city as a whole. The effects of the Great Depressions were alleviated to some degree; nevertheless the city struggled to achieve economic stability once more, but there was hope in sight. Despite the

A 56 year old male arrives in the emergency room after complaints of severe pain to the upper abdomen and jaw. For 7 years he has been seeing a doctor off and on for high blood pressure. He has hyperlipidemia. He smokes ½ packs of cigarettes per day.

The patient was referred to the Radiologist from his GP, because of ongoing pain and difficulty when swallowing. The patient was 45years old male, consumed alcohol regularly and a heavy smoker.

Causes: the NCI has no information or evidence of causes for this type of cancer.

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

Get the reader’s attention. Set the scene. Who is involved? When and where did the event take place? Parents Sara and Brian Fitzgerald have a daughter Kate who at the age of two was diagnosed with a rare and aggressive form of leukemia.

Recurrent invasive ameloblastoma of the infratemporal fossa is an uncommonly encountered phenomenon in the practice of oral and maxillofacial surgery and presents many surgical challenges for the practitioner. This case report will present a patient who underwent previous resection of a mandibular ameloblastoma with multiple recurrences. The patient was diagnosed with a recurrent ameloblastoma of the infratemporal fossa that was subsequently resected and reconstructed using an anterior lateral thigh (ALT) free tissue transfer. There are only few reported cases of recurrent ameloblastomas in the infratemporal fossa and none that describe surgical resection and reconstruction of such a lesion. Due to the uniqueness of the surgical defect an ALT

The patient is an 80-year-old female who presents to the ED with increased dizziness, vomiting and increased nausea. She denies any other symptoms. She felt as if she was spinning and the room was spinning but other than that she had no loss of consciousness, slurred speech, no inability to speak at any time and no type of weakness. The patient's medical history is significant for rheumatoid arthritis, hypertension, and melanoma in 1981. Medications are Metoprolol, Suldac and aspirin which she has stopped taking them because she does not like them. Laboratory work is essentially unremarkable. CT of he head shows no acute nfarct, no hemorrhage or mass effect no midline shift or bleed. She does have calcification of the internal carotid

Multiple myeloma is blood cancer that starts in the plasma cells in bone marrow. Plasma cells are white blood cells that help your body fight infection by producing proteins called antibodies. When plasma cells grow out of control in the bone marrow, they no longer perform their intended function in the immune system, they form tumors in the areas of solid bone, and the growth of these bone tumors makes it harder for the bone marrow to make healthy blood cells and platelets. Multiple Myeloma is the second most common blood cancer in the United States and constitutes approximately 1 percent of all cancers. The age-adjusted death rate was 3.4 per 100,000 men and women per year, based on patients who died in 2005-2009 in the US. A plasmacytoma is tumor formed by a collection of aberrant plasma cells in a single location. Plasmacytomas may be an indication or precursor for multiple myeloma. This paper presents some highlights of the current approach for evaluating and treating plasmacytomas. I am writing about this problem because my father encountered a rare form of plasmacytoma last year that fortunately turned out to be an isolated occurrence with no indication of systemic disease.