PET Scan Case Study

History of Present Illness: Mr. Olson is a very pleasant 57-year-old gentleman with multiple medical problems to include severe COPD, who is here today for an initial consultation for his shortness of breath. He is followed by a pulmonologist Dr. William Goodman, at the Veteran Affairs Administration. His last evaluation there was in February 2015. Mr. Olson states he has had ongoing dyspnea on exertion over the last two years. He complains of minimal cough. He does note some sinus problems for which he is on Flovent. In the past, he has had pulmonary function testing that did demonstrate reversible airflow obstruction, therefore he likely has some component of asthma overlay. He states that occasionally has chest tightness and chest heaviness. He has gained about 25 pounds over the last year. He is currently using Spiriva, albuterol as needed as well as Symbicort. He is also using supplemental oxygen at 2.5L per minute at night as well as on an as needed basis during the day. Mr. Olson admits to continued tobacco use with about a half pack to a pack a day. He states that when he is feeling depressed, he will smoke more.

A recent doctor 's visit reveals that Mr. Amos has stage 3 lung cancer, characterized by his symptoms of nagging chest pain, fatigue, coughing up blood, substantial weight loss, and increased carbon dioxide levels in his blood. The doctor informed Mr. Amos that had he quit his smoking habit several years ago, he would have reduced his risk for developing lung cancer later in life. Mr. Amos immediately begins treatment for the lung cancer that has metastasized to his lymph nodes.

A chest X-ray and CT scan result demonstrated a cavitation of the right lower pulmonary lobe. This result alone along with Bob’s history of smoking is a big red flag related to lung cancer. Bob’s history reveals that he has been smoking a ½ pack or more per day for 37 years. According to a study done on the diagnosis, staging, and treatment of lung cancer, habitual smokers have the highest risk of developing cancer of the lung than any other cancer (Herth, Eberhardt, Ernst, 2006). The study also concludes that a related association with lung cancer is swelling of the tissue, lung tumors and/cavitation, lymph in the bronchioles, and paratracheal areas. The swelling can lead to an obstructed airway, which matches Bob’s symptoms as well. Chest pain, stridor, and chest pain are all indications of complications in the respiratory system.

A cousin of mine, Susan, approached me after her father received open heart surgery. Susan’s father, age 59, has been a chronic smoker since the age of 19. What went from two cigarettes a day quickly become two packs a day, with no end in sight. During July of 2015 he complained of feeling dizziness, shortness of breath,

HISTORY OF PRESENT ILLNESS: David Lockman is here for followup for his traumatic saw injury to his right knee. He is about two and half weeks out now. He was seen, I believe a week or so ago or two weeks ago perhaps, by one of my partners. He was sent for therapy, although he has had some delay in therapy. He just started therapy. He did get a blood clot, I believe recently, and is now on Xarelto for that. He states that the swelling in his leg is much better, at this point. He does continue to smoke, however. I believe he is a half a pack or one pack per day smoker. Again, I went over smoking cessation with him, as well as the risks of uncontrolled bleeding with the Xarelto that he currently on. He understands this, so he should

History of Present Illness: Ms. Noseworthy is a 76-year-old woman who I had seen at the end of July for the evaluation of ILD. She is here today for followup of those results. She has stable cough and shortness of breath. She states that she is exercising on a treadmill on a daily basis and bought an oxygen saturation monitor, which consistently has shown her oxygen levels to be in the low to mid 90's. She denies any chest pain. She has no other complaints today.

Complains of burning eyes, clear drainage from the nose, as well as waking up with dark circles under her eyes. Sometimes wakes up during the night coughing and states it has been like this “since the smoke started.”

Ms. B.T. is a Seventy-seven years old African American female who was brought to Southern Maryland Hospital by her son and daughter in-law on 11/21/14 with a chief complaint of increased fatigue and shortness of breath that has been on going for about 3 days. She has been a smoker of 3-4 packs of cigarette since she the age of 16 years old, but claimed to have stopped smoking since the on set of the symptoms. She is a retired elementary school history teacher that was diagnosed with acute exacerbation of COPD, and was transferred to the medical surgical unit for further evaluation.

Amelia has a history of smoking for thirty years until this year in May she has totally ceased. She enjoys travelling around the world and has been working in German for five years. In 1987 and 1989, Amelia had a right knee arthroscopy. She states sometimes she may have hypertension.

The patient is six years old suffering from coughing , that means it’s a respiratory system related illness (lungs) smoking is ruled out that only leave few symptoms because he’s a child its either Asthma , Allergic reaction or Emphysema.

A sixty-four-year-old male patient with a thirty-five-pack year history of smoking presents to the family practice clinic with progressive difficulty breathing upon performing manual labor or simple tasks and no symptoms while sitting. He also complains of a cough, fatigue, and weight loss. Over the past three years, he has been treated for a respiratory infection each year, and the patient states he feels like another is developing again. Physical examination reveals clubbing of the fingers, use of accessory muscles during respiration, wheezing during auscultation, and hyper-resonance on percussion of the lungs. Pulmonary function studies show FEV1 of 58%. The following paper will discuss patient R.W.’s diagnosis, treatment goals, laboratory values that may be monitored, treatments that may be initiated, monitoring parameters, patient education, adverse reactions that may occur, health promotion education, and long-term prognosis for this patient.

On auscultation her lungs were clear with slightly diminished breath sounds to the bases bilaterally. She states that she does cough on occasion throughout the day which produces a scant amount of clear/yellowish sputum. She advises that she is a smoker of 3 cigarettes per day for apx 45yrs (7pack year hx). Given the pleural effusion seen on xray on Feb 16, smoking, COPD, and recent course of ABX (Clavulin) may be the cause of the sputum (not purulent, not green,

He is a primarily at risk from build-up of secretions on his lungs and potential COPD. His notes say he smoked 20 cigarettes a day up until recently but it does not specify how long he has stopped smoking for. Cigarette smoke can cause hypertrophy and hyperplasia of the goblet cells which leads to the mass production of mucus. Cigarette smoke also has an impact the cilia movement which are used to clear secretions, the smoke in cigarettes makes these cilia smaller and move in different ways which makes them unable to remove the build-up of secretions (Lui, 2012). Damage to the cilia is caused by elements in the cigarette smoke for instance carbon dioxide, carbon monoxide, hydrogen cyanide and nitric oxide. Several studies have shown smoking is linked to respiratory tract infections and build-up of secretions in a smokers lungs (Lui, 2012). Mucociliary is a self-clearing mechanism which allows the body to remove inhaled pathogens and other particles. Pulmonary infections and injury to the lungs in patients with COPD and other lung disorders often occurs when mucociliary function is compromised (Lui,

Active smoker-10 cigarettes per day since the age of 24. No other significant breathing problems.

This is a 36 year old wihte femle who is here complaining of cough, sinus congestion, fever, and gneralized body ache for 4 days. Patient is a resident at Lovelady and reports many ladys are sick at the center. Patient is a smoker with a history of one pack for 20 year hisory. Patient denies use of alcohol or illicit drug use.Patient denies chest pain, N/V/D, but rports SOB and