T. A Case Study

S: YMR stated that she had been living with her mother about one year, has is a newcomer. YMR lived with her maternal grandmother for many years back in her country. YMR stated that when she arrived to the U.S., she found out that her mother was pregnant, She shared that her mother did not want to tell her because she did not know how the client was going to react. YMR stated that she was happy because her mother had had four miscarries before. YMR explained that almost at the same time that she started living with her mother, the mother's partner and father of the child that her mother was going to have moved into her home. YMR stated that her mom used to work from 6am-12pm and the YMR spent a lot of time with her mother's partner. YMR stated that this man has

S.R is a 69-year old man who presents to the clinic because his “wife complains that his snoring is difficult to live with.”

1) Days cash on hand was 66.87 in 2012 and it dropped in 2013. This is better because they are potentially paying off debt and there is no need to just keep money sitting.

Nikoleta’s lab results are not normal. Her white blood cell count is far higher than the average threshold, her MCV is lower than normal, and her hemoglobin is drastically lower than the normal threshold level. The only two components that were normal were her red blood cell count and platelet count. As seen in the figures, her red blood cells are of a light pink color, when they should instead be a dark red color under the microscope.

This type of research is very valuable. This type of research is the most accurate and best way to fully understand the virus. It may be time consuming but it is the best way to study the virus.

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

As a provider, one will care for many patients that have different types of anemia. Anemia is not so much as a disease as a symptom of an underlying issue. Although there can be particular signs and symptoms associated with anemia, the basis of a diagnosis is from laboratory data. For the purpose of this discussion, I will evaluate a case study and give a differential diagnosis. I will also assess how patient history, physical exam, and lab reports support my diagnosis. I will explain the pathophysiology of the type of anemia and give causes and treatment options available.

low platelet count and low white blood cell count. In reference to Mr. J.’s symptoms and CBC results additional diagnostic labs were ordered.

Elevated urine microalbumin/creatinine ratio. His last labs in January did show a mild increase. I will recheck that along with a basic metabolic panel and inform him of those results. A copy of them will be sent to Dr. Dourdoufis, as

People who have Myelodysplastic Syndrome may not experience symptoms at the beginning of the disease. However, there are three main signs that can develop and alert healthcare providers that something is wrong. One of these is a low red blood cell count, or Anemia. Most patients that have myelodysplastic syndromes exhibit this indicator when first diagnosed. A normal red blood count can vary between 4.0 and 6.1 million red blood cells per microliter of blood in the body, depending on the age and sex of the patient. A red blood cell count lower than normal is characteristic of Anemia (Cafasso, Jacquelyn, and Gotter). Not only is Anemia shown by constantly low hematocrit, but it can also be characterized by constantly low hemoglobin. A normal hemoglobin count is between 12.0 and 15.5 grams per deciliter of blood for females, and 13.5 to 17.5 grams per deciliter of blood for males. Levels lower than these show a low hemoglobin level (Mayo Clinic, Hemoglobin Test). Hemoglobin is the protein in blood that carries oxygen to the different tissues in the body.

little or no urine when urinating, swelling in the legs and feet, not feeling like eating,

Case No. 2: A 78-year-old female and nursing home resident, presented with fever and confusion, was diagnosed with pneumonia and UTI. Her past medical history was significant for CKD with AKI (GFR: 10 ml/min/1.73m2 -15 ml/min/1.73m2, BUN: 35mg/dl - 40 mg/dl), hypertension, dementia, diabetes mellitus and congestive heart failure. The patient had inconsistent responses regarding initiation of the dialysis

Mr. Armstrong has a history of renal insufficiency and uncontrolled hypertension, along with symptoms of fatigue, pedal edema, and occasional shortness of breath. He does not have a history of trauma or obstruction to his kidneys, but his creatinine and BUN levels are currently at 3.5 mg/dl and 40 mg/dl. Normal creatinine concentration values are 0.7 to 1.2 mg/dl and normal BUN values are 10 to 20 mg/dl; this reveals that Mr. Armstrong’s kidneys are not removing wastes properly (McCance, Huether, Brashers, & Rote, 2014).  Mr. Armstrong’s history of renal insufficiency and uncontrolled hypertension is commonly found in patients diagnosed with intrarenal (intrinsic) acute renal failure. Intrarenal acute renal failure can be categorized as

In reading the first article Coach Knight: The Will to Win, I found the article found Coach Knight to be very offensive and mean to his players. Coach Knight did not display good leadership skills. According to the article, Coach Knight’s drive and passion for excellence was not always received as well as his record of wins and losses Snook, Per low, Delacey, 2005).

Tale servizio, offerto da Tyring, prevede la sostituzione del battistrada consumato con del materiale nuovo,