23. One day after an uncomplicated vaginal delivery at term of a healthy 3465-g (7-lb 10-oz) male newborn, a 32-year-old woman, gravida 4, para 4, has a 12-hour history of episodes of increasingly severe lower abdominal cramps. The cramps usually occur when she breast-feeds her newborn. She has no history of serious illness and takes no medications. Her temperature is 37°C (98.6°F), pulse is 82/min, respirations are 18/min, and blood pressure is 124/72 mm Hg. The uterine fundus is firm and consistent in size with a 22-week gestation. Release of which of the following is the most likely cause of this patient's symptoms? A) Angiotensin B) Oxytocin C) Parathyroid hormone D) Prolactin E) Renin
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- 16. A 32-year-old woman comesto the physicianbecause of a 4-month history of fatigue; she also has hada 9-kg (20-2)weight gain during this period. Her blood pressure is 150/38 mm Hg; 1 year ago, her blood pressure was 120/85 mm Hg. Physical examination shows moon facies, truncal obesity, and purple striae over the abdomen. Serum situdes showan increased adrenocorticotropic hormone concentration, consistent with measurements at her two most recent visits. This patient most likely has which of the following pathologic changes in the adrenal gland? A. Hyperplasia of zona fasciculata B. Hyperplasia of zona glomerulosa C. Hypertrophy of medulla D. Hypertrophy of zona glomerulosa E. Hypertrophy of zona reticularisCase study 1 A 28 year –old Asian woman is referred by her general practitioner (GP) with persistant vomiting at 7 weeks gestation. She is in her second pregnancy having had a normal vaginal delivery 3 years ago . She is now vomiting up to 10 times in 24 hours and has not managed to tolerate any food for 3 days. She can only drink small amounts of water. She saw her GP a week ago who prescribed prochlorperazine suppositories but these only help for a few. She feels very weak and is unable to care for her son now. On direct questioning, she has upper abdominal pain that is constant, sharp and burning. She has not opened her bowels for 5 days. She is passing small amounts of dark urine infrequently but there is no dysuria or haematuria. There has been no vaginal bleeding. There is no other medical or gynaecological history of note except that she suffered persistent vomiting in her pregnancy requiring two overnight admissions. EXAMINATION She is pyrexia. Lying blood pressure is…Case study 1 A 28 year –old Asian woman is referred by her general practitioner (GP) with persistant vomiting at 7 weeks gestation. She is in her second pregnancy having had a normal vaginal delivery 3 years ago . She is now vomiting up to 10 times in 24 hours and has not managed to tolerate any food for 3 days. She can only drink small amounts of water. She saw her GP a week ago who prescribed prochlorperazine suppositories but these only help for a few. She feels very weak and is unable to care for her son now. On direct questioning, she has upper abdominal pain that is constant, sharp and burning. She has not opened her bowels for 5 days. She is passing small amounts of dark urine infrequently but there is no dysuria or haematuria. There has been no vaginal bleeding. There is no other medical or gynaecological history of note except that she suffered persistent vomiting in her pregnancy requiring two overnight admissions. EXAMINATION She is pyrexia. Lying blood pressure is…
- Case study 1 A 28 year –old Asian woman is referred by her general practitioner (GP) with persistant vomiting at 7 weeks gestation. She is in her second pregnancy having had a normal vaginal delivery 3 years ago . She is now vomiting up to 10 times in 24 hours and has not managed to tolerate any food for 3 days. She can only drink small amounts of water. She saw her GP a week ago who prescribed prochlorperazine suppositories but these only help for a few. She feels very weak and is unable to care for her son now. On direct questioning, she has upper abdominal pain that is constant, sharp and burning. She has not opened her bowels for 5 days. She is passing small amounts of dark urine infrequently but there is no dysuria or haematuria. There has been no vaginal bleeding. There is no other medical or gynaecological history of note except that she suffered persistent vomiting in her pregnancy requiring two overnight admissions. EXAMINATION She is pyrexia. Lying blood pressure is…Case study 1 A 28 year –old Asian woman is referred by her general practitioner (GP) with persistant vomiting at 7 weeks gestation. She is in her second pregnancy having had a normal vaginal delivery 3 years ago . She is now vomiting up to 10 times in 24 hours and has not managed to tolerate any food for 3 days. She can only drink small amounts of water. She saw her GP a week ago who prescribed prochlorperazine suppositories but these only help for a few. She feels very weak and is unable to care for her son now. On direct questioning, she has upper abdominal pain that is constant, sharp and burning. She has not opened her bowels for 5 days. She is passing small amounts of dark urine infrequently but there is no dysuria or haematuria. There has been no vaginal bleeding. There is no other medical or gynaecological history of note except that she suffered persistent vomiting in her pregnancy requiring two overnight admissions. EXAMINATION She is pyrexia. Lying blood pressure is…Case study 1 A 28 year –old Asian woman is referred by her general practitioner (GP) with persistant vomiting at 7 weeks gestation. She is in her second pregnancy having had a normal vaginal delivery 3 years ago . She is now vomiting up to 10 times in 24 hours and has not managed to tolerate any food for 3 days. She can only drink small amounts of water. She saw her GP a week ago who prescribed prochlorperazine suppositories but these only help for a few. She feels very weak and is unable to care for her son now. On direct questioning, she has upper abdominal pain that is constant, sharp and burning. She has not opened her bowels for 5 days. She is passing small amounts of dark urine infrequently but there is no dysuria or haematuria. There has been no vaginal bleeding. There is no other medical or gynaecological history of note except that she suffered persistent vomiting in her pregnancy requiring two overnight admissions. EXAMINATION She is pyrexia. Lying blood pressure is…
- 13. After undergoing a kidney transplant , a 42- year old man requires an antivirtal drug for hepatic lesion, an antigungal drug for esophageal candidasis and , an anti bacterial drug for sinusitis. He is also receiving treatment with cyclosporine for immunosuppression. if an increase in his serum cyclosporine concentration is most likely due to drug-to drug interaction, which of the following drugs is the most likely cause of this findings? (A) Acyclovir (B) Cefoxitin (C) Fluconazole (D) Penicillin (E) TetracyclinCASE STUDY Ruth, a 25 year office worker, decided to visit the doctor’s office after noticing changes in her body. She complained of severe nausea, vomiting, stomach pains and loss in appetite. But her biggest worries are her frequent skin itching, bloated belly and apparent yellowish pallor. After physically examining Ruth, the doctor ordered several laboratory tests. These include CBC, Coagulation studies, blood chemistry and Serologic tests. The results showed Prolonged Prothrombin time, increased INR, decreased blood proteins such as albumin, elevated liver enzymes and bilirubin levels. Her serology was reactive for the Hepatitis B surface antigen, positive for Total anti-HBc but negative for the anti-HBe and anti-HBs Answer the following questions, using the medical information of Ruth. 1. What do you think is the health issue of Ruth? Provide medical evidence.CASE STUDY Ruth, a 25 year office worker, decided to visit the doctor’s office after noticing changes in her body. She complained of severe nausea, vomiting, stomach pains and loss in appetite. But her biggest worries are her frequent skin itching, bloated belly and apparent yellowish pallor. After physically examining Ruth, the doctor ordered several laboratory tests. These include CBC, Coagulation studies, blood chemistry and Serologic tests. The results showed Prolonged Prothrombin time, increased INR, decreased blood proteins such as albumin, elevated liver enzymes and bilirubin levels. Her serology was reactive for the Hepatitis B surface antigen, positive for Total anti-HBc but negative for the anti-HBe and anti-HBs 1. What do you think caused the liver disease of Ruth? Explain your answer2. What other hepatitis virus can infect Ruth?3. Is it an acute or a chronic infection? Explain your answer
- Case Study #1: Ms. C is a 19-year old college student. She was brought to the ER with symptoms of nausea, vomiting and gastric pain and diarrhea for two days. Upon interview, patient revealed that she ate street foods a few hours before the symptoms developed. She is dehydrated with urine output of 500 ml/day, pale and dry skin, her temperature is 38.2 C, and stool culture revealed Salmonella infection. She was given IV fluids and loperamide. 1. Make a SOAP Chart for this case5) Female,54 years old, with a history of gallstone for 8 years. Severe upper abdominal pain for 2 days radiating to the waist, accompanied by nausea and vomiting,and the blood amylase increased twice The following most valuable check is() A Abdominal X-ray B Upper gastrointestinal barium meal C ECG D Abdominal CT E EndoscopyCase Study #1: Ms. C is a 19-year-old college student. She was brought to the ER with symptoms of nausea, vomiting and gastric pain, and diarrhea for two days. Upon interview, the patient revealed that she ate street foods a few hours before the symptoms developed. She is dehydrated with a urine output of 500 ml/day, pale and dry skin, her temperature is 38.2 C, and stool culture revealed Salmonella infection. She was given IV fluids and loperamide. Make a SOAP (Subjective, Objective, Assessment, and Plan) Chart for this case. What is salmonellosis? What causes it? How is it diagnosed? What are the Symptoms? How is it managed? Discuss how salmonellosis can be prevented.