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- A 63-year-old female with a past medical history significant for diabetes mellitus,cirrhosis, gout, and a 30-pack a year smoking history presents to the emergency roomwith chest pain revealing pericarditis in the echocardiogram, secondary to recentlydiagnosed end-stage renal disease. Physical examination reveals yellowishdiscoloration to the skin and sclera, multiple bruises, 2+ bilateral edema, and weaknesslasting more than three weeks. Her medications include Glisten, a new drug for diabetesthat causes ATP sensitive potassium channels to close, thereby releasing insulin. Herrecent laboratory results are as follows: What is the correlation between her illnesses and the low vitamins (D, K, E, and A), renin, and aldosterone levels?7. Which hormone would the body elevate in response to her low calcium levels?Why?For the following cases, what are the signs AND symptoms mentioned, whether the patient has them or not? A 35-year-old woman is seen for easy fatigue for many months. She is now 24 weeks pregnant with her 3rd child in 3 years. She does not see any obstetrician and does not take any vitamins. Lately, she has developed a taste for eating ice. She has no other complaint. Family and past history are negative. She does not smoke or drink. Physical examination is positive for pale conjunctiva, mild spooning of nails, and an II/VI systolic murmur at left lower sternal border. Stools are negative for occult blood.A. A 22-year-old woman (previously adopted, not currently taking medications, negative medical history) presents with hypertension, weakness, and hypokalemia. The patient also has a high urine potassium excretion without diuretics. What is the probable diagnosis? Discuss the patient's disorder. B. A 22-year-old woman (previously adopted, not currently taking medications, negative medical history) presents with hypertension, weakness, and rapid onset of obesity. This patient also exhibits central fat pads, buffalo hump, plethora, thin skin, purple striae, easy bruising, osteoporosis, hyperglycemia/insulin resistance, and recurrent infections. What is the probable diagnosis? Discuss the patient's disorder. C. A 22-year-old woman (previously adopted, not currently taking medications, negative medical history) presents with hypertension, with virilization. This young woman presents with irregular menses diagnosed with polycystic ovary syndrome. She has borderline low cortisol and…
- A 63 yo female w/ a past medical history significant for diabetes mellitus, cirrhosis, gout, and a 30-pack a year smoking history, presents to the emergency room with chest pain revealing pericarditis in the echocardiogram, secondary to recently diagnosed end-stage renal disease. Physical examination reveals yellowish discoloration to the skin and sclera, multiple bruises, and 2+ bilateral edema. Sarah reports weakness lasting more than three weeks. Her medications include Glisten, a new drug for diabetes that causes ATP sensitive potassium channels to close, thereby releasing insulin. Explain the cause of her abnormal stool and urine sample. What cell does Glisten work on? Explain how this medication is able to stimulate insulin secretion.CASE HISTORY 2 The patient was a 19-year-old male who was brought to the emergency room by his sister. He gave a 24-hour history of dysuria and noted some “pus-like” drainage in his underwear and on the tip of his penis. Urine appeared clear, and urine culture was negative although urinalysis was positive for leukocyte esterase and multiple white cells were seen on microscopic examination of urine. He gave a history of being sexually active with five or six partners in the past 6 months. He claimed that he and his partners had not had any sexually transmitted diseases. His physical exam was significant for a yellow urethral discharge and tenderness at the tip of the penis. (A Gram stain done in the emergency room is shown in Fig. 1). He was given antimicrobial agents and scheduled for a follow-up visit 1 week later. He did not return. QUESTIONS: What pathogen caused the disease? Briefly describe the epidemiology and pathogenesis of this disease. What is the morphology and staining…A 5-year-old female has a history of previous lower UTIS. She suddenly becomes very ill and develops rust-colored urine, burning, back pain, and fever. The physician orders a BUN, creatinine, urinalysis, and a urine culture and sensitivity. Her results are below: Increased BUN, Increased Creatinine Dipstick: 2+ protein, 1+ blood, 4+ leukocyte esterase, 4+ nitrate. Other dipstick tests are negative or normal. Microscopic examination: WBCs 25-50/HPF RBCs 5-10/HPF. hyaline cast 0-1/LPF many bacteria. a. What is this patient's condition? WBC casts 5-10/LPF Urine culture: 100,000 colonies/ mL of E. coli, sensitivity pending b. What dipstick findings and what microscopic findings support this decision? c. Is the patient's history significant? d. If the child were taking vitamins and extra vitamin C, could this interfere with the test results?
- Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as…Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as…Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as…