A 37-year-old diabetic, male visits his family physician because his joints have recently become achy. A month ago, he had a bad sore throat. Treatment was not sought at that time. Physical examination reveals he is febrile (100°F) and has a heart murmur which was not evident in the past. No signs of a throat infection are seen, and a rapid strep test was negative. A throat culture was taken. His skin appears normal.
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- The Alaska Department of Public Health was notified that foodborne illness had occurred in fishermen aboard a fishing boat off the Alaska peninsula. The fishermen had eaten steamed clams and mussels, boiled rice, boiled potatoes, and green salad. No alcohol was consumed. Symptoms experienced by the fishermen included numbness of the lips, tingling of the extremities, uncoordinated movements, incoherent speech, and nausea. Identify the etiologic (causative) agent of this outbreak of food poisoning. How did the food get contaminated, and what item was contaminated? What is the treatment, if any? How could this illness have been prevented?Which statement regarding adenocarcinoma of the pancreas is true() A) lt occurs most frequently in the body of the gland B) It carries a 1-2% 5 year survival rate C) It is nonresectable if it presents as painless jaudice D) It can usually be resected if it presents in the body or tail of the pancreas and does not involve the common bile duct E) It is associated with diabetes insipidusA 2-year-old African American boy is brought to his pediatrician because of acute fever, apparent bone pain, and painful swelling of his hands and feet. A physical examination reveals splenomegaly and a blood test shows the presence of hemoglobin S. After the acute symptoms subside with rest, hydration, and the use of analgesics, hydroxyurea is prescribed. This drug would be expected to reduce the risk of further acute episodes of disease via which mechanism? Increasing the synthesis of hemoglobin S Increasing the oxygen-carrying capacity of hemoglobin Reducing the oxygen-carrying capacity of hemoglobin Increasing the levels of hypoxia-inducible factor Increasing the synthesis of hemoglobin F.
- GI Case Study A 45-year-old store manager complained of a burning, gnawing pain, moderately severe, almost always in the epigastric region. The pain is absent when he awakens, appears in midmorning, and is relieved by food but recurs two to three hours after a meal. The pain often awakens him at 1 or 2 a.m. An endoscopic examination and x-ray studies with barium showed normal stomach function but the presence of duodenal ulcers. Fasting serum gastrin levels were normal. H. pylori testing was negative. Treatments for this individual might include the following: Antacids: 15-30 mL of liquid or two to four tablets one to three hours after each meal and at bedtime for six weeks. Histamine (H2) receptor antagonists: cimetidine (300 mg) or ranitidine (150 mg) with each meal and at bedtime for four to eight weeks. Omeprazole (proton pump inhibitor): 20 mg two times a day. Top of Form What is the diagnosis of this individual? What is the significance of doing a fasting serum gastrin level?…GI Case Study A 45-year-old store manager complained of a burning, gnawing pain, moderately severe, almost always in the epigastric region. The pain is absent when he awakens, appears in midmorning, and is relieved by food but recurs two to three hours after a meal. The pain often awakens him at 1 or 2 a.m. An endoscopic examination and x-ray studies with barium showed normal stomach function but the presence of duodenal ulcers. Fasting serum gastrin levels were normal. H. pylori testing was negative. Treatments for this individual might include the following: Antacids: 15-30 mL of liquid or two to four tablets one to three hours after each meal and at bedtime for six weeks. Histamine (H2) receptor antagonists: cimetidine (300 mg) or ranitidine (150 mg) with each meal and at bedtime for four to eight weeks. Omeprazole (proton pump inhibitor): 20 mg two times a day. Top of Form How does omeprazole act in treating this disorder? What is H. pylori? Most person who are H. pylori…Meal Planning and Preparation for Patients Suffering from Different Diseases Diet is a major factor is preventing damage of the organs in the body. It is also important to be aware of the food items to be allowed and restricted to avoid further complications. Please discuss the characteristic, dietary management and rationale of the following disease condition.
- A 63-year-old woman presented with increasing darkening of the skin, dizziness, and easy fatigability, nausea with occasional vomiting and progressive weight loss over eight months prior to presentation. There were no headaches, blurred vision, and neither loss of consciousness nor change in her bowel habit. The medical history and systemic review revealed no abnormality and were not significant as to the likely cause of her disease state. Physical examination revealed an elderly lady, pale, asthenic with generalized hyperpigmentation especially on the face, oral mucosa, palmar creases and knuckles. No features of malnutrition or hypovitaminosis. There was no significant peripheral lymphadenopathy. Main findings in the systemic examination were a pulse of 106 bpm, regular and small; blood pressure 100/60 mmHg supine and 70/40mmHg sitting. She could not stand on account of severe postural dizziness. The apex beat was normal. Fundoscopy revealed a normal fundus. All other systems were…SubjectiveChief Complaint: “I have pain in all of my joints, a swollen left knee, and stiffness every morning.” HPI: Janet Hobbs is a 58-year-old woman who presents to her rheumatologist with generalized arthralgias, a swollen left knee, and morning stiffness. These symptoms have been occurring with increasing severity for the past several weeks. She presented with similar symptoms 3 months ago, at which time her drug regimen was changed from methotrexate and NSAID therapy to her current regimen below. PMH: RA × 6 years S/P, hysterectomy 4 years ago, HTN × 10 years FH: Father died from complications after a traumatic fall at age 65. Mother died of a hip fracture and pneumonia at age 78. No siblings. SH: Housewife; married for 32 years; has two grown children with no known medical problems. Denies alcohol or tobacco use. Volunteers in the community extensively, but has been doing less in the past 2 months. Meds: Hydrochlorothiazide 25 mg PO Q AM, Norvasc 10 mg PO once daily, Nabumetone…A patient with Diabetic Ketoacidosis uses the following medications. Explain the pharmacodynamics of the medications. Diovan 80 mg po OD Prinivil 10 mg po OD Omeprazole 20 mg OD Lantus 18 units subcutaneous q AM Humalog 19 units subcutaneous TID before meals
- A 63-year old presented to a local doctor with a history of alternating constipation and diarrhoea for six months, associated with a feeling of incomplete evacuation following defaecation and several episodes of bright blood coating her bowel motion. A diagnosis was made and a portion of the left colon and rectum was removed surgically. Discuss the aetiology and pathogenesis of the disease and what you consider the most likely cause of the presenting signs and symptoms. Also explain what complications might have ensued if the lesion had not been excised.Patient R., 32 y/o, was delivered with complaints of fatigue, decrease of appetite, intensification of pigmentation in the open areas of the body, palms of the hands, cyanosis, losing weight, nausea and vomiting. The symptoms began to aggravate during 1-2 weeks after acute poisoning. Objectively: arterial pressure – 60/30 mm column of mercury, pulse – 140 beats/minute, skin turgor is lowered, the colour is dark with intense pigmentation of the elbows, scars, skin folds on the palms; clearly low levels of sodium and chlorine, high levels of potassium in the blood; glycemia – 4.3 mmol/l. What is your diagnosis?A. Addisonian crisisB. Uremic coma C. Brain comaD. Acute cardio-vascular insufficiencyE. Hypoglycemic comaA 55 year old lady with a history of recurrent admissions to the hospital to receive chemotherapy for breast cancer. She was admitted to the intensive care unit multiple times with hypotension and uncontrolled diabetes mellitus with significant hyperglycemia. She was diagnosed with hospital acquired pneumonia with hypoxia. Which of the following statements is correct? -Antibiogram focuses on the empiric use of broad-spectrum antibiotics. -Aztreonam cannot be used in patients with penicillin allergy. -Pneumocystis jirovecii is a common cause of hospital-acquired pneumonia. -Acinetobacter baumannii pneumonia exhibits its low resistance to antibiotics. -Doxycycline should be avoided in patients who cannot tolerate cephalosporin.