A 45-year-old woman presents complaining of fatigue, 30 pounds of weight gain despite dieting, constipation, and menorrhagia. On physical examination, the thyroid is not palpable: the skin is cool dry, and rough: the heart sounds are quiet and the pulse rate is 50 bpm. The rectal and pelvic examinations show no abnormalities, and the stool is negative for occult blood. The clinical findings suggest hypothyroidism. Questions A. What other features of the history should be elicited? What other findings should be sought on physical examination? 8. What is the pathogenesis of this patient's symptoms? C. What laboratory tests should be ordered, and what results should be anticipated?
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- Case ScenarioA 22-year-old woman, gravida 2, para 1, presents at the maternity clinic for a prenatal visit. She is unsure of her due date and states that her last menstrual period was about seven or eight months ago. She had one prenatal check-up in the community health center, although she does not have any records from her physician or nurse-midwife. She reports that she has had an uncomplicated pregnancy so far and that earlier ultrasonography indicated that she is going to have a girl. Her medical history is unremarkable aside from a full-term cesarean delivery performed in the government hospital four years ago because of “complete breech presentation.” She is not taking any prenatal vitamins. On examination, her vital signs are unremarkable, her fundal height measures 27 cm, the fetal heart rate is 165 beats per minute, and the fetus is cephalic by Leopold’s maneuvers. 1. What is your insight on the patient’s case concerning her pregnancy? 2. How can you best minimize risks…CASE STUDY: Nelson Amoah, 54-year-old male presents to the emergency department with abdominal pain, nausea, vomiting, abdominal distension and constipation which started 3 days prior to presentation. He denied fever, chills and headache. Except for peptic ulcer disease, he is otherwise healthy with no previous surgeries. He is a smoker, smoking a little less than a pack a day for twenty-two years. On examination he was afebrile, with a heart rate of 120 beats/min, blood pressure 130/80 mmHg and respiratory rate of 22 cycles/min. Abdominal examination revealed mild distension with generalized guarding and marked rebound tenderness in the epigastrium. There were no palpable masses and bowel sounds were absent. Erect and supine abdominal and chest radiographs were normal. However, abdominal ultrasonography revealed free fluid throughout the abdomen and pelvis. a. State at least FIVE questions that you would ask in analyzing Mr. Amoah’s pain b. Identify all;…Clinical Case: A 37-year-old female and her 37-year-old husband present with the complaint of a possible fertility problem. The couple has been married for 2 years. The couple has been trying to conceive since then and reports a high degree of stress related to their lack of success. The patient reports good health, stated that her periods were regular, having periods with a normal cycle. She works as a cashier, runs 12-24 miles each week for the last 2 years, and has no history of STDs, abnormal Paps, smoking, alcohol, or other drugs. She has had no surgery. The patient's partner also reports good health and reports no problems with erection, ejaculation, or pain with intercourse. He has had no prior urogenital infections or exposure to STDs. He has had unprotected sex prior to his current relationship but has not knowingly conceived. He has no medical problems or past surgery. He works as a long-distance truck driver and is on the road for 2-3 weeks each month. He smokes a pack of…
- -Patient age: 55, sex: female.-Onset: 5 years ago -No history of o history of hypertension, photosensitivity, DM and CAD,-Chief complaint at hospital: edema on both lower limbs. Joints pain accompanied by intermittent feverno residual joint deformity. Question: What is Pathophysiology and Etiology?CASE:Chief Complaint: InfertilityBackground: Ms. L.C. is a 34 year old female presenting with concerns of infertility. She has been attempting a pregnancy over the past 16 months with no success. Patient reports that several times she thought she could be pregnant due to a cessation in her menses with accompanying constipation and some abdominal pain. Patient also reports pain that is more intense during menstruation, with “sharp and stabbing” characteristics that is not relieved by use of NSAIDs or hot compresses. The pain radiates from her lower abdominal area into her flanks, which she rates to be a 6 on a scale of 1-10. Patient reports her cycle can be irregular, with the length ranging up to 25-38 days or occasionally no period at all. She is concerned that her and her husband have not had enough intercourse for a pregnancy due to dyspareunia and general pelvic pain. Diagnosis: Endometriosis 1. Explain briefly the terminologies/statements in the case (bold and underlined) 2. What…Case Study: A 52 year-year old man with a history of AIDS, hypertension, diabetes mellitus, and alcohol abuse was found unconscious in his home by his roommate. In the emergency department, he was hypotensive (103/60 mm Hg), febrile (temperature 101F), and unresponsive. Computed tomoggraphy scan of the abdomen showed choleccystitis and gallstones. Laboratory data are listed. The patient was diagnosed with acute renal failure. He was administered intravenous fluids; BUN fell to 68 mg/dL and creatinine fell to 2.2 mg/dL. The patients blood culture report was positive for e. coli. He was treated with tobramycin and cefepime. The patient continued to deteriorate and died 5 days after admission. Cause of death was multiorgan failure secondary to AIDS, sepsis, and alcoholic cirrhosis. DATA TABLE Drugs of Abuse Negative Urinalysis Serum ethanol 84mg/dL Hemoglobin Positive…
- Case study: a 55 year old man with no history of illness suffered a blow to the head. He was unconcious when admitted to the hospital and remained in that state until his death 15 days later. A nasogastric tube was inserted to administer the required nutrients (protein, carbohydrates, fat, minerals and vitamins). The total water intake was 1,500 ml/d. Starting on day 5, his blood pressure gradually fell. The 24 hour urine volumes recorded from an indwelling catherter are listed below: Day After admission urine volume (ml/24 h) 6 1,500 8 1,300 10 1,200 12 1,100 14 900 Patients hemoglobin and hemtocrit were elevated Laboratory results for blood chemistry on day 13 are shown Test Results Reference Intervals total protein 9.4 g/dL…Discuss the biological mechanisms associated with foetal and neonatal diseases. Illustrate your answer with reference to specific pathologies. 500 wordsCASE:Chief Complaint: InfertilityBackground: Ms. L.C. is a 34 year old female presenting with concerns of infertility. She has been attempting a pregnancy over the past 16 months with no success. Patient reports that several times she thought she could bepregnant due to a cessation in her menses with accompanying constipation and some abdominal pain. Patient also reports pain that is more intense during menstruation, with “sharp and stabbing” characteristics that is not relieved by use of NSAIDs or hot compresses. The pain radiates from her lower abdominal area into her flanks, which she rates to be a 6 on a scale of 1-10. Patient reports her cycle can be irregular, with the length ranging up to 25-38 days or occasionally no period at all. She is concerned that her and her husband have not had enough intercourse for a pregnancy due to dyspareunia and general pelvic pain. Diagnosis: Endometriosis 1. Discuss the specific structure involved as to:a. The structure/ anatomyb. The function/…
- Case study HPI: 73 year old Asian male presents to your clinic for a follow-up appointment. He is c/o dyspnea. SOB has gradually increased over the last 4 days and is worse when lying down in bed. He cannot walk more than 25 feet without SOB. He sleeps downstairs in a recliner, mostly so he doesn’t have to go up the stairs. He denies fever, chills, chest pain, palpitations, dizziness constipation, diarrhea, abdominal pain, or nausea. Reports 7 kg weight gain over the past week, chronic nonproductive cough. PmHx: heart failure, DM type II, HTN, CAD, MI, CKD FHx: Father died of MVC at age 62, mother died of heart failure at age 79, sister (age 65, alive) with HTN SHx: never used tobacco, etoh 1-2 drinks/month, retired, married with 1 daughter (ages 41, healthy), used to walk at the neighborhood track, but can’t anymore; eats mostly fish and vegetables, does not use salt. Meds: carvedilol 3.125mg BID lisinopril 40mg daily…S B is a 54-year-old Latina female who went to her healthcare provider with complaints of heartburn, dysphagia, nausea, and chest pain. She feels bloated and obtains little or no relief from over-the-counter antacids. Her past medical history includes 2-pack-a-day cigarette smoking, stressful job, and chronic use of NSAIDs for chronic back pain. 1.What is the recommended diagnostic test to diagnosis GERD? Why?Case study: 22 year old women (previously adopted, not currently taking medications, negative medical history) presents with... ... hypertension and hyperkalemia. She has normal renal funtion (low urine potassium) and metabolic acidosis. What is the diagnosis?