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A 33-year-old man presents to his primary doctor complaining of high fever and chills that lasted for one week. He complained that his chest hurts when he coughs, and the sputum has a greenish tint. During this time, the patient has had an unproductive cough and shortness of breath when he exerts himself. He has a general feeling of malaise and has noticed a decrease in appetite. He has been using an over-the-counter cold medicine for symptom relief, but symptoms return when the medication wears off. The patient has been working outside on a construction job this winter. He is under a lot of stress with the recent move into a new apartment with his pregnant wife.
Physical examination (PE): Patient breathing pattern is rapid and shallow, with some dyspnea during deep breaths. Cough produces green/yellow sputum.
Vital signs: Temperature: 40°C, Pulse: 90/min, Respiratory rate 25/min, Blood pressure: 112/70 mm Hg BMI=20
Laboratory Test
Blood cultures : Positives with Streptococcus pneumoniae.
Chest X-rays: Consolidation of inferior and superior segments of Right Lower Lung and Left Lower Lung
Pulse oximetry: 90% saturation on room air
1. Which laboratory test results strongly support a diagnosis of the disease?
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- A woman visits the emergency department with complaints of fever and fatigue lasting for about 2 weeks. The patient is an immigrant from Eswatini and does not have a primary care physician. The patient reports that he was in good health until a few months ago when he started feeling very tired and having recurrent colds. Upon further questioning, the patient remembers that he had a severe "cold" about 8 to 10 years ago while he was still living in Africa. He was unable to receive medical attention for it, but the cold ultimately resolved. He had been feeling fine until these recent signs and symptoms developed. Suspecting a viral infection, the physician assistant (PA) orders initial laboratory work. What finding in the CBC results would make the physician suspect that the patient is infected with HIV-1? Support your answer by citing at least 3 journals or academic references.A patient presents with symptoms of a heart attack, and it is noted that she also has a fever. Her husband suggests that she must have an infection. What would you tell him?Two days ago, Charity, a 48-year-old journalist from Miami, returned to the United States from a 6-week trip to several countries for a story she is writing on recovery progress after major earthquakes. When she first came home, Charity began to experience diarrhea, which became worse as the day progressed. After the second day of severe diarrhea and the beginning of leg pain, Charity seeks care at a local outpatient health care facility. She reports no vomiting or fever, but has 10 watery stools per day without visible blood or mucus. Questions : What immediate treatment does Charity need? Name at least 5 organisms that may be causing the diarrhea. In a table, contrast the differences in the presentation of the diarrhea and the causative agents.
- A woman visit the emergency department with complaints of fever and fatigue lasting for about 2 weeks. The patient is an immigrant from Eswatini and does not have a primary care physician, the patient reports that he was in good health until a few months ago, he started feeling very tired. Upon further ask, the patient had severe cold about 8 to 10 years ago while he was still living in africa. He was unable to receive medical attention for it, but the cold ultimately resolve, he had been feeling fine until these recent signs and symptoms developed. Suspecting a viral infection, the physician assistant orders initial laboratory work. What finding in the CBC result would make the physician suspect that the patient is infected with HIV-1?A patient is ready for discharge when she spikes a fever of 101.3°F. A call to the physician results in an order for IV antibiotics to be administered every 12 hours for 48 hours. The patient’s family arrives to take her home, and they discover that she now has an IV and will not be discharged for 2 days. They ask, “What happened? Did our mother catch something in the hospital? We thought this is a place of healing.” How will you respond? Your response may have legal implications?Sir Robert, a 42-year-old male, returned to his home in England after an adventure along the Nile Delta. On arrival at his estate, Sir Robert began to experience chills and a fever. The fever remained high for about 2 days and then subsided but spiked again after 5 days. He also noticed an abscess on his right leg, which had become swollen, inflamed, and hot. After a few days, his leg began to enlarge. A this point, Sir Robert promptly set-up an appointment with his physician for 4:00pm the next day. On determining the patient's recent travel history and performing a physical examination, the physician ordered blood and stool samples for parasite study. In addition, the physician surgically opened the abscess and obtained a sample of the contents for parasitic examination. Laboratory examination of the abscess and stool specimens revealed no parasites. However, the Giemsa-stained slide of the blood contained suspicious organisms, each measuring approximately 260μm in length.…
- A 12-year-old male was brought in by his mother for evaluation of diarrhea and crampy abdominal-pain of 2 weeks duration. That morning he had an "accident" in his pants and saw something move. His mother thought it was an earthworm. He had no fever, cough, or hemoptysis. His physical examination was unremarkableA 26 year old woman presents with a fever, malaise, and a sore throat. She tells you she has bouts of vomiting that subside, but have traces of blood in it. She also tells you she just came back from working with Doctors without Borders in Central Africa. You tell her she's lucky to have come in when she did before the dysentery. What has she contracted?Katie is a 14-year-old girl with a history of seasonal hay fever symptoms and eczema. She has been troubled recently by chest tightness, wheezing and cough. The cough is only minimally productive of whitish sputum. There is a strong family history of allergies and she received “allergy shots” when she was younger. She tells her mother that when she visits a friend’s home, where they have two cats, the symptoms seem to be much worse. Concerned about her daughter’s complaints, Katie’s mother takes her to the family clinic, where a diagnosis of asthma is eventually established. What historical factors would raise concern that Katie may have asthma? (Support Your answer with at least four possible outcomes.) What environmental factors could potentially exacerbate her condition? Include examples. (Support Your answer with at least four possible outcomes.) What are the pathophysiologic processes that are responsible for the clinical manifestations of asthma?(Support Your answer…
- Katie is a 14-year-old girl with a history of seasonal hay fever symptoms and eczema. She has been troubled recently by chest tightness, wheezing and cough. The cough is only minimally productive of whitish sputum. There is a strong family history of allergies and she received “allergy shots” when she was younger. She tells her mother that when she visits a friend’s home, where they have two cats, the symptoms seem to be much worse. Concerned about her daughter’s complaints, Katie’s mother takes her to the family clinic, where a diagnosis of asthma is eventually established. What historical factors would raise concern that Katie may have asthma? (Support Your answer with at least four possible outcomes.) What environmental factors could potentially exacerbate her condition? Include examples. (Support Your answer with at least four possible outcomes.)In 2008, 65-year-old Mr. Jones woke up complaining of abnormal fatigue and a scratchy throat. His wife took his temperature and found it to be slightly elevated. He dismissed the condition, blaming it on long days in the garden and an allergy attack. However, his symptom list grew over the next few days. He lost his appetite, his joints and muscles were sore, and he woke up wringing wet from night sweats. He continued to have a fever and his wife was worried at how pale he looked. She insisted on a doctor's visit, and after a physical and throat culture, he was sent home with instructions to take oral penicillin and Tylenol. Symptoms continued for a week, with additional complaints of headache, rapid breathing, and coughing. Heart rate was rapid, and Mr. Jones had a slight heart murmur but his throat culture was negative. As the physician begin to look for other causes, he learned from Mr. Jones that an artificial heart valve had been implanted in his heart 10 years earlier. He also…A pediatric client presents to the office with ruddy checks and a low-grade fever of 101oF. The client’s mother states that the child has been acting normal, but now she notices the child has a slight rash, mainly on the torso. Which disease do you suspect based on this clinical presentation?a. scarlet feverb. fifth diseasec. rubeolad. roseola