M31892 Pathophysiology and Medical Management Assignment Sample 2023
Case Report 1
1. Examination and Analysis
The initial symptom of the patient is chest pain. The age of the patient is 58 years and male in gender. The pain attacked suddenly in the middle of the chest while he was watching TV. The patient vomited before riding in the ambulance. The patient has been informed that he was feeling short of breath that he did not experience earlier, though the breathing did not affect the chest pain as per the feelings of the patient.
Preliminary, the pulse rate of the patients has been checked and that has shown tachycardic pulse rate, 110 bpm. If the pulse rate rises above 100 beats per minute that situation is referred to as Tachycardia. The blood pressure of the patient has been measured as 164/112mmHg.
This is an indication of hypertension. The patient has no chest congestion as it sounds clear and bilateral. The apparent diagnosis has revealed that the person has xanthelasma and corneal arcus. Xanthelasma can be identified if there is yellowish growth around the eyelids. This is mainly caused due to the accumulation of cholesterol under the skin (aocd, 2021).
Besides Xanthelasma, the patient has the deposition of cholesterol, around the cornea that is referred to as corneal arcus. The patient has no peripheral oedema observed in the lower limbs and therefore, there is no need to think about the collection of fluid in the lungs, which can cause short breaths (Van de Water & Ntatamala, 2019). As the abdomen of the patient is soft and normal, therefore, there is no organomegaly and no palpation of the aorta as there is any expansile mass in the abdomen.
2. Differentiation in Diagnosis
The primary diagnosis has been referred to as the patient having an excess accumulation of cholesterol, triglycerides, and phospholipids in the blood flow and under the skin. That is why the xanthelasma and corneal arcus have occurred in the patient’s body. The diagnosis has canceled the scopes of oedema, organomegaly, and palpation of the aorta. Therefore, the problem indicates the occurrence of heart disease in the patients.
That is why the patient is prescribed to check the profile of lipoprotein (nationaljewish, 2021). Apparently, the patient has been treated with a dose of ibuprofen to feel relieved from the chest pain and the patient has been informed last that if the score of the pain was 8 out of 10, then the score presently is 5 out of 10 (Pasku et al. 2021).
3. Medical Management and Treatment
The diagnosis of the 58 years old person indicates that the person has access to high cholesterol in the blood flow and there is a scope of cardiac blocks that cause problems like heart attack and many others. Therefore, according to the medical management since the patient has to perform the tests of lipoprotein profile and after this test, the patient can be prescribed drugs like Statins that decrease the cholesterol level. These drugs can reduce the chances of heart disease.
Case Report 2
1. Examination and Analysis
This is a case of chronic illness that results in the continuous occurrence of cough. The patient’s name is Fred and the age of this patient is 48 years. The profession of Fred is a self-employed plumber. The patient comes to the doctor within a certain gap and the person is suffering from recurrent cough, infection in the upper portion of the respiratory tract.
Though the patient is suffering from these problems for a certain time, there is no such medical history as there is no particular identification of allergies for the issue. The nurses have reported that Fred has a habit to drink alcohol every night and the drinking increases on the weekend. The patient has reported excessive tiredness and the person has been observed as breathless when walking up through stairs.
There is information that Fred has done the test for fasting blood glucose that has given a report recently. The report has shown that the person has glucose level in blood 5.8mmol/l.
As per the observation of the nurses the temperature of the patient is 37 degrees Celsius, pulse rate is 78bpm, R.R is 18rpm shallow in appearance and BMI is 28 KgM2. The observation regarding BP is 148/94mmHg and in repetition, this has appeared as 144/92mmHg. The observation indicates the starting of COPD (Sterling et al. 2020).
2. Differentiation in Diagnosis
The absence of proper medical history and the collection of information regarding the alcohol intake habit indicate that there is a high tendency of respiratory problems that are caused due to effects of alcohol. Regular intake of alcohol can reduce the level of glutathione, which is an antioxidant that can protect the lungs from any infection of the respiratory tract (Rodrigues & Percival, 2019).
This can lead to the occurrence of COPD or chronic obstructive pulmonary disease (cdc, 2021). The observation of breathlessness strongly indicates the scopes of COPD and therefore, a CT scan of the lungs, gas analysis of arterial blood is important to know the proper condition of the respiratory system.
3. Medical Management and Treatment
The analysis of the condition of 48 year old Fred and the diagnosis concluded that the situation can be the starting level of COPD. That is why the patient is needed to give proper medication and care to develop respiratory health of the patients. The nurses of the institution have to make sure that the patient is practicing inhale and exhale exercises, the tests are done properly and the patient is not drinking alcohol during the treatment.
The patient has to go through an education session regarding the symptoms of COPD and the effects of COPD (Peryer et al. 2020). How the medication has to be followed and what should be the behaviour of the patient is completely elaborated in this session so that the patient cooperates with the treatment process.
Case Report 3
1. Examination and Analysis
This case is of the patient Mr. Jones, who is a 72 years old person. The patient has come to the hospital accompanied by his daughter. According to the daughter of the patient, Mr. Jones is not well and the person has become quieter, sleeping more during the last two days. The patient has an easily informed name but felt trouble remembering the date of birth.
The differences can be known as per the statement of the daughter of the patient. According to the information, the patient was full of life and lived independently in the home. During the last 4-5 months, the person behaves differently, has become unsteady on his own feet.
The daughter is unaware of any habit of drugs or alcohol of her father and the last check that Warfarin was working well. Warfarin is used as an anticoagulant that means the person has taken medicines to prevent any clot or thrombosis of blood in the veins.
Observation has revealed that Mr. Jones is troubled to remember the date of birth, but the person is alert about the peripherals. GCS value of Mr. Jone is 14 and the person can open the eyes spontaneously. The neurological examination has revealed that the power of the right arm is 4 out of 5 and the power of the other limbs is normal.
It is normal brisk and reflex in the biceps and triceps of the patient, normal coordination, and normal sensation in the limbs. There is just the presence of some scuffs to the left shoulder and ear and mild bruising on the posterior portion of the ear. These observations have revealed that the person can get scars due to falling on any rough surface.
2. Differentiation in Diagnosis
The examinations of Mr. Jones have revealed that the patient has no symptoms of neurological problems or Alzheimer’s disease (Joe & Ringman, 2019). Therefore, the elimination of these assumptions has indicated the identification of scuffs to the shoulders and ears.
The daughter of the patient has informed that the patient cannot steadily stand on feet and it can occur that the patient has fallen on any rough surface due to imbalance, which is not known clearly to the daughter. Bruising on the posterior part of the ear is observed that may be the side effect of Warfarin (nhs, 2021).
The research and observation of the cases have revealed that the long-time use of Warfarin can cause bruising on different body parts. In this case, brushing has occurred on posterior parts of the ear that can cause the development of infection in the interior part of the ear. An ear infection is related to the imbalance of the patients.
3. Medical Management and Treatment
The observation and diagnosis indicate that the patient, Mr. Jones has to be admitted to the hospital as the person has to be under observation for a few days. The daughter of the patient has informed that the person lives in the home alone and therefore, the daughter cannot know or observe every movement of the person at every moment.
A thorough analysis of the patient is required to identify the requirement of Warfarin and what can be the suitable replacement for that medicine. This is also required to observe that the patient has any additional addiction to any kind of drug or alcohol.
Case Report 4
1. Examination and Analysis
The patient is a woman of age 60 years and named Mrs. Jenny Smith. The woman was diagnosed with the occurrence of myocardial infarction in three years. The primary examination of this patient has revealed that the BMI of the woman is 32 Kg*m2, and BP is 123/78mmHg. The patient has presently a controlled situation of hypertension.
The medical history of this woman has shown that the patient was a smoker and was admitted to the hospital a few times due to acute diverticulitis. This is an occurrence of an infected pouch in the colon that can be formed due to lack of fibers in the regular diet, intake of red meat or fatty food products.
The patient is recently taking medicines like aspirin 75mg per day, bisoprolol 2.5 mg, irbesartan 150 mg regularly. The woman is also used to taking atorvastatin 40 mg per day. Some routine checkups have been performed like level of blood glucose, HbA1c. The glucose level in the blood is between 9 and 13 mmol/l and the value of HbA1c has increased at 59 mmol/mol.
The patient feels the loss of energy, increased thirst, and polyuria in recent times. On the other hand, the examinations have shown that the renal function of the woman is normal and eGFR value is 90 ml/min and there is no occurrence of microalbuminuria. This indicates that the woman has no kidney disease as the absence of albuminuria means that there is no elimination of albumin from the body of the patient (diabetes, 2021).
2. Differentiation in Diagnosis
A thorough analysis of the examinations of Mrs. Smith indicates that the tendency of increasing HbA1c is the indication of high sugar in the blood flow. This is the cause for the development of diabetic complications. Though the patient has no problems in renal functions and has no occurrence of microalbuminuria, the maintenance of diabetic health is important (Khunti et al. 2019). Otherwise, the patient can face problems related to kidney disease in the near future.
3. Medical Management and Treatment
The medical history of this patient indicates that the patient experienced myocardial infarction previously, which is a type of heart attack when the heart muscles cannot get enough oxygen due to the low flow of blood (hopkinsmedicine, 2021). The occurrence of diabetes can be more fatal in the case of such patients who have a history of myocardial infarction.
Therefore, the patient has to go through the proper treatment of diabetes to prevent further heart attacks or any kind of kidney disease (diabetesjournals, 2021). The presence of high levels of glucose in the blood flow can make the blood heavy and that increases the tendency of coagulation in the veins. Therefore, the proper medication and proper diet have to be maintained in the case of Mrs. Smith to prevent further increment of HbA1c level.
References
Journal
Joe, E., & Ringman, J. M. (2019). Cognitive symptoms of Alzheimer’s disease: clinical management and prevention. Bmj, 367. https://www.bmj.com/content/367/bmj.l6217.abstract
Khunti, S., Khunti, K., & Seidu, S. (2019). Therapeutic inertia in type 2 diabetes: prevalence, causes, consequences and methods to overcome inertia. Therapeutic advances in endocrinology and metabolism, 10, 2042018819844694. https://journals.sagepub.com/doi/abs/10.1177/2042018819844694
Pasku, D., Shah, S., Aly, A., & Quraishi, N. A. (2021). Rare, post-periodontitis spondylodiscitis caused by Fusobacterium nucleatum in a patient with multiple sclerosis: challenge of diagnosis and treatment. BMJ Case Reports CP, 14(3), e239664. https://casereports.bmj.com/content/14/3/e239664.abstract
Peryer, G., Barnes, S., & Farquhar, M. (2020). Supportive and palliative care for people with respiratory problems and preexisting serious mental illness. Current Opinion in Supportive and Palliative Care, 14(3), 190-196. https://journals.lww.com/co-supportiveandpalliativecare/Fulltext/2020/09000/Supportive_and_palliative_care_for_people_with.7.aspx
Rodrigues, C., & Percival, S. S. (2019). Immunomodulatory effects of glutathione, garlic derivatives, and hydrogen sulfide. Nutrients, 11(2), 295. https://www.mdpi.com/403908
Sterling, S. A., Palzes, V. A., Lu, Y., Kline-Simon, A. H., Parthasarathy, S., Ross, T., … & Chi, F. W. (2020). Associations between medical conditions and alcohol consumption levels in an adult primary care population. JAMA network open, 3(5), e204687-e204687. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2765853
Van de Water, N., & Ntatamala, I. (2019). Running short of breath: a case study of hard-metal lung disease in an asbestos-exposed worker. Current Allergy & Clinical Immunology, 32(2), 96-100. https://journals.co.za/doi/abs/10.10520/EJC-168042a33a
Websites
aocd.org, (2021), Xanthelasma, https://www.aocd.org/page/Xanthelasma#:~:text=Xanthelasma%20(also%20known%20as%20xanthelasma,usually%20an%20obvious%20clinical%20diagnosis. [Accessed on 28 October 2021]
cdc.gov, (2021), copd-symptoms-diagnosis-treatment, https://www.cdc.gov/copd/features/copd-symptoms-diagnosis-treatment.html [Accessed on 28 October 2021]
diabetes.co.uk, (2021), diabetes-complications, https://www.diabetes.co.uk/diabetes-complications/proteinuria.html [Accessed on 29 October 2021]
diabetesjournals.org, (2021), myocardial infarction, https://care.diabetesjournals.org/content/27/1/201#:~:text=Myocardial%20infarction%20(MI)%20and%20stroke,diabetes%20(4%E2%80%937). [Accessed on 29 October 2021]
hopkinsmedicine.org, (2021), heart-attack, https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-attack [Accessed on 29 October 2021]
nationaljewish.org, (2021), high-cholesterol, https://www.nationaljewish.org/conditions/high-cholesterol/diagnosis [Accessed on 28 October 2021]
nhs.uk, (2021), warfarin, https://www.nhs.uk/medicines/warfarin/#:~:text=The%20main%20side%20effect%20of,or%20if%20you’re%20unwell. [Accessed on 29 October 2021]
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