Case #3 A 68-year-old Caucasian male presents to his pulmonologist for his 3-month follow up visit. He is a smoker, with 150-pack-year history. He has no specific complaints but did mention in passing that he had two episodes where h woke up gasping for air, most recently, two days ago. He has a history of chronic bronchitis and mild emphysema Focused assessment on the pulmonary system was significant for bilateral rales and scattered crackles. Oxyger saturation was recorded at 82% on room air. • What are the other priority assessments for this patient? • What is the next step in managing this patient? • What is the pathogenesis to this disease group?
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- Patient B., 60 years old, was hospitalized with the diagnosis "Myocardial infarction". On examination: cold and cyanotic skin. Respiration is frequent, superficial, arterial pressure 90/60 mm Hg, pulse - 110 beats / min (normal 60-90 beats per minute). The patient is transferred to the intensive care unit. Questions: 6. Describe typical changes of gas parameters and pH in blood at this type of TPP? 7. List the signs of adaptive reactions available to the patient.Case Study: -An 18-year-old man with no significant past medical history presented to the emergencydepartment with a history of cough and shortness of breath with exertion, along withsubjective fevers, chills, and rigors. He was noted to be hypoxic (low oxygen saturation level)on examination. The chest X-ray showed bilateral infiltrates in a diffuse butterfly patterninvolving both central lung fields. The patient reported a history of IV drug use, with frequentsharing of needles.Diagnosis: PCP PneumoniaCase study presentation should include the following:1. Case2. Patient initials (Ex. 50-year-old man)3. History of the present illness (Symptoms and may include the physical exam of the patient)4. Chief Complaints (Ex. Morning stiffness in his joints for over a year)5. Diagnosis and Causative agent6. Pathophysiology7. Treatment and Management8. ReferencesCase Study 3:An 18-year-old man with no significant past medical history presented to the emergencydepartment with a history of cough and shortness of breath with exertion, along withsubjective fevers, chills, and rigors. He was noted to be hypoxic (low oxygen saturation level)on examination. The chest X-ray showed bilateral infiltrates in a diffuse butterfly patterninvolving both central lung fields. The patient reported a history of IV drug use, with frequentsharing of needles.Diagnosis: PCP PneumoniaCase study presentation should include the following:1. Case2. Patient initials (Ex. 50-year-old man)3. History of the present illness (Symptoms and may include the physical exam of the patient)4. Chief Complaints (Ex. Morning stiffness in his joints for over a year)5. Diagnosis and Causative agent6. Pathophysiology7. Treatment and Management8. ReferencesPossible answer: Chief complaint: Cough and shortness of breath Diagnosis: PCP Pneumonia Causative Agent: Pneumocystis jirovecii…
- Case r/t Thorax and Lungs examination Adela, a market vendor, visits the clinic with a chief complaint of body malaise. She tells the physician, "I just don't feel good." Her vital signs are the following: T 39°C; respirations 25 and shallow; HR 100 bpm; BP 126/87. Past history indicates that she has been a pack-a-day smoker for 20 years. During the patient interview, she states that she has a family history is COPD and her father had lung cancer. Adela is being evaluated for COPD B. Develop a teaching plan for herPatient B., 60 years old, was hospitalized with the diagnosis "Myocardial infarction". On examination: cold and cyanotic skin. Respiration is frequent, superficial, arterial pressure 90/60 mm Hg, pulse - 110 beats / min (normal 60-90 beats per minute). The patient is transferred to the intensive care unit. 4. What other causes except myocardial infarction can cause this type of TPP? 5. Describe the mechanism of development of this TPP in the patient. STDDOCase r/t Thorax and Lungs examination Adela, a market vendor, visits the clinic with a chief complaint of body malaise. She tells the physician, "I just don't feel good." Her vital signs are the following: T 39°C; respirations 25 and shallow; HR 100 bpm; BP 126/87. Past history indicates that she has been a pack-a-day smoker for 20 years. During the patient interview, she states that she has a family history is COPD and her father had lung cancer. what would be important when considering further assessment on this patient ?
- Patient M., 36 y/o, was found in the street unconscious. The patient has a medical history of diabetes. There is a smell of alcohol from the mouth. The skin is moist, warm, arterial pressure -145/90 mm column of mercury, convulsive twitching of muscles. Breathing is shallow, eye ball tone is retained, pupils are dilated, hyperflexion. How would you treat this patients?A. Intravenous introduction of 40-80-100 ml 40% glucose solution B. Injecting 20 units of insulin subcutaneouslyC. Injecting 20 units of insulin intravenouslyD. Injecting 500 ml 5% glucose solution intravenouslyE. Injecting 500 ml 0.9% sodium chloride intravenouslyFor each of the following Patient Profiles, determine the most appropriate triage category (red, yellow, green, or black), and why. patient profiles: 1. severe right leg pain - tells you his legs hurt - respirations : 26/min - radial pulse : present 2. patient pinned under large bench - moans weakly when you talk to her - respirations : 36/min - radial pulse : absent 3. chest pain, dyspnea, cardiac history - tells you shes having trouble in breathing - respirations : 18/min - radial pulse : present 4. dislocated shoulder-bleeding - tells you his shoulder hurt - respirations : 26/min - radial pulse : present 5. cyanotic -unconscious - respirations : begins breathing when you open the airway - radial pulse : presentCase #2 Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago. Blood Gas Arterial Venous pH 7.51 7.40 PaCO2 30 mmHg 45 mmHg PaO2 60 mmHg 30 mmHg HCO3 24 mEq/l 21 mEq/l BE - 1 - 4 SaO2 90 % 60 % Hb 15 g/dl 15 g/dl Interpret his ABG
- A 10-year-old boy with known HbSS disease presented to the Paediatric Emergency Department with a oneweek history of fever and severe pain in his right leg, severity 9/10 for the last two days. On examination:Pulse – 100 beats/min, BP – 110/70 mmHg, Capillary refill < 2sec and Respiratory rate – 20 breaths/ min. He has point tenderness anteriorly on proximal tibia. There is no joint swelling.X-ray of the affected limb shows marked periosteal elevation.His complete blood count is: Hb – 6.5 g/dL WBC 30 x 10 /L Plt – 120 x 10 /L with a reticulocyte count of 1%.Of the following the MOST appropriate management in this patient would bea. Ibuprofen, Cefotaxime and top-up transfusionb. Morphine, Ampicillin and hydration therapyc. Morphine, Cefotaxime and hydration therapyd. Morphine, Cefotaxime and top-up transfusionMr. Reddy is a 62 yo presenting to ED at 1500hrs. He was preparing the gas cylinder for a Sunday BBQ when it suddenly exploded while he was trying to connect the hose. Family standing by tried to extinguish the fire with their hands and tried to remove his clothing. Burns 30% TBSA – Face, hands, bilateral lower limbs. Complaints of severe pain and burning 10/10. Past Medical History: Hypertension, Type II DM Regular medications – Candesartan 8mg, Glimepiride 4mg, Metformin 500mg and Pravastatin 20mg. Fully vaccinated against COVID. Airway. - Patent, superficial burns to right side of face Breathing. - Spontaneous, RR-22mt, SPO2-92% RA, air-entry equal Circulation- Lower limb odema, cap refill 3 seconds, bilateral dorsal pedis pulses weak. BP- 88/50 mmHg, HR- 127/mt, sinus tachycardia, Disability - GCS-15 E4V5M6, PEARL- 3mm, Exposure - Temperature 35.9 deg Celsius. Full thickness burns to right lower limb and right arm, partial thickness burns to left lower limb, bilateral hands.…Rodjerick Assignment: 1. Discuss the steps and sequence on Artificial Respiration and Cardio Pulmonary Resuscitation 2. 2. Discuss soft tissue injuries/wounds 3. The different kinds of open wound 4. Discuss burns Submit tomorrow. write on one