Case Study #10: A 4-year old girl presents at the emergency room with bloody diarrhea, fever and vomiting. The child's mother reports that the child has had these symptoms for about 24 hours and she has not passed any urine for about 12 hours. The child is enrolled in a day care center and the group had recently made a field trip to a fast food place to learn about different jobs. The children had a lunch of ground beef, fries, and cola after meeting with different workers. This field trip was 4 days earlier on Friday. The child had a temperature of 39C and showed physical signs of dehydration. Blood samples drawn showed evidence of greatly reduced kidney function and lysed red blood cells. 1. What is your presumptive diagnosis for this patient? 2. What is the name of the most likely bacterium responsible? 3. What were the key critical features leading to your diagnosis? Lab test(s) to confirm diagnosis? Expected results? 5. What virulence factor of this organism caused the severity of this problem?
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- Case Study #10: A 4-year old girl presents at the emergency room with bloody diarrhea, fever and vomiting. The child's mother reports that the child has had these symptoms for about 24 hours and she has not passed any urine for about 12 hours. The child is enrolled in a day care center and the group had recently made a field trip to a fast food place to learn about different jobs. The children had a lunch of ground beef, fries, and cola after meeting with different workers. This field trip was 4 days earlier on Friday. The child had a temperature of 39C and showed physical signs of dehydration. Blood samples drawn showed evidence of greatly reduced kidney function and lysed red blood cells. 1. What is your presumptive diagnosis for this patient? 2. What is the name of the most likely bacterium responsible? 3. What were the key critical features leading to your diagnosis? 4. Lab test(s) to confirm diagnosis? Expected results? 5. What virulence factor of this organism caused the severity…Case Study 5:A 4-year-old boy was seen in the public health clinic because of intermittent bouts of diarrhealasting almost 4 weeks. The mother did not note any bright red blood in the stool. The child waspale, listless, and had a protuberant abdomen. He had a number of small erythematous vesicleson his feet. His mother said that he sometimes ate dirt and always had a good appetite. The familylived in a rural part and had a well from which they got their drinking water. This part of thecountry had only recently been connected to the local city’s sanitation system. The physicianinitially ordered a complete blood count with an elevated Eosinophil count. The physicianordered a stool culture for bacterial pathogens and stool examination. The bacterial culture wasnegative for enteric pathogens, but the stool examination revealed parasitic organisms and thepresence of Charcot-Leyden crystals. Diagnosis: Capillariasis Causative Agent: Capillaria philipinensis Case study presentation should…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…
- CASE STUDY: A 26 year old woman appeared in the outpatient clinic with the complaint of abdominal discomfort, diarrhea, and an 18lb, unintentional weight loss during the past 2-3 years. She related a similar period of 5-6 years of abdominal distress and diarrhea in childhood, but this essentially disappeared when she was about 12-13 years old. She was now having three to five bowel movements daily, which were described as bulky, malodorous, and floating. She weighed 106lb and was 67 in tall. She never had surgical procedures. Physical examination revealed poor skin turgor, general pallor, and a protuberant abdomen. Abnormal clinical laboratory values included those in Case Study table 28.5.1 Fecal examination revealed no ova or parasites, and bacteriologic culture revealed no pathogens. CASE STUDY TABLE 28.5.1 Analyte Result Hemoglobin 8.1 g/dL Hematocrit 30% RBC count 4.1 X 10^6/uL Serum sodium…Case Study #8: A 35-year -old Native-American male presents in the clinic with a complaint of recurrent low-grade fevers, sweating, weakness, muscle pains and a loss of about 10% of his body weight over a 4 month period. The worsening weakness and muscle pain prompted the visit. The patient reports that he has been working on a bison slaughter line owned by his tribe, and blood and tissue juices often splash in his face or contaminate minor hand and arm injuries. He likes to hunt and fish. He is married and has two children. He eats fairly well, but he has not been as hungry lately. He had rheumatic fever as a child and was in a fairly serious car accident three years earlier, resulting in a leg broken in three places. He feels he was physically fit prior to the past 4 months. He likes to play basketball and softball. He has had all the usual childhood immunizations, but does not see the doctor often. On physical examination, the patient has a temperature of 101F. He has mildly swollen…Question: Can you make an Introduction paper about the given Case Scenario? INFANT WITH TETRALOGY OF FALLOT Case Scenario: Baby Pearl, a 9-month-old girl presents to the emergency department with his mother,who reports episodes of tachypnea, cyanosis, and irritability during feeding. The mother explainsthat these episodes have become more frequent, with baby Pearl becoming more cyanotic aroundthe mouth and fingers especially when crying (tet spells) when she was around 7 months old.These episodes resolve spontaneously but are occurring every few days. The mother breastfeeds every 3 hours, but sometimes takes a long time to feed. She alsoobserved that baby Pearl becomes diaphoretic with feeding, and stops frequently to catch herbreath while feeding. She reported to the nurse that vomiting the milk (sometimes goes out fromthe nose) and becomes more frequent after feeding. The patient currently appears comfortable,with no signs of respiratory distress, fever, or neurological…
- 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;…CASE STUDY A 36-year-old man was admitted to the hospital after presenting at the emergency department with a self-reported, 7-month history of numbness and weakness in his right leg. He had lost 25 lb in body weight, was experiencing fecal incontinence, and had been unable to urinate for 3 days. Two years previously, the patient had been diagnosed with human immunodeficiency virus (HIV) infection. A physical examination demonstrated bilateral lower extremity weakness, and his reflexes were slowed throughout his body. Kaposi sarcoma (KS) lesions were noted, especially on the lower extremities, along with thrush and herpes lesions in the perianal region. The patient had no fever, and magnetic resonance imaging (MRI) ruled out spinal cord compression. The patient had a history of intravenous (IV) drug abuse, chronic diarrhea for 1.5 years, KS for 2 years, and pancytopenia for several weeks. The patient had large right arachnoid cysts of congenital origin. No previous laboratory reports…Case 1 A 20-year-old man presents for evaluation of a rash that he thinks is an allergic reaction. For the past 4 or 5 days, he has had the "flu," with fever, chills headache, and body aches. He has been taking an over-the-counter flu medication without any symptomatic relief. Yesterday he developed a diffuse rash made up of red, slightly raised bumps. It covers his whole body, and he says that it must be an allergic reaction to the flu medication. He has no history of allergies and takes no other medications, and his only medical problem in the past was being treated for gonorrhoea approximately 2 years ago. On further questioning, he denies dysuria or penile discharge. He denies any genital lesions now but says that he had a "sore" on his penis a few months ago that never really hurt and went away on its own after a few weeks so he didn't think much about it. On exam, his vital signs are all normal. He has palpable cervical, axillary, and inguinal adenopathy. His skin has an…
- A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…*Case Study* A 2-year-old boy fell from a backyard gym set. His shoulder and upper arm became very swollen shortly after the fall. The boy’s mother took him to the emergency department a few hours after th incident because he was complaining of pain. On physical examination, the physician noted that large hematoma had formed in the upper part of the boy’s right arm. There was no history of surgery (he had not been circumcised), injury, or illness. The boy was receiving no medication. Emergency department treatment consisted of aspirating the hematoma Subsequent to this treatment, the boy began to bleed extensively. He was admitted to the hospital. The following laboratory tests were ordered: a hemoglobin and hematocrit, platelet count, and bleeding time. Because the bleeding continued, a type and crossmatch for two units of fresh blood were ordered on a standby basis. Additional information from the mother revealed that the boy’s cousin had “bleeding problem.” Laboratory Data…