Patient Profile: Steven, a 27-year-old male, returned home from a 4-day camping trip. Two days later he developed a fever, headache, along with vomiting and diarrhea. Over the following two days, he developed a rash along with crusty, red eyes. At the local ER, a tick bite was discovered and Steven was diagnosed with Rocky Mountain spotted fever. Using the information provided in the textbook, answer the following questions about this patient. 1. What classification of an antibiotic would be most appropriate for Steven? 2. List ONE most commonly used generic drug that is of the type of antibiotic you selected. 3. Are there any special warning/precautions for this drug? 4. Is this drug safe for children and pregnant women? Why or why not? 5. Does this drug lose effectiveness after its expiration date?
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- M.L. is a 26-year-old homosexual man admitted to the hospital for progressive respiratory distress, fever, weakness, and chronic diarrhea. He tested HIV positive about 3 years ago, but his infection has remained asymptomatic until 2 months prior to admission. Pneumocystis jiroveci (carinii) pneumonia was suspected and confirmed by culture. Laboratory analysis demonstrates a low CD4+ count of 185 cells/ml. HAART treatment with the antiretrovirals azidothymidine (AZT), efavirenz (Sustiva), and ritonavir (Norvir) was started 2 months ago. QUESTIONS: A medical student asks you to draw a picture of the HIV virion and a CD4+ cell, and to explain the mechanism of intracellular infection and the role of reverse transcriptase. What would you show on the drawing and explain about the process?M.L. is a 26-year-old homosexual man admitted to the hospital for progressive respiratory distress, fever, weakness, and chronic diarrhea. He tested HIV positive about 3 years ago, but his infection has remained asymptomatic until 2 months prior to admission. Pneumocystis jiroveci (carinii) pneumonia was suspected and confirmed by culture. Laboratory analysis demonstrates a low CD4+ count of 185 cells/ml. HAART treatment with the antiretrovirals azidothymidine (AZT), efavirenz (Sustiva), and ritonavir (Norvir) was started 2 months ago. QUESTIONS: P. jiroveci pneumonia is an opportunistic infection to which immunocompetent people are immune. What other opportunistic infections are commonly seen in AIDS patients? Are there any data to suggest that M.L. may have one of these? A medical student asks you to draw a picture of the HIV virion and a CD4+ cell, and to explain the mechanism of intracellular infection and the role of reverse transcriptase. What would you show on the drawing…Clinical History:A 25-year-old woman had pelvic pain, fever, and vaginal discharge for 3 weeks. On physical examination, she has lower abdominal adnexal tenderness and a painful, swollen left knee. Laboratory studies show WBC count of 11,875/mm3 with 68% segmented neutrophils, 8% bands, 18% lymphocytes, and 6% monocytes. Gram negative rods were found. Photo includes gram stain. When reviewing the patient’s paperwork, what type of information would you look for, or perhaps ask patient if not listed on the paperwork? What type of specimen would you collect? What tests would you run to ID the causative agent? Typical treatment? Advice for patient? no references, just homework please include references
- case study: C was a six year old boy who passed away at the Lady Cilento Children’s Hospital on14 January 2017. He was a generally healthy and happy child. C’s treating team at the Lady Cilento Children’s Hospital attributed his death to overwhelming sepsis due to melioidosis. His death was not discussed with the coroner at that time. No autopsy was performed. C’s death was first reported to the State Coroner on 3 May 2018 due to the family’s concerns about the care C received from a remote hospital over several days leading up to his admission on 10 January 2017 and subsequent transfer to a regional hospital by which time he was seriously ill. The family also lodged a complaint with the Office of the Health Ombudsman. The Health Ombudsman considered the family’scomplaint potentially identified broader systemic issues and undertook a systemicinvestigation. The family’s concerns related to failure by remote hospital staff to correctly diagnoseand investigate the cause of C’s worsening…Mr. Jones is a 69-year-old man who was admitted to the hospital 10 days earlier with a diagnosis of acute diverticulitis. He was given intravenous fluids and empiric antibiotic coverage with ceftriaxone and metronidazole. His antibiotics were stopped after 7 days, and he continued to do well until today, when he developed abdominal pain, fever, and diarrhea. A diagnosis of Clostridium difficile colitis was made, and antibiotic treatment was initiated. Discuss the following questions: What diagnostic test would confirm the diagnosis? What risk factors did Mr. Jones have to acquire a Clostridium difficile infection? Why is oral but not intravenous vancomycin a potential treatment option for this infection? One person from each group should respond to this discussion with a link to their group’s recording and a summary of the discussion that took place.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 9-year-old boy complained of fever and sore throat over a 3-day period. On examination by his physician, the patient’s pharynx was red, and both tonsils were swollen. Pronounced cervical lymphadenopathy was present. A swab of the tonsillar area was taken and inoculated to a sheep blood agar (SBA) plate. After 24 hours of incubation, small, shiny, translucent colonies showing β- hemolysis were noted. The microscopy shows a Gram positive coccus arranged in pairs.Diagnosis: Acute PharyngitisCase 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. References
- Mrs. A , age 35 was given a pap test during a routine medical check-up. The test showed marked dysplasia of cervical cells but no sign of infection. 1. Discuss the purposes and uses of diagnostic testing and how it applies in this scenario 2.Discuss how the following terms might apply to this scenario: prognosis, latent stage, remission, exacerbations, predisposing factors 3.Compare and contrast the various types of common cellular adaptions focusing on dysplasia and the testing for the condition. Question2, MRS A's baby girl, Baby C, who is 3 months old,has had severe watery diarrhea accompanied by fever for 24hours, she is apathetic and responds weakly to stimulation, the condition has been diagnosed as viral gastroenteritis question A) list the major losses resulting from diarrhea and fever. question)list other signs and data that…SCENARIO Identifying Data: This 72-year-old female presents with a biopsy proven adenocarcinoma of the sigmoid colon at 20 cm. History of Present Illness: The patient has been noted to have some bright red bleeding intermittently for approximately 8 months, initially presumable of a hemorrhoidal basis. She recently has had intensification of rectal bleeding but no weight loss, anorexia, or obstructive pain. No significant diarrhea or constipation. Some low back pain, probably unrelated. Recent colonoscopy by Dr. Scoma revealed a large sessile (attached by a broad base) polyp, which was partially excised at 20-cm level, showing infiltrating adenocarcinoma at the base. The patient is to enter the hospital at this time after home antibiotic and mechanical bowel prep, to undergo sigmoid colectomy and possible further resection. 1. Using the scenario above, answer the following questions: A. What chronic symptoms did this patient have? Describe the symptoms using medical…A 62-year-old male, his back has been red and swelling for 1 week. At first it was a small piece of skin induration of about 3×2cm, with multiple pus spots, then the skin swelling area expanded, infiltrating edema appeared, local pain increased, the surface skin was purple-brown with area about 6×5cm, the body temperature was 39.2℃, and he had diabetes history for 10+ years. The following treatment measures are incorrect for this patient: Remove pus and inactivated tissue The incision line should exceed the edge of the lesion The incision can be filled with yarn One-stage suture of the incision Make a "++" incision