interpret and apply medical terminology ass 2
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School
TAFE NSW - Sydney Institute *
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Course
HLT37315-0
Subject
Medicine
Date
Jun 22, 2024
Type
docx
Pages
12
Uploaded by BrigadierThunderMole7
Case Study Assessment
Criteria
Unit code, name and release number
BSBMED301 - Interpret and apply medical terminology appropriately (1)
Qualification/Course code, name and release number
HLT33115 – Certificate III in Health Services Assistance (2)
HLT37315 - Certificate III in Health Administration (2)
HLT47315 - Certificate IV in Health Administration (2)
HLT43015 – Certificate IV in Allied Health Assistance (2)
HLT57715 – Diploma of Practice Management (1) Student details
Student number
880692649
Student name
Manpreet kaur
Document title: BSBMED301_AE_CS_2of3
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Resource ID: TBS_18_013_BSBMED301_AE_CS_2of3
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Version:
1.0
Date created:
13 October 2022
Date modified:
20/06/2024
For queries, please contact:
Technology and Business Services SkillsPoint
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© 2019 TAFE NSW, Sydney
RTO Provider Number 90003 | CRICOS Provider Code: 00591E
This assessment can be found in the: Learning Bank
The contents in this document is copyright © TAFE NSW 2019, and should not be reproduced without the permission of the TAFE NSW. Information contained in this document is correct at time of printing: 20 June 2024. For current information please refer to our website or your teacher as appropriate.
Document title: BSBMED301_AE_CS_2of3
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Assessment instructions
Table 1 Assessment instructions
Assessment details
Instructions
Assessment overview
The objective of this assessment is to assess your knowledge and performance as would be required to interpret and apply medical terminology.
Assessment Event number
2 of 3
Instructions for this assessment
This is a case study assessment and it will be assessing you on your knowledge and performance of skills required by the unit.
This assessment is 1.
Case studies – Female Reproductive System, Blood System
Submission instructions
On completion of this assessment, you are required to upload it or hand
it to your trainer for marking. Ensure you have written your name at the bottom of each page of this assessment.
It is important that you keep a copy of all electronic and hardcopy assessments submitted to TAFE and complete the assessment declaration when submitting the assessment.
What do I need to do to
achieve a satisfactory result?
To achieve a satisfactory result for this assessment all questions must be answered correctly.
What do I need to provide?
Pen or suitable electronic device.
If this assessment is being used for online/distance delivery, the student must upload the assessment.
What the assessor will provide?
Computers and access to the internet. Access to the case studies.
Due date and time As per the training plan
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Assessment details
Instructions
allowed
Assessment feedback, review or appeals
Appeals are addressed in accordance with Every Students Guide to Assessment.
Specific task instructions
The instructions and the criteria in the case study below will be used by the assessor to determine whether you have satisfactorily completed the Case Study Scenario. Use these instructions and criteria to ensure you demonstrate the required knowledge.
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Resource ID: TBS_18_013_BSBMED301_AE_CS_2of3
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Part 1: Case study – Female Reproductive System
To complete this part of the assessment, you will be required to read the Case Study Scenario below. Once you have read the information, you are required to complete your written responses to questions 1 – 7 in the spaces provided in this document. Once completed you will need to submit this assessment to your assessor for marking.
Case Study Scenario:
Patient: Susan Smith
Susan Smith has recently consulted with her Gynaecologist for a routine check-up and Pap smear. Susan is generally a healthy, active woman with no previous history of abnormal readings on her smears. Please review the report below and then answer the following questions:
PATIENT
SMITH, Susan
DATE TO BE ADMITTED
MAY 9, 2019
CHIEF COMPLAINT
Right ovarian cyst
HISTORY OF PRESENT
ILLNESS Susan is a 34-year-old Caucasian female who had a routine examination on April 21, 2018, at which time the examination
revealed the right ovary to be approximately two to three times normal size. Otherwise, all was normal. The Pap smear performed at the time revealed atypical cells of undetermined significance. The patient returned for a colposcopy, and this revealed what appeared to be squamous
epithelial lesions CIN I-II. Biopsies were performed which revealed chronic cervicitis and no evidence of CIN. The patient was placed on Lo-Ovral for two cycles and then was rechecked. The right ovary continued to enlarge and got to the point where it was approximately 4 x 5 cm, floating anteriorly in the pelvis, and was fairly firm to palpation. A pelvic ultrasound confirmed the clinical findings. Superior to the right adnexa was a 4 x 5 cm mass, possibly with haemorrhage into either a paraovarian cyst or a dermoid cyst.
The patient is to be admitted now for an exploratory laparotomy.
PAST MEDICAL HISTORY
The patient had the usual childhood diseases and has had good health as an adult.
Previous Surgery
The patient had a Hymenotomy and dilatation and curettage in 2006.
Menstrual History
Menstrual cycle is 28 days, averaging a three to six day flow.
Obstetrical History
The patient is a Gravida 0.
FAMILY HISTORY
Heart disease in the family. Father died of lung cancer. Mother L/W.
REVIEW OF SYSTEMS
Non-contributory.
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STUDENT NAME:
S. Cunningham MD
Physical examination
GENERAL
The patient is a well-developed, well-nourished Caucasian female in no acute distress.
VITAL SIGNS
Height: 170 cm Weight: 61 kg Blood Pressure: 110/82. Normal. The trachea is in
the midline. The thyroid is not enlarged.
CHEST
Lungs: Clear to percussion and auscultation. Heart: Regular sinus rhythm with no murmur. Breasts: Normal to palpation.
ABDOMEN
Soft and flat. No scars or masses.
PELVIC
The outlet and vagina are normal. The cervix is moderately eroded. The uterus is normal size and anterior. The left adnexa is negative. The right adnexa has a firm, irregular cystic ovary that is anterior and approximately 5 × 5 cm. This is mobile and non-tender.
EXTREMITIES
Normal. Reflexes are grossly intact.
DIAGNOSIS
Right ovarian cyst.
PLAN
The patient is to be admitted for exploratory laparotomy and ovarian cystectomy.
S. Cunningham, MD
Short Answer Questions:
1.
State the patient’s current diagnosis (50 words maximum)
The patient has been diagnosed with a Right Ovarian Cyst. An ovarian cyst is a fluid-filled sac located
in or on the ovary. When ovulation begins, the egg sac disappears. However, if the egg does not leave the sac, the sac is filled with fluid and can form cysts
2.
Define the term “Pap smear”.
A Pap smear is a kind of screening test used to identify or look for any alteration or differences in the
cells of the cervix that can cause cancer.
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3.
Dr Cunningham performed a colposcopy. Describe this procedure. What were the findings on Colposcopy? (50 words maximum)
The patient lies down and loosened on the treatment table. Then the doctor inserts the microscope into the vagina and opens it. Then wash the vagina with acetic acid, a vinegar-like solution. Next, the doctor examines the patient's cervix with a colposcope. A colposcope is a medical toll or device that looks like binoculars on an illuminated stand. Then a tissue sample is taken and sent for further examination. Ms. Smith's colposcopy showed squamous epithelial lesion CIN I-II
4.
The ultrasound performed revealed a mass that was considered to be a cyst. What possible type of cyst did this prove to be?
Para-ovarian cyst or a dermoid cyst
5.
List and define the two surgeries performed on Susan Smith in 2006:
1. Hymenotomy – Minor surgery which involves separating part or all or most of a woman's hymen. This procedure is conducted on patients having an imperforate (hymen mostly blocking the vagina) or septate (extra tissue wrapping the hymen) hymen. A hymenotomy is offered to decrease pain in sexual activity, and lack of normal menstruation which can cause the blood to back up into a woman’s vagina, uterus, fallopian tube, or abdomen, and severe abdominal discomfort or pain throughout menstruation
2. Dilation and Curettage –a kind of minor surgery for removing tissues from a female uterus. A Dilation and Curettage is typically carried out after a miscarriage occurs or abortion to remove small pieces of the placenta from the uterus. That helps to limit any future infection or heavy bleeding
6. How many children have Susan Smith had?
No Children
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7. Susan Smith is due to be admitted to hospital. List and define the surgeries that have been planned for this admission?
1. Exploratory laparotomy: That is a surgical procedure aimed at opening the abdominal section.
This kind of operation is done to find the origin of problems that cannot be diagnosed by any test, such as abdominal pain or bleeding. It is also used when abdominal trauma requires any urgent
medical attention. This surgery uses a large incision or cut. 2. Ovarian cystectomy: This is surgery to remove a cyst from a human ovary. Laparoscopic surgery is the least invasive medical technique that
uses only a few minor cuts in the patient’s lower abdomen.
Case study – The blood system
To complete this part of the assessment, you will be required to read the Case Study Scenario below. Once you have read the information, you are required to complete your written responses to questions 1 – 4 in the spaces provided in this document. Once completed you will need to submit this assessment to your assessor for marking.
Patient: Harry Lindsay
Harry Lindsay has had a history of feeling unwell, losing his appetite and weight loss. After consultation with his family doctor Dr Stevens, Harry was referred on for additional tests. He has now come under the care of Dr Ellis (Oncologist)
Please review the report below and then answer the following questions:
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STUDENT NAME:
Department of Oncology/Haematology
Outpatient Report
PATIENT
: Lindsay, Harry
DATE:
March 25, 2018
Mr Lindsay is a 58-year-old man seen for myelodysplasia while hospitalised on March 17, 2018. He
was transfused with 4.0 U of packed cells during that hospitalisation. A bone marrow revealed histology consistent with chronic myelomonocytic leukaemia (myelodysplasia).
A follow-up blood count was obtained through Dr. Stevens’ office on March 20, 2018, and revealed a hemoglobin of 11.0 G/DL and a haematocrit of 31.0%.
There have been no fevers, sweats or anorexia; but he has noted some weight loss. There has been no bleeding. There has been no nausea, vomiting or dark and bloody stools.
ON EXAMINATION
Weight: 78 kg. Blood Pressure: 120/50. Temperature: 37°C. Pulse: 88. Respirations: 18.
Mild gum atrophy and inflammation. Neck: Supple. Lymph nodes: There is no adenopathy. Lungs: Clear. Cardiovascular: Normal. Abdomen: Soft and non-tender. The spleen is enlarged. Extremities: Without oedema or petechiae.
CURRENT LABORATORY RESULTS
Complete blood count reveals a total leukocyte count of 6600/cu mm, a haemoglobin of 8.0 G/DL, a haematocrit of 23.0%, and a platelet count of 149,000/cu mm.
CLINICAL DIAGNOSIS
Chronic myelomonocytic leukaemia (myelodysplastic syndrome). The patient is transfusion dependent. The patient will be typed and cross matched today and will be transfused with 2.0 U of
packed red blood cells through the Oncology Day Facility tomorrow on March 26, 2018. I have asked the patient to follow up with Dr. Stevens next week and with me in two weeks.
Anna Ellis MD
A ELLIS, MD
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1.
Provide a brief definition for the following medical terms found in the above medical report:
Oedema
This is an accumulation of fluid in the spaces between cells of the body. This kind of fluid leaks out of damaged cells and this fluid is unable to be drained with only a needle and may not improve if we take 'water tablets or capsules
Petechiae
Petechiae are pinpoint, round swell spots that appear on the skin because of bleeding.
That bleeding causes the petechiae to appear red, brown, or purple.
Anorexia
An impulsive disorder is identified by an obsessive desire to lose weight or a severe psychological disorder by refusing to eat.
Atrophy
Atrophy is wasting away or diminution of body parts in partial or complete. For example, muscle atrophy is a reduction in muscle mass, often due to extended immobility. It can restrict the dimension of a cell, tissues, or body parts, even an organ. Causes of atrophy involve mutations, which may destroy the regeneration of cells or tissues to build up the organ, inadequate nourishment, poor circulation in a specific part, loss of
hormonal support, loss of neurological tissues belongs to the target organ
Adenopathy
Adenopathy is a kind of illness or inflammation that involves glandular tissue or lymph nodes. Lymph nodes can become
enlarged due to inflammatory disorders, infection, or cancer
Histology
Histology is the microscopic analysis or examination of cells and tissues. Every cell of the tissue model is unique and different from others. Remarkably histology uses the most advanced imaging methods to analyse and recognise the tissues and structures that appeared with an electronic microscope.
2.
Identify Mr. Lindsay’s diagnosis and give a brief description of it (50 words max)
Diagnosis: Chronic myelomonocytic leukemia (myelodysplastic syndrome)
Description: Large numbers of white blood cells identify CMML compared to others in the blood and bone marrow, also known as monocytes. CMML is narrowed down to two other types of blood cancer named ‘Mixed myelodysplastic (MDS) and myeloproliferative neoplasm (MPN)’. WHO also recognize them. MPN is a different kind of dysfunction caused by stem cells of bone marrow that generate excess amounts of one or more types of blood cells (white cells, red cells, or platelets)
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3.
Mr Lindsay has an enlarged spleen. Provide the correct medical term for this condition:
Splenomegaly
4.
Dr Ellis has developed a treatment plan for Mr. Lindsay. List the three elements of this plan:
1. The patient depends on blood transfusions. Today, Mr. Lindsay, who was early treated for
chronic myelomonocytic leukemia, will be typed and cross-matched.
2. At the Oncology Day Facility, Mr. Lindsay will receive a 2.0 U RBC transfusion on March 26, 2018.
3. Mr. Lindsay will be re-inspected by Dr. Stevens next week and Dr. Ellis in two weeks.
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