Week 3 Summary and Plan
.docx
keyboard_arrow_up
School
Chamberlain College of Nursing *
*We aren’t endorsed by this school
Course
509
Subject
Nursing
Date
Apr 29, 2024
Type
docx
Pages
2
Uploaded by BarristerNeutron4870
A.W., 23 year old female presents today with complaints of fever, sore throat, chills, mild headache and tender, swollen cervical lymph nodes. Patient is a law student with prior history of mononucleosis at age 15. Patient is sexually active and performs oral sex 'a few times. Family
history includes a mother with hypertension. Patient is up to date on all vaccines, except this year's flu vaccine. Patient drinks on average 4 drinks a week. Physical assessment finding include swollen, tender cervical lymph nodes, erythematous posterior pharynx, and swollen bilateral tonsils with exudate. No shortness of breath noted, negative for nasal or ear discharge or build-up. Pharmacology
- Penicillin V 250 mg oral 4 times a day for 10 day duration for infection
- Acetaminophen OTC 325 mg 1-2 tabs oral q 4-6 hours; max dose 10 tablets per day for
fever, headache and/or pain Supportive care
- Wash hands often, including after sneezing, coughing, touching your face, using the restroom etc. (CDC, 2022) to reduce the spread of infection
- Do not share food, utensils or drinks to prevent the spread of infection
- Increase fluid intake to prevent dehydration
- Rest more; do not attend school; note given for 48 hours out of school to prevent the spread of infection Patient Education Influenza PCR nasal swab - negative
Rapid influenza diagnostic test (RIDT) – negative for influenza A and B
SARS-CoV-2 antigen – negative
Group A Streptococcal rapid antigen test – negative
There is a relatively low incidence of false-negative tests for Group A Streptococcal rapid
antigen testing, however there are still some who are positive, but test negative for this test (Rystedt, Hedin, Tyrstrup, Skoog-Ståhlgren, Edlund, Giske, Gunnarsson, & Sundvall, 2023).
Throat culture – pending (results will be available within 7 days)
Pharyngitis, group A streptococcal - bacteria infects the pharynx (back of throat), causing the tonsils to swell up. They normally drain into the anterior cervical lymph nodes, causing them to swell. Follow- up
- Take all doses of antibiotic treatment; do not stop when symptoms improve
Seek medical attention if symptoms are not improving within 48 hours, if fever worsens or persists for 3 days or more, or if shortness of breath or difficulty breathing occurs.
- Seek medical attention in the event you become lightheaded or faint, have changes in your breathing pattern, have breathing difficulties, wheezing begins, your skin becomes clammy, and/or confusion begins. These may be signs of a life-threatening allergic reaction.
- Follow-up in 2 weeks for influenza vaccination Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer.
CDC. (2022). Pharyngitis (strept throat). Received on March 23, 2023 from https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html Katzung, B. G. & Vanderah, T. W. (2021). Basic & Clinical Pharmacology (15th ed.). McGraw Hill Education.
Rystedt, K., Hedin, K., Tyrstrup, M., Skoog-Ståhlgren, G., Edlund, C., Giske, C. G., Gunnarsson, R.,
& Sundvall, P.-D. (2023). Agreement between rapid antigen detection test and culture for group
A streptococcus in patients recently treated for pharyngotonsillitis - a prospective observational
study in primary care. Scandinavian Journal of Primary Health Care, ahead-of-print(ahead-of-
print), 1–7. https://doi.org/10.1080/02813432.2023.2182631
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Related Questions
Male, non-perinatal pathological history. Vaccines up to date. No morbid family history.Family history. He presented recurrent infections: at 8 months of age, pneumonia with good response to amoxicillin, lower urinary tract infection with normal renal ultrasound. Response to amoxicillin, lower urinary tract infection with normal renal ultrasound; at 9 months of age, adenophygma at 9 months, left cervical adenophygmon surgically drained; at 18 months of age he was hospitalized for study of chronic diarrhea without definitive diagnosis, which progressed with pyoderma of the scalp. At 2 years and 9 months he was admitted for pneumonia without response to three antimicrobials regimens. Computed tomography (CT) scan of the chest showed right upper lobe lung disease and hilar, mediastinal, and retroperitoneal lymphadenopathies. The fiberoptic bronchoscopy showed inflammatory granuloma, pulmonary tuberculosis was considered as the first treatment with isoniazid, pyrazinamide, ethambutol and…
arrow_forward
Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year.
Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child.
Physical Examination as follows:
General: thin, anxious, acutely ill-appearing, young white man with tachypnea
Neck/LN: slight cervical lymphadenopathy, thyroid normal
Lungs/Thorax: CTA, slight axillary lymphadenopathy
Labs
Chest X-ray: Bilateral subtle infiltrates
Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus
Assessment: breakthrough opportunistic infection
Case Study Questions:
Aside from HIV, what is your diagnosis? Support your clinical diagnosis.
Could…
arrow_forward
Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year.
Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child.
Physical Examination as follows:
General: thin, anxious, acutely ill-appearing, young white man with tachypnea
Neck/LN: slight cervical lymphadenopathy, thyroid normal
Lungs/Thorax: CTA, slight axillary lymphadenopathy
Labs
Chest X-ray: Bilateral subtle infiltrates
Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus
Assessment: breakthrough opportunistic infection
Case Study Questions:
1.Aside from HIV, what is your diagnosis? Support your clinical diagnosis.
arrow_forward
Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year.
Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child.
Physical Examination as follows:
General: thin, anxious, acutely ill-appearing, young white man with tachypnea
Neck/LN: slight cervical lymphadenopathy, thyroid normal
Lungs/Thorax: CTA, slight axillary lymphadenopathy
Labs
Chest X-ray: Bilateral subtle infiltrates
Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus
Assessment: breakthrough opportunistic infection
question:
Could any of the patient’s problems have been caused by drug therapy?
arrow_forward
Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year.
Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child.
Physical Examination as follows:
General: thin, anxious, acutely ill-appearing, young white man with tachypnea
Neck/LN: slight cervical lymphadenopathy, thyroid normal
Lungs/Thorax: CTA, slight axillary lymphadenopathy
Labs
Chest X-ray: Bilateral subtle infiltrates
Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus
Assessment: breakthrough opportunistic infection
question:
What drug, dosage form, schedule, and duration of therapy are best for treating this…
arrow_forward
Female, 26 years old, married. Abdominal pain, diarrhea, fever, vomiting for 20 hours
After 24 hours of eating, the patient developed abdominal discomfort, paroxysmal with
nausea, vomiting stomach contents, fever and diarrhea several times, loose stools, no pus and
blood, body temperature 37-38.5°C, come to our hospital for emergency, the routine test of
stool was negative. She was treated according to "acute gastroenteritis". The abdominal pain
worsened in the evening, accompanied by fever of 38.6°C. Then, the abdominal pain moved
from the stomach to the right lower abdomen, and there was still diarrhea, she come to see a
doctor again at night, check blood routine WBC21×10%/L, and be admitted to the hospital
urgently.
Previous history: healthy, no history of drug allergy.
Physical examination: T38.7°C, P120/min, BP 100/70mmHg, no bleeding spots and rashes on
the skin all over the body, no large superficial lymph nodes, no pallor of the conjunctiva, no
yellow staining of the sclera,…
arrow_forward
Mr. Morningstar has no history of serious medical conditions. Although he tested negative for RPR, HBsAg and HIV, he confided that he used to have sex with both men and women in the Bar he owned in Los Angeles a year ago. According to him, that was before his relationship with Ms. Decker. He also mentioned that before they travelled here in the Philippines two weeks ago, he shared a few bottles of beer and Kansas-style barbecue with his brother named Amenadiel in Midtown Missouri. He also offered you (the interviewer) a sachet of crystal clear methamphetamine.
Will you accept Mr. Morningstar as a Donor for Patient Chloe Decker?
What are the following parameters that you will consider in order to accept or defer Mr. Morningstar as a Donor for Patient Chole Decker?
Justify your answers.
arrow_forward
Mr. Morningstar has no history of serious medical conditions. Although he tested negative for RPR, HBsAg and HIV, he confided that he used to have sex with both men and women in the Bar he owned in Los Angeles a year ago. According to him, that was before his relationship with Ms. Decker. He also mentioned that before they travelled here in the Philippines two weeks ago, he shared a few bottles of beer and Kansas-style barbecue with his brother named Amenadiel in Midtown Missouri.
Will you accept Mr. Morningstar as a Donor for Patient Chloe Decker?
What are the following parameters that you will consider in order to accept or defer Mr. Morningstar as a Donor for Patient Chole Decker?
Justify your answers.
arrow_forward
Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and
reached
the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting,
headache,
dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. He
visited a local hospital and-underwent a blood routine test: WBC=8.7X10°L, N=21%,
RBC= 3.36X10%/L, BPC=75X 10°/L, Hb=109g/L; peripheral -blood smear shows:
atypical cells 29%. The local hospital suspected "infectious mononucleosis", thus
intravenous ganciclovir was given and his blood was extracted to check for anti-EBV
antibody simultaneously.
After 6-days of intravenous ganciclovir, his body temperature still fluctuated at around:
38°C. Anti-EBVVCA-IgM(-), anti-VCA-IgG(+)
1. Do you think the doctor's diagnosis is correct? And what do you think the next step
would the doctor take?
2. How long does a normal fever and infectious fever last?
arrow_forward
Nursing
Mrs. Stevens is an 80-year-old woman who has recently moved into a long term care facility. She has congestive heart failure and osteoarthritis. She is in general good health but has mobility issues and requires assistance with her care. She has no known allergies. In the past, she has been hesitant to receive immunizations stating she doesn’t like needles and she never has gotten the flu before.
1.Based on her age and living conditions what vaccinations would be recommended for this resident?
arrow_forward
5 year old African American male presents with his mother to the ER where you are the physician assistant helping the ER attending in a very busy rural hospital. He is complaining of abdominal pain for one day and nausea with vomiting. His mother reports a fever and malaise. He has no significant medical history but his mother is concerned that he may have the "kissing disease" as he has a boy friend who had mononucleosis six months ago and she does not approve of him anyway. He describes the abdominal pain as sharp and points to his umbilical region. He ranks it 10/10 on a 1-10 scale at its worse and he says it gets worse with sudden movements or if he sits up too quick or laughs. He is not on any medications and his vital signs are normal except for a temperature of 101 degrees Fahrenheit. On examination he looks sick and his skin is clammy to the touch. Heart and lung examination is unremarkable. Abdominal examination shows good bowel sounds and umbilical tenderness and…
arrow_forward
15 year old African American male presents with his mother to the ER where you are the physician assistant helping the ER attending in a very busy rural hospital. He is complaining of abdominal pain for one day and nausea with vomiting. His mother reports a fever and malaise. He has no significant medical history but his mother is concerned that he may have the "kissing disease" as he has a boy friend who had mononucleosis six months ago and she does not approve of him anyway. He describes the abdominal pain as sharp and points to his umbilical region. He ranks it 10/10 on a 1-10 scale at its worse and he says it gets worse with sudden movements or if he sits up too quick or laughs. He is not on any medications and his vital signs are normal except for a temperature of 101 degrees Fahrenheit. On examination he looks sick and his skin is clammy to the touch. Heart and lung examination is unremarkable. Abdominal examination shows good bowel sounds and umbilical tenderness and…
arrow_forward
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…
arrow_forward
Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia
5. List some general education points regarding sleep hygiene
arrow_forward
Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?
arrow_forward
Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…
arrow_forward
Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia
Do you have any concerns about his pain medication?
arrow_forward
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…
arrow_forward
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…
arrow_forward
A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows:
Hemoglobin (Hb) 7.5 g/dL
White blood cells (WBC) 37 × 109/L (lymphocytes 86%)
Platelets 26 × 109/L
What blood component is best to harvest to find out the patient’s disease?
Why lymphocytes are prevalently seen in the peripheral blood film?
arrow_forward
A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows:
Hemoglobin (Hb) 7.5 g/dL
White blood cells (WBC) 37 × 109/L (lymphocytes 86%)
Platelets 26 × 109/L
What blood component is best to harvest to find out the patient’s disease?
Why lymphocytes are prevalently seen in the peripheral blood film?
What is the clinical significance of the platelet count?
NOTE: If you could answer all the questions please. Thank you!
arrow_forward
History of present illness:
Patient is a 16 year old male with multiple white and black heads as well as dome shape pimples filled with pus throughout his face and forehead. Patient has a history of oily skin.
Family history:
Both mother and father have a history of acne
Social History:
High school student, no history of alcohol, tobacco, or recreational drug abuse.
Allergies:
None
Medications:
None
Key Labs, images, or procedures performed in relation to current diagnosis:
Normal lab work and chest x-rays.
Image © Shutterstock, Inc.
Please answer the following questions about this case study:
Note: If you do not have time to finish the questions, hit Save to retain your answers until you can return to finish the assignment. Click Submit when you are completely finished answering the questions. After submitting, you will receive an email confirmaiton and a PDF of your answers.
1. Provide the diagnosis *
2. Provide the pathophysiology for…
arrow_forward
History of present illness:
Patient is a 16 year old male with multiple white and black heads as well as dome shape pimples filled with pus throughout his face and forehead. Patient has a history of oily skin.
Family history:
Both mother and father have a history of acne
Social History:
High school student, no history of alcohol, tobacco, or recreational drug abuse.
Allergies:
None
Medications:
None
Key Labs, images, or procedures performed in relation to current diagnosis:
Normal lab work and chest x-rays.
5. Provide predominant age and sex *
6. Provide treatment *
7. Provide the prognosis for the diagnosis at hand *
arrow_forward
History of present illness:
Patient is a 16 year old male with multiple white and black heads as well as dome shape pimples filled with pus
throughout his face and forehead. Patient has a history of oily skin.
Family history:
Both mother and father have a history of acne
Social History:
High school student, no history of alcohol, tobacco, or recreational drug abuse.
Allergies:
None
Medications:
None
Key Labs, images, or procedures performed in relation to current diagnosis:
Normal lab work and chest x-rays.
arrow_forward
History of present illness:
Patient is a 16 year old male with multiple white and black heads as well as dome shape pimples filled with pus throughout his face and forehead. Patient has a history of oily skin.
Family history:
Both mother and father have a history of acne
Social History:
High school student, no history of alcohol, tobacco, or recreational drug abuse.
Allergies:
None
Medications:
None
Key Labs, images, or procedures performed in relation to current diagnosis:
Normal lab work and chest x-rays.
Image © Shutterstock, Inc.
Please answer the following questions about this case study:
Note: If you do not have time to finish the questions, hit Save to retain your answers until you can return to finish the assignment. Click Submit when you are completely finished answering the questions. After submitting, you will receive an email confirmaiton and a PDF of your answers.
5. Provide predominant age and sex *
6. Provide treatment *
7.…
arrow_forward
In family 3, can the mother or father donate blood to their child? Explain your answer.
arrow_forward
What would happen if someone did not receive a compatible blood type during a blood
transfusion? (Hint: Reaction between antigens and antibodies when blood typing.)
arrow_forward
NCP
arrow_forward
SEE MORE QUESTIONS
Recommended textbooks for you
Understanding Health Insurance: A Guide to Billin...
Health & Nutrition
ISBN:9781337679480
Author:GREEN
Publisher:Cengage
Medical Terminology for Health Professions, Spira...
Health & Nutrition
ISBN:9781305634350
Author:Ann Ehrlich, Carol L. Schroeder, Laura Ehrlich, Katrina A. Schroeder
Publisher:Cengage Learning
Related Questions
- Male, non-perinatal pathological history. Vaccines up to date. No morbid family history.Family history. He presented recurrent infections: at 8 months of age, pneumonia with good response to amoxicillin, lower urinary tract infection with normal renal ultrasound. Response to amoxicillin, lower urinary tract infection with normal renal ultrasound; at 9 months of age, adenophygma at 9 months, left cervical adenophygmon surgically drained; at 18 months of age he was hospitalized for study of chronic diarrhea without definitive diagnosis, which progressed with pyoderma of the scalp. At 2 years and 9 months he was admitted for pneumonia without response to three antimicrobials regimens. Computed tomography (CT) scan of the chest showed right upper lobe lung disease and hilar, mediastinal, and retroperitoneal lymphadenopathies. The fiberoptic bronchoscopy showed inflammatory granuloma, pulmonary tuberculosis was considered as the first treatment with isoniazid, pyrazinamide, ethambutol and…arrow_forwardMr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year. Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child. Physical Examination as follows: General: thin, anxious, acutely ill-appearing, young white man with tachypnea Neck/LN: slight cervical lymphadenopathy, thyroid normal Lungs/Thorax: CTA, slight axillary lymphadenopathy Labs Chest X-ray: Bilateral subtle infiltrates Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus Assessment: breakthrough opportunistic infection Case Study Questions: Aside from HIV, what is your diagnosis? Support your clinical diagnosis. Could…arrow_forwardMr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year. Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child. Physical Examination as follows: General: thin, anxious, acutely ill-appearing, young white man with tachypnea Neck/LN: slight cervical lymphadenopathy, thyroid normal Lungs/Thorax: CTA, slight axillary lymphadenopathy Labs Chest X-ray: Bilateral subtle infiltrates Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus Assessment: breakthrough opportunistic infection Case Study Questions: 1.Aside from HIV, what is your diagnosis? Support your clinical diagnosis.arrow_forward
- Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year. Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child. Physical Examination as follows: General: thin, anxious, acutely ill-appearing, young white man with tachypnea Neck/LN: slight cervical lymphadenopathy, thyroid normal Lungs/Thorax: CTA, slight axillary lymphadenopathy Labs Chest X-ray: Bilateral subtle infiltrates Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus Assessment: breakthrough opportunistic infection question: Could any of the patient’s problems have been caused by drug therapy?arrow_forwardMr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year. Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child. Physical Examination as follows: General: thin, anxious, acutely ill-appearing, young white man with tachypnea Neck/LN: slight cervical lymphadenopathy, thyroid normal Lungs/Thorax: CTA, slight axillary lymphadenopathy Labs Chest X-ray: Bilateral subtle infiltrates Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus Assessment: breakthrough opportunistic infection question: What drug, dosage form, schedule, and duration of therapy are best for treating this…arrow_forwardFemale, 26 years old, married. Abdominal pain, diarrhea, fever, vomiting for 20 hours After 24 hours of eating, the patient developed abdominal discomfort, paroxysmal with nausea, vomiting stomach contents, fever and diarrhea several times, loose stools, no pus and blood, body temperature 37-38.5°C, come to our hospital for emergency, the routine test of stool was negative. She was treated according to "acute gastroenteritis". The abdominal pain worsened in the evening, accompanied by fever of 38.6°C. Then, the abdominal pain moved from the stomach to the right lower abdomen, and there was still diarrhea, she come to see a doctor again at night, check blood routine WBC21×10%/L, and be admitted to the hospital urgently. Previous history: healthy, no history of drug allergy. Physical examination: T38.7°C, P120/min, BP 100/70mmHg, no bleeding spots and rashes on the skin all over the body, no large superficial lymph nodes, no pallor of the conjunctiva, no yellow staining of the sclera,…arrow_forward
- Mr. Morningstar has no history of serious medical conditions. Although he tested negative for RPR, HBsAg and HIV, he confided that he used to have sex with both men and women in the Bar he owned in Los Angeles a year ago. According to him, that was before his relationship with Ms. Decker. He also mentioned that before they travelled here in the Philippines two weeks ago, he shared a few bottles of beer and Kansas-style barbecue with his brother named Amenadiel in Midtown Missouri. He also offered you (the interviewer) a sachet of crystal clear methamphetamine. Will you accept Mr. Morningstar as a Donor for Patient Chloe Decker? What are the following parameters that you will consider in order to accept or defer Mr. Morningstar as a Donor for Patient Chole Decker? Justify your answers.arrow_forwardMr. Morningstar has no history of serious medical conditions. Although he tested negative for RPR, HBsAg and HIV, he confided that he used to have sex with both men and women in the Bar he owned in Los Angeles a year ago. According to him, that was before his relationship with Ms. Decker. He also mentioned that before they travelled here in the Philippines two weeks ago, he shared a few bottles of beer and Kansas-style barbecue with his brother named Amenadiel in Midtown Missouri. Will you accept Mr. Morningstar as a Donor for Patient Chloe Decker? What are the following parameters that you will consider in order to accept or defer Mr. Morningstar as a Donor for Patient Chole Decker? Justify your answers.arrow_forwardLin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. He visited a local hospital and-underwent a blood routine test: WBC=8.7X10°L, N=21%, RBC= 3.36X10%/L, BPC=75X 10°/L, Hb=109g/L; peripheral -blood smear shows: atypical cells 29%. The local hospital suspected "infectious mononucleosis", thus intravenous ganciclovir was given and his blood was extracted to check for anti-EBV antibody simultaneously. After 6-days of intravenous ganciclovir, his body temperature still fluctuated at around: 38°C. Anti-EBVVCA-IgM(-), anti-VCA-IgG(+) 1. Do you think the doctor's diagnosis is correct? And what do you think the next step would the doctor take? 2. How long does a normal fever and infectious fever last?arrow_forward
- Nursing Mrs. Stevens is an 80-year-old woman who has recently moved into a long term care facility. She has congestive heart failure and osteoarthritis. She is in general good health but has mobility issues and requires assistance with her care. She has no known allergies. In the past, she has been hesitant to receive immunizations stating she doesn’t like needles and she never has gotten the flu before. 1.Based on her age and living conditions what vaccinations would be recommended for this resident?arrow_forward5 year old African American male presents with his mother to the ER where you are the physician assistant helping the ER attending in a very busy rural hospital. He is complaining of abdominal pain for one day and nausea with vomiting. His mother reports a fever and malaise. He has no significant medical history but his mother is concerned that he may have the "kissing disease" as he has a boy friend who had mononucleosis six months ago and she does not approve of him anyway. He describes the abdominal pain as sharp and points to his umbilical region. He ranks it 10/10 on a 1-10 scale at its worse and he says it gets worse with sudden movements or if he sits up too quick or laughs. He is not on any medications and his vital signs are normal except for a temperature of 101 degrees Fahrenheit. On examination he looks sick and his skin is clammy to the touch. Heart and lung examination is unremarkable. Abdominal examination shows good bowel sounds and umbilical tenderness and…arrow_forward15 year old African American male presents with his mother to the ER where you are the physician assistant helping the ER attending in a very busy rural hospital. He is complaining of abdominal pain for one day and nausea with vomiting. His mother reports a fever and malaise. He has no significant medical history but his mother is concerned that he may have the "kissing disease" as he has a boy friend who had mononucleosis six months ago and she does not approve of him anyway. He describes the abdominal pain as sharp and points to his umbilical region. He ranks it 10/10 on a 1-10 scale at its worse and he says it gets worse with sudden movements or if he sits up too quick or laughs. He is not on any medications and his vital signs are normal except for a temperature of 101 degrees Fahrenheit. On examination he looks sick and his skin is clammy to the touch. Heart and lung examination is unremarkable. Abdominal examination shows good bowel sounds and umbilical tenderness and…arrow_forward
arrow_back_ios
SEE MORE QUESTIONS
arrow_forward_ios
Recommended textbooks for you
- Understanding Health Insurance: A Guide to Billin...Health & NutritionISBN:9781337679480Author:GREENPublisher:Cengage
- Medical Terminology for Health Professions, Spira...Health & NutritionISBN:9781305634350Author:Ann Ehrlich, Carol L. Schroeder, Laura Ehrlich, Katrina A. SchroederPublisher:Cengage Learning
Understanding Health Insurance: A Guide to Billin...
Health & Nutrition
ISBN:9781337679480
Author:GREEN
Publisher:Cengage
Medical Terminology for Health Professions, Spira...
Health & Nutrition
ISBN:9781305634350
Author:Ann Ehrlich, Carol L. Schroeder, Laura Ehrlich, Katrina A. Schroeder
Publisher:Cengage Learning