DescriptionA-45-year-old woman presents complaining of fatigue, 30 pounds of weight gain despite dieting, constipation, and menorrhagia. On physical examination, thethyroid is not palpable: the skin is cool, dry, and rough: the heart sounds are quiet; and the pulse rate is 50 bpm. The rectal and pelvic examinations show noabnormalities, and the stool is negative for occult blood. The clinical findings suggest hypothyroidism.QuestionsA. What other features of the history should be elicited? What other findings should be sought on physical examination?B. What is the pathogenesis of this patient's symptoms?C. What laboratory tests should be ordered, and what results should be anticipated?D. What are the possible causes of this patient's condition? Which is most likely?E. What other conditions may be associated with this disorder?

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Answered: A 45-year-old woman presents…

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Ricky, a 55-year-old man presented to hospital's emergency room with severe, radiating substernal pain. He was overweight (BMl = 40) , however all other vital signs including cardiological assessments were normal. He admitted to imbibing excessive amount of alcohol the night before. He reported no overt use of nonsteroidal anti-inflammatory drugs (NSAIDs) but indicated that he sometimes experiences a burning sensation in your chest with difficulty in swallowing and regurgitation of food or sour liquid. The doctor prescribed omeprazole and directed him perform an upper endoscopy (a)Identify the cause of Ricky's pain and justify you answer. (b) Briefly outline the mode of action of omeprazole in alleviating his symptoms.
A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. A CT scan in both the 50 year old man and a 14 year old girl show a pituitary mass. Why are their symptoms not similar? a.) One is producing GH, the other isnt b.) They are the same c.) They are of different ages d.) They are of different genders
A 56-year-old Asian man with hypertension, hypercholesterolemia, and type 2 diabetes mellitus comes to a physician for a check-up. It has been several years since he has been to the doctor. His past medical history is significant for an acute illness at the age of nine, which involved a high fever, pleuritic chest pain, migrating joint pain, and a pink, nonpruritic rash on his torso. His blood pressure is 155/100 mm Hg and heart rate is 70/min. Auscultation of the heart reveals a low-pitched diastolic rumble heard best at the apex. What is the most likely pressure change that would be seen in this patient’s heart? (A) Decreased left atrial pressure (B) Decreased left ventricular pressure (C) Increased left atrial pressure (D) Increased left ventricular pressure (E) Increased right atrial pressure
James Dunn is a 40-year-old African American man. He presents to the physician’s office today complaining of headache. His vital signs during triage are as follows: blood pressure 165/90 mm Hg, heart rate 80 beats/minute, temperature 98.5F, weight 125 kg (275 lb), and height 5 ft 11 in. He currently has no other diagnosed medical conditions. The physician gives Mr. Dunn a prescription for lisinopril/hydrochlorothiazide (Prinzide) 10/12.5 mg with directions to take one tablet by mouth daily in the morning. (Learning Objectives 1, 3, 4, 8) 1. In which stage of hypertension would you place Mr. Dunn? 2. What lifestyle modifications should Mr. Dunn be encouraged to follow? 3. What class of antihypertensive is lisinopril/hydrochlorothiazide? 4. What would you tell Mr. Dunn about his new medication?
43. A 13 year old boy with type 1 diabetes mellitus is brought to the emergency department because of nausea and weakness for 24 hours. He did not take his last 3 doses of insulin. His temperature is 37C(98.6F), pulse is 120/min, respirations are 30/min, and blood pressure is 90/60 mm Hg. Physical examination shows dry mucous membranes and decreased skin turgor. Laboratory studies show: Serum HCO3 Glucose Arterial blood gas analysis on room air: pH PCO2 6 mEq/L 400 mg/dL a. Buffering by HCO3 b. Buffering by inorganic phosphates c. Buffering by intracellular proteins d. Increased renal excretion of titratable acid e. Pulmonary excretion of CO2 derived from HCO3 7.10 20 mm Hg Which of the following processes is the initial defense against the decrease in arterial pH in this patient?
A07822 CONTRAINDICATION/WARNING: Do not take if you are pregnant and do not become pregnant while taking this medicine because it can cause miscarriage or other serious complications. See accompanying information. Store at or below 25°C (77°F), in a dry area. SEARLE Usual Adult Dosage: See accompanying literature. 100 mcg (misoprostol) Cytotec NDC 0025-1451-20 120 Tablets Rx only Pharmacist: Dispense in this unit-of-use, child-resistant container with Patient Leaflet attached. Pkgd. by Searle & Co., San Juan PR 00936 Mfd. by Searle, Morpeth, England For G.D. Searle & Co., Chicago IL 60680 USA 8 receive for each dose? at bedtime for a patient with a history of gastric ulcers. How many tablets will the patient The licensed prescriber has prescribed Cytotec 0.2 mg po four times daily with meals and Press Esc to exit full screen
Patient A: Has Diabetes insipidus. They have polyuria and dilute urine. They present with some signs of sever dehydration including increased thirst, rapid respirations and rapid heart rate. Their blood pressure is low Patient B: Has Diabetes mellitus type 1. They are not taking medication for it. They are confused and lethargic. They are breathing heavy and fast and the breath has a fruity odor. They have polyuria and increased thirst. 4: For Patient A, the doctor orders a Head CT scan. She does not order this for Patient B. What would the doctor be looking for in the CT scan, and whywould this not be ordered for patient B?
A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What is the diagnosis that best matches this patients conditions? a.) gigantism b.) crushing's c.) acromegaly d.) hypopituitarism
Consider the following case study: Shaylee is a 24-year-old female. She is a member of the millennial generation who relies heavily on technology for many things, including healthcare. She comes into the clinic complaining of gastrointestinal distress. She also says that she is often constipated, gets diarrhea easily, and has noticed blood in her stool on several occasions. Shaylee has visited several websites and is certain that she has inflammatory bowel disease (IBS). Her mother also suffers from IBS, and WebMD stated that IBS runs in the family. You explain to Shaylee that to officially diagnose her with IBS and to ensure she gets the appropriate treatment, she must undergo several diagnostic tests. Shaylee refuses the tests explaining that she does not have good health insurance and cannot afford them. She insists that she has done her research on IBS and becomes agitated when you state that you cannot confirm the diagnosis without testing. Shaylee emphatically states that she…
A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What accounts for the patients proganthism? a.) High growth hormone levels after epiphyseal plate closure cause thickening of bone structure b.) low testosterone leads to increased bone growth and density c.) normal bone growth with aging d.) Low IGF=-1 stimulates bone growth
A 27-year old woman of 35 wks gestation with gestational diabetes reports having headaches for the last day that will not go away. Discuss what questions you would ask the patient, and what further testing you would want to have performed.
Describe and discuss any two of the following chronic diseases. What are their risk factors? What are treatment options and preventive measures? How does each affect men and women differently? Fibromyalgia? Alzheimer's disease Autoimmune diseases Thyroid disease

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