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- A 36-year-old woman, who has been taking aspirin for back pain, experiences a sudden sense of chest discomfort and feeling faint that is accompanied by the vomiting of coffee-ground emesis and the passing of tarry stool. She relates that she has not had any signs of stomach disorders like pain or heartburn prior to this episode. 1. What is this patient's most likely diagnosis? 2. Based upon your diagnosis, why would this patient not have experienced symptoms prior to this episode? 3. Do some research and explain why NSAIDS like aspirin degrade the mucosal layer of the stomach (be specific and relate NSAIDS mechanisms of action!!!).1. A 57-year-old man is admitted to the emergency department with complaints of acute onset of intense abdominal pain. On physical examination, the pain appears to be localized to the upper abdomen near the epigastric area and radiating to the back. While being examined, the patient experiences nausea and vomiting. The patient denies recent alcohol consumption and states that he has not been feeling well during the past few days. A. What diagnoses should be considered for the patient? B. What laboratory tests can aid in making a definitive diagnosis?A 74-year old woman with history of rheumatic fever (in her twenties) presented to her physician with complaints of increasing shortness of breath (dyspnea) upon exertion. The typical swelling she’s had in her ankles for years has started to get worse over the past two months. In the past week, she’s had a decreased appetite, some nausea and vomiting and tenderness in the right upper quadrant of the abdomen. On physical examination, the patient’s jugular veins were noticeably distended. Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra “S3” heart sound. (i) What is causing this murmur? (ii) Is the history of rheumatic fever relevant to the patient’s current symptoms? Explain. (iii) Examination of the patient’s abdomen reveals an enlarged liver (hepatomegaly) and a moderate degree of ascites (‘water’ in the pericardial cavity). Explain these findings. (iv) Examination of the patient’s…
- A 74-year old woman with history of rheumatic fever (in her twenties) presented to her physician with complaints of increasing shortness of breath (dyspnea) upon exertion. The typical swelling she’s had in her ankles for years has started to get worse over the past two months. In the past week, she’s had a decreased appetite, some nausea and vomiting and tenderness in the right upper quadrant of the abdomen. On physical examination, the patient’s jugular veins were noticeably distended. Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra “S3” heart sound. (i) Examination of the patient’s ankles reveals significant “pitting oedema”. Explain this finding. (ii) What is the general term describing this condition?A 37-year-old patient was hospitalized with the diagnosis "Infectious hepatitis". On examination: intensive icteric colour of the skin and mucous membranes is noted. In the blood is found an increase in indirect bilirubin, the fecal masses are discolored. Questions: 4. Describe the pathogenesis of patient's disorders in the pigment exchange. 5. What changes in hepatic transferase activity and bile acid concentration are characteristic for this pathology,A 37-year-old patient was hospitalized with the diagnosis "Infectious hepatitis". On examination: intensive icteric colour of the skin and mucous membranes is noted. In the blood is found an increase in indirect bilirubin, the fecal masses are discolored. Questions: 6. Define the concept of liver failure. 7. What clinical manifestations of hepatic insufficiency should be assumed in the patient?
- Of the diseases that can cause pain listed in the prior question (pancreatits, GERD, Aortic Dissection, appendicitis). Which of these is immediately life threatening and what exam finding would raise your suspicion for it? 4. 1 point Pancreatitis, vomiting GERD, blood in the stools Aortic dissection, absent pulse in one foot Appendicitis, pain with urinationA 32 year old female complained of chronic cough and hoarseness. Upon interview, it was learned that she also had burning sensation in her chest usually after eating which is usually worse at night. She usually has this sensation of lump in her throat. 1. What is the probable diagnosis?2. What part/structure of the esophagus is involved in this disorder?3. Explain the pathophysiology of this disease.4. What factors can aggravate this disorder?5. Give some medications effective against this disease.A 16-year-old nonsmoker teenager was admitted to the outpatient clinic complaining of a 14-month history of postprandial vomiting that progressed into hematemesis the last week. The patient was suffering from fatigue, dysphagia related to solid food, and loss of appetite which led to weight loss; the body mass index (BMI) dropped from 27.7 kg/m2 to 16.3 kg/m2 during this period; before that, the patient had been seeing many clinics outside the country without any conclusive diagnosis. Clinical examination revealed a pale-colored skin with mild jaundice, and the abdomen did not show any palpable mass (hepatomegaly, splenomegaly, and enlarged lymph nodes), tenderness, or rebound tenderness. The remainder of the physical examination was unremarkable. A lower esophageal sphincter narrowing was found by an upper gastrointestinal endoscopy (UGE) corresponding with a fragile bleeding gastric mass; that prevented from taking a biopsy. CT studies supported these findings by determining a large…
- A 43-year-old patient complains of pain in the right hypochondrium, periodic body temperature rises of up to 38°C, periodic icteric skin color changes, heartburn, nausea. Ultrasound examination revealed an increase in the size of the liver and gall bladder. Multiple small stones were found in the lumen of the gall bladder and bile ducts, Questions: 7. What changes in the cardiovascular system are typical for this type of jaundice.in Section 1: from 119 of 143 CA) Celiac trunk OB) Common hepatic artery C) Inferior phrenic vein Gross An 119. A 55-year-old woman comes to the physician because of intermittent abdominal cramps and dianthea during the past 4 weeks. She was tas Sp period. Abdominal examination shows mild distention and diffuse tenderness. A CT scan of the abdomen shows a mass in the unde possohe pse n Which of the following vessels is most likely being compressed by the tumor? OD) Left renal vein OE) Superior mesenteric vein d Embryology SA 38-year-old patient presents to urgent care with lower right quadrant pain that continues to worsen over time, however, she reports a brief period of relief in which afterward, she began to have nausea and vomiting. Vital signs are within normal range other than an oral temperature of 100.0 F. Which symptom on an abdominal exam makes peritonitis four times more likely the etiology? Answers: A-D A Rebound Tenderness B Rigidity C Point Tenderness D Guarding O O O