A 78 year old male presents to your office with c/o 1 week of "cold" symptoms with cough. 2 days ago he noticed bloody sputum. He tried taking an OTC cough medication with little effect. This morning he noticed some CP when he exerted himself that lasted for about 30 seconds. He has had similar pains in the past. He admits to having bloody stool with diarrhea as well for the past month but thought it would go away on its own. He has no abdominal pain, N/V, dizziness, or HA. No recent travel. He has been visiting his wife regularly in the Nursing Home 2-3x/week.
Please open and read the attached case before responding to the following questions:
1. What are your differential diagnoses and why you choose each one? Please list at least 5 differentials. (10 points)
2. What lab and diagnostic tests would you order and why? (12 points)
3. What is your follow up going to include with this patient? (8 points)
Ans-1 A- Acute bronchitis...blood in cough can be cause by acute bronchitis because here inflammation of the respiratory tract is present and blood can be present in cough
B-Bronchestisis -- Bronchestisis is also the cause of blood in cough as there is presence of infection and pus but it can have blood
C- pnumonia - pneumonia are the cause of blood in cough because due to infection of the respiratory tract it can cause this menisfestation
D-pulmonary embolism-- it is a serious disese which cause restrictions of lung movement and cause symptoms of blood in cough
E- pulmonary tuberculosis- pulmonary tuberculosis iis the most common risk factor for blood in stool in case of if patient having cough for more than 14 days
Ans-2
1- chest X ray for lung pathology
2- complete blood count for looking any increase in wbc coount as it occur iin case of infection
3- ct scan chest for the Bronchestisis
4- lung respiratory test to check for the lung capacity
5- sputum for the tuberculosis
6- bloood for culture for any pathogen
7- Electrocardiogram for any associated heart pathology
8- liver function test for general examination
9- renal function test for detecting renal patholog
10- MRI for brain pathology
11- ESR - as it increase in many case
12- pleural fluid culture as in case of pleural effusion it can have any infection
Ans-3
Normal blood checkup for any infection pathology and time to time x ray for the lung pathology .....
In case of tb patients every month follow up is required
In case of any cerebral pathology nearly one month follow up is required
Proper maintenance of hygine and in case of any problems take strict instructions to the physician
A 78 year old male presents to your office with c/o 1 week of "cold" symptoms...
A 78 year old male presents to your office with c/o 1 week of "cold" symptoms with cough. 2 days ago he noticed bloody sputum. He tried taking an OTC cough medication with little effect. This morning he noticed some CP when he exerted himself that lasted for about 30 seconds. He has had similar pains in the past. He admits to having bloody stool with diarrhea as well for the past month but thought it would go away on...
NURS-60506: Comprehensive Study A 78 year old male presents to your office with c/o 1 week of "cold" symptoms with cough. 2 days ago he noticed bloody sputum. He tried taking an OTC cough medication with little effect. This morning he noticed some CP when he exerted himself that lasted for about 30 seconds. He has had similar pains in the past. He admits to having bloody stool with diarrhea as well for the past month but thought it would...
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