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)
lab and diagnostic tests
follow up will include
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...
A 4-year-old male was admitted to the hospital with vomiting, prolonged bloody diarrhea, abdominal cramping and recent anuria. The patient appeared pale and his vital signs indicated he was hypertensive. Upon questioning, the boy’s father reported that their family had experienced acute self-limiting diarrhea earlier this week. The physician ordered a stool culture and the following laboratory results were reported three days later: Direct Stool exam: Fecal leukocytes: Negative Stool Culture: Negative for Salmonella, Shigella, and Campylobacter species The physician...
A 32-year-old male presents to your office for initial evaluation. He is a busy systems analysis for a computer manufacturer who travels a lot, and put in many hours of work with in adequate rest. He is mildly obese but continues to have a poor diet. He eats fatty foods and does not exercise, aside from when he is running late to an appointment. He snacks often I'm salty foods. For the past two months, he complained of feeling weak,...
M.E., a 72-year-old white female presents to her local primary care office in January with c/o a worsening, productive cough and increased SOB. She describes the sputum as “a dime size amount that’s thick and yellow every time I cough.” Symptoms began 1 week ago after visiting her daughter in New Mexico and worsened three days ago. Denies sick exposure but did travel by air to visit daughter. She was seen at an urgent care clinic two days prior and...
A 48-year-old man presents to the emergency department with 2 days of crampy abdominal pain, nausea, vomiting, diarrhea, and fever. He has not had any blood in his stool. He denies contact with anyone with similar symptoms recently. He has not eaten any raw or unprocessed foods recently. The only food that he did not prepare himself in the past week was a breakfast of eggs “sunny side up” and bacon that he had at a diner the day before...
Case 1 A 19-year-old male college student presents to the student health department with abdominal pain, diarrhea, and fever. He say that his symptoms started 1 day ago. He has had 10 stools in the past day and has noted blood mixed in with the stool on several occasions. He usually eats at home but reports having eaten chicken in the college cafeteria days ago. He has no history of gastrointestinal (GI) disease. On examination he has a temperature of...
Case 3 A 48-year-old man presents to the emergency department with 2 days of crampy abdominal pain, nausea, vomiting, diarrhea, and fever. He has not had any blood in his stool. He denies contact with anyone with similar symptoms recently. He has not eaten any raw or unprocessed foods recently. The only food that he did not prepare himself in the past week was a breakfast of eggs “sunny side up” and bacon that he had at a diner the...
A 51-year-old male presents to your office with left lower abdominal pain, diarrhea, nausea, and vomiting. He states that he has a decreased appetite along with a low-grade fever and chills. His past medical history includes a diagnosis of hypertension and obesity. He is a smoker. Upon arrival, his vital signs are normal aside from a pulse of 102 and a temperature of 100.0. On exam you note the patient is visibly uncomfortable. When you exam his abdomen, you note...
A 47-year old male presents in the clinic with a complaint of recurrent low-grade fevers, weight loss (about 20% of his body weight over a 6 month period), muscle and joint pains, episodes of profuse sweating, weakness and extreme fatigue (in spite of sleeping well at night he feels tired during the day). He eats healthy, but lately, he has no appetite. He disregarded all these symptoms and thought he was just getting old, but then a week ago he...