Assignment:
Case 1:
Clinical Notes: Patient presented with tonsillitis two weeks prior. Laboratory testing indicated the presence of streptococcus infection. Patient did not follow suggested antibiotic treatment and symptoms persisted.
Current vital signs: BP 110/76, HR 78 bpm, Temperature 101.1°F
Today, patient presents with general fatigue and joint pain in bilateral knees and ankles. Inflammation and nonpruritic rash present on arms and trunk. Subcutaneous nodules have appeared on posterior surface of bilateral wrist and elbows.
After visual examination and laboratory testing, the physician confirms the diagnosis of rheumatic fever.
Question 1: Which of the patient's symptoms are consistent with rheumatic fever?
Question 2: What are other possible signs and symptoms of rheumatic heart disease that are not mentioned in this case?
Question 3: If a complete blood count and blood smear were ordered, which abnormalities would likely be present?
Question 4: Why is the patient's previous streptococcus infection relevant in this case?
Question 5: Why is treatment imperative? What complications may occur if left untreated?
Case 2:
Clinical Notes: Female patient presents with large, swollen lumps in the axillae and neck. She reports that the lumps are painless and non-tender with palpation.She reports increasing fatigue and malaise over several weeks, which is exacerbated with consuming alcohol.
Current vital signs: BP 118/68, HR 84 bpm, Temperature 98.1°F
The physician suspects lymphoma and orders further diagnostic testing. Patient has no family history of lymphoma, but has a personal history of Epstein-Barr infection and chronic otitis media in childhood.
Question 1: Briefly define lymphoma and explain its etiology.
Question 2: What are the painless lumps that are found in this case?
Question 3: Which risk factors for lymphoma does Ms. Singh display?
Question 4: Which types of diagnostic testing may be used to confirm the type of lymphoma present? List and briefly describe at least 3 diagnostic tests/procedures.
Question 5: Diagnostic tests indicate the presence of Reed-Sternberg cells and determines that lymph nodes above the diaphragm are affected bilaterally. Lymph nodes below the diaphragm are not affected. Which type and stage of lymphoma does Ms. Singh have?
Case 3:
Clinical Notes: Female patient presents with fatigue, pallor, and shortness of breath. She reports symptoms have been present for at least one week.
Current vital signs: BP 112/74, HR 110 bpm, Temperature 98.5°F
Laboratory tests ordered: Complete blood count, blood smear, hematocrit
Diagnosis: Iron-deficiency anemia
Question 1: Microscopic examination of Ms. Williams' blood smear would likely reveal which erythrocytes abnormalities?
Question 2: In Ms. Williams' complete blood count, which abnormalities would most likely be present?
Question 3: If Ms. Williams' anemia goes untreated, what complications may occur?
Question 4: Why might Ms. Williams' physician want to know more details about her menstrual cycle?
Question 5: Dietary iron supplementation will likely be recommended.How will this affect hemoglobin and oxygen?