Case Study # 3 Mr. Vigo was diagnosed with smear-positive pulmonary TB in January. He was treated with isoniazid, rifampin, and pyrazinamide by his private physician. He visited his physician again in March. His drug susceptibility test results were not available at the time of this appointment. Nevertheless, the physician discontinued his prescription of pyrazinamide and gave him refills of isoniazide and rifampin. Mr. Vigo visited his physician again in April. He had a persistent cough, and his sputum smear was found to be positive. What should be done next? Answer:
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- QUESTIONS. A. What diagnostic testing would identify the cause of T.H.'s Cushing syndrome? B. What is the usual treatment for Cushing syndrome? C. What is meant by a "medical adrenalectomy"? Thank you! :)2020SP Case Study RHK is a 68 year old man who has been brought to the ER by his son. The two were outside planting spring bulbs when RHK passed out after standing up from a kneeling position. His son managed to break the fall and there is no injury associated with the incident. Afterward, there was a brief period of chest discomfort and shortness of breath. RHK reports feeling lightheaded with some palpitations just before he fainted. He reports feeling pronounced weakness during the prior week. He is two years post CABG. He has no previous episodes of fainting or recent illnesses. He has no other complaints. The patient lives with his wife, uses alcohol occasionally, past tobacco use, no drug use Past medical history includes MI, CAD, 4 vessel CABG, hypercholesterolemia, claudication, and paroxysmal AF. Medications include warfarin 2mg PO QD, Metoprolol 25mg PO QD, Simvastatin 20mg PO QD, Triamterene/HCTZ 25mg PO QD, amiodarone 200mg PO QD Vital Signs BP 116/53 RR 16 HR 52 Oxygen…CASE STUDY CONNECTION You work for a public health organization and have been asked to educate the public about BPA and to suggest ways to minimize exposure to the chemical. You begin by examining your lifestyle and finding ways to use alternatives to BPAcontaining products. Create a list of five ways you are exposed daily to BPA, and then list approaches that would avoid or minimize these exposures. Do these steps require more time and/or money? What are some costs of embracing these changes? What would you tell an interested person about BPA as it relates to human health?
- Suggest a mode of action for fluorouracil in cancerchemotherapy.CASE STUDY Ruth, a 25 year office worker, decided to visit the doctor’s office after noticing changes in her body. She complained of severe nausea, vomiting, stomach pains and loss in appetite. But her biggest worries are her frequent skin itching, bloated belly and apparent yellowish pallor. After physically examining Ruth, the doctor ordered several laboratory tests. These include CBC, Coagulation studies, blood chemistry and Serologic tests. The results showed Prolonged Prothrombin time, increased INR, decreased blood proteins such as albumin, elevated liver enzymes and bilirubin levels. Her serology was reactive for the Hepatitis B surface antigen, positive for Total anti-HBc but negative for the anti-HBe and anti-HBs 1. What do you think caused the liver disease of Ruth? Explain your answer2. What other hepatitis virus can infect Ruth?3. Is it an acute or a chronic infection? Explain your answerCASE STUDY Ruth, a 25 year office worker, decided to visit the doctor’s office after noticing changes in her body. She complained of severe nausea, vomiting, stomach pains and loss in appetite. But her biggest worries are her frequent skin itching, bloated belly and apparent yellowish pallor. After physically examining Ruth, the doctor ordered several laboratory tests. These include CBC, Coagulation studies, blood chemistry and Serologic tests. The results showed Prolonged Prothrombin time, increased INR, decreased blood proteins such as albumin, elevated liver enzymes and bilirubin levels. Her serology was reactive for the Hepatitis B surface antigen, positive for Total anti-HBc but negative for the anti-HBe and anti-HBs Answer the following questions, using the medical information of Ruth. 1. What do you think is the health issue of Ruth? Provide medical evidence.
- Case Scenario John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: Dr. Ramos is Mr. Doe’s surgeon and Dr. Reyes is Mr. Doe’s anesthesiologist. Both come to see him and discuss the surgery the evening before. How does the nurse ensure informed consent? What must the patient consent to for the procedure to be done? (Discuss in 5-6 sentences)b. What is her CrCl? 4. J.C., a 70 year old male (5'8", 100 kg) is to begin Vancomycin (along with Zosyn and Levaquin) for broad-spectrum coverage for pneumonia (moderate infection with goal AUC 500-600). WBC=13.8, SCr=0.9 mg/dL. Using AUC dosing, please come up with a dosing regimen that is appropriate for JC. a. What is the dosing weight? CrCl ? b. What LD & MD & interval would you recommend? c. When should you order a vancomycin trough for J.C? Now, lets adjust his dose Assume his initial dose was 1750mg g 12h scheduled at 0900 & 2100. Assume his doses were given on time. The hospital policy required an infusion time of 2hr. The peak was 45ug/ml drawn after the 4th dose at 1230, 3.5hr after the start of the infusion. The trough level was 21ug/ml drawn at 2030, 11.5hr after the 4th dose. How would you adjust the dose? a. Calculate the patient specific k b. Calculate Cmax & Cmin c. Calculate the AUC d. Calculate patient specific Vd e. Calculate new dosing interval f. Calculate new…CASE STUDY Background A 'typical' suburban Hill City, Antipolo, family has been stricken by several illnesses during the past several years, most or all of which may have been foodborne illnesses resulting from foods prepared in their home. The Dela Cruz family - father, Wilson age 61; mother, Nimfa, age 35; daughter, Girly, age 12; and son, Boyet, age 10 - can recall three recent episodes that seem to have been food related: 1. Three of the family members began vomiting within 2 hours of eating a meal that included 3day old Dangit Fried Rice. Girly, the only member who did not become ill, had not eaten the Pilaf. 2. All family members experienced repeated diarrhea within 14 hours of eating a winter holiday meal that included a dressed and roasted 4 kg Bantam Chicken. Because this meal was a family tradition, all members ate heartily. 3. Two family members and three of four visiting neighbors experienced simultaneous vomiting and diarrhea within 1 day of feasting at an outdoor barbeque…
- tein X Case Studies.docx X + rl=https://wheatland.orbundsis.com/einstein-freshair/Videos/0216D9403D0ED43358766A676D8A4817/Case+Stuc TCentral | NBA... a Amazon.com: Onlin... (6) The Reason Why... Isaiah Blames Zora... Beyond The Lights... Case Study, Chapter 26, The Digestive System Mr. McArthur is hospitalized with pancreatitis and cholecystitis. Neither his gallbladdernor his pancreas are functioning normally at this time. The client is placed on a NPO (nothing by mouth) diet order, given intravenous fluids and pain medication. The nurse is aware that the pancreas has two functions: one being endocrine, secretion of hormones to assist with glucose control and the other being exocrine, aiding the digestive system. Mr. McArthur is scheduled for gallbladder removal in the morning to treat the cholecystitis. (Learning Objective 4) 1. The client asks what his gallbladder does. What is the nurse's best response? 2. The client also asks how the pancreas works to help with digestion. What…sion controller? 23. A primary healthcare provider ordered ceftriaxone (Rocephin) for a 4-year old child with lower respiratory tract infection. The dose required is 20 mg/kg/day divided twice a day, administered per dose via IV. The child's weight is 29 lbs. The drug comes prediluted in a concentration of 10mg/ml. How much of the medication will you administer in mL?Need help with these PKU questions. Phenylketonuria (commonly known as PKU) 1.) What are the effects of the disease/disorder 2.) How does it affect the individual? 3.) What are the symptoms?