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Eugene Shaw, 87-years-old, is a retired illustrator and former Marine who served in the Korean War. He and Nancy, his wife of 59 years, live in the city. Gene has had cold sensitization and nocturnal pain in his lower limbs and hands since trench foot, acquired in Korea, required amputation of several toes. He has hypertension, osteoarthritis, and Type 2 Diabetes. He is overweight, and he smokes and drinks. Chronic leg pain and ulcerations brought Eugene to the hospital.
Address at least three teaching areas that are a priority for Mr. Shaw and his health status?
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- Your patient is a 2-year-old male named Justin. He is suffering from hypotonia (decreased muscle tone), weakness and growth failure, and is unable to walk. His mother has just brought him into the emergency room from the family beach house, where they have been spending the summer, because he has had a seizure. X-rays indicate that the toddler is suffering from rickets, which is a result of a nutritional deficiency of Vitamin D. But his mother insists that her son’s diet is not Vitamin D-deficient. He drinks three glasses of milk a day, and his diet also includes meat and eggs. A simplified scheme of Vitamin D metabolism is shown to the left. The chemical name of active Vitamin D is 1α, 25-dihydroxycholecalciferol, and it is synthesized via the pathway shown. Catalysts, both in the form of enzymes and ultraviolet light, are required for Vitamin D synthesis. The two main sources of active Vitamin D are diet and sunlight. Food supplemented with “Vitamin D” usually contains…Mrs. Aguilar is a 78-year-old Caucasian woman who lives alone in a small, one-story home she and her husband purchased several years ago before he died. She lives on Social Security income and her deceased husband's corporate pension and is financially secure. Though she is in relatively good health, she has been having increasing difficulty walking for the past several years, which has been attributed to peripheral vascular disease. She complains of weakness and pain in her legs and a loss of feeling in her fingers and feet. She also suffers from occasional constipation. She is happiest just doing her activities of daily living, such as preparing breakfast, lunch, and a late afternoon snack, then relaxing in her living room until it is time for bed. She has a good relationship with her adult children, who have been discussing with her the possibility of hiring a visiting nurse as her mobility declines. Her children take turns visiting on Sundays. When they come, they help with her…Samuel Dexter is a 52-year-old African-American man who is both a husband and father. He is moderately obese (BMI of 32), and has smoked two packs of cigarettes a day for the past years. He awakes one morning with weakness on his right side. He is a bit confused, sees double, and his speech is slurred. When he attempts to walk to the bathroom, he stumbles a few times and falls once. His wife suspects that he has suffered a stroke and calls 911. Emergency personnel arrive within minutes of her call and transport Samuel to the emergency room of the nearest hospital. Upon examination by the emergency room physician, Samuel is found to have right hemiparesis and diminished pinprick and two-point discrimination on the right side of his head and arm. His deep tendon reflexes are brisk on the right and there is a positive Babinski reflex on the right. He has difficulty articulating answers to the questions he is asked, speaking only a few words and frequently responding with just a verb or…
- The patient is a 65-year-old male with long history of type 2 Diabetes and obesity. He does not smoke. He had knee surgery 10 years ago but otherwise has had no other major medical problem. Over the years he has tried low glycemic diet and Aerobic exercise program to reduce his weight but has not been very successful. His granddaughter just started high school and he wants to see her graduate and go on college. He understands that his diabetes puts him at high-risk for heart disease and is frustrated that he cannot lose the necessary weight. His neighbor told him about a colleague at work who had his stomach stapled (Gastric or Bariatric surgery) and as a result not only lost over 100 lbs, but also “cured” his diabetes. In addition, one family member told him about intermittent fasting and Keto diet while other relative is regularly doing High-intensity interval training (HIIT). He wants to know which among those treatments or interventions would be the best option for him. 1.…The patient is a 65-year-old male with long history of type 2 Diabetes and obesity. He does not smoke. He had knee surgery 10 years ago but otherwise has had no other major medical problem. Over the years he has tried low glycemic diet and Aerobic exercise program to reduce his weight but has not been very successful. His granddaughter just started high school and he wants to see her graduate and go on college. He understands that his diabetes puts him at high-risk for heart disease and is frustrated that he cannot lose the necessary weight. His neighbor told him about a colleague at work who had his stomach stapled (Gastric or Bariatric surgery) and as a result not only lost over 100 lbs, but also “cured” his diabetes. In addition, one family member told him about intermittent fasting and Keto diet while other relative is regularly doing High-intensity interval training (HIIT). He wants to know which among those treatments or interventions would be the best option for him. What type…Samuel Dexter is a 52-year-old African-American man who is both a husband and father. He is moderately obese (BMI of 32), and has smoked two packs of cigarettes a day for the past years. He awakes one morning with weakness on his right side. He is a bit confused, sees double, and his speech is slurred. When he attempts to walk to the bathroom, he stumbles a few times and falls once. His wife suspects that he has suffered a stroke and calls 911. Emergency personnel arrive within minutes of her call and transport Samuel to the emergency room of the nearest hospital. Upon examination by the emergency room physician, Samuel is found to have right hemiparesis and diminished pinprick and two-point discrimination on the right side of his head and arm. His deep tendon reflexes are brisk on the right and there is a positive Babinski reflex on the right. He has difficulty articulating answers to the questions he is asked, speaking only a few words and frequently responding with just a verb or…
- A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. A CT scan in both the 50 year old man and a 14 year old girl show a pituitary mass. Why are their symptoms not similar? a.) One is producing GH, the other isnt b.) They are the same c.) They are of different ages d.) They are of different gendersA 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What accounts for the patients proganthism? a.) High growth hormone levels after epiphyseal plate closure cause thickening of bone structure b.) low testosterone leads to increased bone growth and density c.) normal bone growth with aging d.) Low IGF=-1 stimulates bone growthA 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What is the diagnosis that best matches this patients conditions? a.) gigantism b.) crushing's c.) acromegaly d.) hypopituitarism
- Topic: Fred Davis is a 52 - year old overweight male who is complaining of tiredness and blurred vision. He says that for the last two weeks, he's been very hungry and very thirsty, but despite eating more, he has lost 8 pounds. He also mentions that he has been urinating more frequently. When asked, he mentions that his paternal grandfather suffered from heart disease and diabetes. Blood tests show blood glucose of 190 mg / dL. Question: Symptoms (what is the patient complaining of / experiencing)Ms. Mellon is a 43year old woman who has lived in a Residential Habilitation Center from age 11 to 40. For the last three years she has been in a Tenant Support Program. This past year staff noticed that she had begun to lose weight. This became a concern because she had always been rather slender. Staff had encouraged her to eat more and had routinely prepared the foods she liked the most. Still, she was losing weight and was about 15 pounds below her ideal weight. At a staff meeting to discuss Ms. Mellon's food consumption, it was discovered that she was generally eating breakfast but not lunch or dinner. While lunches and dinners were always made and served to her, she often dumped the food in the garbage when staff members were not present. She also was not drinking much water and staff wondered if this was part of the problem. Because Ms. Mellon did not talk, staff could not find out why she wasn't eating more than breakfast. Staff decided to use the "Determine Your Nutritional…Twenty year old Kelly has a sore throat, fever, weight loss, no appetite, and is very lethargic. Her periods are mild, without much bleeding. She sleeps all night and most of day. She admits to having several boyfriends this semester at college. Her hematocrit is 44%, Hemoglobin 12. Diabetes runs in her family, so the Doctor also ordered a fasting glucose, which was80 mg/dl, and a Hemoglobin A1C, which was 4.9%, Finally her CBC with differential revealed neutrophils of 30%, lymphocytes of 60% , basophils of less than 1% and an elevated monocyte count. First address each blood test and explain if it is normal or not. Then provide a few possible diganosis for Kelly. Explain why you chose these possibilities.