Lung Cancer Case Study

PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia

Another Consultation Report dated 12/06/2016, indicated that the claimant presented with exacerbation of COPD, acute bronchitis, and pseudomonas aeruginosa. The CT scan of the chest revealed bilateral lower lobe atelectatic changes, fibrosis, and a small 1 cm left lower lobe nodular density. A pulmonary consultation was recommended. His blood pressure was 142/79 mmHg. The physical examination revealed bilateral decreased breath sounds and scattered wheezes. His glucose was 189. DuoNeb, IV Solu-Medrol, and IV antibiotics were prescribed.

PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia noted. No edema noted in extremities. Patient skin is cool to touch, slightly clammy. EEG shows prolonged QRS wave, with ischemic ST changes and PVCs. Chest radiograph clear.

Cardiac: Mrs. Elliot states she has experienced chest pain 5-6 times starting three weeks ago when she is Short of breath. The pain she said is on the left side of chest and describes is as sore and uncomfortable. Additionally, the patient has experienced palpitations the past few weeks and is positive for peripheral edema. Denies redness, cyanosis, jaundice, flushing.

Childhood illnesses include measles, mumps, rubella, and chickenpox. She has fallen many times however, has never broken any bones. Serious traumas include three concussions. Has had many surgeries including tonsils removed, gastric bypass, right hip replacement, 2 bilateral knee surgeries, cataracts removed, back surgery and is waiting for shoulders to be replaced. Reports sinus infections in the spring and fall due to pollen and mold. These symptoms are similar to the ones she is experiencing now. Several years ago, she traveled around the world for 7 months and was in England for the Mad Cow Disease outbreak.

Crouthamel's current bronchodilator regimen. She should also continue to use her supplemental oxygen. She has essentially had no changes on her symptoms of shortness of breath and cough. I have recommended pulmonary rehabilitation, which she is unable to do at this time given the fact that she is the primary care taker of her husband who has advanced Alzheimer's dementia. I have counseled her on the need for smoking cessation and as previously stated in my last note in April, she will have repeat CT scan performed in December 2015 for 12 month follow up of a previously identified pulmonary

examination was remarkable for crackles at her right lung base. The examination of her cardiac,

This is 51 year old AAF. Patient is here complaining of several issues as listed. Patietn reports for the past several days she had increased SOB at rest, non-productive cough, adiouble wheezes. Patient denies chest pain, N/V/ D. Patient is a current tobacco user wit 20 pack year hisotyr. Denies use of alcohol or illicit drug use. Denies depressive moods, current pain 3/10.

No family or self history of lung disease. Denies having ever smoked or living/working conditions that affect breathing. Denies ever having had a TB test. States she does not believe in immunizations and refused them when offered by her physician. States she does not remember when her last chest xray was done. Uses no respiratory medications.

M. H. states that she is generally in good overall health. No cardiac, respiratory, endocrine, vascular, musculoskeletal, urinary, hematologic, neurologic, genitourinary, or gastrointestinal problems.

She doesn’t recall any sick contacts, but her husband is a minister, and she mingles with members of his congregation three to four days a week. On physical exam her oral pharynx is slightly erythematous but there is no cobblestoning and her nasal turbinates are neither pale nor inflamed. She has no lymphadenopathy, and her lungs sound clear without any wheezing or crackles.

Occupational exposure: Arsenic, bischloromethyl ether, hexavalent chromium, mustard gas, nickel, polycyclic aromatic hydrocarbons are some of the chemicals linked to lung cancers

Tobacco use is the number one cause of lung cancer, but people who don't smoke may get lung cancer secondhand. The risks of developing lung cancer are related to three main factors: the age when a person started smoking, how long a person has

Risk factors that increase the chances of developing lung cancer include smoking, exposure to secondhand smoke, exposure to radon gas, exposure to asbestos or other chemicals, and family history of lung cancer.1 Above all others, cigarette smoking is the most strongly correlated and preventable risk factor in lung cancer development.1,2 Approximately 80-90% of the deaths from lung cancer are the result of smoking, accounting for 90% of the lung cancer deaths in men and 80% of the deaths in women.1,2 Cancer cells are formed by DNA-mutating

Breathlessness – Restricts her from walking long distances, it started in 2007 changing after a stopover in Singapore.