A 42-year-old man comes to the office with rectal bleeding. He used to haveoccasional streaks of blood on the tissue after wiping, but for the past several dayshe has seen blood dripping into the toilet bowl at the end of defecation. The patientreports chronic constipation and has to strain during defecation but has no rectal orabdominal pain. He works as a truck driver, and his diet consists mainly ofhamburgers and French fries. Abdominal examination is unremarkable. There is nomass or tenderness on digital rectal examination, but anoscopy shows bulgingpurplish-blue mucosal lesions above the dentate line. Rubber band ligation of thelesions is most likely to involve which of the following?108

We have a case of 43 year old man. Chief complaints: -Rectal bleeding. -he has seen at the end of…

Answered: A 42-year-old man comes to the office…

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Alfonso is a 67-year-old male. He is admitted to the hospital due to an infection. Alfonso only speaks Spanish and has trouble communicating with the healthcare staff. He has dysphagia, difficulty swallowing and must meet his nutritional needs via a tube feeding. At home, he is very self-sufficient and does his own bolus feedings. He has been in the hospital for nearly forty-eight hours. The nursing notes indicate that he has been tolerating his tube feeding well and administering it himself, however, when he meets with the dietitian, the patient admits that he has not had any tube feeding. The dietitian looks in the room and does not see any tube feeding products. The dietitian speaks with the RN and the Nurse Manager to discuss the situation.
Mrs. Jones is a 70-year-old woman you are admitting to the skilled nursing facility after a total hip replacement. When you obtain her past medical history, she reports a problem with a chronic rash under her breasts and in her supragluteal fold. She has tried a number of topical antifungal treatments without success. She has never seen a dermatologist. While she finds the rash a nuisance and experiences an occasional increase in itchiness, it is something she can live with. Her primary care provider diagnosed the rash as Candida and encouraged her to keep the area clean and dry and to use antifungals. Recently, her 42-year-old daughter was diagnosed with psoriasis and asked about a family history of the disease. Mrs. Jones was unaware of anyone in her or her husband’s family with that diagnosis. On physical examination, you note a shiny, erythematous lesion with symmetrical distribution under both breasts. It is well demarcated without drainage and without the presence of any…
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A 32 yr old female presented to your office complaining of abdominal pain. She states this pain started yesterday and increased over the course of a couple of hours. It is mostly in the epigastric region and does radiate at times to the RUQ. She states it has been constant since then. Currently rates it at a 7/10. She has never had pain like this before. Denies any vomiting but does complain of nausea. She denies any diarrhea or constipation. Denies any documented fevers but has felt a little chilled this am. Denies any abdominal bloating. She does state she drinks a glass of wine each evening. Denies any tobacco use or street drug use. Current labs WBC 13.2 Hgb 14.0 Hct 38.9 Plt 250 Na 142K 4.0BUN 26CR 1.2Total bilirubin 2.5 mg/dl AST 289 ALT 302Alk Phos 358 What does the AST/ALT ratio indicate for this patient What if your AST/ALT ratio were >1. What would that suggest?
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140. A 42-year-old man is brought to the emergency department by his wife because of a 24-hour history of severe abdominal pain. His wife says that he has been drinking excessive amounts of alcohol for the past 3 days. His blood alcohol concentration is 160 mg/dL. Physical examination shows scleral icterus and right upper quadrant tenderness of the abdomen. Microscopic examination of a liver biopsy specimen shows hepatocyte necrosis, bridging portal fibrosis, and macrovesicular steatosis. There are numerous Mallory bodies and neutrophilic infiltrates. Which of the following abnormalities is most likely in this patient? A) Globules of a-antitrypsin OB) Impaired synthesis of fatty acids C) Increased conjugation of bilirubin D) Increased generation of ATP by mitochondria E) Increased NADH/NAD* ratio F) Increased oxidation of fatty acids

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