CASE STUDY TABLE 25-3.1 LABORATORY RESULTS ALT (SGPT) AST (SGOT) Alkaline phosphatase Lactate dehydrogenase Serum bilirubin Urine bilirubin Hepatitis A antibody (IgG) Hepatitis A antibody (IgM) Hepatitis B surface antigen Hepatitis B surface antibody Hepatitis C antibody Elevated Elevated Minimally elevated Elevated 5 mg/dL Increased Negative Positive Negative Negative Negative
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The following laboratory results were obtained from a 19-year-old college student who consulted the Student Health Service because of fatigue and lack of appetite. She adds that she recently noted that her sclera appears somewhat yellowish and that her urine has become dark (Case Study Table 25-3.1).
Questions:
What is the prognosis?
What additional factors in the patient's history should be sought?
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- 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 study : Ms. X, a 32-year-old Hispanic woman, has had a history of intermittent pleuritic chest pain and joint pain for the past several years. Recently, she went to her physician because she noticed that an erythematous, butterfly-shaped rash had appeared on her face. Further lab tests indicated protein in her urine. Her blood test indicated the presence of numerous antinuclear antibodies, especially anti-DNA, and mature neutrophils containing nuclear material. A diagnosis of systemic lupus erythematosus (SLE) was made. Discussion Questions 1. Discuss possible reasons why SLE was not diagnosed earlier 2.Discuss how the presence of antibodies can cause such widespread damage in organ systems. 3. Discuss possible manifestations of SLE 4. Discuss treatments for SLE and a prognosis for the patient in this case.
- Based on the image below, select the correct statement. Complex II QH₂ Q- 10 2 HO 2 HO Fe-S (2.8 FADH₂ FAD- Succinate Fumarate https://canvas.uts.edu.au/assessment questions/356986/files/1562694/download? 2e verifier-eUTT3hYal2YYTWlywV8TIFA3USmzCsM52jECmvTo O Succinate is reduced to fumarate O Succinate is oxidised to FAD O The Fe-S center shuffles electrons from FAD to ubiquinone (Q) O The Fe-S center shuffles electrons from FADH2 to ubiquinone (Q) The Fe-S center shuffles electrons from FADH2 to ubiquinonol (QH2) W 88 16°CNursing question [3. make table to differentiate ITP, TTP, HIT, DIC.Question:- A 25-year-old man comes to the emergency department because of a 2-day history of fever and rash. He has a history of complex partial sezure secondary to an arteriovenous malformation. He has had breath through seizure several times each despite treatment with several medication regions. Initially, treatment with phenytoin, which caused sedation. Two weeks ago, he was stitched to valproic acid and lamotrigine. He states that he has not had any seizure during topiramate and phenytoin, which caused sedation. Two weeks ago, he was switched valproic acid and lamotrigine. He states that he was not ad nay seizure during this time, and he finished his sample package of lamotrigine. He is awake and alert but appears ill. Vital signs are temperature 39.0 oC (102.2 oF), pulse 1110/min, respiration 22/min. and blood pressure 130/90 mm Hg. Examination shows extensive bullae, especially over the hands and feet. There are erosive lesions over the mouth and genital area. Which of the…
- CASE STUDY 2 History and Physical Examination This 6-year-old white male patient was taken to a pediatri- cian because of recurring abscesses since the age of 1 month. The current abscesses were lanced and he was placed on antibiotic therapy... The patient had two brothers who had died in infancy of infections. His parents and two sisters are healthy. Laboratory Data Hemoglobin and hematocrit-slightly decreased Total leukocyte count-elevated Differential leukocyte count-increased percentage of segmented neutrophils Immunoglobulin profile-polyclonal elevation of all Ig classes Neutrophil oxidative burst assay (DHR) activity absent Nitroblue tetrazolium (NBT) test (automated)-reduction of unstimulated and stimulated neutrophils Culture of abscess revealed S. aureus Questions 1. What does the patient's family history suggest? a. A genetic disorder in male offspring b. A genetic disorder in female offspring c. Lack of leukocyte production d. Anemia producing an immune dysfunction What…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…CASE STUDY 15.6 A 52-year-old woman presents with a localized swelling and purulent abscess in her right hand and enlarged lymph nodes in her axial region (under the armpit). She sustained a small puncture wound while replanting rose bushes 1 week earlier. She has repeatedly cleaned and dressed the wound with antibiotic treatment, with no success. The physician collects an aspirate from the abscess. Gram stain reveals gram-positive cocci in clusters Laboratory data follow Catalase: Positive Coagulase: Latex positive Multiple Choice Questions From the patient's history and laboratory results, which organism is the most likely cause of the infection. Micrococcus luteus Staphylococcus aureus Staphylococcus epidermidis Sporothrixschenckii ANS: b. Staphylococcus aureus What other clinical condition could arise from this injury if treatment were not initiated? No concerns; infections are self-limiting. Patient may develop a bacteremia, resulting in a more serious infection.…
- 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 Identifying Intravenous Delivery Systems, Administration Method, Infusion Rate, Stability/Compatibility, and Labelling of an Intravenous Admixture Mr. Blair, a 75-year-old man weighing 60 kg, was admitted to the Gastroenterology Unit of the Miracle Hospital with severe diarrhea due to food poisoning. After examining Mr. Blair, Dr. Clark ordered IV fluids of D5W 1000 mL q12h, for the next three days with added electrolytes, such as potassium, sodium, calcium, and magnesium, since Mr. Blair was severely dehydrated. In addition, suspecting Salmonella poisoning, Dr. Clark prescribed Septra, 500 mg IV q12h, to be mixed in the D5W electrolytes fluid admixture. What considerations must be taken into account prior to admixing this order? (NAPRA 6.1, 6.2, 8.3, 9.2) 2.If the drug is determined to be incompatible with D5W and electrolytes, what IV delivery system and/or administration method would you use to administer the medication? (NAPRA 2.3, 6.1, 6.2, 8.3, 9.2)…Discuss why gamma globulin injections are painful.