83. A 25-year-old woman comes to the physician because of a 2-week history of left flank pain. She has had progressive weakness and decreased appetite during thisperiod. Her temperature is 38°C (100.4°F). Physical examination shows left flank tenderness. Laboratory studies show a leukocyte count of 18,500/mm³. Urinalysisshows numerous RBCs and WBCs. A CT scan of the abdomen confirms an abscess of the lower pole of the left kidney. Which of the following is most likely preventingthe spread of the infection to the surrounding organs?A) Fatty layer (Camper fascia) of the abdominal tela subcutaneaB) Greater omentumC) Membranous layer (Scarpa fascia) of the abdominal tela subcutaneaD) Pararenal fasciaE) Perirenal (Gerota) fascia

Patient is 25 year old women . She has left flank pain. And investigations indicates that her WBC…

Answered: 83. A 25-year-old woman comes to the…

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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Mr. Jonas is admitted to the hospital for fever of unknown origin. He is a 55-year-old patient who has been receiving outpatient dialysis for the last 6 months. He is no longer able to work at the construction job he had for the past 30 years. His wife has recently gone to work part time as a teacher’s aide. Mr. Jonas receives dialysis three times a week and must have someone provide transportation to and from the dialysis center. This is a constant worry for him because his wife has gone back to work. His neighbor takes him to and from the dialysis center and seems happy to have something to do. Mr. Jonas has difficulty hearing but does not consistently wear his hearing aid. When he forgets to wear the hearing aid he tends to talk loudly to everyone, which is annoying to his wife. This morning Mr. and Mrs. Jonas are sitting in his room after finishing breakfast. Lucy, a first-year student nurse who is assigned to Mr. Jonas, enters his room and introduces herself. Question: Lucy…
169. A 65-year-old woman comes to the physician because of a 10-week history of low-grade fever, fatigue, and pain in her right arm. She recalls no trauma to the arm. She has a history of cancer treated with radiation therapy. Her temperature is 37.7°C (99.8°F). Physical examination shows tenderness of the right distal humerus. Laboratory studies show anemia. An x-ray of the right upper extremity is shown. This patient most likely has an abnormality of which of the following cell types? A) Hematopoietic stem cells B) Monomyelocytic stem cells C) Natural killer cells D) Osteoclasts E) Plasma cells
Following assessment by the surgical team, it has been determined that Mr Johns has developed sepsis from a perforated bowel during his previous surgery Explain 4 possible signs and symptoms you would see with a patient who has developed sepsis. Minimum 2 sentences for each point.
James Dunn is a 40-year-old African American man. He presents to the physician’s office today complaining of headache. His vital signs during triage are as follows: blood pressure 165/90 mm Hg, heart rate 80 beats/minute, temperature 98.5F, weight 125 kg (275 lb), and height 5 ft 11 in. He currently has no other diagnosed medical conditions. The physician gives Mr. Dunn a prescription for lisinopril/hydrochlorothiazide (Prinzide) 10/12.5 mg with directions to take one tablet by mouth daily in the morning. (Learning Objectives 1, 3, 4, 8) 1. In which stage of hypertension would you place Mr. Dunn? 2. What lifestyle modifications should Mr. Dunn be encouraged to follow? 3. What class of antihypertensive is lisinopril/hydrochlorothiazide? 4. What would you tell Mr. Dunn about his new medication?
Awakened in the early morning by screams and pounding on your front door, you rush to answer the door. You find Mrs. Winters, your older neighbor from across the street. She knows you are trained in first aid and CPR and asks you to please help her husband. As you hurry across the street, she tells you her husband had been feeling ill for several hours and then vomited. She says that he emerged from the bathroom clutching his chest and in apparent pain. He suddenly collapsed to the floor. As you enter the house, you find Mr. Winters lying motionless on the floor just outside of the bathroom. You want to help. How do you respond?
A male patients who is 83-year-old , was admitted to a local hospital with recurrent urinary tract bleeding and an infection associated with prostatitis ( inflammation of the prostate) . He had a CBC upon admission. The results were: RBC: 4.15 X1012/ L Hb: 81 g/L Hct: 26% Platelets: 174 X109/L WBC: 2.8 X109/L Reticulocyte count: 2.6% Serum iron: 18 μg/dL TIBC: 425 μg/dL a. How would you describe his anemia morphologically? b Calculate % saturation. ( normal to be more than 15%) c. Is this value normal, decreased,o r increased?
A 38‐year‐old man presents to his dentist with bleeding gums. The dentist refers him for medical evaluation due to gingival hypertrophy and oral purpura. The full blood count is abnormal, with numerous immature blast cells noted. Which ONE of the following is the most likely diagnosis? Select one: A.Acute promyelocytic leukaemia B.Secondary acute myeloid leukaemia C.Acute lymphoblastic leukaemia D.Acute monoblastic leukaemia
A 50-year-old patient was operated for a perforated stomach ulcer. Three days after the operation, he felt weakness, dizziness, nausea, intensive pain in the area of the postoperative suture. On examination: hyperemia and edema of the postoperative suture, sharp pain during its palpation. Body temperature - 38,9° C. Questions: 1. What is the name of an increase in body temperature of this patient? 2. What caused this increase in body temperature? 3. What other causes can lead to an increase in body temperature?
24. A 45-year-old man is brought to the physician because of a 3-week history of fever and facial pain. His temperature is 38°C (100.4°F), pulse is 74/min, and respirations are 14/min. Physical examination shows tenderness, edema, and erythema around the left zygomatic bone. A CT scan of the head shows that the left maxillary sinus is filled with fluid. Fiberscopic rhinoscopy is done to examine the maxillary sinus. The inserted endoscope is most likely to traverse which of the following spaces before immediately entering the maxillary sinus in this patient? A) Frontonasal duct B) Inferior meatus C) Middle meatus D) Nasolacrimal duct E) Parotid duct F) Sphenoethmoidal recess G) Superior meatus
3) You are called to the surgical ICU to assess Mrs. King, who had open heart surgery and is 20 hours postoperative. Describe how you would assess her readiness for extubation.
A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film?
A 45-year-old man had a 10-day history of appetite loss, flu-like symptoms, and nausea. He noticed that upon urination, his urine had been dark in color over the past 4 days. On examination, he had tenderness in his upper right quadrant of his abdomen. Laboratory tests show: Total Bilirubin- 4.5 mg/dL Direct Bilirubin- 2.5 mg/dL Indirect Bilirubin- 2.0 mg/dL 1. What is the clinical importance of the result of: a. Total Bilirubin b. Direct Bilirubin c. Indirect Bilirubin 2. What does the dark-colored urine indicate? 3. What is the diagnosis of the patient? 4. What other tests are needed to be done to support your diagnosis?

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