case

Scenarios in the case study address Course Outcomes:1. Use relevant vocabulary, including anatomical positions, to describe human anatomy and physiology and the role of homeostasis and metabolism in the normal functioning of organ systems.2. Apply knowledge of the chemical basis of life and biological processes to explain basic cell structure and function as it relates to the development of tissues and organs in anatomy and physiology.3. Use the scientific method to apply the principles of anatomy and physiology to form hypotheses and draw conclusions related to real-world problems about human systems. 4. Using quantitative reasoning, analyze and interpret vital signs and other diagnostic measurements to make decisions about health status.CASE STUDY REPORT General OutlineStudent is presented with a medical case study scenario.Student will then be asked to create a case study report with 6 content area subheadings. Make sure you answer all the questions comprehensively. Use complete sentences.1. Diagnosis Name What is the name of the disease/disorder?2. Explanation What are the reasons for your diagnosis?|3. Causes/Risk Factors What are some of the factors that put this patient at risk for the disease? What other questions might you have for the patient that would provide you with more data? 4. Clinical Manifestation Describe the clinical features of the disease that are present in the individual.5. Diagnostic Procedures What types of procedures were done on the patient and what were the results? Are there other diagnostic procedures that you would like to have performed? If so, which ones and why?6. Treatment Describe the treatment plan that you would prescribe for this patient.Patient M is an active woman, 70 years of age, who lost consciousness and collapsed at home. Her daughter, who was visiting her at the time, did not witness the collapse but found her mother on the floor, awake, confused, and slightly short of breath. The daughter estimated that she called EMS within 5 minutes after the collapse, and EMS responded within 10 minutes. EMS evaluated Patient M, drew blood for a glucose level.On presentation in the emergency department, Patient M is immediately triaged. Because Patient M is still somewhat confused, her daughter is asked to provide information on the patient’s history. The daughter reports that her mother had had an episode of sudden-onset numbness and tingling in the right limb, with slight confusion and slurred speech, 3 days previously. The episode lasted only 5 minutes, and Patient M had not called her primary care physician. Additional information provided by the daughter indicates that Patient M has been treated for hypertension for 10 years but notes that she is often not compliant with her antihypertensive medicine, a diuretic. The patient has never smoked, drinks occasionally, and is of normal weight.On physical examination, Patient M’s blood pressure is 150/95 mm Hg. She has pain in her left arm and a slight headache. There are slight carotid bruits on the right. She is assessed with use of the NIHSS and found to have left hemiparesis and left visual/spatial neglect. The results of laboratory tests, including a complete blood count, prothrombin time, serum electrolyte levels, cardiac biomarkers, and renal function studies, are all within normal limits. CT of the brain indicates a thrombus in a branch of the right internal carotid artery, with approximately 50% occlusion due to atherosclerosis. There is an area of infarction in the right anterior hemisphere. There is no evidence of a subarachnoid hemorrhage.I HAVE ATTACHED MY FIRST CASE STUDY AS AN EXAMPLE OF HOW THIS ONE SHOULD BE WRITTEN OUT. THANK YOU!
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Case study # 1
Porsche L. Hamilton
University of Maryland University College
Introduction to Human Anatomy and Physiology
Professor James Cummings
March 29, 2018
1. Diagnosis
Essential tremor
2. Explanation for the diagnosis
? Age of the patient- above 55 years
? Progressively worsening hand tremors
? Bilateral tremors that increase with activity
? Worsening handwriting- sprawling in nature
? Tremor improves with alcohol intake
? Family history of tremors
? No tremors at rest
? No rigidity or Bradykinesia
? Back and forth horizontal involuntary movement of the head
? No change in mental status, normal muscle strength and tone, cranial nerves,
sensation and deep tendon reflexes.
3. Causes and risk factors
The cause of essential tremor is not known but it is believed that there is an
abnormality in the functioning of the central oscillator that is located near the
brain stem and usually involves the inferior olivary nucleus. (Rana and Chou,
2015).
Risk factors
? Age- it is more common in those over the age of 60
? Genetic predisposition – is an autosomal dominant trait that has been
linked to the inheritance of ETM1 and ETM2 gene
? Caucasian race
Additional questions
? Is there a history of memory loss?
? Is there a history of loss of consciousness?
? What worsens the tremors and other than alcohol what else improves
the symptoms?
? If there are any other body parts that are affected by the tremors?
? Is there a history of convulsions?
? Is there a history of previous neurological abnormalities?
? Is there a history of sudden falls or gait abnormalities or difficulty in
initiating motion?
4. Clinical manifestations
? No tremors at rest
? No rigidity or Bradykinesia
? Back and forth horizontal involuntary movement of the head
? No change in mental status, normal muscle strength and tone, cranial
nerves, sensation and deep tendon reflexes
5. Diagnostic procedures
? Lipid profile – was normal
? Thyroid stimulating hormone – was normal
? Fasting blood sugar – normal
Other diagnostic procedures
? Blood urea nitrogen – high levels in kidney disease is associated with
tremors
? Liver function tests (AST, ALT, serum albumin) – liver disease could
point towards hepatic encephalopathy
? Serum ceruloplasmin – to rule out Wilson’s disease
? Imaging studies
? CT scan and MRI – could rule out space occupying lesions and long
standing brain injury that could also cause tremors.
6. Treatment
o Supportive treatment- monitors the patient for any sudden changes and
deteriorations.
o Medical treatment – the mainstay is Primidone 50- 62.5 mg per oral or
Propranolol at 10-40 mg usually an hour before activity.
Alcohol can also be used for intermittent reduction of tremors.
o Surgery – preserved for medically refractory essential tremors
? Thalamotomy
? Deep brain stimulation
Work cited
Rana, A. and Chou, K. (2015). Essential Tremor in Clinical Practice. Cham: Springer
International Publishing (Rana and Chou, 2015).
Kumar, H. and Sen, S. (2015). 125. Tremor: essential and palatal tremor. Toxicon, 93, pp.S38S39.

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