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Medical Case Presentation

Transcript: Medical Case Presentation Timeline A 5-Day Timeline of Events Timeline 5 Timeline 2. 4. 2. 4. 4 2. 4. Future Considerations Complications Encountered Revised Diagnosis Looking forward, this case highlights the need for improved protocols in patient monitoring and a more integrated approach to multidisciplinary care. Future practices should focus on leveraging technology for better tracking of patient conditions and enhancing communication among medical teams. Further Testing The patient exhibited signs of respiratory distress and electrolyte imbalance, indicating potential complications from treatment. These issues necessitated immediate reassessment of the patient’s condition to prevent further deterioration. The results from Day 2 testing indicated an evolving clinical picture, leading to a revised diagnosis of a potential systemic infection. This shift underscored the importance of adaptability in medical diagnoses and treatment protocols when patient conditions change. In response to the patient’s declining status, further diagnostic tests were conducted, including blood cultures and imaging studies. These investigations aimed to identify underlying causes of the patient's deterioration and to tailor an effective treatment strategy. Demographics Day 4 Events: Complications and Responses 3 Key Learnings Conclusion Patient Profile Critical insights from this case emphasize the importance of timely interventions, comprehensive assessments, and collaboration among healthcare professionals. The evolving nature of patient conditions necessitates continuous monitoring and adaptability in treatment approaches. This section encapsulates the timeline of events, highlighting the critical insights gained throughout the medical case presentation over five days. The patient is a 45-year-old male, presenting with no known allergies. He lives alone and works as an accountant, leading a sedentary lifestyle. This demographic information provides insights into potential health risks and lifestyle-related conditions. Adjustments in Treatment Understanding the patient profile is essential for effective diagnosis and treatment. This section summarizes crucial demographic information, medical history, and current medications for a holistic view of the patient's health. Day 2 Events On Day 4, the patient experienced unexpected complications, altering the treatment trajectory. Prompt adjustments were necessary to effectively address new clinical challenges and ensure patient safety. In response to the complications, the treatment plan was modified to include supplemental oxygen and intravenous fluids for rehydration. This prompted close monitoring to evaluate effectiveness and mitigate further risks. Current Medications Changes in Patient Condition Medical History Consultations with Specialists Summary of Timeline On Day 2 of the case trajectory, significant changes in the patient's condition prompted immediate reevaluation. This set the stage for a series of critical tests and a necessary revision of the initial diagnosis, illustrating the evolving nature of medical assessments. Currently, the patient is on Lisinopril for hypertension. Additionally, he takes a multivitamin daily but reports no use of over-the-counter medications or supplements, which is critical for medication reconciliation. By Day 2, the patient exhibited noticeable alterations in vital signs, including elevated heart rate and fluctuating blood pressure. Symptoms such as increased discomfort and altered consciousness levels were reported, necessitating reassessment of the treatment plan. The patient has a medical history of hypertension diagnosed 5 years ago, managed with lifestyle changes. There is no significant surgical history or family history of chronic diseases, which influences the treatment options available. With the emergence of complications, consultations with pulmonology and nephrology specialists were initiated. Their insights guided the medical team in refining the treatment strategy and ensuring comprehensive care. The timeline of this case illustrates a series of pivotal events leading from initial symptoms to final assessments over five days. Key decisions and interventions shaped both the patient’s experience and outcomes, reinforcing the value of structured medical timelines in patient care. 2 3. 1. 1 Overview of Medical Case Discharge Planning Outcome of Treatment The medical case involves a patient who presented with multiple symptoms requiring a systematic analysis. Over five days, various diagnostic tests, treatments, and responses will be chronologically detailed to illustrate the clinical journey and decision-making process. 3. 1. Discharge planning involved a multidisciplinary team assessing the patient's needs for home care, follow-up appointments, and medication instructions. Effective communication and coordination ensured the patient understood their post-discharge care, minimizing the risk of complications. The treatment plan

Medical Intervention Case Report

Transcript: Medical Intervention Case Report Maya Washington/ Medical Interventions September 2022 SUMMARY Breaking news Greetings, I have come to inform you that there has been an outbreak of meningitis in your area. With this outbreak the Meningitis pathogens enter the body through sharing spit or saliva. For example sharing a drink, taking a bite after someone or kissing someone. If meningitis goes too long without being treated it can cause serious blood infections, infections in the lining of the brain and the spinal cord What is meningitis? what is meningitis Meningococcal Disease Scientific Name:Neisseria Meningitidis Other wise known as Meningitis; is inflammation of the meninges Medical Interventions that were taken Medical interventions THE ELISA Test THE ELISA Test What is the ELISA Test? ELISA is an enzyme-linked immunosorbent assay which provides quantitative results determining how much of the detected substances present. How this experiment works is positive samples will contain simulated meningitis antigens that stick to the Wells. After washing the primary antibody is added to 12 the primary antibody will bind to it. This repeats with the secondary antibody finally the substrate tmb is added if the secondary antibody is present the HRP enzyme will produce color change. The traditional ELISA requires 2 antibodies primary and secondary that the secondary antibody is covalently link to the enzyme called horseradish Peroxidase or HRP that lets us detect the presence of antibody-antigen complex. To perform ELISA samples are added to the wells in the integers are allowed to absorb the surface through hydrophobic associations. Bioinformatics Bioinformatics What is Bioinformatics? Bioinformatics, as related to genetics and genomics, is a scientific subdiscipline that involves using computer technology to collect, store, analyze and disseminate biological data and information, such as DNA and amino acid sequences or annotations about those sequences. Scientists and clinicians use databases that organize and index such biological information to increase our understanding of health and disease and, in certain cases, as part of medical care. https://www.genome.gov/genetics-glossary/Bioinformatics Final Diagnosis Final Diagnosis Who's infected Infectants The College students infected with the Meningitis B Outbreak are -Sue -Maria -Jill -Marco How did it spread How it spreads The disease has spread from close contact kissing sharing drinks and living together so this disease can likely be spread by people who have roommates, people who like go out and party and use different cups and also couples while kissing. How should the situation be handled? Handling and management Quarantine will be a good way to keep this outbreak undercontrol and handled. It makes students have to stay inside to prevent the spread of the disease. Also enforcing masks and making sure that theres no shared contact with each other.

Medical Case Presentation

Transcript: Boulanger David medicine student Medical case presentation Identity Identity Name: Johnson Forname: William DOB: 24th September 1979 Occupation: Teacher (school director) Social status: Married Child: 2 (girl: 12 boy: 8) Live in: Grenoble (France) Symptom(s) Symptom(s) - Dizziness - Headache - Muscle aches - Insomnia - Nausea and vomiting - Irritability - Loss of appetite - Swelling of the hands, feet, and face - Rapid heartbeat - shortness of breath with physical exertion - Coughing - Chest congestion - Pale complexion and skin discoloration - Inability to walk or lack of balance - Social withdrawal Family history (FH) Family history (FH) TIME FATHER: myocardial infarction (67) MOTHER: Diabetes (32) Siblings: NAD Past medical history Past medical history TIME appendectomy (14) tonsillectomy (15) withdrawal of wisdom teeth (18) Broken leg (23) Social history (SH) Social history (SH) TIME Walking Trekking Climbing Swimming Skiing Examination (O/E) Examination (O/E) examination (O/E) examination (O/E) Weight: 70 Size: 1.75 Weight: 70 Size: 1.75 BP: 140/80 BP: 140/80 P: 180 P: 180 Respiratory frequency 20 / Min Respiratory frequency 20 / Min P02: 92% P02: 92% T: 37.5°C T: 37.5°C DIAGNOSIS DIAGNOSIS Acute Mountain Sickness (AMS) ? Acute Mountain Sickness (AMS) Treatment Treatment Medications : acetazolamide, to correct breathing problems blood pressure medicine lung inhalers dexamethasone, to decrease brain swelling aspirin, for headache relief Other treatments Lower altitude Lower altitude At rest At rest Water Water

Medical Case Presentation

Transcript: O God, that men should put an enemy in their mouths to steal away their brains! That we should with joy, pleasance, revel, and applause transform ourselves into beasts! William Shakespeare (1564-1616) British poet and playwright. 48 year old Caucasian female "My stomach is really hurting" HPI 48 y/o lady with a PMH of alcoholic liver cirrhosis, and esophageal varices "My stomach really hurts" She's been having abdominal pain for the past 6 days. Describes the pain as dull (constant and diffuse) 8/10 in severity starting from the epigastrium moving to the lower part of the belly. She feels relief when she lies down and worse sitting up. She also mentions that she noticed gradual distention of her belly for the past three weeks. She denies any nausea, vomiting, weight loss, or fever but notices some swelling in her left leg. In addition, she has recently been experiening some shortness of breath. She has dyspnea on exertion but denies orthopnea and paroxysmal nocturnal dyspnea. Of note, she mentions that she had similar belly pain 2 weeks ago which was associated with episodes of bloody vomiting. She went to Eastern Shore Hospital, admitted for upper GI bleed, underwent a panel of tests that included an endoscopy, ultrasound, and ascitic tapping and diagnosed with liver dx. She also mentions that she felt a lot better after that and hoped to get tapping done at SAH. Past Medical History Alcoholic liver cirrhosis Grade one esophageal varices Anemia Hx of thrombocytopenia Anxiety disorder GERD Cholecystitis Alcohol abuse Past Surgical History Rhinoplasty Allergies Acetaminophen (rash) Oxycodone (nausea) Medications Propanolol 10 mg po BID Pantoprazole 40 mg po BID Lactulose 15 mg po Qday Spironolactone 25 mg po Qday Sertraline 100 mg po Qday Clonazepam 1 mg po BID Review of Systems General: Muscle weakness, fatigue, and chills HEENT: No headaches, vision change, hearing changes, sinus troubles, bleeding gums, swollen glands Cardiac: No chest pain, palpitations Resp: Cough (non productive) and wheezing Breasts: No lumps, pain, nipple discharge GI: per HPI GU: No trouble urinating, no pain on urination, no hematuria, LMP was three years ago Extremities: per HPI Skin: No rashes, lesions, or color changes Endocrine: No heat or cold intolerance, excessive thirst or hunger Neuro: No seizures, numbness, or tingling Hematologic: No easy bruising or past transfusions Physical Exam 99.0 T 76 P 18 RR 115/60 BP 97% on 2L nasal cannula Weight: 70.307 kg General: Middle aged lady, in obvious pain but no acute respiratory distress, alert and oriented to person, place, and time. HEENT: Scalp normal, pupils equally round and reactive to light and accomodation. Fundoscopic exam reveals normal vessels, tympanic membranes are normal, oral pharynx is normal, neck is supple, no abnormal adenopathy in cervical or supraclavicular areas, thyroid is normal without any masses. Cardio: No murmurs/rubs, heart sounds S1 and S2 are present. Resp: Decreased air entry over the rt lower lung field, some expiratory wheezing bilaterally. GI: The abdomen is distended and bulging at the flanks but not tense, diffuse tenderness to palpation exquisitely over the epigastrium, Murphy's sign not present, bowel sounds are present, positive for shifting dullness, liver palpable 2 fingers below the subcostal margin, unable to appreciate exact size of liver or any splenomegaly MS: No cyanosis, clubbing, or edema noted. Peripheal pulses in the dorsalis pedis, and radial arms are normal. Skin: Multiple spider angiomas over subclavicular region, face and shoulders Neuro: Alert, oriented x3, CN II-XII intact, power 5/5 all extremities. March 10: Hypoxic requiring 100%FIO2 and PEEP of 12. March 11: Breathing improving requiring PEEP of 5 and FiO2 of 40%. Renal function improving with the CVVHD March 12: Breathing treatment the same, worsening encephalopathy, sedated but arousable, does not follow commands this am, eye opening present. CT of abdmn showed mild ascites, possible ascending colitis. Displaying multiorgan failure. March 13: Family decides to change code to DNI/DNR and request pt to be extubated with pastoral services present. March 14: Pt displays agonal breathing, no longer arousable. On morphine drip for pain. March 15: Worsening agonal breathing, no longer arousable. On morphine drip for pain. March 16: Pt passes away at 6:21pm. SBP Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection in the peritoneum and severe consequence of ascites. Patients with cirrhosis who are in a decompensated state are at the highest risk of developing spontaneous bacterial peritonitis. Patients at greatest risk for spontaneous bacterial peritonitis have decreased hepatic synthetic function with associated low total protein level or prolonged prothrombin time (PT). The diagnosis is established by a positive ascitic fluid bacterial culture and an elevated ascitic fluid PMN count >250 cells/mm3 SBP Fever and chills occur in as many as 80% of patients.

Medical Dermatology Case Report

Transcript: Introduction Significance of Case Reports Case reports in dermatology provide valuable insights into rare skin conditions and unique patient experiences, contributing to medical research and education. -Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease -Typically presents in the elderly -Pathogenesis: deposition of immuno globulin G (IgG) antibodies on the hemidesmosomes of the basement membrane. -BP is associated with malignancies especially in the elderly -BP has been associated with autoimmune disorders such as inflammatory bowel disease, rheumatoid arthritis and lupus erythematosus - significant association with neurological dis orders, such as Parkinson disease, stroke Localized BP is very rare, with only about 100 cases reported. So here, a case of bilateral, localized BP in a young adult patient is presented Dermatology Overview Dermatology involves the study and treatment of skin, hair, and nail diseases, playing a crucial role in maintaining overall health. Initial Symptoms and Assessment Diagnostic Procedures The patient presented with red, itchy patches on the arms and legs, along with occasional swelling and discomfort. Extensive diagnostic workup, including blood tests, skin biopsies, and allergy screenings, was conducted to pinpoint the underlying cause of the skin condition. Agenda for the Discussion The discussion will cover the patient's background, initial symptoms, diagnostic procedures, treatment plan, and final diagnosis, providing a comprehensive overview of the case. Treatment Plan Purpose of the Presentation The treatment regimen involved a combination of topical corticosteroids, antihistamines, and lifestyle modifications to manage the skin rash effectively. This presentation aims to explore a medical dermatology case report, highlighting the diagnostic process, treatment strategy, and patient outcomes to enhance understanding of dermatological conditions. Case Description Providing in-depth insights into the patient's medical background, symptoms, diagnosis, and treatment plan. Patient Background The patient is a 45-year-old male with a history of psoriasis and eczema, seeking medical help for a persistent skin rash. Differential Diagnoses Considered Diagnosis and Outcome Various differential diagnoses were considered, including autoimmune disorders, infectious diseases, and genetic skin conditions. The final diagnosis of the challenging dermatology case revealed a rare skin condition that had eluded initial assessments. Final Diagnosis The final diagnosis confirmed a rare autoimmune skin disorder, leading to a targeted treatment plan for the patient. Importance of Accurate Diagnosis Treatment and Recovery Case Report: Bilateral localized bullous pemphigoid in a young adult patient Following the treatment plan, the patient showed significant improvement in symptoms and overall skin health. The case highlights the critical importance of accurate diagnosis in dermatology for effective treatment and patient outcomes. Follow-up and Progress Marwa Akhdar, M.D Regular follow-up appointments were essential in monitoring the patient's progress and optimizing the treatment outcome.

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