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A 29 years old female, married, G1PO AOG 16 weeks, complained of vague abdaminal wall pain for 3 days, with slight fever and urgency. She took Paracetamol 500 mg and there was temporary relieved of symptoms. A few minutes prior to consultation, she noticed blood tinged urine. Husband is an overseas worker (Seaman). What is the probable clinical impression on consultation?
- Acute cystitis. hemorrhagic
- Acute pyclonephritis complicated
- Acute pyelonephritis uncomplicated
- Acute urethritis syndrome
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- Phyllis was having great fun traveling until she ate some contaminated food and developed _____________. She felt miserable and needed to stay in her hotel because of the frequent flow of loose or watery stools.A 22 year old black woman present with complaints of burning and frequency of urination for the past 2 to 3 days. It is getting worse. She feels she has to void, rushes to the bathroom and then is only able to void a small amount. it is painful. There is no sign of blood in the urine. She denies fever, chills, diarrhea, nausea, vomiting or vaginal discharge. " I have to rush to the bathroom, and it hurts when I urinate". Physical Ex: Essentially unremarkable. Negative suprapubic tenderness: negative costovertebral angle tenderness. Negative abdominal pain and benign abdominal exam. Negative back pain. Afebrile. Vital signs normal. No complaints of vaginal discharge. Uranalysis shows+ WBCs, trace RBCs. What additional data are important to factor into this picture? Do you do vaginal ex and why? Should you do urine culture and sensitivity? What are things in the medical history that may provide clues to the possible cause of dysuria? What are the possible differential diagnoses for…35 year old white male presents to the ER with low back pain for two weeks with increasing severity. He had a normal Lumbar spine X-ray and had a normal CBC and blood chemistry. A urinalyisis was done to look for signs of nephrolithiasis and showed no white cells or red blood cells but large protein and no bacteria. He had a slight fever and was in such pain that IV morphine did not even touch it. Examination was difficult as he could not even get into a comfortable position to lessen his pain. Internet searches on the local state pain medication abuse systems did not show him to be drug seeking but the ER doctor considers him drug seeking and wants him out of his ER. You are called as the nurse practitioner helping the nighttime hospitalist admit new patients to the hospital and you are paged to consult as your physician is busy with another admission on the floor with an MI. You question this young man and find him to be in terrible pain and barely able to answer your…
- A 38-year-old woman came in the outpatient department because of headache.She has no vomiting, fever, changes in sensorium and nuchal rigidity. Shedescribed the headache as ”band-like” and has been occurring intermittentlyespecially during stressful situations. Vital signs and physical examinations areall normal. The physician diagnosed her as having tension headache andprescribed Acetaminophen 1g/ tab PO q6H for 3 days. The pharmacy only hasthe 250mg tablet preparation. How many tablets does she need to take perdose? How many tablets should the pharmacist give her to complete the entiretreatment regimen?Clinical History:This 29-year-old male's illness began 10 weeks prior to death, with an episode of "flu". Two weeks later his urine became "smoky". He was found to have hematuria, albuminuria and elevated BUN (180 mg/dl). He died from a pulmonary embolus. Photos include throat photo, blood agar, and grain stain. What specimens should be taken, aside from blood? What tests should be run? Include both a rapid test option and a lower cost test option. What signs and symptoms should have alerted the patient to come in for testing during or after his viral flu episode? What was the most likely cause to the embolus? No references, just homework please include references29 yo female PTC with a 3 day history of sore throat, fatigue, fever, and swelling in the neck and underarms. Patient denies having been around anyone who was sick. Patient reports reduced appetite but no vomiting Vitals: 116/72, Temp 101.2, RR: 16 rpm, O sat: 99% Pulse: 89 bpm Physical findings reveals an erythematous pharynx with 3+ tonsils with bilateral exudates and palatal petechiae Anterior and posterior cervical lymphadenopathy and axillary lymphadenopathy present Abdominal: no abdominal tenderness or organomegaly 1. What do you want to do next? 2. Using the grading scales how likely is it that this patient has strep throat?
- Male, 50 years old, was admitted to the emergency department with abdominal pain for 7 hours The patient overate 8 hours before and felt discomfort in the upper abdomen after drinking alcohol. 7 hours ago, there was sudden severe pain under the xiphoid process, accompanied by nausea and vomiting of stomach contents several times. 5 hours ago, abdominal pain spread to the right lower abdomen with onset of fever. The patient refused to press the abdomen due to pain, irritable, and had cold sweats. Physical examination: T38.6 °C, P104 /min, R24 /min, BP100/60mmHg. Acute painful appearance, irritability, no obvious lesions in cardiopulmonary examination, flat abdomen, no gastrointestinal and peristaltic waves, extensive abdominal muscle tension, tenderness in the subxiphoid area and right middle and lower abdomen, obvious rebound pain. The most prominent undershoot, liver and spleen are not reached, Murphy sign (-), shifting dullness (-). dullness (-). Bowel sounds are heard occasionally,…explain in detail what the pathogensis may be for a A 25-year-old female pateint presented to her 28-week antenatal appointment with the complaint of lethargy, who was also noted pale but was diagnosed with microsytic anemia. give full pathogensis. explain more the 1 cause in detail. 600 words23. A 48-year-old woman comes to the emergency department 2 hours after the sudden onset of severe flank pain. She also has a 2-month history of mild exacerbation of her baseline constipation. She has had no fever, chills, pain with urination, or increased urinary frequency. She has a history of infrequent urinary tract infections, with the most recent occurring more than 5 years ago. She has no personal or family history of renal calculi. Her pulse is 92/min, and blood pressure is 138/88 mm Hg. Physical examination shows no other abnormalities. Laboratory studies show: Serum Na* 144 mEq/L K+ 3.8 mEq/L CI- 100 mEq/L HCO₂- Ca2+ 27 mEq/L 10.6 mg/dL Urea nitrogen 19 mg/dL Creatinine Phosphorus Urine blood Which of the following is the most likely cause of these findings? A) Hyperoxaluria B) Hyperparathyroidism C) Hyperuricemia D) Hypervitaminosis D. E) Milk-alkali syndrome 0.8 mg/dL 2.9 mg/dL 2+
- An 86-year-old woman with a history of diabetes and hypertension presents to the emergency room with a complaint of chest pain x 4 hours. And I noticed intense nausea with two bouts of vomiting, too. She is now free of chest pain. Her blood pressure is 130/70, heart rate 50, breathing 20, and oxygen saturation 95% in room air. A physical examination reveals normal breathing sounds. 1- What is the medical diagnosis? 2- What is the specific investigation in order of priority? 3 What is the link between a patient's history and diagnosis? 4- Nursing care for this patient.Admitting diagnosis is Hematemesis I need help with careplan for electrolyte imbalanceFemale patient whose is a 13-year-old, was admitted to the hospital with complaints of progressive weakness and shortness of breath with minimal physical effort. She has experienced recurrent fevers reaching 38.8°C. Physical examination reveals a well developed teenage with good nutritional status and in no acute distress. There is no lymphadenopathy or organomegaly. Many petechial hemorrhages cover her chest and legs. Several bruises are found on her legs and thighs. Laboratory tests were ordered upon admission. The laboratory tests result were as the following: RBC 2.24 X1012 /l Hb 71 g/l PCV 24% Plt 8.0 X109/l WBC 1.2 X109/l Differential Segmented Neutrophils 2% Lymphocytes 94% Monocytes 4% Reticulocyte count 0.7% She was referred to a hematologist who ordered a bone marrow examination. Bone marrow biopsy showed a markedly hypocellular marrow with very few hematopoietic cells and…
