Female, 40 years old, sudden right upper abdomen and heart fossa knife colic with paroxysmal exacerbation for 1 day, 12 hours after the onset, chills, high fever, yellow sclera, deep tenderness on the right side of the xiphoid process, mild muscle tension in the right upper abdomen, Body temperature 38℃, WBC15×109/L, TBIL 65umol/L, urobilinogen (-), urinary bilirubin (2+), she should be diagnosed as( ) Acute pancreatitis Acute cholecystitis Common bile duct stones High appendicitis Duodenal perforation
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Female, 40 years old, sudden right upper abdomen and heart fossa knife colic with paroxysmal exacerbation for 1 day, 12 hours after the onset, chills, high fever, yellow sclera, deep tenderness on the right side of the xiphoid process, mild muscle tension in the right upper abdomen, Body temperature 38℃, WBC15×109/L, TBIL 65umol/L, urobilinogen (-), urinary bilirubin (2+), she should be diagnosed as( )
- Acute pancreatitis
- Acute cholecystitis
- Common bile duct stones
- High appendicitis
- Duodenal perforation
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- Patient R., 32 y/o, was delivered with complaints of fatigue, decrease of appetite, intensification of pigmentation in the open areas of the body, palms of the hands, cyanosis, losing weight, nausea and vomiting. The symptoms began to aggravate during 1-2 weeks after acute poisoning. Objectively: arterial pressure – 60/30 mm column of mercury, pulse – 140 beats/minute, skin turgor is lowered, the colour is dark with intense pigmentation of the elbows, scars, skin folds on the palms; clearly low levels of sodium and chlorine, high levels of potassium in the blood; glycemia – 4.3 mmol/l. What is your diagnosis?A. Addisonian crisisB. Uremic coma C. Brain comaD. Acute cardio-vascular insufficiencyE. Hypoglycemic comaClinical 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 referencesFemale, 26 years old, married. Abdominal pain, diarrhea, fever, vomiting for 20 hours After 24 hours of eating, the patient developed abdominal discomfort, paroxysmal with nausea, vomiting stomach contents, fever and diarrhea several times, loose stools, no pus and blood, body temperature 37-38.5°C, come to our hospital for emergency, the routine test of stool was negative. She was treated according to "acute gastroenteritis". The abdominal pain worsened in the evening, accompanied by fever of 38.6°C. Then, the abdominal pain moved from the stomach to the right lower abdomen, and there was still diarrhea, she come to see a doctor again at night, check blood routine WBC21×10%/L, and be admitted to the hospital urgently. Previous history: healthy, no history of drug allergy. Physical examination: T38.7°C, P120/min, BP 100/70mmHg, no bleeding spots and rashes on the skin all over the body, no large superficial lymph nodes, no pallor of the conjunctiva, no yellow staining of the sclera,…
- 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.Discuss prostatitis.Diagnose this patient: - 67 year old obese woman - patient - Eats a lot of junk food and drinks wine frequently - Doesn't excersize - Father passed away from heart attack and mother has type 2 diabetes and hypertension - Patient has had hypertension for a few years taking beta blockers - Experiences shortness of breath and pain in the chest when walking but when the patient sits down she feels fine - light headed, weak, nauseous, dizzy, - ECG shows the patient has high ST elevation and blood test shows high levels of myocardium-specific troponin in her blood - The patient is given heparin intravenously as well as an anti-platelet and a fibrinolytic drug What is the diagnosis and why did symptoms disappear when the patient sat down?
- A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…37) Female,51 years old,has swelling and pain in both wrist joints for 3 months. The 3rd and 4th interphalangeal joints of both hands are swollen and painful, second metacarpophalangeal joint of both hands is swollen and painful for 2 months, morning stiffness for 2 hours, and low fever. Her most likely diagnosis is? A Systemic lupus erythematosus B Rheumatoid Arthritis C Osteoarthritis D Gout E Spondyloarthropathy
- Topic: Cholecystitis 1. Definition of the disease 2. Signs and Symptomscase study: C was a six year old boy who passed away at the Lady Cilento Children’s Hospital on14 January 2017. He was a generally healthy and happy child. C’s treating team at the Lady Cilento Children’s Hospital attributed his death to overwhelming sepsis due to melioidosis. His death was not discussed with the coroner at that time. No autopsy was performed. C’s death was first reported to the State Coroner on 3 May 2018 due to the family’s concerns about the care C received from a remote hospital over several days leading up to his admission on 10 January 2017 and subsequent transfer to a regional hospital by which time he was seriously ill. The family also lodged a complaint with the Office of the Health Ombudsman. The Health Ombudsman considered the family’scomplaint potentially identified broader systemic issues and undertook a systemicinvestigation. The family’s concerns related to failure by remote hospital staff to correctly diagnoseand investigate the cause of C’s worsening…A 30-year-old male demonstrated a subtle onset of the following symptoms: dull facial expression; droopy eyelids; puffiness of the face and periorbital swelling; sparse, dry hair; dry, scaly skin; evidence of intellectual impairment; lethargy; a change of personality; bradycardia (60 b/min); a blood pressure of 90/70; anemia (hematocrit 27); enlarged heart (upon radiological exam); constipation, and hypothermia. Serum free T4 0.3 ng/dL (low).Radioimmunoassay (RIA) of peripheral blood indicated elevated TSH levels. A TSH stimulation test, using recombinant human TSH, did not increase the output of thyroid hormones from the thyroid gland. What endocrine organ is involved here? a. Is this a primary or secondary disorder? What is a primary vs secondary disorder? b. Why? What data is presented that supports your answer? Is a TSH and/or TRH determination necessary for your diagnosis? 3. a. Describe the normal complete feedback loop involved. b. How is it affected in this…