Description
Patient Scenario
Addresses Learning Outcomes:
- Use knowledge of biological principles and the Scientific Method to ask and answer relevant questions about human health and disease
- Analyze information to distinguish between diseased and healthy structure and functioning.
- Analyze how internal and external factors cause disruption of healthy body function, leading to disease and disorders.
Mr. Smith is 60 years old. He was diagnosed with a prostate cancer five years ago. Over the past few days, Mr. Smith has been feeling weak and increasingly tired and has also been suffering from a headache that did not respond to over-the-counter medications. He scheduled an appointment with his physician.
His physician performed a physical examination and recommended a battery of laboratory tests and imaging procedures.
The table below shows Reference values in the right-hand column. These values reflect the normal range of values for patients without disease or illness. The center column reflects the resulting values for medical test results obtained for Mr. Smith.
Take note whether Mr. Smith’s values are within normal limits.
Mr. Smith | Reference Values | |
K+ | 2.6 mmol/L | 3.8-4.9mmol/L |
Hb (Hemoglobin) | 7.5 g/dL | 13.8 to 18.2 g/dL |
Hct (Hematocrit) | 20.4% | 45-52% |
Platelet Count | 49x109/L | 150-400x109/L |
After receiving Mr. Smith’s test results, his physician admits him to the hospital. Hospital staff treated him and discharged him.
The following week, Mr. Smith returns to his physician with the same complaint of weakness and a new complaint of shortness of breath. His blood pressure is 160/100 mmHg. MRI reveals metastasis of prostate cancer to osseous tissue. Abdominal CT shows obstruction of intestine due to nodular enlargement of adrenal glands.
Laboratory results from Mr. Smith’s second hospital admission and medical tests show following findings:
Mr. Smith | Reference Values | |
K+ | 2.6 mmol/L | 3.8-4.9mmol/L |
Hb | 7.3 g/dl | 13.8 to 18.2 g/dL |
Hct | 20.4% | 45-52% |
Platelet Count | 20x109/L | 150-400x109/L |
HCO3 | 38 mmol/l | 22-26 mmol/L |
Urinary K+ | 70 mmol/L/24 hr | 25-120 mmol/L/24 hr |
Blood Glucose | 460 mg/dl | 64.8-104.4 mg/dL |
Serum Aldosterone | 1 ng/dl | |
24 hour Urinary Aldosterone | 8.4 mcg/24 hr | 2.3-21.0 mcg/24 hr |
Renin | 2.1 ng/ml/hr | 0.65-5.0 ng/ml/hr |
ACTH (Adrenocorticotropic Hormone) | 1082 pg/ml | 9-46 pg/ml |
Cortisol | 155.5 microg/dL | 0-25 microg/dL |
CONCLUSION AND DIAGNOSIS
Laboratory findings, MRI and CT confirmed metastatic prostate adenocarcinoma, hypertension and refractory hypokalemia due to ectopic ACTH production. High levels of circulating cortisol caused continuous activation of mineralocorticoid receptors resulting in hypokalemia, metabolic alkalosis and hypertension.
After reading provided scenario, answer the following questions:
1. What are the components of physical examination? Describe each component. (See Module 1, Commentary, Topic 8. Disease Categories, Part B. Steps in Diagnosis)
2. Mr. Smith’s blood pressure was 160/100 mmHg. How does a medical provider take or measure blood pressure? What do the top (numerator) and bottom (denominator) numbers mean in the biological sense? What is the significance the size of these two numbers? Is Mr. Smith’s blood pressure within normal range? Explain how you concluded whether Mr. Smith’s blood pressure is/is not within normal range.
3. Based on the data provided, what laboratory tests were performed and what samples were taken from the patient? Select one of the laboratory tests ordered for Mr. Smith and discuss why Mr. Smith’s physician might have ordered the test and the information she might have expected to obtain from that particular test.
4. Compare Mr. Smith’s values with reference values and indicate whether MR. Smith’s values are below, above, or within normal range (compare Mr. Smith’s values with the Reference values) for each laboratory tests in the table above from the second set of tests.
5. What imaging procedures did Mr. Smith undergo? Discuss the distinctions and similarities between the two different imaging approaches. What were the results of imaging procedures in Mr. Smith’s case?
6. Select one of the medical terms from the CONCLUSION and DIAGNOSIS section above and define what it means. Also, discuss, in your own words and based on what you can gather about Mr. Smith’s condition, how the laboratory or imaging tests helped with drawing a conclusion or making the diagnosis. In your own words, discuss how medical providers use the scientific method to come to work through the examination and diagnosis of a patient.
You should write a short paper addressing all six questions and submit it into the assignment folder. Your grade will depend upon the content, clarity and originality of responses written in your own words. Good writing practices, including the use of correct grammar, sentence and paragraph structure, and punctuation, and presence of logical reasoning, will account for a portion of your grade.
Cite all sources in APA format within your answer text as well as full citations in APA format at the end of the assignment.
Explanation & Answer
Hey buddy, there we go. 👍 👌
When it comes to the correct procedure to diagnosing a patient, the first step should be critically
looking into the medical history of the patent. The physicians should always ensure that they have
talked to the patients, regarding their information, getting to know their history, symptoms that
have been experienced before and the possible relief of the illness (Pagana, & Pagana, 2017).
Through this, it is vital to indicate that the physician would be able to understand the actual
conditions, which the patient is suffering from. The second step should be carrying out a physical
examination on the patient so as to identify the cause of illness. In this case, some of the procedures
include palpation, inspection and auscultation, which have been described as the main components
of physical examination. In terms of the inspection process, the physician is expected to examine the
proportion and physical body posture of the patient so as to see if the individual had been involved
in any injury (McPherson & Pincus, 2017). After inspection, the physician should also use his
hands or fingers to feel the body temperature of the patient, and this procedure is the one that is
identified as palpation. After the palpation process, the physician should also tap the body ports of
the patient so as to get the information about the sick person’s tissues. This process is also identified
as percussion. Lastly, there is auscultation, which involves the process of listening to the heart and
the body’s sound by use of the stethoscope.
Question Two
The blood pressure that is exerted on the arteries’ walls is identified as “blood pressure” or the
“arterial blood pressure.” It is also important to indicate that this helps in the process of propelling
the blood along the arteries at a very high velocity. Additionally, it is critical to note that the blood’s
unit is always done in millimetres of mercury (mm Hg), and this should be done using an instrument
that is identified as the sphygmomanometer (Pagana, & Pagana, 2017). While measuring the
blood pressure, this instrument makes use of the air pressure and by observing the levels when it
becomes the same as the radial artery’s blood pressure. On the other hand, the blood pressure is
supposed to be measured in two phases of the cycle of the heart. The first measurement that is
done is the systolic pressure, which is described as the peak pressure that is normally exerted on the
walls of the arteries during the time that the left ventricle contracts while in the blood pumping
process, out of the heart. It has been indicated that during the time when man is resting on a normal
occasion, the blood pressure should always be placed at 120 mm Hg, and this is also described as the
arterial blood pressur...
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