Reference no: EM133454904
Assignment:
CLINICAL CASE 1
REPRODUCTIVE
A 34 year old patient comes to the clinic reporting abdominal discomfort, a fever of 2 days, and scant bleeding although she is 2 weeks in between her menstrual cycle. She was diagnosed with chlamydia infection recently but did not fill the prescription due to financial concerns, stating, "I didn't feel that bad at the time, so I didn't think it was a big deal." Today, vital signs include BP 140/88 mm Hg, R 16 breaths per minute, P 90 beats per minute, and T 104°F (40°C). Examination performed by the health care provider demonstrates cervical and adnexal tenderness, and purulent vaginal drainage; negative for the presence of pelvic abscess. Laboratory results include:Hgb 12.1g/dl, Hct 40%, RBCs 4.9, Plt 260, WBC 22.
Questions:
- Highlight the findings that are consistent with the diagnosis of pelvic inflammatory disease (PID).
- Which are the causative agents of this disease?
- How these microorganisms were introduced into the internal organs of the woman's reproductive system?
- Give explanation of the signs and the symptoms concerning areas outside of the woman's the reproductive system (pelvic area)
- What are some other complications of STDs?
CLINICAL CASE 2
ENDOCRINE SYSTEM
Hypothyroidism
Ms. Smith is a 44-year-old female who has no significant medical history other than generalized anxiety disorder. It has been 3 years since she was taking alprazolam. Today, she reports feeling "different", getting old, tired all the time, doesn't have the motivation or energy to do things like before. She says this feeling has been persisting for the past year and seems to be worsening. She reports no further symptoms other than being cold all the time, and sometimes constipated. Ms. Orion is 5' 4" tall and weighs 218 pounds (BMI 37.4 kg/m2); a year ago she was 206 pounds. Vital signs include blood pressure of 144/90 mm Hg, heart rate 88 beats per minute, respirations 18 breaths per minute, and temperature 98.3°F.
Questions
1, Which characteristic signs and symptoms of hypothyroidism Ms. Smith has?
2. How to differentiate that these signs such as being tired, lack of energy, being cold and constipated and weight gain, are associated with hypothyroidism, a side effect of alprazolam, or both?
3. Which battery of tests are needed to diagnose her with hypothyroidism? What is the difference between hypothyroidism and myxedema?
4. Which condition is the patient at risk of developing?
The client is seen by the health care provider, and laboratory work is ordered. A week later, the client returns for a follow-up appointment to discuss the results of the diagnostic findings. Based on an elevation in the client's TSH, she is diagnosed by the provider with hypothyroidism and placed on a starting dose of levothyroxine.
5. Which actions would be recommended and which are contraindicated in her everyday living?
6. What are you to expecting to see improved in her follow-up appointment to evaluate the efficacy of taking levothyroxine and making some lifestyle adjustments.