Reference no: EM133366728

Assignment:

CASE STUDY:

A 17-year-old female presents to the clinic with dizziness and fainting, with a past medical history of anxiety. She reports increasing episodes of vertigo over the past two weeks, lasting 5 to 15 seconds. She states the episodes are triggered by standing from a seated position. She reports one episode of losing consciousness. The patient was working as a cashier at Brookshire's and at the end of her shift, she experienced dizziness and had to sit down in the back of the store. She reports waking up on the ground with her coworkers standing around her. She was transported to the local emergency department, diagnosed with dehydration, and sent home after receiving a fluid bolus. The patient reports dieting due to a school-sponsored dance in the next month. The patient stated she felt overweight and had begun cutting calories to 0 to 500 daily. The patient verbalized that her intake of water has been inadequate. She said she had been too busy with school and exercise to have time to eat and drink as she should.

She is a healthy-appearing 17-year-old Caucasian female currently attending high school with plans of attending college after graduation. She lives at home and states that she has many friends. The risk factor for the patient is anxiety. The only past medical history for the patient is anxiety. Psychiatric history contains anxiety. When starting high school, the patient was diagnosed three years ago and put on Zoloft 50 mg once daily.

The patient is an underweight 17-year-old female per the BMI scale (18) that appears in no acute distress. HR: 85, BP: 107/73, RR: 18, SpO2: 99%. The patient denies any sinus congestion, fever, pharyngitis, or otalgia. No stiffness or restricted range of movement was noted in the neck. Her heart rate was 85 in a regular rhythm with normal S1 and S2. Lungs were clear to auscultation. The patient denied any shortness of breath. The abdomen was soft, non-tender non-distended, with bowel sounds auscultated at all four quadrants, and extremities were without edema and cyanosis. The patient is A&Ox4 and denies numbness, tingling, or weakness in extremities. The patient has a normal gait. Skin is warm and dry without rash.

Recommended diagnostic testing for this condition includes CBC, CMP, liver function test, magnesium, and urea.

Responding to Case:

1. Based on the initial case presentation, list your top three differential diagnoses.

2. Choose the most likely diagnosis.

• Eating disorder- What kind? anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID), and pica.

3. Support your decision with scholarly sources (within the last 5 years) that represent a logical link between the case study and article information. Use sources?published within the last?five?years or the most current clinical practice guidelines.