Name : Mrs. Paula Johnson Age : 65 years old Gender : Female Description Mrs. Pa
ID: 248109 • Letter: N
Question
Name: Mrs. Paula Johnson
Age: 65 years old
Gender: Female
Description
Mrs. Paula Johnson is a 65-year-old white woman with a previous history of a sedentary lifestyle, hypertension, hypercholesterolemia, and diabetes mellitus type II. She is a heavy smoker since she was 20 years old. She was brought to the emergency room because her family found her unresponsive on the floor. She was diaphoretic. Her family thought she had her diabetes decompensated. Mrs. Johnson’s daughter indicated her mother was complaining of nausea and epigastric pain the day before. Also, her blood pressure was high.
On the physical examination we found:
Remarkable Signs on Physical Exam by Regions
Chest: Palpitation
Remarkable Signs on Physical Exam by Systems
Integumentary system: Profuse diaphoresis, coldness, and pallor
Respiratory system: Tachypnea
Cardiovascular system: Weak pulse, tachycardia, and hypotension
Nervous system: Unconsciousness. No other neurologic signs.
Lab Tests
Complete blood count (CBC)
Cardiac enzymes
Glucose level
Lipid panel
EKG
Cardiac catheterization
Diagnosis
Silent myocardial infarction
Other Diagnoses
Essential hypertension
Dyslipidemia
Diabetes mellitus
Based on the case study provided, respond to the following questions:
Mention the symptoms and signs you found in this patient.
Did you find any remarkable detail in the personal and social history of our patient that can help to make the diagnosis?
What is a silent myocardial infarction, and why did it happen to this patient?
What results do you expect to find in the tests ordered?
What are some differential diagnoses?
What are some complications of myocardial infarction?
The patient suffers from silent myocardial infarction, but there are other types of heart diseases. Consider these questions:
Describe the heart valvular disorders and how they can produce cardiac failure.
What is endocarditis, and what are the most common causes?
How many types of shocks are there? Explain them.
As a lifetime smoker, the patient is at risk of several respiratory disorders. Consider these questions:
What is COPD? What are the three most common diseases that produce a COPD? What are their causes?
What is asthma? Explain the origin of its symptoms.
What is a pneumothorax? What are its symptoms and signs, and what are its causes?
Explanation / Answer
Mention the symptoms and signs you found in this patient.
Unresponsiveness and diaphoretic along nausea and epigastric pain.
Did you find any remarkable detail in the personal and social history of our patient that can help to make the diagnosis?
Inactive lifestyle. This is major indicator along with blood pressure problems.
What is a silent myocardial infarction, and why did it happen to this patient?
It is settled that coronary supply route infection is a noteworthy entanglement of diabetes mellitus, speaking to a definitive reason for death in the greater part of all patients with this sickness. Clinicopathological relationships, and a few angiographic contemplates, recommend that diabetic patients have more broad atherosclerotic malady, influencing the coronary courses specifically. Besides, myocardial dead tissue in diabetic patients for the most part is more broad and more extreme than in nondiabetic patients. The long haul survival rate after intense myocardial localized necrosis among diabetic patients is additionally lower than that among nondiabetic patients.
What results do you expect to find in the tests ordered?
Studies exhibit that, in spite of control of anginal side effects with antianginal drugs, understanding with stable angina keep on having ECG confirmation of myocardial ischemia on AECG observing amid standard day by day exercises. The nearness of quiet myocardial ischemia in this generally stable patient predicts poor survival and recognizes the high hazard coronary malady persistent.
What are some differential diagnoses?
Diabetic patients speak to a heterogeneous gathering with various examples of coronary supply route ailment and diverse forecasts.
What are some complications of myocardial infarction?
-Mechanical: heart disappointment, cardiogenic stun, mitral valve brokenness, aneurysms, cardiovascular crack.
-Arrhythmic: atrial or ventricular arrhythmias, sinus or atrioventricular hub brokenness.
-Thrombosis.
Describe the heart valvular disorders and how they can produce cardiac failure.
Valvular stenosis. This happens when a valve opening is littler than ordinary because of firm or intertwined pamphlets. The limited opening may influence the heart to work hard to direct blood through it.
Valvular inadequacy. Additionally called disgorging, ineptitude or "flawed valve", this happens when a valve does not close firmly. On the off chance that the valves don't spill in reverse over the valve. As the hole compounds compensate for the flawed valve, and less blood may stream to whatever remains of the body. Contingent upon which valve is influenced, the molded is called tricuspid spewing forth, aspiratory disgorging, mitral spewing forth or aortic spewing forth.
What is endocarditis, and what are the most common causes?
Endocarditis is a disease of inward covering of heart cavities besides heart valves. Circulation system to travel to your heart, and append to strange heart valves or harmed heart tissue. Certain kinds of microscopic organisms cause most cases, yet growths or different microorganisms additionally might be capable.
How many types of shocks are there? Explain them.
The principle indication of shock is stumpy pulse. Different side effects incorporate quick, shallow breathing; icy, damp skin; fast, frail heartbeat; unsteadiness, swooning, or shortcoming. There are a few sorts of shock: septic stun caused by microscopic organisms, anaphylactic shock caused by excessive touchiness or unfavorably susceptible response. Four sorts of stun are perceived: distributive, cardiogenic, hypovolemic, besides obstructive. Be that as it may, these are not selective, and numerous patients with circulatory disappointment have a blend of in excess of one type of shock.
What is COPD? What are the three most common diseases that produce a COPD? What are their causes?
It is a ceaseless provocative lung ailment that causes impeded wind current bodily fluid creation and wheezing. It's caused by long haul presentation to bothering gases or particulate issue, regularly from tobacco smoke. Emphysema and interminable normal conditions that add to COPD. It's described by day by day hack and bodily fluid generation. Emphysema is a condition in which the alveoli toward the finish of the littlest air sections (bronchioles) of the lungs are decimated because of harming introduction to tobacco smoke and other disturbing gases and particulate issue.
Manifestations of COPD may include:
-Shortness of breath, particularly amid physical exercises
-Wheezing
-Chest snugness
-Having to make a sound as if to speak before anything else, because of abundance bodily fluid in your lungs
-A ceaseless hack that may create bodily fluid (sputum) that might be clear, white, yellow or greenish
What is asthma? Explain the origin of its symptoms.
Asthma is a malady manipulating the aviation directions that convey air to and from your lungs. Side effects:
-The muscles around your aviation routes take care of, narrowing the aviation route.
-Less air can course through the aviation route.
-Inflammation with additionally narrowing the aviation route.
-More bodily fluid is delivered in the aviation routes, undermining the stream of air significantly more.
What is a pneumothorax? What are its symptoms and signs, and what are its causes?
A pneumothorax happens when air spills in lung and chest divider. This air pushes outwardly influences it to crumple. As a rule, just a bit of the lung breakdown. The primary indications of a pneumothorax are sudden chest torment. Be that as it may, these side effects, an assortment of medical issues, and some can be dangerous.
A pneumothorax be able to be instigated by:
-Chest damage.
-Lung infection.
-Ruptured air rankles.
-Mechanical ventilation.
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