For each question answer thoroughly in paper format Name : Mrs. Paula Johnson Ag
ID: 248177 • Letter: F
Question
For each question answer thoroughly in paper format
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
The patient’s symptoms include unconsciousness, tachypnea, profuse diaphoresis, coldness, pallor, weak pulse, reduced blood pressure, and palpitation. The remarkable detail in the personal and social history of the patient related to her current diagnosis is, she had hypertension, and type II diabetes, had a sedentary lifestyle and heavy smoker, which together increase the susceptibility of cardiovascular diseases.
She was brought lying unconscious on the floor and was immediately examined for various symptoms. The results suggested that she had a silent myocardial infarction because there was no pain felt. She was cold, diaphoretic, had a weak pulse and was unconscious. These were the results found after examining her physically by regions and also by systems. After the physical examination, it was decided that she must undergo these lab tests. These tests proved that it is silent myocardial infarction (differential diagnosis) and was also confirmed by several other diagnoses. The laboratory tests were expected to show high levels of troponin and CK-MB (cardiac enzymes), high blood glucose level, high lipid levels, and EKG findings such as large peaked T waves, pathologic Q waves, ST elevation, and negative T waves.
She must be placed under observation but she will not experience any outward pain. The medical personnel should be more specific and must dig deeper for the other symptoms. She must take medication for reducing her blood pressure and also must maintain the diabetic level. Thus this will help her maintain a stable condition.
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