Week 3: Cardiovascular, Cellular, and Hematologic Disorders Part One - Discussion
Loading...
This week's graded topics relate to the following Course
... [Show More] Outcomes (COs). 1 Analyze pathophysiologic mechanisms associated with selected disease
states. (PO 1) 2 Differentiate the epidemiology, etiology, developmental considerations,
pathogenesis, and clinical and laboratory manifestations of specific
disease processes. (PO 1) 3 Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through
specific therapeutic interventions. (PO 1, 7) 4 Distinguish risk factors associated with selected disease states. (PO 1) 5 Describe outcomes of disruptive or alterations in specific physiologic
processes. (PO 1) 6 Distinguish risk factors associated with selected disease states. (PO 1) 7 Explore age-specific and developmental alterations in physiologic and
disease states. (PO 1, 4)
Discussion
Discussion Part One (graded)
past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts
feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50,
pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.
What is your list of differential diagnoses in this case and explain how each of these fits with the
case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses.
Indicate which of these you would select as the most likely diagnosis and explain why.
Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your
differential?
How do you treat this patient now? Are they any preventative actions that could have been
taken?
0
Responses
Rechel DelAntar 5/15/2016 7:54:30 PM
Differential Diagnoses
Hello Professor and Class,
Differential Diagnoses
A case of a 17 year old African American from the inner city complaining of sever chest and
abdominal pain seen in the ER but was released after clinical examinations and tests reveal no
abnormalities with the assumption that the patient is drug seeking. She comes back 4 hours after
running track in school with symptoms of extensive chest and abdominal pain and jaundice and
expressed low-grade fever of 100F earlier. BP 98/50, tachycardic at 112 RR=28. Once n the ER,
patients symptoms have progressed to exhibiting stroke like features. Based on the patient’s
presentation and symptoms, patient may have:
1. Sickle Cell Disease – The term sickle cell disease (SCD) describes a group of inherited red blood cell
disorders. People with SCD have abnormal hemoglobin, called hemoglobin S or sickle hemoglobin, in their
red blood cells. In SCD, a person inherits 2 abnormal genes, one from each parent. In all forms, one of
the genes causes the production of hemoglobin S. In the case of Sickle cell anemia, a patient has 2
hemoglobin S, hemoglobin SS. Among all the types of SCD, sickle cell anemia is the most common
type (National Heart, Lung and Blood Institute, 2015). Normally, red blood cells are flexible and round,
moving easily through the blood vessels. In sickle cell disease, red blood cells become rigid and sticky
and shaped like sickles/crescent moons. These irregularities causes the cells to get stuck in small blood
vessels, which can slow or block blood flow and decrease oxygen supply to parts of the body. Pain is
the major symptom when the patient is in “crisis”. Pain develops when sickle-shaped red blood cells
block blood flow through tiny blood vessels to your chest, abdomen and joints. Pain is sporadic and
can last for hours or weeks. Continued poor oxygen supply to organs may eventually lead to organ
damage. Stroke is a common manifestation of the disease because of blood flow obstruction (Mayo
Clinic, 2014). This diagnosis fits the patient’s presentation and her experiencing signs of stroke is one
of the symptoms of the disease.
2. Hemochromatosis - causes your body to absorb too much iron from the food you eat. Excess iron is
stored in your organs, especially your liver, heart and pancreas. Too much iron can lead to lifethreatening
conditions, such as liver disease, heart problems and diabetes. Symptoms include
abdominal pain, weakness, fatigue, heart failure such as chest pain and liver failure (National Institute
of Diabetes and Digestive and Kidney Disease, 2014). Although some of these symptoms are similar to
the one in the case study, hemochromatosis occurs mostly among Caucasians and the pain in this
disease is more chronic and not severe which does not fit the profile of the patient.
3. G6PD – Glucose-6-dehydrogenase Deficiency is a hereditary type of hemolytic anemia in which red
blood cells break down when the body is exposed to certain drugs or the stress of infection. It is
common between Mediterranean and African origin and is characterized by abnormally low levels of
glucose-6-phosphate dehydrogenase, an enzyme involved in the pentose phosphate that is especially
important in the red blood cell. G6PD deficiency is the most common human enzyme defect. There is no [Show Less]