Homework Answers
1. If left untreated, rheumatic fever can lead to:
- stroke
- permanent damage to your heart
- death
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CASE STUDY #3 While working as a nurse in the hospital, 35-year-old Emily noticed that she...
John is a 35-year-old nurse who had rheumatic fever as a child. He noticed a persistent...
John is a 35-year-old nurse who had rheumatic fever as a child. He noticed a persistent tachycardia and light-headedness. Chest x-rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation and mild pulmonary congestion. Cardiac evaluation resulted in the following information: Cardiac output (CO) 3.4 L/min Blood pressure (BP) 100/58 mm Hg Left atrial pressure (LAP) 16 mm Hg Right ventricular pressure (RVP) 44/8 mm Hg Heart sounds revealed valvular regurgitation. 1) Deduce which A-V valve...
Case Study #3 Clinical History: A 67-year-old male had rheumatic heart disease for thirty years. Three...
Case Study #3 Clinical History: A 67-year-old male had rheumatic heart disease for thirty years. Three months prior to death he began to have episodes of fever and chills accompanied by signs of worsening congestive heart failure. Splinter hemorrhages and purpuric skin rashes were noted three weeks before death. Laboratory Findings: Blood cultures grew alpha-hemolytic streptococci. Gram stain shows gram positive cocci in chains. Autopsy revealed thickening of the mitral valve. Many friable calcified pink-gray granular lesions were present on...
N-CLASS/ONLINE CASE STUDY CHAPTER 36 Mitral Stenosis Patient Profile L.S. is a 59-year-old female who goes...
N-CLASS/ONLINE CASE STUDY CHAPTER 36 Mitral Stenosis Patient Profile L.S. is a 59-year-old female who goes to see her primary care provider because of increasing fatigue and shortness of breath with activity. She has a history of hypertension, hypothyroidism, rheumatoid arthritis, and rheumatic fever as a child. She is taking the following medications: Triamterene/hydrochlorothiazide 37.5/25 mg PO daily . Levothyroxine 150 mcg PO daily Methotrexate 15 mg PO every Sunday Subjective Data Does not exercise, but was always able to...
Brief Patient History Mr. K is a 58-year-old white man admitted to the cardiac unit from...
Brief Patient History Mr. K is a 58-year-old white man admitted to the cardiac unit from the medical unit after cardiac arrest (VF). He was successfully defibrillated after one shock (biphasic at 200 joules). He has a history of hypertension, myocardial infarction, mitral valve regurgitation, atrial fibrillation, and hyperlipidemia. Mr. K was scheduled for mitral valve replacement and the maze procedure. Mr. K is a school administrator, is married, and has two daughters who live out of state. Clinical Assessment...
Case Study 5 ( PLEASE EXPLAIN all options for Q1-4) A 28-year old woman presents with...
Case Study 5 ( PLEASE EXPLAIN all options for Q1-4) A 28-year old woman presents with fever for the past 8 weeks. She admits to low back pain and a 10- pound weight loss but has no other complaints. She is otherwise healthy. On physical examination, she a prominent holosystolic murmur heard at best at the apex with radiation to the axilla. No diastolic murmur is heard. There is no rash, and the results of the remainder of the examination...
Case #2 A 72-year old woman has increasing shortness of breath with exertion. At present, she...
Case #2 A 72-year old woman has increasing shortness of breath with exertion. At present, she is unable to climb even one flight of stairs without stopping to rest and catch her breath. This symptom started over a year ago and has gradually worsened. The patient is afebrile with a heart rate of 110/min and a blood pressure of 180/70 mmHg. Cardiac examination reveals a loud diastolic murmur heard along the left sternal border consistent with aortic valve regurgitation. The...
Case Study M.T. is a 72-year-old woman, who is transported by ambulance to the hospital, with...
Case Study M.T. is a 72-year-old woman, who is transported by ambulance to the hospital, with dizziness, fainting, weakness, fatigue, nausea, sweating, shortness of breath, and indigestion (heart burn) pain. These symptoms began about 2 hours ago and have become progressively worse since arriving at the hospital. Blood pressure is 200/100; pulse is 102 and regular. Lung sounds are clear. No murmur is noted on cardiac auscultation. Her ECG and cardiac enzyme levels are indicative of myocardial infarction. Her past...
CASE STUDY A 19-year-old female college student presents to the emergency department complaining of chest tightness...
CASE STUDY A 19-year-old female college student presents to the emergency department complaining of chest tightness and dyspnea. She was cutting and trimming the lawn when these symptoms developed. Rhinorrhea and tearing began soon after she went outside and preceded the chest discomfort. Going inside did not relieve her symptoms. During the physical examination, she said, "I have had asthma since childhood, and my mother and brother also have asthma." Her respiratory rate was 30 breaths per minute, and she...
CASE STUDY I A 19-year-old female college student presents to the emergency department complaining of chest...
CASE STUDY I A 19-year-old female college student presents to the emergency department complaining of chest tightness and dyspnea. She was cutting and trimming the lawn when these symptoms developed. Rhinorrhea and tearing began soon after she went outside and preceded the chest discomfort. Going inside did not relieve her symptoms. During the physical examination, she said, “I have had asthma since childhood, and my mother and brother also have asthma.” Her respiratory rate was 30 breaths per minute, and...
Case Study #1 Clinical history: An HIV positive male presented in clinic with confusion and disorientation. He had a fev...
Case Study
#1
Clinical
history: An HIV positive male presented in clinic with
confusion and disorientation. He had a fever 38.5°C and
photophobia. His CD4 T cell count was 80/ul. An MRI and lumbar
puncture were performed. The MRI showed various small lesions
within the brain. CSF analysis indicated 32 White Blood Cells/ul
with 89% lymphocytes, and 6% monocytes, glucose of 22mg/dl, and
protein of 89mg/dl. Gram stain showed yeast and India ink negative
stain showed a thick capsule.
Image...
Case Study #3 Clinical History: A 67-year-old male had rheumatic heart disease for thirty years. Three months prior to death he began to have episodes of fever and chills accompanied by signs of worsening congestive heart failure. Splinter hemorrhages and purpuric skin rashes were noted three weeks before death. Laboratory Findings: Blood cultures grew alpha-hemolytic streptococci. Gram stain shows gram positive cocci in chains. Autopsy revealed thickening of the mitral valve. Many friable calcified pink-gray granular lesions were present on...
N-CLASS/ONLINE CASE STUDY CHAPTER 36 Mitral Stenosis Patient Profile L.S. is a 59-year-old female who goes to see her primary care provider because of increasing fatigue and shortness of breath with activity. She has a history of hypertension, hypothyroidism, rheumatoid arthritis, and rheumatic fever as a child. She is taking the following medications: Triamterene/hydrochlorothiazide 37.5/25 mg PO daily . Levothyroxine 150 mcg PO daily Methotrexate 15 mg PO every Sunday Subjective Data Does not exercise, but was always able to...
CASE STUDY A 19-year-old female college student presents to the emergency department complaining of chest tightness and dyspnea. She was cutting and trimming the lawn when these symptoms developed. Rhinorrhea and tearing began soon after she went outside and preceded the chest discomfort. Going inside did not relieve her symptoms. During the physical examination, she said, "I have had asthma since childhood, and my mother and brother also have asthma." Her respiratory rate was 30 breaths per minute, and she...
Case Study
#1
Clinical
history: An HIV positive male presented in clinic with
confusion and disorientation. He had a fever 38.5°C and
photophobia. His CD4 T cell count was 80/ul. An MRI and lumbar
puncture were performed. The MRI showed various small lesions
within the brain. CSF analysis indicated 32 White Blood Cells/ul
with 89% lymphocytes, and 6% monocytes, glucose of 22mg/dl, and
protein of 89mg/dl. Gram stain showed yeast and India ink negative
stain showed a thick capsule.
Image...
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