A 27-year old white female presented at the walking
clinic of her local physician on August 15. On physical exam, the
patient had a fever of 38.5C. She appeared fatigued, had tender
joints, and complained of a headache, a stiff neck and a backache.
The physician noticed a circular "rash" about 5 inches in diameter,
with a bright red leading edge and a dim center in the form of a
"bull’s eye". The physician noted an irregular heartbeat. The
patient complained of lack of ability to concentrate.
The patient gave the following history:
She is a graduate student in the wildlife program at the university
in town. She was in the field for three weeks in Wisconsin during
the months of May and June. She tracks small mammals in the field
and studies their behavior. It had been a warm, wet spring and she
complained of a large number of biting flies, mosquitoes and ticks
in the area. She felt well until about 2 weeks after returning to
her home. Since that time, many of her symptoms had progressed. She
finally found that she could take it no more.
1. What is your best
diagnosis of this case?
2. What features are
critical to your diagnosis?
3. What further steps
should be taken to clear up the problem?
Ans 1. As per the complaint of patient my diagnosis is Ticks bite fever.
Ans 2.High Fever , Tender joint and Neck stiffness are more critical condition because hemostasis of body not properly maintained.
Ans 3.First of all Patient take complete bed rest at home and for fever take Paracetamol and for pain and swelling diclofinic sodium and seratopeptidase and for skin rashes any anti fungal ointment and if systemetic problems occur then take antibiotics also.
A 27-year old white female presented at the walking clinic of her local physician on August...
III. A 27-year old white female presented her self at her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender abdomen and complained of headache, stiff neck and backache with diarrhea. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the University in her town. She was...
Nester et al. MICROBIOLOGY: A Human Perspective Case 1 A 22-year old female automotive technician presents herself at the doctor's office. She complains of fever and of pain in her left hand. On physical examination, the patient had a deep wound on her left palm that was oozing pus. She had purplish, red streaks running up her left arm. She had enlarged lymph nodes at the elbow and under her arm. The patient's skin was warm and dry. In her...
A 51-year-old woman complained to her family practitioner that she had felt very fatigued for several weeks. She had lost 7–10 pounds in weight over the previous month. On physical examination the physician discovered a firm nodular swelling, about 3–4 cm in diameter, in the left breast that was anchored in tissue several centimeters beneath the skin. Questions: 1. To which additional areas of this woman’s body should the physician direct special attention during the physical examination and why? 2....
Clinical Case 14 A 38-year-old woman complained to her primary care physician of two separate attacks during which she experienced fear and anxiety. These occurred suddenly without waming or precipitation by any circumstance. These episodes were brief, lasting a minute or so each. She noted increasing levels of anxiety and irritability, even in between these attacks. Friends and family were concerned about her increasingly "odd" behavior and unprovoked outbursts of anger. There were brief episodes during which she became incoherent....
Lase 1.2 September a woman brings her 14-year-old daughter, Meg, to e family physician. Meg shows the doctor the back of her thigh e there are pale red, nonraised discolorations. The rash covers a wide area of the thigh and seems to be roughly circular. The center of the circular area appears normal. Meg has no other symptoms, but her mother brought her in because the rash has been present for over three weeks and it seems to be growing....
. HISTORY: A 29-year old Caucasian female presented at clinic with a new onset of bilateral ankle pain. Symptoms started after she began a running program consisting of 3 miles on Tuesday, Thursday and Sunday two weeks prior. Her pain level has progressed from mild to severe. She had not previously engaged in regular exercise. She described her pain as achy, an “7” on a 10-point pain scale, and mostly in the medial ankles. The pain was made worse with walking and minimized at...
Ms. Y is a 31-year-old woman who reported to her physician that she has recently lost weight, always seems tired, and has experienced night sweats. A few months ago, she had noticed a small firm lump on her neck that was painless and not tender, so she ignored it. Closer physical examination revealed a swelling of several lymph nodes in the neck and throat region. A blood test indicated a decreased lymphocyte count and a lymph node biopsy revealed the...
1. Adrian is a 29-year-old female visiting her physician. She is 10 weeks into her first pregnancy. What should be ordered as part of her prenatal workup? Urine test: for proteins and glucose levels Prenatal testing: cell- free fetal DNA screens for down syndrome, trisomy 13, trisomy 19, and Rh fetal blood type. Another type of testing that can be done is NIPT screen for Down syndrome and other chromosomal abnormalities. 2. Initial testing indicates that Adrian is B negative....
Case 1 Clinic Note This 57-year-old female patient comes to the clinic today for her annual physical. HEENT: Normal LUNGS: Clear ABDOMEN: Soft, nontender RECTAL EXAM: Refused NEUROLOGICAL: Congenital spastic paralysis, left leg There are no physical findings that need to be addressed at this time. I have reviewed her care plan, and she should continue per her care plan at the residential home where she resides. ICD-10-CM Code Assignment.....x........ Case 2 Sleep Clinic Note This patient returns today following...
vase 9rae rupua ryuveinuoua- A 26-year-old woman presented with paintul, stiff knees of 4 weeks duration. She had a 6-year history of Raynaud's phenomenon. On examination, she had bilateral effusions in both knee joints, but all oth er joints were normal. She had no skin lesions, muscle tendemess, proteinuria or fever. The results of relevant investigations are shown in Table C10.1. On the basis of these, a diagnosis of Systemic Lup us Erythematosus (SLE) was made and the patient treated...