Exam (elaborations) NR 507 PATHOPHYSIOLOGY WEEK 3 TD1 Vascular, Cellular and Hematologic Disorders Discussion Part One.pdf

Week 3: Cardiovascular, Cellular, and Hematologic Disorders Part One - Discussion Loading... This week's graded topics relate to the following Course 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