Praopan Yodrabum BIO -
1141L -
05
NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
A Rough Semester:
What’s Wrong with Katie?
Thomas E. Hynd, Elizabeth V. Berkeley, Janet C. Daniel, Justin W. Brown, and Bisi T. Velayudhan
Part I – To the Health Center
Katie Robinson returned to her dorm room after another long day as a college sophomore. Things seemed to have
been getting tougher the last few weeks, Katie thought, but she attributed this to her heavy course load that included
anatomy, chemistry, physiology and microbiology courses required by her health science program. Noticing Katie was
going to bed earlier and sleeping later than usual, her roommate Jasmine asked her if everything was alright. “Yeah,
I’m fine,” she replied. “I’m just stressed. After midterms are over, I’ll feel better. I just wish there were more hours in
the day.”
Midterms came and went and her condition did not improve, so Katie decided to make an appointment at the on-
campus health center. Jennifer, the health center’s nurse practitioner on duty, took Katie’s history.
Patient History
Chief complaint: flu-like symptoms with headache and fatigue.
History of patient illness: This 20 year-old white female, a college sophomore, presented at the on-campus
health center with flu-like symptoms that began three weeks prior. She also describes a rash under her arm
that won’t go away, likely from playing weekly intramural tennis matches at the university. The symptoms
do not appear to be related to stress as she successfully concluded her midterms over a week ago. She also
complains of “tired eyes” due to studying endlessly for her midterms. She has not tried any remedies, other
than rest, to alleviate the symptoms.
Past medical history: Patient has been in good health for most of her life. She denies any surgery or hospital
stays; she has only taken prescription drugs (hydrocodone) when she had her wisdom teeth removed as an
outpatient procedure two years ago.
Family history: Patient’s mother has beaten breast cancer six years ago and is now cancer free. Patient’s father
suffered a stroke, according to patient, “when I was really little.” Patient’s younger brother was diagnosed
with diabetes mellitus five years ago. Maternal grandmother died (age 97) of Alzheimer’s disease when pa-
tient was in high school.
Physical examination: Patient was awake and oriented at time of examination. Height was 162 cm; weight
was 62 kg. Vital signs were recorded and are shown in Table 1. Arterial pulses were within normal limits. The
heart rate was regular with no evidence of murmur or abnormal heart sounds. Head and neck exam were
normal, no swollen lymph nodes. Lungs were clear of any abnormal sounds on auscultation. She stated she
does not smoke or drink and does not have diabetes. She does not know her cholesterol level.
Thomas Hynd, Janet Daniel, Justin Brown, and Bisi Velayudhan are affiliated with the Biology Department of James Madison University, Har-
risonburg, Virginia. Elizabeth Berkeley is affiliated with the Department of Biology and Earth Science, Otterbein University, Westerville, Ohio.
Case copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York.
Originally published March 18, 2019. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this
work.
This study Licensed
source photo © Fizkes
was downloaded | Dreamstime.com,
by 100000840858457 from id 94908209. on 02-26-2022 20:14:13 GMT -06:00
CourseHero.com
https://www.coursehero.com/file/88609409/NCCSTSurinalysiscase-2pdf/
, NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
Table 1. Katie’s vital signs recorded at the on-campus health center.
Katie Normal
Systolic blood pressure (mmHg) 140 120
Diastolic blood pressure (mmHg) 90 80
Oral temperature (°C) 38.3 36.6–37.3
Heart rate (beats per minute) 81 60–80
Respiratory rate (breaths per minute) 18 12–20
Oxygen saturation (%) 97 95–100
Questions
1. What are the red flags in Katie’s physical exam and history?
Oral temperature 38 3
-
.
systolic blood pressure dont ration )
-
140 MmHg .
Diastolic blood pressure 90 mmHg C Relaxations
-
.
.
Her brother with diabetes
-
,
mom breast cancer ,
her dad had a stroke .
2. Given the red flags you’ve identified, what are some possible diagnoses?
Infection
-
she can possible have problem with Urinary Tract
3. What are common causes for the above diagnoses?
-
purpose holding in urine for long periods of time .
Not
drinking enough fluid
-
.
spinal injured
-
cord or nerve
damage .
when is her last
day period ?
-
4. What questions would you like to ask her to confirm your diagnoses?
If she ever have any abdominal pain ?
-
what color of her urine ?
-
How much her of water ?
consuming
-
5. How would you treat her symptoms if you were the clinician at the on-campus health center?
her to drink water
Suggest more
-
Give her the Antibiotic and chlorothat i done
-
“A Rough Semester” by Hynd, Berkeley, Daniel, Brown, & Velayudhan Page 2
This study source was downloaded by 100000840858457 from CourseHero.com on 02-26-2022 20:14:13 GMT -06:00
https://www.coursehero.com/file/88609409/NCCSTSurinalysiscase-2pdf/
1141L -
05
NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
A Rough Semester:
What’s Wrong with Katie?
Thomas E. Hynd, Elizabeth V. Berkeley, Janet C. Daniel, Justin W. Brown, and Bisi T. Velayudhan
Part I – To the Health Center
Katie Robinson returned to her dorm room after another long day as a college sophomore. Things seemed to have
been getting tougher the last few weeks, Katie thought, but she attributed this to her heavy course load that included
anatomy, chemistry, physiology and microbiology courses required by her health science program. Noticing Katie was
going to bed earlier and sleeping later than usual, her roommate Jasmine asked her if everything was alright. “Yeah,
I’m fine,” she replied. “I’m just stressed. After midterms are over, I’ll feel better. I just wish there were more hours in
the day.”
Midterms came and went and her condition did not improve, so Katie decided to make an appointment at the on-
campus health center. Jennifer, the health center’s nurse practitioner on duty, took Katie’s history.
Patient History
Chief complaint: flu-like symptoms with headache and fatigue.
History of patient illness: This 20 year-old white female, a college sophomore, presented at the on-campus
health center with flu-like symptoms that began three weeks prior. She also describes a rash under her arm
that won’t go away, likely from playing weekly intramural tennis matches at the university. The symptoms
do not appear to be related to stress as she successfully concluded her midterms over a week ago. She also
complains of “tired eyes” due to studying endlessly for her midterms. She has not tried any remedies, other
than rest, to alleviate the symptoms.
Past medical history: Patient has been in good health for most of her life. She denies any surgery or hospital
stays; she has only taken prescription drugs (hydrocodone) when she had her wisdom teeth removed as an
outpatient procedure two years ago.
Family history: Patient’s mother has beaten breast cancer six years ago and is now cancer free. Patient’s father
suffered a stroke, according to patient, “when I was really little.” Patient’s younger brother was diagnosed
with diabetes mellitus five years ago. Maternal grandmother died (age 97) of Alzheimer’s disease when pa-
tient was in high school.
Physical examination: Patient was awake and oriented at time of examination. Height was 162 cm; weight
was 62 kg. Vital signs were recorded and are shown in Table 1. Arterial pulses were within normal limits. The
heart rate was regular with no evidence of murmur or abnormal heart sounds. Head and neck exam were
normal, no swollen lymph nodes. Lungs were clear of any abnormal sounds on auscultation. She stated she
does not smoke or drink and does not have diabetes. She does not know her cholesterol level.
Thomas Hynd, Janet Daniel, Justin Brown, and Bisi Velayudhan are affiliated with the Biology Department of James Madison University, Har-
risonburg, Virginia. Elizabeth Berkeley is affiliated with the Department of Biology and Earth Science, Otterbein University, Westerville, Ohio.
Case copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York.
Originally published March 18, 2019. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this
work.
This study Licensed
source photo © Fizkes
was downloaded | Dreamstime.com,
by 100000840858457 from id 94908209. on 02-26-2022 20:14:13 GMT -06:00
CourseHero.com
https://www.coursehero.com/file/88609409/NCCSTSurinalysiscase-2pdf/
, NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
Table 1. Katie’s vital signs recorded at the on-campus health center.
Katie Normal
Systolic blood pressure (mmHg) 140 120
Diastolic blood pressure (mmHg) 90 80
Oral temperature (°C) 38.3 36.6–37.3
Heart rate (beats per minute) 81 60–80
Respiratory rate (breaths per minute) 18 12–20
Oxygen saturation (%) 97 95–100
Questions
1. What are the red flags in Katie’s physical exam and history?
Oral temperature 38 3
-
.
systolic blood pressure dont ration )
-
140 MmHg .
Diastolic blood pressure 90 mmHg C Relaxations
-
.
.
Her brother with diabetes
-
,
mom breast cancer ,
her dad had a stroke .
2. Given the red flags you’ve identified, what are some possible diagnoses?
Infection
-
she can possible have problem with Urinary Tract
3. What are common causes for the above diagnoses?
-
purpose holding in urine for long periods of time .
Not
drinking enough fluid
-
.
spinal injured
-
cord or nerve
damage .
when is her last
day period ?
-
4. What questions would you like to ask her to confirm your diagnoses?
If she ever have any abdominal pain ?
-
what color of her urine ?
-
How much her of water ?
consuming
-
5. How would you treat her symptoms if you were the clinician at the on-campus health center?
her to drink water
Suggest more
-
Give her the Antibiotic and chlorothat i done
-
“A Rough Semester” by Hynd, Berkeley, Daniel, Brown, & Velayudhan Page 2
This study source was downloaded by 100000840858457 from CourseHero.com on 02-26-2022 20:14:13 GMT -06:00
https://www.coursehero.com/file/88609409/NCCSTSurinalysiscase-2pdf/
