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Home Q & A Board Biology-Related Homework Help Anatomy and Physiology
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teetea06 teetea06
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10 years ago
I need help answering a few question from the Case Study #1. Its due in two weeks and I am stuck on a few question. If any one can help me with them, I would be greatly appreciate it.

Case Study 1:
  2.  What perinatal tests should Jim and Jane inquire about?
Case study 2:
6.  If the surgeon prescribes a nonselective COX inhibitor for the pain, how does it work?
7.  How is a selective COX-2 inhibitor different from a nonselective COX inhibitor?
Case Study 3:
3.  What is the classification for the type of healing the abrasions will use to heal?
4.  What is the classification for the type of healing the surgical wounds will use to heal?

Case #5:
Bill Anderson, a 60-year-old Caucasian male of normal build, presents in the emergency room with severely labored breathing. He reports progressively worsening shortness of breath over the past three days. He has been lethargic and has been just “lying around” because of the shortness of breath. The patient also has hypertension and is sweating, but without fever. Upon examining the patient’s medical history, the emergency room doctor learns that Bill has multiple myeloma and has undergone several cycles of chemotherapy, including steroid and high dose thalidomide therapy. The emergency room doctor orders a chest X-ray and echocardiography.
1.  What is multiple myeloma?
2.  What side effects do multiple myeloma, chemotherapy, immobility, steroids, and thalidomide have in common that could be an issue here?
3.  The emergency room doctor suspects a fairly obvious problem, what condition is the doctor trying to confirm?
4.  Why is the echocardiogram important?
5.  How has the condition caused high blood pressure? 
6.  Is the heart at risk of failing? If so, what side of the heart, and is it acute or chronic?
7.  What is the recommended therapy?


Help please if you have all ten may you please send them to me
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8 Replies
Replies
wrote...
#1
10 years ago
Case Study 1
2.  What perinatal tests should Jim and Jane inquire about?  There are several tests that should be conducted after the birth of the baby.  These tests usually include checking the baby’s head, eye, lungs, spine, hips, skin, mouth, genitals, hand, feet, and heart.  These tests are usually conducted right after birth up until the first week.  This is called a full examination-a head to toe check for any problems or conditions.  Once the full examination is done, the next test that should be done is the heel prick test.  During this test, doctors will take a small sample of blood from the baby’s heel and test it for: an enzyme deficiency, called phenylketonuria (PKU), cystic fibrosis, which affects the lungs and digestive system, MCADD- medium chain acyl-CoA dehydrogenase deficiency, a rare condition that affects the way the body converts fat into energy, sickle cell disease, a genetic blood disorder, and for a thyroid deficiency (Najik, 2011).  Jim and Jane should schedule Emma for this test to make sure there isn’t anything wrong with the baby internally. 
Case Study 3
3.  What is the classification for the type of healing the abrasions will use to heal?  An abrasion can be classified as secondary healing (Thomas & Gordon, 2004).  These wounds are usually larger than incised wounds and require more healing time.  These wounds are very common injuries of the skin. 
4.  What is the classification for the type of healing the surgical wounds will use to heal?  The classification used for a surgical wound is called primary healing (Thomas & Gordon, 2004).  This usually occurs from a surgical incision as in Chris’ case, where the surgical closures meet at the wounds edges

Case Study 5

1.  What is multiple myeloma? Multiple myeloma is a hematologic cancer, or cancer of the blood.  This cancer usually develops in the bone marrow (Brandon, 2013).
2.  What side effects do multiple myeloma, chemotherapy, immobility, steroids, and thalidomide have in common that could be an issue here?  Some of the side effects that can be seen here are tiredness, nausea, flu like symptoms, hypertension, sweating and shortness of breath.  This can be an issue because shortness of breath is a significant indicator of possible heart trouble (Stetson, 2012). 
3.  The emergency room doctor suspects a fairly obvious problem, what condition is the doctor trying to confirm?  More than likely the doctor is trying to confirm if the patient has had a heart attack or is having one.  An X-ray image of the chest allows the doctor to check the size of an individual’s heart and its blood vessels and to look for any fluid in the lungs or damage.  The patient is sweating, already has hypertension and shortness of breath which are early signs of a heart attack (Stetson, 2012). 
4.  Why is the echocardiogram important?  An echocardiogram is important because it can be used to find out if there is an abnormality of the heart that could lead to stroke.  Since the patient has hypertension and multiple myeloma, this will determine if the cancer has affected the heart.  Also, this is used to see if there are any suspected blood clots in the heart (Richman, 2012).
5.  How has the condition caused high blood pressure?  Certain medication such as, steroids can cause high blood pressure.  Also, in multiple myeloma, cancerous plasma cells can multiply rapidly in the bone marrow and invade the outer layers of the bones. They also make too much of one specific type of immunoglobulin (an antibody protein). Large amounts of immunoglobulins in the bloodstream may cause the blood to become thick and sticky. When this happens, it can lead to high blood pressure, blood clots, and eventually a heart attack  (Richman, 2012). 
6.  Is the heart at risk of failing? If so, what side of the heart, and is it acute or chronic?  Yes the heart is at risk for failing because the patient already has signs and symptoms of a heart attack.  Heart failure can be right-sided, left-sided or combined. Right-side heart failure means the heart can't get the blood to the lungs to pick up oxygen, and left-side heart failure means the heart can't pump the blood to the rest of the body (Brandon, 2013). In this case, the hard proteins build up preventing blood to flow smoothly to the rest of the body.  So the left side of the heart fails.  This patient has chronic heart failure since it is an ongoing problem.  Acute means that it is sudden or has just started. 
7.  What is the recommended therapy?  The recommended therapy is chemotherapy.  Chemotherapy is often used when treating multiple myeloma to kill off cancerous cells or prevent them from dividing.  In addition, stem cell therapy can be used as well for people with multiple myeloma.  It is administered in conjunction with high doses of chemotherapy.

Good Luck, the other ones I forgot.
Source  References
Brandon, M. M.  (2013, January 15). American Cancer Society.  Multiple Myeloma.  Retrieved from http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-what-is-multiple-myeloma

Stetson, R. A.  (2012, May 2
padre,  princessdlp23
wrote...
#2
10 years ago
Awesome thank you very much..
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jessecattyjessecatty
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10 years ago
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wrote...
#4
10 years ago
Quote from: jessecatty (10 years ago)
Case Study 1
2.  What perinatal tests should Jim and Jane inquire about?  There are several tests that should be conducted after the birth of the baby.  These tests usually include checking the baby’s head, eye, lungs, spine, hips, skin, mouth, genitals, hand, feet, and heart.  These tests are usually conducted right after birth up until the first week.  This is called a full examination-a head to toe check for any problems or conditions.  Once the full examination is done, the next test that should be done is the heel prick test.  During this test, doctors will take a small sample of blood from the baby’s heel and test it for: an enzyme deficiency, called phenylketonuria (PKU), cystic fibrosis, which affects the lungs and digestive system, MCADD- medium chain acyl-CoA dehydrogenase deficiency, a rare condition that affects the way the body converts fat into energy, sickle cell disease, a genetic blood disorder, and for a thyroid deficiency (Najik, 2011).  Jim and Jane should schedule Emma for this test to make sure there isn’t anything wrong with the baby internally. 
Case Study 3
3.  What is the classification for the type of healing the abrasions will use to heal?  An abrasion can be classified as secondary healing (Thomas & Gordon, 2004).  These wounds are usually larger than incised wounds and require more healing time.  These wounds are very common injuries of the skin. 
4.  What is the classification for the type of healing the surgical wounds will use to heal?  The classification used for a surgical wound is called primary healing (Thomas & Gordon, 2004).  This usually occurs from a surgical incision as in Chris’ case, where the surgical closures meet at the wounds edges

Case Study 5

1.  What is multiple myeloma? Multiple myeloma is a hematologic cancer, or cancer of the blood.  This cancer usually develops in the bone marrow (Brandon, 2013).
2.  What side effects do multiple myeloma, chemotherapy, immobility, steroids, and thalidomide have in common that could be an issue here?  Some of the side effects that can be seen here are tiredness, nausea, flu like symptoms, hypertension, sweating and shortness of breath.  This can be an issue because shortness of breath is a significant indicator of possible heart trouble (Stetson, 2012). 
3.  The emergency room doctor suspects a fairly obvious problem, what condition is the doctor trying to confirm?  More than likely the doctor is trying to confirm if the patient has had a heart attack or is having one.  An X-ray image of the chest allows the doctor to check the size of an individual’s heart and its blood vessels and to look for any fluid in the lungs or damage.  The patient is sweating, already has hypertension and shortness of breath which are early signs of a heart attack (Stetson, 2012). 
4.  Why is the echocardiogram important?  An echocardiogram is important because it can be used to find out if there is an abnormality of the heart that could lead to stroke.  Since the patient has hypertension and multiple myeloma, this will determine if the cancer has affected the heart.  Also, this is used to see if there are any suspected blood clots in the heart (Richman, 2012).
5.  How has the condition caused high blood pressure?  Certain medication such as, steroids can cause high blood pressure.  Also, in multiple myeloma, cancerous plasma cells can multiply rapidly in the bone marrow and invade the outer layers of the bones. They also make too much of one specific type of immunoglobulin (an antibody protein). Large amounts of immunoglobulins in the bloodstream may cause the blood to become thick and sticky. When this happens, it can lead to high blood pressure, blood clots, and eventually a heart attack  (Richman, 2012). 
6.  Is the heart at risk of failing? If so, what side of the heart, and is it acute or chronic?  Yes the heart is at risk for failing because the patient already has signs and symptoms of a heart attack.  Heart failure can be right-sided, left-sided or combined. Right-side heart failure means the heart can't get the blood to the lungs to pick up oxygen, and left-side heart failure means the heart can't pump the blood to the rest of the body (Brandon, 2013). In this case, the hard proteins build up preventing blood to flow smoothly to the rest of the body.  So the left side of the heart fails.  This patient has chronic heart failure since it is an ongoing problem.  Acute means that it is sudden or has just started. 
7.  What is the recommended therapy?  The recommended therapy is chemotherapy.  Chemotherapy is often used when treating multiple myeloma to kill off cancerous cells or prevent them from dividing.  In addition, stem cell therapy can be used as well for people with multiple myeloma.  It is administered in conjunction with high doses of chemotherapy.

Good Luck, the other ones I forgot.
multiple myeloma is a cancer of the blood? i hope you don't mean red blood cells... it's a cancer of plasma B cells that travels back to the bone marrow
wrote...
#5
10 years ago
If you have answers to Case Study 1-4? Let me know where to find it.
wrote...
#6
9 years ago
Quote from: jessecatty (10 years ago)
References for case study 1
Albany, B. A. (2006, April 8). Phenylketonuria. Men’s Health. Retrieved from
http://www.studyhealth.com/phenylketonuria
Holtzman, N. A. (2011, April 13). Med Help. Loss of Dietary Control in Phenylketonuria.  Retrieved from  http://www.medhelp.org/lib/pku.htm
Najik, B. B.  (2011, Sept 30).  Medicine Net.  Phenylketonuria.  Retrieved from       http://www.medicinenet.com/phenylketonuria/article.htm
References for case study 3
Bernard, O. D.  (2013, Jan 22). Med Line.  Spleen Diseases.  Retrieved from http://www.nlm.nih.gov/medlineplus/spleendiseases.html
Jones, H. W. (2010, March 12). Web MD. The Spleen. Retrieved from http://www.webmd.com/digestive-disorders/picture-of-the-spleen
Thomas, J. N., & Gordon, A. H. (2004). Pathophysiology.  Concepts and Applications for Health Care Professional. New York, NY: McGraw-Hill.
References for case study 5
Brandon, M. M.  (2013, January 15). American Cancer Society.  Multiple Myeloma.  Retrieved from http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-what-is-multiple-myeloma
Stetson, R. A.  (2012, May 25). Multiple Myeloma Research Foundation.  What is Multiple Myeloma.  Retrieved from http://www.themmrf.org/living-with-multiple-myeloma/newly-diagnosed-patients/what-is-multiple-myeloma/
Richman, M. F. (2012, March 01). Web MD. Heart Disease & Atherosclerosis. Retrieved from http://www.webmd.com/heart-disease/guide/atherosclerosis-faq



These are some good references!
wrote...
#7
9 years ago
Quote from: jessecatty (10 years ago)
Case Study 5


6.  Is the heart at risk of failing? If so, what side of the heart, and is it acute or chronic?  Yes the heart is at risk for failing because the patient already has signs and symptoms of a heart attack.  Heart failure can be right-sided, left-sided or combined. Right-side heart failure means the heart can't get the blood to the lungs to pick up oxygen, and left-side heart failure means the heart can't pump the blood to the rest of the body (Brandon, 2013). In this case, the hard proteins build up preventing blood to flow smoothly to the rest of the body.  So the left side of the heart fails.  This patient has chronic heart failure since it is an ongoing problem.  Acute means that it is sudden or has just started. 


Good Luck, the other ones I forgot.

The failure likely lies with the right side, not the left.  If the patient were cyanotic, the failure would lie with the left side, as oxygen is not getting to the body. However, the shortness of breath would indicate a lack of oxygen in the blood, which it would pick up in the lungs, which gets blood via the right side.
wrote...
#8
9 years ago Edited: 9 years ago, Landie
Hi,
Can anyone help with these case study questions, thanks
Case Study:
A 36 year old man is seeing his physician because he is becoming increasingly weak. He reports that the weakness progresses throughout the day. He has a desk job and can hardly keep his eyes open and head up by the end of the day. Other history is unremarkable. Cranial nerve examination shows weak facial muscles, inability to repeat movements, and bilateral ptosis. The patient’s shoulders droop with a very poor posture.

1. What is the likely diagnosis?

2. What is the pathogenesis of this disease?

3. What other deficits might present if untreated?

4. Why do the symptoms seem to worsen later in the day?

5. What other conditions should be ruled out?

6. What treatment should be sought
 



Post Merge: 9 years ago

This post was answered by "Agelessperson" 17 hours ago on another thread. these are the responses given.

1. What is the likely diagnosis?
Ocular Myasthenia Gravis.

 2. What is the pathogenesis of this disease?
MG is an autoimmune disease where antibodies are produced against the voluntary muscles. MG can be limited to the eyes which would show his problems at work. Muscle contraction is a result of the electric signals from the CNS. In MG, antibodies block acetylcholine receptors preventing the binding and creating a breakdown in communication between the nervous system and the muscle.

3. What other deficits might present if untreated?
Double Vision
Eyelid dropping
Progression to other muscle groups
Asymmetric/bilateral ptosis

4. Why do the symptoms seem to worsen later in the day?

Blurred and double vision from the constant use of the muscles.

5. What other conditions should be ruled out?
Other conditions that present like MG is Muscular Dystrophy, Multiple Sclerosis, Lambert-Eaton Syndrome, and Lupus.

6. What treatment should be sought?
Treatment with oral anticholinesterase agents.
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