Benjamin Cavill I-human Case study with Feedback from Expert with All Sections, Exams of Humanities

Download Benjamin Cavill I-human Case study with Feedback from Expert with All Sections and more Exams Humanities in PDF only on Docsity! Benjamin Cavill I-human Case study with Feedback from Expert with All Sections Assessment Test Results Graded | Approach | Question Is the amount you urinate more or OSs less than usual? @ |ccSsx How can | help you today? RR Do you ever feel/have a problem XJ Assoc Sx | vith lightheadedness? X | Assoc Sx | Do you have high blood pressure? D Do you have pain/discomfort when Oe asScC Sx | you urinate? Do you have difficulty getting or x | Assoc Sx | keeping an erection (erectile | dysfunction)? Do you have any other symptoms OR eSSoc Ox or concems we should discuss? xr Assoc Sx | Are you a heavy snorer? x | Assoc Sx | pave have any pain in your @ | Assoc Sx py oging or pumbness, in your | Have you gained or lost weight @ Assoc Sx | unintentionally, despite normal appetite and exercise? How is your appetite? Any recent | change | Information Obtained Clinic Notes Response It's got to be more. I've been unusually tired for the last | few weeks — well, maybe longer, like a few months. I'm not sure. | think it is because I'm not getting hk any sleep because | have to get up | and pee so much during the night. | My wife has been telling me | needed to come in and get it evaluated. She thought | might have something wrong with my | kidneys. | No | don't think so; but I've had a few | borderline readings over the last few years. No, just a whole lot of urinating No, thank goodness. My wife said | should also tell you my vision sometimes gets a bit blurry. Nothing else | can think of. Not that my wife's complained of. No chest pain. No. Well, when | retired, | started sitting around too much and gained quite a bit of weight, tipped the scales at about 217. | just seem to keep gaining it too, about 8 pounds without really trying. In fact, I've been trying to walk the dog more. ~ | It's weird... What do you think? It's definitely increased. Oe  Assessmen asa oT Physical Exam Feedback @ Performed Correctly * auscultate abdomen e You performed the simulation correctly + auscultate heart Carefully assess vital organs in patients with fatigue e You performed the simulation correctly e You interpreted assessment correctly. + auscultate lungs Carefully assess vital organs in patients with fatigue: e You performed the simulation correctly. e You interpreted left lung and right lung correctly. + blood pressure * genitourinary male exam Fatigue may result from infectious causes so a thorough examination Is relevant for th + inspect eye Le le conditions Eye inspection, specifically the sclerae, conjunctivae and global position in the skull, sho that could be the source of the patient's fatigue and blurry vision * inspect mouth/pharynx Inspection of mucus membranes reveals Clues to hydration status. Breath oc j leading to mainutrition, infectious etiologies of fatigue, and endocrine causes of fatig inspect skin overall Inspection of the skin shows important clues to diagnoses that might affect the patient's health complications of those diagnoses * measure ginh  Assessmen' Ca iG Diagnosis SSR SS SS + measure girth Abdominal obesity is an independent risk factor for type 2 diabetes mellitus as well as being at increased risk for heart disease, hypertension, dyslipidemia and nonalcoholic fatty liver disease. Prevailing guidelines define abdominal obesity in terms of waist circumference: © Women: 35" (88 cm) or greater © Men: 40" (102 cm) or greater | orthostatic blood pressure (BP) * palpate extremities Edema provides clues to cardiopulmonary, endocrine, and vascular diseases that may be a part of the patient's clinical picture. perform fundoscopic exam with ophthalmoscope There are many causes of blurred vision, so it is important to do a gross, undilated fundoscopic exam to directly examine the retina and optic nerve for serious treatable problems that may be related to the diagnosis prostate exam Fatigue may result from infectious causes so a thorough examination is relevant for this patient sensory tests (light touch, pain, position, temperature, vibration) Sensory testing includes light touch, pain, position, temperature and vibration. Location and laterality of any deficits provide imponant information for diagnosis test visual acuity Visual acuity is important in any person that presents with concerns of a visual problem Changes from past values are of clinical importance visual inspection abdomen Abdominal inspection is looking for abdominal hemias and other vascular markers visual inspection extremities Acomprehensive visual inspection of the lower-extremities should address the following: © Signs of impaired peripheral perfusion and/or oxygenation © Sigris of fluid overload ® Not Required, Not Inappropriate ars | Peer | Cees  Missed gross pain stimulus administered a pain stimulus to a conscious patient. examine pupils You performed the simulation correctly. not interpret anything for left pupil. | did not interpret anything for right pupil. monofilament test Ph ; t test is a simple way to quantity the degree of sensory deficits as a speci a filament. ; administer You You didn't listen for at least 15 sé at left carotid You did not check radial pulse firs! s adult patient (ou did not interpret anything for rate You did not interpret anything for rhythm (ou did not interpret anything for strength aI Cola Bel jamin Canil Is a 65-yo-M who presents to the clinic with complaints of being tired, increased frequency, blurry vision, inintentional weight gain, increased thirst, and appetite for the last few months. Physical assessment reviews decreased visual fecal central adiposity with a waist circumference of 48inc, BMI 30.6, Elevated blood pressure, large neck circumference ‘out snoring, No further prostate enlargement with no dribbling or trouble starting or stopping the stream. He has a PMH for BPH and takes over-the-counter palmetto and multivitamins. He walks his dog every day. Diet includes a balanced diet at home. He has no known allergies. 1, diabetes mellitus type 2 2. benign prostatic hyperplasia (BPH) Ptah g Diabetes mellitus, tvoe 2 Obstructive sleep aonea, cus —diseas hing’s Benign prostat DO Pc etes mellitus, Obstructive sleey Cushing's “Benign prostate rf wee 4 ‘. ane 1 disease hypertrophy ‘Blurred vision, decreased visual acuity perexam ‘Central obesity: waist circumference 48", BMI=30.6 ‘Blevated blood pressure Lack of snoring per partner, large neck ciroumterence ‘Lack of further prostate enlargement or recent urinary dribbling, ‘Starting/stopping stream “PN pertinent negative, absence of the symptom lowers the related diagnosis on the differential list ‘Diabetes meiiitus, type 2 ( T2DM); This diagnosis fits the full list of key findings for the patient It is a common condition in the population affecting 25% of tne population above 65 years of age and accounting for 90% of diabetes diagnoses. itis ‘chotee for the difterential list than diabetes mellitus, type 1, which most commonly presents earlier in life and accounts % Of diabeles Giagnoses While T2DM does not nave to occur with elevated blood pressure, elevations in pressure > concommantly since obesmy is a nsk factor for both T2DM and elevated blood pressure apnea: This conamon matches several of the patient's key findings including demographics central ‘cwoumference fatigue and elevated blood pressure. While snoring |s not a part of nis clinical picture. " thor Aco mldsne-oncatulke nnnnidacadantha-ditfacaatinklins  IE lag ) ee Cl) } PXSrt Toul g | Your | — Your i Graded Alt Graded MNM Graded eo e oo] _| Ce e 0) @ sc leleloa e following information addresses /ead and must-not-miss designations in the differential diagnosis list. Diabetes mellitus, type 2 (T2DM): This diagnosis fits all the key findings in the case. It is the /ead diagnosis. Eel) PST Tug  sessment Test Results em TT Diagnosis Feedback New-onset type 2 diabetes mellitus The patient's presenting symptoms of increased fatigue, thirst, urination, and appetite are consistent with new-onset type 2 diabetes mellitus and resulting polyuria. His associated symptoms of visual disturbance are secondary effects of uncontrolled glucose levels and high post-prandial blood sugars. The laboratory finding of elevated HbA1c (8.5%) indicates the average severity of his hyperglycemic state. Uncontrolled DM can lead to further micro and macrovascular complications, such as erectile dysfunction, renal disease and cardiovascular disease, as well as susceptibility to infection