This Assignment Contains Two Case Studies

CASE STUDY 1: 30 MARKS

CASE STUDY 2: 30 MARKS

 Instructions

• The assessment should be completed in your own words with the information being clear, concise and easy to understand. Please avoid using direct quotes or definitions from other resources.
• Material should be obtained from at least four other sources (other than the set text) which could include reference textbooks, research papers or web sites (academic), among others. Please do not use Wikipedia.
• All information presented in the case studies must be correctly referenced following either the Harvard style or APA Referencing style as directed by the College.
• Any diagrams must also be properly referenced as separate pieces of information.
• Students are also expected to use in-text referencing where appropriate.
• Information on how to use Harvard referencing can be obtained from the library

 Presentation

• This assessment must be typed. Arial [11] font; single or 1½ line spaced.
• Assignment must have a cover sheet that contains your name, student ID and assignment title
• Each page of the submitted assignment must have student name and student number in the footer.
• Please remember to clearly label each answer for ease of marking and follow the word limit.
• Answers should be within 10% of the word limit. Answers that fall outside this range may be penalized.
• Use of correct spelling and grammar is expected.

Submission of the Report

• The assignment has to be submitted as a single document, for both the case studies, with a turnitin score. (Instructions for submission to Turnitin can be found on the Endeavour LMS website under BIOC211). Each case study requires its own Reference List.
• The completed assessment is due no later than 11:55 pm of the Sunday following Session 24.
• If the student requires an extension, then this it at the discretion of the teacher and should be applied for in advance of the due date by discussion with the teacher and completing and submitting the required “Application for Extension” form to the teacher.
• Late assignments without previously arranged extensions will incur College stipulated penalties.

      

 CASE STUDY 1 (30 MARKS)

Word Count: 750 words (including in-text citations)

Joshua is a marine biologist who travels frequently to attend conferences. He has presented to his GP complaining of stabbing pain in the epigastrium and discomfort in his chest, which he says has been getting worse over the past three months. This discomfort increases after meals, especially if he eats fatty or spicy food that cause a burning sensation in the epigastric region which is relieved by further eating or a glass of milk, along with bloating and dyspepsia. Because of his frequent travelling, he admits that his eating habits are pretty irregular.

His symptoms started about 5 months ago with discomfort in the abdomen and recurrent flatulence and disturbed sleep. This situation progressed gradually, and has exaggerated over the past month. Sometimes Joshua is nauseated, but it is unrelieved by belching.

 Family History:

• Mother suffers from pernicious anaemia

 Vital signs:

Test	Result	Normal range
Blood pressure	125/90	(110-130/70-80) mm of Hg(for this age group)
Pulse rate	92 per minute	60-100 per minute
Respiratory rate	18 breaths / minute	12-16 breaths per minute
Temperature	36.9 ˚C	36.6 – 37.2 ˚C

 

Haematology:

Test	Result	Normal range
Haemoglobin	125 gms/L	(140-160) gms/L
Hematocrit	28	36 – 49
Mean Cell Volume (MCV)	105 fl	76 – 100
Mean Cell Haemoglobin (MCH)	32 pg	27 – 32 pg
Fasting blood sugar	4.4 mmol/L	3.6 – 5.3 mmol
Platelets	420 (x106 /L)	150-400 (x106 /L)

 

     

Questions:

1)  List all the signs and symptoms from the given case study. Identify which ones are signs and which ones are symptoms?

2)  Outline three (3) possible conditions for Joshua, and provide the rationale for the conditions that you have chosen. These conditions will represent your differential diagnosis.

3)  Briefly explain the haematology test results for Joshua.

4)  Apart from the signs and symptoms presented in this case, name four (4) other clinical findings that may be discovered if a physical examination was conducted on Joshua?

5)  Select two (2) further investigative tests that you would you like to order to help you arrive at a definitive diagnosis? Explain how these tests can help the diagnosis?

6)  Select one of your differential diagnoses as the most likely reason for Joshua’s complaints. What are the conventional treatments used for this condition?

7)  How could this condition be managed apart from the treatments?

 

CASE STUDY 2 (30 MARKS)      

Word Count: 750 words (including in-text citations)

Alf is a 67 years old male who presents to you with haematuria, swollen ankles and puffiness of his face. He diagnosed with high blood pressure three years ago, possibly due to some underlying kidney disease. His BP is currently 180/115. His GP prescribed anti-hypertensives, but Alf admits that he doesn’t take his medications on a regular basis.

Alf has a very poor diet. He consumes too much fat in his diet, and not enough fruits and vegetables. He admits that he isn’t much of a cook, and his diet has worsened since his wife passed away, and he now has to cook for himself. He is very busy with volunteering for the Animal Welfare League, and often eats on the run, grabbing the most convenient ‘fast-food’.

Alf admits to doing very little regular exercise, preferring to spend time with the animals under his care.

Alf’s doctor has warned him that his diet could lead to vascular disease, along with his tardiness in taking his blood pressure medication. Alf was also diagnosed with Type ll diabetes five years ago and takes Metformin 500mgs tds.

For your records, you have photographed Alf’s oedematous feet, and that image is below.

 Blood analysis

Test	Result	Normal range
Serum Creatinine	3.8mg/dL	0.6-1.2 mg/dL
Serum Urea nitrogen (BUN) test	80 mgs/dL	7-20 mgs/dL
Fasting Glucose	7.9 mmols/L	3.5-6.6 mmols/L

 

Urine examination

Test	Result	Normal range
Colour	Pale	Pale amber
pH	7.9	4.6 – 8.0 (average – 6.0)
Protein	45 mg/dL	Negative
Glucose	+	Negative
Blood	+++	Negative

 

Questions:

1)  Identify the signs and symptoms that Alf is presenting with.

2)  From the information given in this scenario, propose three conditions that you would put forward as your differential diagnoses for Alf. What is the rationale for your choice?

3)  Describe the pathophysiology underlying the mechanism of developing hypertension due to kidney disease.

4)  What is the significance of high serum creatinine and urea levels in kidney diseases?

5)  What three (3) investigative tests would you propose for Alf to establish a definitive diagnosis, giving your rationale for each?

6)  Having investigated Alf’s case, what condition most likely explains Alf’s signs and symptoms?

7)  Alf has asked for your advice. He wants to know the following:

• What are the complications that may arise from this condition?
• What are the treatments for his condition?
• What steps can he take to help manage his condition?

  Please CHAT WITH LIVE Assignment Advisor to know more about Referencing styles and Citations.

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