Directions: Read the following case studies and provide a minimum of a one page paper for each that addresses the issues.
Can’t Stop Coughing
Evelyn is a 65 y.o. female who has been feeling under the weather ever since she contracted a cold approximately one month ago. She no longer has a runny nose, but she continues to cough, but only small amounts of mucus are coughed up. She also has a sore throat and hoarseness and a headache. One morning she wakes up feeling as if she just cannot get her breath and decides to go to the emergency room. After listening to her heart and lungs, the physician orders an x-ray and takes a sample of her sputum.
X-Ray Findings: Scattered small patches of density show in the lungs.
Sputum: Is positive for influenza A.
The doctor diagnoses Evelyn with Viral Pneumonia and sends her home with a treatment plan including an antibiotic. He tells her to return in a month for a re-check.
- a) What signs/symptoms indicate Evelyn may have pneumonia?
- b) What about her history and the tests done indicate this is viral pneumonia and not bacterial pneumonia.
- c) What are two things Evelyn could have done to prevent pneumonia?
- d) What is the likely treatment regimen that the doctor prescribed for Evelyn and why? Why didn’t she need to go to the hospital?
- e) If this is a viral pneumonia, why did the doctor send Evelyn home with an antibiotic?
- f) Evelyn returns to the doctor a month later and she is still having the same symptoms and is now coughing up blood. What other disease might the doctor start checking for and why?
- Soccer Cough
Jeremy is a 11 y.o. male who has been playing soccer for two years. He wanted to quit soccer last year because according to Jeremy “I am just not any good.” His parents, however, have encouraged him to try playing one more year. His parents are noticing that Jeremy is very tired after soccer and he often falls asleep doing his homework.
While watching soccer practice one day, Jeremy’s mother notices that Jeremy seems to be short of breath and is coughing a lot. He has trouble keeping up with the other boys on the field. She does not think this is normal and makes a doctor’s appointment for Jeremy. The doctor listens to Jeremy’s chest and hears some wheezing. He also does some breathing tests and takes a chest x-ray. The findings are as follows.
Chest X-Ray: clear
Spirometry before exercise: normal
Spirometry after running in place: decreased
Oximetry before exercise: normal
Oximetry after running in place: decreased
The doctor diagnoses Jeremy with exercise-induced asthma (EIA) and sends Jeremy home with a beta2-agonist bronchodilator in an inhaler as well as information on how to control his asthma.
- a) What signs and symptoms indicate exercise induced asthma? What medical tests help confirm this diagnosis?
- b) Is EIA a common disease? How common?
- c) What is at least 3 goals of treatment for EIA?
- d) Give 2 examples of beta2-agonist bronchodilators that might be used in EIA and what a normal dose might be. What is the difference between a short and a long term bronchodilator?
- e) Will Jeremy need to stop playing soccer? Why or why not?
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