Case Studies (Brief)
Case Study 1:
Mr. Y. is a 57 year old man, pleasant, cheerful, hard-working, good guy. During our interview he seated himself at his bedside, maintained an upright posture, maintained his cellular respiration, from all appearances, admirably. Mr. Y.’s breath sounds are clear to auscultation, and he has four working limbs.
Of note, Mr. Y. spent eight years mining emeralds in South Africa, during which time he says he smoked heavily, though not cigarettes. Mr. Y. was not sure what it was he was smoking. He said it was a tarry substance that he purchased from time to time in the markets of Johannesburg, not tobacco, he was quick to volunteer, but of a viscous appearance, sometimes mixed with animal fibers, possibly hair. After leaving employment in the emerald mines, Mr. Y. worked as an accountant in Chicago.
Mr. Y. lives alone and has eight children, the whereabouts of which he is not sure. His decision maker is a friend from his local church, who speaks Taiwanese. Mr. Y. will need a translator present at all medical interviews in the future.
Mr. Y. would like to be a full code.
Mr. Y’s chief complaint is toe pain and intractable headaches.
Based on this information, what do you consider to be the differential diagnoses?
Case Study 2:
Mrs. P. is a 99 year old woman, nonverbal at time of assessment, snoring respirations, with shallow breathing. Her son says she was an avid gardener. Mrs. P. lives with her 102 year old spouse, for whom she is the primary caregiver. Breath sounds are fine crackles throughout. Of note, Mrs. P has a large bruise on her shin, which matches the bruises found on every inch of her nonagenarian body.
Mr. P. brought in his wife today because of his concern over her mental status, which he says is now slightly decreased. Mr. P. thinks his wife’s mental status has changed from barely conscious to mostly unconscious, but he is quick to note that he is not a doctor, and this is not a medical diagnosis.
Where in the patient’s chart would you find information on patient’s insurance?
Case Study 3:
Mr. L is a 28 year old male. Mr. L. was hostile during my interview. Difficult to attain relevant medical history, as Mr. L. is a poor historian. For instance, I asked him the date of the French Revolution, and he was not sure. He thought 1800. Ha! Only if you date the Republic from the date of the Constitutional Referendum! Absurd! I guess the October Days of 1789 never even happened or something?
Mr. L.’s chief complaint was an ulcerated wound on his abdomen. Nasty! He should really get some help with that. Looks purple.
How do I work this defibrillator?
