MEA2203 MODULE 05 CASE STUDIES
Patient Name: Janice Navarro
Date of Birth: 12/3/1971
Clinical Notes: The patient presents with chronic shortness of breath and dyspnea upon exertion.
Symptoms started several years ago and have progressively gotten worse. She reports that she is no
longer able to walk around her block without severe breathlessness. She has a history of heavy smoking,
does not take any regular medications, and has no personal or family history of heart disease. Physical
exam reveals cyanosis in bilateral fingernail beds.
Current vital signs: BP 140/92, HR 88 bpm, Temperature 98.4°F
After a physical examination, imaging, and laboratory testing, the physician confirms the diagnosis of
emphysema.
Question #1: What might Ms. Navarro’s spirometry (pulmonary function test) results look like? (Please
use your textbook as a reference.)
Question #2: What are other possible signs and symptoms of emphysema that are not mentioned in this
case?
Question #3: What types of imaging tests may be used to confirm emphysema? Describe the
abnormalities that would be present in the imaging test.
Question #4: How is the cyanosis in Ms. Navarro’s nailbeds related to her diagnosis?
Question #5: How is the pathophysiology of Ms. Navarro’s condition of emphysema different from the
pathophysiology of chronic bronchitis?
MEA2203 MODULE 05 CASE STUDIES
Patient Name: Jeffrey Buddell
Date of Birth: 1/18/1985
Clinical Notes: Male patient presents with fatigue, jaundice, dark urine, unintended weight loss, and
poor appetite. He reports that the symptoms have been getting worse over several weeks. He states
that he “thought I was just dehydrated and everything would get better, but it’s getting much worse.”
Yesterday, he noticed several bruises on his hips and legs but does not remember any injury that would
have caused the bleeding.
Mr. Buddell admits to heavy alcohol intake in the past and three instances of intravenous drug use, but
he has been sober for more than six months.
Current vital signs: BP 122/78, HR 88 bpm, Temperature 100.2°F
The physician suspects hepatitis and orders laboratory tests to confirm his diagnosis.
Question #1: Given Mr. Buddell’s symptoms and history, which type of hepatitis is most likely? (Note,
incubation periods of the different types of hepatitis.)
Question #2: Describe the pathophysiology and route of infection for the type of hepatitis you believe
Mr. Buddell is exhibiting.
Question #3: What are potential complications of hepatitis that Mr. Buddell should be aware of?
Question #4: If the physician orders a complete blood count (CBC), which abnormal results would you
expect?
Question #5: Should Mr. Buddell worry about passing this disease to other people? If so, what
protective measures can he take?
MEA2203 MODULE 05 CASE STUDIES
Patient Name: Rajani Jefferson
Date of Birth: 11/17/1984
Clinical Notes: Female patient presents with extreme, acute right-sided lower back pain. She reports
that the pain began as a dull ache last evening, but escalated to an intense sharp pain quickly since this
morning. The pain radiates in the lower right abdomen. She denies any history of trauma. The patient
reports experiencing hematuria a few hours ago.
Medical history reveals multiple urinary tract infections, dehydration, Cushing syndrome, and a family
history of multiple cancers (breast, prostate, colon).
Current vital signs: BP 126/78, HR 76 bpm, Temperature 98.6°F
The physician ordered an ultrasound of the right kidney, which identified renal calculi. A CT scan of the
kidneys, ureters, and bladder was ordered as a follow-up.
Laboratory tests ordered: Complete blood count, urinalysis
Diagnosis: Nephrolithiasis
Question #1: Which risk factors did Ms. Jefferson exhibit for the diagnosis of urolithiasis?
Question #2: If her CT scan revealed renal calculi larger than 6mm in size, what type of treatment(s)
would likely be recommended?
Question #3: Lab results determine that Ms. Jefferson has the most common type of kidney stones,
calcium oxalate and calcium phosphate. Does this mean her renal calculi are caused by a high dietary
intake of calcium? Why or why not?
Question #4: What type of complications may occur if Ms. Jefferson does not go through with the
recommended treatment?
Question #5: What preventative measures should Ms. Jefferson take to avoid recurrence?
MEA2203 MODULE 06 CASE STUDIES
Patient Name: Fiona Miller
Date of Birth: 4/13/1994
Clinical Notes: Patient reports to the clinic with increasing dysmenorrhea. She describes the pain as
cyclical, increasing in intensity during menstruation. The pain started as mild cramps several years ago,
but has progressively become more severe and is now debilitating. The patient denies any abnormal
vaginal discharge.
Current vital signs: BP 110/82, HR 68 bpm, Temperature 98.4°F
Her gynecologist completes a pelvic exam and notes no structural abnormalities of the vagina or cervix.
The gynecologist suspects endometriosis or polycystic ovarian syndrome and recommends imaging
studies for diagnosis and treatment.
Question #1: Why would the physician order imaging tests instead of lab tests in order to determine the
diagnosis in this case?
Question #2: If Ms. Miller has polycystic ovarian syndrome, what other symptoms might you expect her
to exhibit?
Question #3: Ms. Miller’s MRI report shows lesions surrounding the ureters, round ligaments, and
bladder. Which of the physician’s diagnoses is correct and why?
Question #4: Why might hormonal birth control be a good treatment option for Ms. Miller?
Question #5: Should Ms. Miller be concerned about her chances of becoming pregnant in the future?
Why or why not?
MEA2203 MODULE 06 CASE STUDIES
Patient Name: Aboubacar Heinrich
Date of Birth: 2/11/1952
Clinical Notes: Male patient reports difficulty urinating. His symptoms started two weeks ago and were
sporadic at first. He is now urinating more frequently, especially at night, and feels a sense of
incomplete bladder emptying. He reports that he has a weak, interrupted stream of urine.
Current vital signs: BP 122/78, HR 82 bpm, Temperature 98.2°F
The physician suspects prostate issues and suggests a digital rectal exam and prostate-specific antigen
test.
Question #1: If the issue is related to a structural abnormality of the prostate, which other symptoms
(not mentioned here) may he experience?
Question #2: What is a prostate-specific antigen test and why was it ordered in this case?
Question #3: Mr. Heinrich’s digital rectal exam revealed abnormal bumps on the prostate. Which other
diagnostic procedures may be recommended as a follow-up?
Question #4: It is determined that Mr. Heinrich has benign prostatic hyperplasia and a procedure called
TURP is recommended. Explain what TURP stands for and how the procedure is completed.
Question #5: If Mr. Heinrich does not follow through with treatment, what types of complications may
occur and why?
MEA2203 MODULE 06 CASE STUDIES
Patient Name: Deborah Spitzner
Date of Birth: 12/2/1999
Clinical Notes: Female patient reports vaginal pain that increases with sexual intercourse and abnormal
vaginal discharge. She has mild, burning pain during urination. Her symptoms have been present and
progressively worsening for three weeks.
Current vital signs: BP 126/78, HR 66 bpm, Temperature 100.6°F
The physician refers her to a gynecologist for a pelvic exam and orders a complete blood count,
urinalysis, and STD screening panel. Lab tests confirm a diagnosis of chlamydia.
Question #1: What is the pathophysiology of a chlamydial infection?
Question #2: How might the symptoms in this case study be different if the patient was male?
Question #3: Is chlamydia curable? What type of treatment is usually recommended?
Question #4: What type of complications may occur as a result of chlamydia?
Question #5: What preventative measures should Ms. Spitzner take to avoid recurrent infections and to
avoid transmitting chlamydia to her partners?