Case Study #1 Work-Up Sheet

Group Members: Elizabeth Johnson, Zach Maynard, Zac Spangler, Jacob Wentworth
1) What signs does the patient have?
Swelling of nasal cavity, narrowing of nasal passages and erythema of the pharynx, dry cough
2) What symptoms does the patient have?
Headaches, sore throat, tiredness.
3) Was there any other key information (besides signs and symptoms) given in the patients
history?
The patient has no key information in her history.
4) What structures are affected? What helped you to make this decision?
The pharynx and the nasal cavity are affected because of the redness and swelling so it may
not be able to allow as much air flow.
5) For each structure you listed above, name its normal function and then describe how it could
be affected in this patient.
Pharynx if suppose to act as a passageway for air
The nasal cavity is supposed to allow air to flow through, humidify, trap the dust.
6) What diagnostic tests or information (if any) did you need to help solve your case? For each
requested test or information:
a) Explain what the test/information is. No test
b) Explain why you think you need this test/information. No Test
c) Discuss what results you expect and what this will tell you about the patient. No Test
7) List your rule-outs.
We ruled out any lower respiratory infections/diseases because her sinuses were affected. Also,
we ruled out any obvious diseases that had nothing to do with her symptoms, like any physical
extremity damage.
8) What is your diagnosis? Explain why you chose this diagnosis instead of the other rule-outs
on your list.
We diagnosed the patient with a common cold. She has all of the symptoms of the common
cold: slight fever, congested sinuses, sore throat, headache, tiredness. We ruled out what we
had originally thought to be a sinus infection because there was only mild inflammation in the
nasal cavity, which would have been very inflamed with more than usual amount of white blood
cells.
9) What are your recommendations for treatment and/or management? Explain your reasoning
behind each recommendation.

I would recommend any over-the-counter medicine to attack each symptom. A decongestant for
the congested sinuses, throat lossanges for the sore throat, ibuprofen for the headaches, and
lots of rest. Since the common cold is viral, antibiotics would not help.
10) What would happen if this patient were not treated for this problem?
The common cold runs its course in about 10 days for adults, but there would be no relief, if not
worsening of the symptoms. If the symptoms were medicated to a point where they were
tolerable, then the patient would be a lot more comfortable while the virus goes through its
course.

Case Study #2 Work-Up Sheet

Group Members: Zach Maynard, Elizabeth Johnson, Zac Spangler, Jacob Wentworth
1) What signs does the patient have?
The patient has cracked, dry lips, moderate gingivitis, nicotine stained teeth, and wheezing
upon auscultation.
2) What symptoms does the patient have?
The patients symptoms are developed cough for over a month, being tired more than usual,
and painful breathing.
3) Was there any other key information (besides signs and symptoms) given in the patients
history?
There was no other key information in family history but the patient is a smoker and drinks 3-5
alcoholic beverage a week.
4) What functions are affected? What helped you to make this decision?
I believe the breathing function would be affected because smoking causes damage to the
lungs and tar build up could lead to fast and painful breathing.
5) For each function you listed above, name the structure associated with it and then describe
what may changes in structure could have disrupted normal function in this patient.
The lungs is associated with breathing the tar build up from the cigarettes can cause the lungs
capacity to decrease and could also being to make the lungs hard instead of spongy like they
are supposed to be.
6) What diagnostic tests or information (if any) did you need to help solve your case? For each
requested test or information:
My group used arterial blood gas, hematocrit, spirometry, and a thoracic XR to help determine
the case.
a) Explain what the test/information is.
Arterial Blood Gas= mild hypoxemia and normal carbon dioxide value
Hematocrit= Patient: 55%
Spirometry= Marked decrease in expiratory flow, hyperinflation and air trapping
Thoracic XR= Lateral view shows signs of hyperinflation and loss of vascular pattern

b) Explain why you think you need this test/information.

I think we needed this information to be able to find the cause of the painful, fast breathing.
c) Discuss what results you expect and what this will tell you about the patient.
I think the test result will tell us that the patients has damaged their lungs from smoking.
7) List your rule-outs.

We ruled out asthma.

8) What is your diagnosis? Explain why you chose this diagnosis instead of the other rule-outs
on your list.
Our diagnosis is emphysema. We chose this diagnosis because the symptoms of emphysema
match the ones our patient was having and emphysema can be cause by consistent smoking.
9) What are your recommendations for treatment and/or management? Explain your reasoning
behind each recommendation.
We recommend inhaled steroids, such as, Corticosteroid drugs, but do not want them using it
for a prolonged time because it can lead to weakness of bones, diabetes, and high blood
pressure. If the steroids does not help we would like for the patient to try pulmonary therapy to
try and reduce the breathlessness.
10) What would happen if this patient were not treated for this problem?
If the patient is not treated for this problem the diagnosis could get severe and if they go long
enough without treatment the only option would be a lung transplant.

Case Study #3 Work-Up Sheet

Group Members: Elizabeth Johnson, Zach Maynard, Zac Spangler, Jacob Wentworth
1) What signs does the patient have?
The injuries on the skull and shoulder, the lower sound activity on the left lung.
2) What symptoms does the patient have?
The shortness of breath, the pain ratings, the anxiety
3) Was there any other key information (besides signs and symptoms) given in the patients
history?
The patient was just in a car accident, which seemed to affect only the left side of the body.
4) What functions are affected? What helped you to make this decision?
The arm/forearm: there are full thickness wounds.
Skull: there is an abrasion to the left side of the skull.
Thorax: this could be resulting in broken ribs, collarbone, or a collapsed lung.
5) For each function you listed above, name the structure associated with it and then describe
what may changes in structure could have disrupted normal function in this patient.
The arm/forearm: it is only the skin affected. If not treated, it could get affected and cause many
problems.
Skull: There could be brain damage, so that needs to get checked out. If left untreated, there
could be many mental problems.
Thorax: There could be broken ribs, collarbones, or damage to the lungs. There could be
definite uncomfort, and possible death if the bones are displaced, if broken.
6) What diagnostic tests or information (if any) did you need to help solve your case? For each
requested test or information:
a) Explain what the test/information is. No test
b) Explain why you think you need this test/information. No test
c) Discuss what results you expect and what this will tell you about the patient. No test

7) List your rule-outs.

Any virus or disease - the patient was healthy before the accident. This was obviously a
traumatic event, so there could only be trauma-induced problems. We ruled out anything that
wasnt due anywhere near the thorax or the skull, near the obvious affected area. Since there
was no broken skull, we ruled out any brain damage, minus a possible concussion.
8) What is your diagnosis? Explain why you chose this diagnosis instead of the other rule-outs
on your list.
We diagnosed the patient with a collapsed lung, or pneumothorax. The patient was
experiencing tachypnea and dyspnea, which is a symptom of a collapsed lung. Also, there was
little to no sound coming from the left thorax, around the left lung (which we believe to be the
one that collapsed). We ruled out any brain damage because of the pain in the lungs and only
the skin wounds on the skull.
9) What are your recommendations for treatment and/or management? Explain your reasoning
behind each recommendation.
A mild pneumothorax may heal on its own. But, it would be advised for the doctor to get rid of
the excess air in the thoracic cavity with a needle, giving the lung better room to expand. If
severe, there might be a chest tube placed in to get rid of the excess air. Surgery may be in
need.
10) What would happen if this patient were not treated for this problem?
The patient would have problems breathing, and would be in pain. If serious and left untreated,
the injury could be fatal.