Case Study 1
In medical practice, there are a large number of diseases that develop quite quickly. Such diseases can be difficult to diagnose due to ambiguous symptoms reported by patients. The proposed case study describes the case of a racial minority patient (44 years old) who developed a pulmonary embolism after the surgical treatment of his tumor.
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The things that went wrong in the case include the lack of necessary postoperative care, blood tests, and CTA tests helping to distinguish the condition (Tan & Haramati, 2016). Also, it is possible to suppose that the providers attributed the patients’ symptoms to possible heart problems or the effects of anesthetic medications used to perform surgical procedures.
The potential reasons why blood clots continued to be misdiagnosed are related to the providers’ level of professional experience and the similarities between the symptoms indicated and the signs of a heart attack. Furthermore, difficult breathing is listed among the most common effects of anesthesia and it could cause misdiagnosis (Haden, 2017). Another reason is the unique character of reported symptoms (the presence of gas pains, the absence of chest pain, unusual skin color, etc.).
There are specific strategies that could be used to prevent the development of blood clot complications and the patient’s death. Obtaining the medical history, it would be necessary to study the presence of common risk factors such as the cases of thromboembolic disease in his family medical history, an increased BMI, the history of inflammatory disease, or a sedentary lifestyle. When it comes to ordering diagnostics, it would be important to conduct blood and urine tests, do an ECG to exclude heart diseases, and a pulmonary angiogram to define the presence of blood clots. Potential treatment options include transporting the patient to an emergency room and the use of thrombolytics to improve the circulation of blood. In case of these measures’ ineffectiveness, blood clots should be removed surgically.
Case Study 2
According to the case, a female patient who is twenty-eight years old suffers from asthma but has no specific complaints related to her physical condition. As is clear from the medical history obtained by the specialist, the patient uses necessary drugs to block the symptoms of asthma regularly. The data on this chronic disease is extremely important in the given case. Nowadays, some researchers suppose that abnormal iron levels in adult women are strictly interconnected with asthma and can exacerbate the disease (Brigham, McCormack, Takemoto, & Matsui, 2015).
The patient’s social history indicates that she is quite conscious about her health (the use of tobacco and alcohol is minimized). Despite the absence of clear complaints, some negative findings indicate the need for further research.
The data presented in the case allows making a differential diagnosis. The lab reports presented in the case show that the patient has an insufficient level of hemoglobin. Her hemoglobin is 10 which is low for adult women who are not pregnant. The patient’s hematocrit level is also low. At the same time, the lab reports indicate an increased mean cell volume. All these findings can indicate the presence of macrocytic anemia. The patient history also plays the role in the diagnosis – it is known that this type of anemia can be caused by the regular intake of medications. Physical examination helps to identify many symptoms of this type of anemia such as accelerated heartbeat, decreased appetite, or tiredness.
As for the pathophysiology of macrocytic anemia, it occurs due to the absence of some chemical substances in the human body or affected replication of the DNA. About the most common causes of the condition, this type of anemia is associated with the low levels of B12 and a folate deficiency (Takahashi et al., 2016). Treatment options include the use of special diets and vitamin supplements. The decision concerning the necessity of specialized care should be made based on the presence of dangerous symptoms such as syncopal episodes or bleeding.
Brigham, E. P., McCormack, M. C., Takemoto, C. M., & Matsui, E. C. (2015). Iron status is associated with asthma and lung function in US women. PLoS One, 10(2), e0117545.
Haden, M. (2017). Post-operative shortness of breath. Emergency Medicine Journal, 34(5), 330-331.
Takahashi, N., Kameoka, J., Tamai, Y., Murai, K., Honma, R.,… & Ishizawa, K. (2016). Causes of macrocytic anemia among 628 patients: Mean corpuscular volumes of 114 and 130 fL as critical markers for categorization. International Journal of Hematology, 104(3), 344-357.
Tan, S., & Haramati, L. B. (2016). Overdiagnosis versus misdiagnosis of pulmonary embolism. American Journal of Roentgenology, 206(4), W59.