Case Study
Personal Information
Name: Mrs. Paula Johnson
Age: 65 years old
Gender: Female
Description
Mrs. Paula Johnson is a 65-year-old white woman with a previoushistory of a sedentary lifestyle, hypertension,hypercholesterolemia, and diabetes mellitus type II. She is a heavysmoker since she was 20 years old. She was brought to the emergencyroom because her family found her unresponsive on the floor. Shewas diaphoretic. Her family thought she had her diabetesdecompensated. Mrs. Johnson’s daughter indicated her mother wascomplaining of nausea and epigastric pain the day before. Also, herblood pressure was high.
On the physical examination we found:
Remarkable Signs on Physical by Regions
- Chest: Palpitation
Remarkable Signs on Physical by Systems
- Integumentary system: Profuse diaphoresis, coldness, andpallor
- Respiratory system: Tachypnea
- Cardiovascular system: Weak pulse, tachycardia, andhypotension
- Nervous system: Unconsciousness. No other neurologicsigns.
Lab Tests
- Complete blood count (CBC)
- Cardiac enzymes
- Glucose level
- Lipid panel
- EKG
- Cardiac catheterization
Diagnosis
- Silent myocardial infarction
Other Diagnoses
- Essential hypertension
- Dyslipidemia
- Diabetes mellitus
In at least 750 words, or 3 double-spaced pages, prepare a casereport that addresses the following:
- Based on the case study provided, respond to the followingquestions:
- Mention the symptoms and signs you found in this patient.
- Did you find any remarkable detail in the personal and socialhistory of our patient that can help to make the diagnosis?
- What is a silent myocardial infarction, and why did it happento this patient?
- What results do you expect to find in the tests ordered?
- What are some differential diagnoses?
- What are some complications of myocardial infarction?
- The patient suffers from silent myocardial infarction, butthere are other types of heart diseases. Consider these questions:
- Describe the heart valvular disorders and how they can producecardiac failure.
- What is endocarditis, and what are the most common causes?
- How many types of shocks are there? Explain them.
- As a lifetime smoker, the patient is at risk of severalrespiratory disorders. Consider these questions:
- What is COPD? What are the three most common diseases thatproduce a COPD? What are their causes?
- What is asthma? Explain the origin of its symptoms.
- What is a pneumothorax? What are its symptoms and signs, andwhat are its causes?
