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Two days ago, Charity, a 48-year-old journalist from Miami, returned to the United States from a 6-week trip to several countries for a story she is writing on recovery progress after major earthquakes. When she first came home, Charity began to experience diarrhea, which became worse as the day progressed. After the second day of severe diarrhea and the beginning of leg pain, Charity seeks care at a local outpatient health care facility. She reports no vomiting or fever, but has 10 watery stools per day without visible blood or mucus.
Questions :
- What immediate treatment does Charity need?
- Name at least 5 organisms that may be causing the diarrhea. In a table, contrast the differences in the presentation of the diarrhea and the causative agents.
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- Mrs. Gina Ryan, a 52-year-old court stenographer, was admitted to the nursing unit from her physician's office. She had a gnawing pain on. her right side radiating to her back for 3 days. she now describes her pain as "excruciating after eating or drinking". In the past 48 hours she has been vomiting about 2 to 3 hours after she eats. she has not had anything to eat or drink for the past 12 hours. Mrs. Ryan stated that she had not been successful in adhering to the weight reduction diet that had been prescribed by her physician and that she had rapidly lost, then regained, weight several times in the past year and a half. She stated, "My life is just too busy - I work late hours in the court system and had to buy my meals put a lot". She indicated that in addition to her work, she and her husband share the responsibility for raising their two teenage daughters. Admission physical examination revealed BP-130/80, PR-102, RR-24, Temp-37.3, height - 5'7", weight - 122kg, skin warm, no…Ms. K is 35 years old and the CEO of a small company. On the weekend of May of 2000 she and her friend Mr. L had escaped from the stresses of the big city to spend a quiet weekend in the country. They had stopped in Walkerton for lunch. Both of them developed a moderately severe diarrheal illness, which resolved after one week. Since then Ms. K has noticed a change in her bowel habits. About every 2-3 weeks she is either very constipated or she has very soft stools 4-5 times a day over about 2 days. During these times she often feels bloated and there is pain that goes away after the bowel movement. Although she now drinks only bottled water, there have been no other changes to her diet. Ms. K appears to suffering from Irritable Bowel syndrome (IBS). Which of the following are features of IBS and how does it differ from IBD? A. IBS is considered a “functional” disorder without any identifiable structural or biochemical cause underlying the symptoms. B. Similar to IBD, IBS is still…Kathy Morningside is a 55-year-old woman who has had spells of gastroin- testinal problems over the years (dyspepsia), but a formal diagnosis has never been conclusive. During the past four months, she has had a history of vomiting after some meals and she has lost about 5 kg over this time. Mrs Morningside, together with an old school chum, went to London for a weekend theatre break to see Les Miserables. On the Friday evening, she began to feel unwell, but put it down to her fear of flying. They went to the theatre on the Saturday evening and followed this with a light opera supper at a nearby restaurant. Mrs Morningside suffered a haematemesis and was rushed to hospital with massive bleeding. Her condition settled and follow- ing overnight rehydration, she returned to her home in Newcastle where she was examined by a gastrointestinal consultant. The consultant noted that Mrs Morningside was pale and tachycardic. Her blood pressure was 130/90 mmHg. Rectal examination revealed frank…
- During my clinical rotation in the emergency department, Imet Grace Gilligan. She was a 28-year-old woman who cameto the emergency department with complaints of severeepisodes of nausea and vomiting over the last 48 hours. She has a past medical history of Crohn’s disease, a gastrointes-tinal (GI) problem for which she underwent bowel resection surgery 1 month ago. “I thought the surgery would help myproblems.” The patient was dehydrated and needed IV fluidtherapy.My co-assigned nurse attempted to start a peripheralvenous access not once, but six times. The patient was already upset by her recurrent abdominal symptoms, butnow had to deal with the continuous painful stick of aneedle. During the course of attempts to start the IV, thepatient stated that a nurse on the IV team always had to becalled to insert her IVs. Although my nurse acknowledgedthe information, she continued trying to start the IV. Finally,on the sixth try, as the patient was in tears, the nurse wassuccessful. It…Jeanette is a 46-year-old woman who has visited her general practitioner (GP) today, brought in by her husband, Steve, with a 5-day history of nausea, mild abdominal pain and constipation. She decided to see the doctor today, as the pain and nausea were much worse when she woke up this morning and she has vomited twice in the past 3 hours. She also reports her abdomen feels distended and bloated. Jeanette says she had tried to drink more water and eat more fruit and was having bran for breakfast for the past 3 days, as she initially thought she was simply constipated. With the increased generalized abdominal pain and vomiting this morning, she thought she should get a medical opinion. Jeanette has a past medical history of hypercholesterolemia, hypertension, atrial fibrillation and type 2 diabetes mellitus (T2DM) and her BMI is 32 kg/m2. She experienced appendicitis 6 months ago,for which she had an appendectomy. Her current medications are simvastatin, warfarin, and metformin. The GP…Mr. J is a 35 year old male who arrives at the emergency department ( ED ) with a complaint of unbearable intermittent pain that started one day ago , while at work . He felt nauseated and was diaphoretic later that day . He was unable to take fluids because the nausea would not subside . The following day he observed that his urine was scant and the color was pink-red . He went to work because the pain had decreased much . While at work , he felt a pain radiated from his left side of the abdomen to the centre and it was severe for a few minutes . He informed his brother who work nearby , and transported him to ED at once . Mr. J denies previous episodes of this type of pain and has no past or current medication history . His vital signs are within normal limits except for a temperature of 38.3'c . Laboratory evaluation : Ct scan shows calcium oxalate crystal in the left kidney calyx urine dipstick shows positive for hematuria urinalysis reveals red blood cells the urine has no odor…
- Mr. J is a 35 year old male who arrives at the emergency department ( ED ) with a complaint of unbearable intermittent pain that started one day ago , while at work . He felt nauseated and was diaphoretic later that day . He was unable to take fluids because the nausea would not subside . The following day he observed that his urine was scant and the color was pink-red . He went to work because the pain had decreased much . While at work , he felt a pain radiated from his left side of the abdomen to the centre and it was severe for a few minutes . He informed his brother who work nearby , and transported him to ED at once . Mr. J denies previous episodes of this type of pain and has no past or current medication history . his vital signs are within normal limits except for a temperature of 38.3'c . Laboratory evaluation : Ct scan shows calcium oxalate crystal in the left kidney calyx urine dipstick shows positive for hematuria urinalysis reveals red blood cells the urine has no odor…A small town’s pediatrician saw three children, ages 5, 7, and 10 years, who were ill with vomiting and diarrhea within 12 hours of each other. The child aged 5 years had become so sick that the pediatrician recommended her mother take her to the emergency department at the local hospital. The 5-year-old child initially complained of nausea around 10:00 a.m. The nausea was followed by vomiting and multiple episodes of diarrhea. The child was unable to eat or drink anything without vomiting. That afternoon, the child became listless, so the pediatrician sent the child to the emergency department where she was noted to be dehydrated and had a fever. Stool and blood specimens were collected, and the child was treated with intravenous fluids and released. The two neighborhood children had had similar symptoms (i.e., nausea, vomiting, diarrhea, and fever) but had not become as ill as the 5-year-old. Both had returned to school the day after becoming ill. The three children usually did not…A 74-year old woman with history of rheumatic fever (in her twenties) presented to her physician with complaints of increasing shortness of breath (dyspnea) upon exertion. The typical swelling she’s had in her ankles for years has started to get worse over the past two months. In the past week, she’s had a decreased appetite, some nausea and vomiting and tenderness in the right upper quadrant of the abdomen. On physical examination, the patient’s jugular veins were noticeably distended. Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra “S3” heart sound. (i) What is causing this murmur? (ii) Is the history of rheumatic fever relevant to the patient’s current symptoms? Explain. (iii) Examination of the patient’s abdomen reveals an enlarged liver (hepatomegaly) and a moderate degree of ascites (‘water’ in the pericardial cavity). Explain these findings. (iv) Examination of the patient’s…
- A 74-year old woman with history of rheumatic fever (in her twenties) presented to her physician with complaints of increasing shortness of breath (dyspnea) upon exertion. The typical swelling she’s had in her ankles for years has started to get worse over the past two months. In the past week, she’s had a decreased appetite, some nausea and vomiting and tenderness in the right upper quadrant of the abdomen. On physical examination, the patient’s jugular veins were noticeably distended. Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra “S3” heart sound. (i) Examination of the patient’s ankles reveals significant “pitting oedema”. Explain this finding. (ii) What is the general term describing this condition?Latasha’s doctor prescribed Amoxicillin for her to take for 10 days upon her diagnosis of Strep Throat. She began to feel better and stopped taking the Amoxicillin after 5 days. A couple of weeks later, she began to feel ill again and returned to the doctor. This time, the doctor prescribed that she takes the antibiotic Zithromax for 5 days.traveler's diarrhea is also known as what