What evidence do you have from patient complaints and testing that Frank has had a NSTEMI?Discuss

Description

Develop a 1–2-page case study analysis including the genetic principles as they relate to the patient. In your assignment:

• identify genes associated with the disease,

• the effects genetics have on the body of a patient with this chief complaint and diagnosis, and

• note the education you would provide the patient related to CAD/HTN and genetics.

Answer the following questions in the spaces provided, then select Submit.

1. What evidence do you have from patient complaints and testing that Frank has had a NSTEMI?

2. How do you know that the myocytes have been affected?

3. What steps were taken to reverse further damage to the myocytes?

4. What evidence do you have that Frank has decompensated CHF?

5. What effect would Frank’s low blood pressure have on the renin-angiotensin-aldosterone system?

Are there any limitation in diagnostic tools in pre-hospital setting?Discuss

How do we diagnose? (550 words)
How do we assess a patient? (Please refer to Appendix -1)
-Consent?
-Primary survey-ABCDE negative or positive?
-Secondary survey – SOAP (subjective data, objective data, assessment, Plan) Why SOAP is important? (Appendix -2)
Data gathering tools. SAMPLER, SOCRATES
– How effective are these tools? Does taking history only rule in/out a diagnosis? (Evidence research please for peer reviewed journal or book)
Consultation models and why they are useful?
(Such as; Cambridge model- structured well- how effective are they -in brief)

What are the tools with which we make decisions? How useful are these?

Are there any limitation in diagnostic tools in pre-hospital setting?

Diagnosis and Management: (650 words)
What mechanisms or diagnostic tools do we have to help? (Such as; News score 2/sepsis screening tool- relevant to a case study)

What are our choices of treatment?

Do they follow guidance, and is that local or national?

What is the evidence base behind our choices?

Referral of patients to an appropriate health care setting, medical practitioner or to other agencies.

Appendix 1:
Case study of 68-year-old female (Mrs X)- presenting with pyrexia and abdominal pain.
On the arrival on the scene, Mrs X answered a door for an ambulance crew, she said she has woken this morning with a high temperature and complains having a low abdominal pain and back pain since last 24 hours. She said she has been sitting on her armchair with a hot water bag placing on her abdomen and reported having a frequent small urination and discomfort whilst urinating. Mrs X lives alone, found to be alert with GCS 15.

Appendix 2:
Primary Survey
Airway: Patent and clear
Breathing: RR 22, Spo2 99% on air, equal chest rise
Circulation: HR 103, BP 110/60, Strong regular pulse
Disability: Temperature 39, GCS 15, Normal BM
Examine: Suprapubic abdominal tenderness and lower back tenderness

Appendix 3:
Secondary Survey (SOAP)
S= Subjective Data:
Patient complaining of her low abdominal pain and discomfort while micturating.
Patient states having a burning sensation when urinating & increased frequency to urinate with reduced output
Patient states her urine slightly cloudy but denies haematuria
Patients states normal bowel, denies any dizziness or confusion and denies vomiting & nausea
Denies shortness of breath
O= Objective Date:
Vital signs
Well hydrate
No history of UTI and no other past medical history
Suprapubic abdominal tenderness, lower back tenderness.
bowel sound normal
A= Assessment
Based on history and examination
Likely- UTI
Unlikely – pyelonephritis
Rare: Appendicitis

P=Plan
Impression?
ASHICE (enroute handover to hospital)
Iv paracetamol administered? (Please follow JRCALC for drug management)
Preparation of Morphine if patient still have constant pain following the paracetamol administration.
Fluid if BP drops and Ondansetron for nausea/vomiting.

What organizations in the state of Georgia (United States) would be responsible for surveillance of the disease, and identifying when an outbreak might occur?

Using the COVID-19 pandemic, discuss:
1. What organizations in the state of Georgia (United States) would be responsible for surveillance of
the disease, and identifying when an outbreak might occur?
2. What organizations outside of the state of Georgia (outside of the United States) might be involved
in an outbreak or pandemic investigation or response?
3. What does your “dream team” of disease investigators look like?
4. What types of professions or individuals would you recruit for your outbreak investigation team?
5. Are there any agreements in place with organizations outside of the state of Georgia (United States)
would be helpful in disease surveillance or investigation? What are they?

Discuss : Wear characteristic of zirconia and lithium disilicate fixed prosthesis in bruxism patient.
Discuss :Wear characteristic of zirconia and lithium disilicate fixed prosthesis in bruxism patient.

Literature review of an in vitro study testing the wear characteristic of zirconia and lithium disilicate fixed prosthesis opposing natural enamel, Zirconia and lithium disilicate in patient with bruxism
Materials to be tested (the new GC Ceramics(company )
Control group (natural enamel, Ivoclar porcelain system( IPS emax press, IPS CAD,IPS Emax zir CAD )