Q. 1
A physical examination is usually conducted by a physician one each patient to acquire a better understanding of the symptoms and related health issues linked with the complaints of patients (Duan, Mukherjee & Federman, 2020). The components of a physical examination include observation, percussion, auscultation, and palpation. The data collected must be pensively incorporated with the history and pathophysiology of the patient. The physician uses observation to look for physical signs of a disease such as facial expression, posture, alertness, mobility, and skin or eye colour (Duan, Mukherjee & Federman, 2020). Palpation encompasses inspection of the body of the patient using the sense of touch. Percussion involves tapping areas of interest of the body using fingers to assist in diagnosis. Auscultation is listening to the internal sounds of the body using tools such as the stethoscope.
Q. 2
According to (Cifu & Davis, 2017), the standard device that a physician will use to measure the blood pressure of the patient is the sphygmomanometer. However, in some scenarios, though not accurately, a physician may use a stethoscope and a blood pressure cuff. The upper denominator signifies the systolic blood pressure, which shows the amount of pressure in the arteries during the contraction of the heart muscle. The denominator indicates the diastolic blood pressure, which means blood pressure when the heart is between beats (Cifu & Davis, 2017). The importance of these figures is there warning of suitable pressure tolerance frequency and are hence essential in determining the health status of a patient. The standard range of BP is lower than 120/80, and increased BP begins at 120 or above 80 (Cifu & Davis, 2017). Mr Smith's pressure reading is at160/100; therefore, he is suffering from HTN.
Delegate your assignment to our experts and they will do the rest.
Q. 3
From the data provided, various tests were carried out on the patient. These include bicarbonate, potassium, aldosterone, renin, glucose, ACTCH, and cortisol, which requires blood serum for the test to be conducted. Moreover, other criteria such as hematocrit and haemoglobin require whole coagulated blood to be undertaken. Abdominal computerized scans were also performed on Mr Smith, and Mr Smith was diagnosed with prostate cancer, and an MRI scan was also acquired.
Q. 4
Hb test: Standard range = 13.6-17.0g/dL (Feher, 2017). The value of Mr Smith is at 7. g/dL (low) and may lead to Anaemia.
K+ test: Normal blood K + level is 3.6 to 5.2mmol/L. Mr Smith's K + level is at 2.6mmol/L which is low (Hypokalemia)
Platelet count: Standard count varies from 150,000-450,000 platelets/microliter of blood (Feher, 2017), while for Smith, his platelet tally is low.
Hct test: Standard value 38.8% to 50%. Mr Smith's rate is 20.4%, which is quite low.
HCO3 test: Standard range is 2228mmol/L, while for Smith, his figure is at 38mmol/L, which is elevated.
ACTH test: Standard value taken early in the morning is at 52pg/ml (Feher, 2017), while the value for Mr Smith is 1082 pg/ml (abnormally elevated).
Cortisol test: Standard level in the morning is at 5 to 23mcg/dL, and in the afternoon, it is from 3 to 16mcg/dL (Feher, 2017). Mr Smith's value is at155.5mcg/dL (very high).
Blood glucose test: Standard value is 100 to 125mg/dl (Feher, 2017). Smith’s figure is at 460mg/dL (very elevated).
Q. 5
In this patient scenario, CT and MRI were used. MRI is a test that applies both magnetic fields and pulses of radio wave energy to generate images of structures and organs present in the body (Lecouvet et al. 2017). Conversely, CTI is a scanning technique that utilizes a unique x-ray device to make exhaustive scans or images of internal areas of the body. The outcome of the MRI indicates metastasis of cancer of the prostate. Also, the abdominal computerized tomography findings indicate blockage of intestines because of the swelling of the nodes of adrenal glands.
Q. 6
The CT and MRI results and laboratory findings confirmed the presence of metastatic prostate cancer, HTN, and refractory hypokalemia caused by the ectopic generation of ACTH. Prostate adenocarcinoma is another word for prostate cancer (Lecouvet et al. 2017). The excessive quantities of circulating cortisol led to the progressive activation of the receptors of mineralocorticoids, leading to hypokalemia, HTN, and metabolic alkalosis. The importance of technology in the early diagnosis of patients is critical to ensure that the patient receives immediate medical attention. According to Lecouvet et al. (2017), through technologies such as the CT and MRI procedures, physicians are capable of providing a more accurate assessment of patients, which significantly improves the general effectiveness of medical care, reduces hospital readmissions, and therefore lower the cost of medication.
Reference(s)
Cifu, A. S., & Davis, A. M. (2017). Prevention, detection, evaluation, and management of high blood pressure in adults. Jama , 318 (21), 2132-2134.
Duan, L., Mukherjee, E. M., & Federman, D. G. (2020). The Physical Examination: A Survey of Patient Preferences and Expectations During Primary Care Visits: Physical Exam Preferences and Expectations. Postgraduate Medicine , (just-accepted).
Feher, J. J. (2017). Quantitative human physiology: an introduction . Academic Press.
Lecouvet, F. E., Oprea-Lager, D. E., Liu, Y., Ost, P., Bidaut, L., Collette, L., ... & Kramer, G. (2018). Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group. The Lancet Oncology , 19 (10), e534-e545.
