You will use available resources to research a patient’s case, then use that information to answer the stated questions in detail.   PBL allows you to learn how the normal physiology we discuss in class is related to disease and pathophysiology.  In other words: in order to be a great health care provider, you need to fundamentally understand what happens to the body when things go wrong.  And to understand that, you have to fundamentally understand what happens to the body when things are normal!

What are the resources?  First, use the free internet to research the signs, symptoms, and test results. spend your first week doing this. You’ll start to see the same diseases showing up. But the end of week 1 has a list of possible diseases.  Spend week 2 researching these diseases by, again, using the free internet. By the middle of week 2, you should have narrowed your list down to one disease that makes sense.  Now, use the library databases (peer reviewed scholarly articles) to research that one disease and the answers to the questions. You need to find sources in these databases that you can cite.  You can also visit the Library and ask the Librarians for assistance in researching these databases.   Spend the beginning of week 3 writing your responses to the stated questions. No need for a complete essay, but answer each question separately.  You do need to use complete arguments with substantiating information and cite each question with an appropriate resource. Lastly, utilize the Writing Center and feel free to show me a rough draft. While I cannot tell you if you are right or wrong, I will review the draft and let you know if you have enough supporting information.   peer-reviewed

A 17-year-old female presents to her local hospital’s E.R. at 7:45 in the morning on a school day. She appears apprehensive and uncomfortable. She winces and splints her chest to the right side when she coughs. She is examined by the attending resident.

Patient History:
The patient appears apprehensive upon initial examination by the physician. The patient’s first question of the attending physician is whether or not anything that she says, or that the physician finds out must be reported to her parents.

The patient is 17-years-old, and has been a smoker since the age of 12. Recently she has had a persistent cough that has not responded to O.T.C. cold medicine. This morning, as the student was getting ready for school she noticed that she was coughing up blood. Therefore, rather than driving to her high school she decided to come to the E.R. for an examination. She is quite concerned about the blood in her sputum and the possibility of lung cancer. In addition, she is quite concerned that her parents will find out that she is a smoker.

Physical Examination:

· Blood pressure is 125/75, and her pulse is 125.

· Cardiac sounds are normal at all ausculation points.

· Temperature is 104.3 F.

· Respiratory rate is 23/minute.

Height is 5’10”, weight is 117 lbs.

The attending reassures the patient that preliminary tests will be run to potentially rule out the chances of cancer. The following preliminary tests are conducted, with the results noted:

· HEENT examination: normal

· Lungs: Inspection, palpation, percussion and ausculation of the lungs are normal expect for the following findings on the right lung:

· With the patient seated upright, ausculation reveals the following findings at the 2nd and 3rd intercostal spaces along the right midaxillary line: diminished vesicular breath sounds; enhanced bronchial breath sounds; increased intensity and clarity of spoken voice and whispered sounds; egophony; fine rales near the end of deep inspiration.

· Percussion dullness is found at the same sites.

· Cardiovascular examination: normal except for the tachycardia

· Abdomen: normal

· Genitourinary examination: normal

· Musculoskeletal examination: normal

· Neurological examination: normal

· Sputum examination: Mucous is yellowish and very thick, with streaks of bright-red blood.

· Throat swab: normal

PA and lateral chest films are ordered by the attending physician.