Case Study #1

25-year old Caucasian female 5’6” 110 pounds

Allergic to wheat

No medications currently taken

CC:  Glossitis and diarrhea

Patient noticed over the past week her tongue has become sore and inflamed.   She feels the pain is constant, aggravated by eating and alleviated by “not letting anything touch it.”  Patient states tongue feels “tender.”  She has no idea what is causing it.  No other treatments have been attempted.  Severity/significance is a 9 out of 10.  She also states she has had diarrhea “worse than usual for the past 6 months.”  When asked if she has an chronic conditions, she states she has Celiac Disease but has a “tendency not to avoid pastries – her favorite!” Currently, her diarrhea is worse after she eats going up to 6 times per day.  She does notice the frequency increases when she eats any bread product and it is stops when she stops eating bread products.  On occasion, she takes over the counter diarrhea medication.  The severity is 5 out of 10.  Blood work shows red blood cells are larger than normal (macrocytic).

Case Study #2

70-year old Black male 5’10” 200 pounds.

No Known Drug Allergies

Currently taking Lisinopril and Crestor

CC:  Dysphagia

Patient has noticed he has had difficulty swallowing food over the past 8 months.  He has noticed that in the beginning it only occurred with solid food but now it has progressed to include really any type of food.  Nothing appears to alleviate the condition.  He is only reminded of it “when he starts to eat.”  He has tried no other treatments.  Severity is 8 out of 10.  When asked if he has noticed anything else, he mentioned he has lost 10 pounds without trying in the last month and feels he has lost his strength.  Also, he notices when he actually “decides to eat” he does not eat much and feels full quickly.  CT scan shows epigastric mass.

Case Study #3

57-year old female

5’5” 300 pounds

No Known Drug Allergies

Current medications – none

CC:  Sudden one-sided facial paralysis

Patient states that her family noticed during Thanksgiving dinner that one side of her face became “frozen.”  Patient became extremely upset and wanted to be taken to the emergency room.  Family took her to the emergency room and the following exams were done:

CT – negative for infarct but to be sure MRI was done and was also negative for infarct, mass lesion or hemorrhage.  Facial paralysis went away within the hour.  However, patient was kept in the hospital for observation.

Clinical Science Midterm & Final Instructions and Rubric

1. You must complete all three case studies. In order for your work to be considered complete and eligible for full points, you will need to follow all of these instructions.

2. From the conditions that we have covered this term, choose
one working diagnosis
and
three other differential diagnoses
, for a
total of four diagnoses
, that you will discuss for each case. Clearly state what you think the best diagnosis is for each. Using narrative format (i.e., written in paragraph form with complete sentences), discuss the following:

· Which risk factors, signs, symptoms, labs, etc., led you to choose each diagnosis?

· Drawing on the risk factors, signs, symptoms, labs, etc., explain why the working diagnosis was ruled in and why the differentials were ruled out.

· As a general rule of thumb, each case should be about 2 pages long; it is possible for them to be shorter or longer depending on individual style and each case’s details.

3. Cite your work in APA format using appropriate sources (DO NOT use course notes). The following items are specifically graded related to APA formatting:

a) Each reference, whether direct or paraphrased, is correctly cited within the document

b) Each reference is listed in APA format in a reference list.

You can find details on APA in their publication manual:

American Psychological Association. (2010). Publication Manual of the American Psychological Association (6th Ed.). ISBN-13: 978-1433805615. ISBN-10: 1433950618.

There are also APA formatting & citation handouts available in the PCOM library and on the PCOM library’s website.

4. Format your document using the following APA guidelines:

· double-spaced

· 1-inch margins

· 12-point font, preferably Times New Roman

5. Proofread for grammatical errors and typos

6. These assignments are to be completed on an individual basis; the Pacific College Honor Code is expected to be followed at all times.

Submit your work online via the course page. It must be in a , x or format in order to submit. Documents must be submitted prior to the deadline. Please do not forget to put your name on your paper!

Grading rubric that will be applied for this assignment; total possible is 300 points:

Yes
10 pts/case;

30 pts total

Most or all were missing/incorrect
0 pts

Yes
30 pts for entire assignment