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Assignment Questions

Essay on College Entrance

1. The case is to be one that is thought-provoking, rather than straightforward in the evaluation and diagnosis. It is intended as a learning experience for the class.
2. The case presentation is to address: presenting symptoms; pertinent history; findings on assessment; results of pertinent diagnostic tests and procedures; rationale for narrowing differential diagnoses to that chosen; treatment plan including plans for teaching, follow-up and/or referral and primary/secondary/tertiary prevention. Grade is based on the following: Subjective 1. Initial presentation: initials, age, gender, ethnic background, general appearance 2. Historical information: Chief complaint, History of Present Illness, Personal Medical History, Family History, Social History, Meds, Allergies

3. Pertinent positive and negative Review of Systems and physical exam findings

4. Diagnostic tests: provide pertinent positives and negatives


5. Lead discussion regarding differential diagnoses (at least 5) ? how final one selected and others eliminated.

6. Review briefly the pathophysiology of diagnosis

7. Discuss management options. Integrate research-based interventions & standards of care.

8. Identify key components to the teaching plan and expected outcomes. Include in plan all three levels of preventive services.

9. Describe special considerations pertinent to the case e.g. culture, gender, age etc., and describe how care would be different within other groups.

PATIENT I PICKED: Patient is a 18 year old Filipino-American who presents complaining of diarrhea X 3-4 months (although states on and off for 1 year). Complains of blood (bright red) when wiping X 1 month. No nausea, No vomiting. High school senior, states he recently lost pounds for wrestling season States stress related to grades and college entrance. States similar episode 1 year ago, was seen by pediatrician who recommended surgical consult for rectal tag removal and started him on iron pills because of “low hemoglobin/hematocrit” (blood tests from previous MD not available). Blood tests drawn on office visit CBC: WBC-7.82 RBC-4.91 HGB-11.7 (L) HCT-36.8 (L) MCV-74.9 (L) MCH-23.8 (L) MCHC-31.8 (L) PLT-474 (H) MPV-9.1 (L) CMP-NORMAL TSH-1.344 (NORMAL). Sent to gastroenterologist for colonoscopy (reports/pathology attached)- INFORMATION CAN BE ADDED/DELETED FROM CASE TO FIT REQUIREMENTS OF PRESENTATION

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