Part 1 is asking you to find the most likely disease that fits these symptoms – not the most obscure disease to fit these symptoms. There are many diseases that fit but select one that is most likely i.e. fits the symptoms but also is common. Marks in this assignment are not attained for regurgitating facts – you must use the facts (aetiology and pathophysiology) to justify your proposed disease – that is, how well does the proposed aetiology and pathophysiology fit the symptom profile, how realistic is it, why do you think that this is the most likely disease? It might be useful to look at epidemiology and the risk factors that increase the chances of one disease being more likely than another Read the rubric – half the marks are for analysis and the rest split evenly between logical construction and use of evidence. This assignment is heavily weighted towards how you use your facts and how you structure your argument – there are no marks for piling facts up randomly. The marker do not have a list of diseases that you must satisfy to get marks. If you justify your selected physiology with a rational argument as to its likelihood you will have marks accorded. The first sentence in part 2 is a statement. You do not need to provide a rationale at this stage. In the rest of part 2 you will need to provide examples of diagnostic tests and/or further information from Mr Jackson that the collaborative care team might employ to differentiate between the two diseases that you have selected. It might be appropriate to compare and contrast the two pathophysiologies at this point. How many references do you need? If you use three or less, then you are in danger of having a very restricted information base to make an effective argument
HPB Assignment Patient Case Study Mr Bob Jackson is a 55 year old man admitted to ED with a presenting complaint of diarrhoea, nausea and malaise. His Subjective and Objective examinations are as follows: History of presenting complaint: 1 week history of increasing Left Lower Quadrant (LLQ) abdominal pain and diarrhoea Medical History: • Obesity • Osteoarthritis Right knee • Hypertension • Seasonal rhinitis • Depression • AF Surgical History: • Appendicectomy as a child • Knee arthroscopy 2005 Allergies • NKA Medications • Celebrex • Ramipril • Metoprolol Review of Systems CNS • Currently not on antidepressants, describes normal mood in last year • No dizziness, headache, vision change noted, except some headache during last few days Resp • Recurrent bronchitis and colds over last year • CXR NAD 12 months ago • Recent haemoptysis and persistent cough with mild pleuritic pain over 1/12 CVS • Regular antihypertensives (Ramipril) • No central chest pain/ palpitations/dizziness reported GIT • 3/12 Hx of occasional loose stools and frank blood in bowl. • States that over the years that he has often had runs of watery diarrhoea that he treats with ‘gastro-stop’ • States a history of ‘piles’ UGS • No retention/hesitancy/pain MKS • Nocturnal bone pain in hips and back noted last 2/12 – treated with OTC Ibuprofen • Hx of knee and lumbar pain Social History • Sheep farmer at Patersons Plains, a rural community 100 km Northwest of Melbourne. Married with 2 adult children. Lifestyle • Currently smokes – pack a day for the last 35 years • Alcohol: 6 stubbies of heavy beer a week • Denies illicit drug use On examination: Vital signs: T-37, HR -96 Sinus Rhythm, RR 20, BP 165/110, SpO2 98% on RA CNS • Alert and orientated Resp • Chest clear on auscultation CVS • Warm and well perfused, cap refill < 3 sec, slight pallor GIT • Pain Left lower Quadrant • 6/10 at rest ↑8/10 on movement • Mildly obese • abdo soft and tender in LLQ • Lower abdominal distension noted UGS • Urinalysis shows SG 1.05, otherwise NAD MKS • NAD Assignment question Answer the following questions in regards to Mr Jackson’s presentation. 1. Hypothesise the most likely chronic disease process that fits Mr Jackson’s symptoms and history. Your hypothesis must be justified by aetiology and pathophysiology relevant to Mr Jackson’s presentation. 2. Name one other chronic disease that explains Mr Jackson’s symptoms. Justify what further data, such as diagnostic tests and/or further history, which would enable a clinician to discriminate between these two diseases. Guidelines Part 1 is asking you to find the most likely disease that fits these symptoms – not the most obscure disease to fit these symptoms. There are many diseases that fit but select one that is most likely i.e. fits the symptoms but also is common. Marks in this assignment are not attained for regurgitating facts – you must use the facts (aetiology and pathophysiology) to justify your proposed disease – that is, how well does the proposed aetiology and pathophysiology fit the symptom profile, how realistic is it, why do you think that this is the most likely disease? It might be useful to look at epidemiology and the risk factors that increase the chances of one disease being more likely than another Read the rubric – half the marks are for analysis and the rest split evenly between logical construction and use of evidence. This assignment is heavily weighted towards how you use your facts and how you structure your argument – there are no marks for piling facts up randomly. The marker do not have a list of diseases that you must satisfy to get marks. If you justify your selected physiology with a rational argument as to its likelihood you will have marks accorded. The first sentence in part 2 is a statement. You do not need to provide a rationale at this stage. In the rest of part 2 you will need to provide examples of diagnostic tests and/or further information from Mr Jackson that the collaborative care team might employ to differentiate between the two diseases that you have selected. It might be appropriate to compare and contrast the two pathophysiologies at this point. How many references do you need? If you use three or less, then you are in danger of having a very restricted information base to make an effective argument. Assignment Instructions Format: • The assignment will be read on-screen by markers so use a web-friendly font and spacing: Use–Georgia, Arial or Verdana size 12 font with 1.15-1.5 spacing. • Dot point format not acceptable • References used should be acknowledged in-text using APA version 6 formatting • Provide a full list of end-text references using APA Version 6 formatting. Construction: • No introduction or conclusion required • Use headings for Part 1 and part 2 to partition the assignment but do not use the assignment questions in the heading. • The discussion must be presented using academic assignment format with attention to good paragraph structure, grammar, Australian spelling and formal academic expression.