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    Health and Homeostasis 1 Assessment Task 1: Clinical Case Scenario Analysis

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    maureen
    This document describes three clinical case scenarios: 1) A 53-year-old female presented with a nine-month history of left shoulder pain from multiple rotator cuff tears, as confirmed by MRI. 2) A 57-year-old man experienced sudden headache, weakness, and was found to have an intracerebral hemorrhage on CT due to noncompliance with medication for hypertension. 3) A 55-year-old man presented with chest pain and was found to have critical aortic stenosis based on echocardiography findings.

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    Health and Homeostasis 1 Assessment Task 1: Clinical Case Scenario Analysis

    Uploaded by

    maureen
    37 views4 pages
    This document describes three clinical case scenarios: 1) A 53-year-old female presented with a nine-month history of left shoulder pain from multiple rotator cuff tears, as confirmed by MRI. 2) A 57-year-old man experienced sudden headache, weakness, and was found to have an intracerebral hemorrhage on CT due to noncompliance with medication for hypertension. 3) A 55-year-old man presented with chest pain and was found to have critical aortic stenosis based on echocardiography findings.

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    AT1.clinical.case.scenarios.SET.1.2020

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    This document describes three clinical case scenarios: 1) A 53-year-old female presented with a nine-month history of left shoulder pain from multiple rotator cuff tears, as confirmed by MRI. 2) A 57-year-old man experienced sudden headache, weakness, and was found to have an intracerebral hemorrhage on CT due to noncompliance with medication for hypertension. 3) A 55-year-old man presented with chest pain and was found to have critical aortic stenosis based on echocardiography findings.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views4 pages

    Health and Homeostasis 1 Assessment Task 1: Clinical Case Scenario Analysis

    Uploaded by

    maureen
    This document describes three clinical case scenarios: 1) A 53-year-old female presented with a nine-month history of left shoulder pain from multiple rotator cuff tears, as confirmed by MRI. 2) A 57-year-old man experienced sudden headache, weakness, and was found to have an intracerebral hemorrhage on CT due to noncompliance with medication for hypertension. 3) A 55-year-old man presented with chest pain and was found to have critical aortic stenosis based on echocardiography findings.

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    © All Rights Reserved
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    Download as pdf or txt
    of 4

    HEALTH AND HOMEOSTASIS 1

    ASSESSMENT TASK 1: CLINICAL CASE SCENARIO ANALYSIS

    SET 1

    ROTATOR CUFF TEAR

    CEREBRAL BLEED

    AORTIC STENOSIS
    HEALTH AND HOMEOSTASIS 1
    ASSESSMENT TASK 1: CLINICAL CASE SCENARIO ANALYSIS

    SET 1A

    Rotator Cuff Tear

    History: A 53-year-old female presented with a nine-month history of sharp and deep
    pain on the anterolateral aspect of her left shoulder. There was no history of trauma,
    and the onset was gradual. The pain was aggravated by abduction and flexion of the
    left shoulder. It was aggravated by lying on the shoulder. She was awakened at night
    when she rolled onto the affected arm. The pain was relieved by medications and
    keeping shoulder adducted. Despite physiotherapy and pain relievers, the pain and
    shoulder movement restriction persisted. She has difficulty dressing up, washing
    herself, reaching, and lifting with the left arm. Her past medical and family history was
    unremarkable

    Physical examination: Upper extremity deep tendon reflexes and light touch
    sensation were normal bilaterally. Flexion and rotation of the cervical spine were full
    and pain free. Painful arc sign and drop arm test were positive on the left. There was
    weakness in internal and external rotation, abduction, and flexion of the left
    glenohumeral joint. There was tenderness over the deltoid tuberosity, left deltoid,
    supraspinatus, infraspinatus, and teres muscles.

    Laboratory studies: Radiographs of the left shoulder revealed reduced glenohumeral


    joint space. MRI revealed multiple rotator cuff tears in the left shoulder.
    HEALTH AND HOMEOSTASIS 1
    ASSESSMENT TASK 1: CLINICAL CASE SCENARIO ANALYSIS

    SET 1B

    Cerebral Bleed

    History: A previously healthy 57-year-old retired police officer is sitting with his wife
    having lunch when he suddenly develops a severe headache, dizziness, giddiness,
    nausea, and left arm and leg weakness. The nearest EMS ambulance is dispatched
    for a possible stroke. He has been non-compliant with his medication for hypertension
    and lipidaemia. He has also been a smoker for most of his adult life.

    Physical examination: The man sits on a chair with his head down on the kitchen
    table and his left arm hanging down to his side. Upon assessment, there is significantly
    reduced grip strength of the left hand. He answers questions but appears sleepy. The
    initial set of vital signs reveal a blood pressure of 220/120 mmHg, heart rate of 110
    bpm, and respiratory rate of 20 breaths per minute.

    Laboratory studies: His serum glucose by finger stick is 9 mmol/L and the cardiac
    monitor shows a normal sinus rhythm. The EMS personnel suspects a cerebral bleed
    and notifies the destination hospital enroute. CT imaging confirms the presence of an
    intracerebral haemorrhage involving the basal ganglia.
    HEALTH AND HOMEOSTASIS 1
    ASSESSMENT TASK 1: CLINICAL CASE SCENARIO ANALYSIS

    SET 1C

    Aortic Stenosis

    History: A 55-year-old male presented to the ED with new-onset, retrosternal,


    nonradiating chest pain, partially relieved by sublingual nitroglycerine. He was mildly
    breathless and in distress. Prior to this consult, he had been experiencing fatigue,
    palpitations, and dizziness. One time, he almost lost consciousness. He also
    complained difficulty of breathing while lying supine.

    Physical examination: His blood pressure was 120/70, heart rate 110 beats/min, and
    respiratory rate 20/min. He appeared pale. There is a loud crescendo-decrescendo
    late-peaking murmur (swooshing sound heard in aortic area that radiated to the
    carotids. His carotid upstrokes were reduced in volume and delayed in upstroke. His
    peripheral pulses were weak.

    Laboratory studies: Troponin was negative. A 12-lead EKG revealed sinus rhythm
    at 75 beats/min with left ventricle hypertrophy and repolarization abnormality but no
    acute ST-T changes suggestive of myocardial injury. Echocardiography revealed an
    ejection fraction of 55–60%, suspected bicuspid aortic valve with critical aortic stenosis
    and peak velocity of 5.8 m/sec, a peak transvalvular gradient of 135 mm of Hg (mean
    gradient of 77 mm of Hg), and an indexed valve area of 0.52 cm2, all of which were
    suggestive of critical aortic stenosis.

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