Dialogue #1
Analysis, Symptom and Sickness Administration
MSN5600
Prof. L. Oliva
Case #1
• M.R. is a 28-year-old female patient in good well being that visits the clinic for the primary time. She not too long ago moved to Florida
from New York because of work relocation. She admits not visiting her PCP ceaselessly however requires medical clearance for her
new clerical place. She is sexually lively, unprotected, in a monogamous relationship. ROS and bodily examination are
unremarkable. What to do? She says she does not see her physician fairly often, however she wants medical clearance for her
new job within the workplace. She is sexually lively, has no safety, and is in a relationship with just one particular person. ROS and the bodily examination are each
unremarkable. Learn how to act?
case #1
• Is there a type to fill? sure or not. If sure, what are the necessities?
• Laboratory work-up:
ØRoutine: CBC w/ differential; CMP; U/A
ØTitters?
• Is a 12-Lead EKG required?
• Is a CXR vital?
• Would you do HCG?
• What about different suggestions for screening? Which sort of stage of care is this?
case #2
• A 58-year-old male patient with historical past of HTN and T2DM presents to the clinic for a common examine up. He denies present
symptomatology and his final examine up was 2 years in the past. Along with a thorough bodily examination. Which laboratory check would
count on to be ordered? (Choose all that apply)
qCBC, BMP, U/A
qCBC, CMP, U/A
qLipid profile
qCardiac enzymes
qHgbA1c
qTSH
qCXR
case #2
• The patient’s anti-HTN remedy consists of Lisinopril 10 mg PO each day and Amlodipine 5 mg PO each day. Are there any findings
bodily or laboratory anticipated from this drugs?
case #2
• You’d have a look at the degrees of Magnesium and Phosphorus for the alternative of Potassium if relevant. Which of the
following checks would come with these two electrolytes?
ØBMP
ØCMP
ØLiver profile
ØLipid profile
—>
Study Notes:
Case #1:
For the patient’s first visit, a comprehensive medical history and physical examination should be performed.
A form for medical clearance for the patient’s new job may need to be filled out, but it would depend on the specific requirements of the employer.
Laboratory work-up may include a complete blood count (CBC) with differential, comprehensive metabolic panel (CMP), and urine analysis (U/A).
A 12-lead EKG and chest x-ray (CXR) may not be necessary based on the patient’s unremarkable ROS and physical examination.
A human chorionic gonadotropin (HCG) test may be considered to screen for pregnancy, as the patient is sexually active and not using protection.
Additional screening recommendations may include a screening for sexually transmitted infections (STIs) and possibly a pap smear if the patient is due for one. This visit would likely be considered a preventative care visit.
Case #2:
Laboratory tests that may be ordered for a general check-up for a patient with a history of hypertension (HTN) and type 2 diabetes mellitus (T2DM) include a complete blood count (CBC), basic metabolic panel (BMP), urine analysis (U/A), lipid profile, HgbA1c, TSH, and CXR.
Lisinopril and Amlodipine, the patient’s anti-HTN medications, can have side effects such as hypotension, dizziness, and electrolyte imbalances.
To check for electrolyte imbalances, levels of magnesium and phosphorus can be measured, which would be included in a basic metabolic panel (BMP).
