Patient Name: Fiona Miller
Date of Birth: 4/13/1994
Clinical Notes: Patient reports to the clinic with increasing dysmenorrhea. She describes the pain as cyclical, increasing in intensity during menstruation. The pain started as mild cramps several years ago, but has progressively become more severe and is now debilitating. The patient denies any abnormal vaginal discharge.
Current vital signs: BP 110/82, HR 68 bpm, Temperature 98.4°F
Her gynecologist completes a pelvic exam and notes no structural abnormalities of the vagina or cervix. The gynecologist suspects endometriosis or polycystic ovarian syndrome and recommends imaging studies for diagnosis and treatment.
Question #1: Why would the physician order imaging tests instead of lab tests?
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Question #2: If Ms. Miller has polycystic ovarian syndrome, what other symptoms might you expect her to exhibit?
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Question #3: Ms. Miller’s MRI report shows lesions surrounding the ureters, round ligaments, and bladder. Which of the physician’s diagnoses is correct and why?
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Question #4: Why might hormonal birth control be a good treatment option for Ms. Miller?
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Question #5: Should Ms. Miller be concerned about her chances of becoming pregnant in the future? Why or why not?
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Patient Name: Aboubacar Heinrich
Date of Birth: 2/11/1952
Clinical Notes: Male patient reports difficulty urinating. His symptoms started two weeks ago and were sporadic at first. He is now urinating more frequently, especially at night, and feels a sense of incomplete bladder emptying. He reports that he has a weak, interrupted stream of urine.
Current vital signs: BP 122/78, HR 82 bpm, Temperature 98.2°F
The physician suspects prostate issues and suggests a digital rectal exam and prostate-specific antigen test.
Question #1: If the issue is related to a structural abnormality of the prostate, which other symptoms (not mentioned here) may he experience?
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Question #2: What is a prostate-specific antigen test and why was it ordered in this case?
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Question #3: Mr. Heinrich’s digital rectal exam revealed abnormal bumps. Which other diagnostic procedures may be recommended as a follow-up?
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Question #4: It is determined that Mr. Heinrich has benign prostatic hyperplasia and a procedure called TURP is recommended. Explain what TURP stands for and how the procedure is completed.
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Question #5: If Mr. Heinrich does not follow through with treatment, what types of complications may occur and why?
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Patient Name: Deborah Spitzner
Date of Birth: 12/2/1999
Clinical Notes: Female patient reports vaginal pain that increases with sexual intercourse and abnormal vaginal discharge. She has mild, burning pain during urination. Her symptoms have been present and progressively worsening for three weeks.
Current vital signs: BP 126/78, HR 66 bpm, Temperature 100.6°F
The physician refers her to a gynecologist for a pelvic exam and orders a complete blood count, urinalysis, and STD screening panel. Lab tests confirm a diagnosis of chlamydia.
Question #1: What is the etiology of a chlamydial infection?
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Question #2: How might the symptoms in this case study be different if the patient was male?
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Question #3: Is chlamydia curable? What type of treatment is usually recommended?
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Question #4: What type of complications may occur as a result of chlamydia?
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Question #5: What preventative measures should Ms. Spitzner take to avoid recurrent infections and to avoid transmitting chlamydia to her partners?
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