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Chad, a 14 y/o male presents to the ER with complains of wheezing, dyspnea, and fatigue. He is not a smoker and is in generally good shape. He is speaking in short phrases due to breathlessness. His BP is 140/80 mmHg, HR at 115 bpm, RR of 25 bpm and an O2 sat of 92% on room air. After performing a spirometry test, his FEV1 results were low. However, after receiving an albuterol tx, his FEV1 improved by 25%.

Identify the medical terms and abbreviations that you are not familiar with.  What do his signs and symptoms indicate provide a D-Dx and explain why you believe these diagnoses may be relevant.  Explain what the FEV1 is and how does it provide essential information which helps us come to a diagnosis?  What are the major concerns regarding Chad's vital statistics?

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Bob is a 68 y/o male who presents to the ER late one evening complains of increasing SOB, dizziness, and the sensations of his "heart racing". On admission, his HR is 160 pps, BP 100/50 mmHg, RR 26 bpm, and O2 sat 88% on room air.  An ECG shows rhythm with no visible P waves and irregular QRS complex.

What are the concerns with this patient?  What do his signs and symptoms tell us?  Provide a D-Dx for this patient and indicate what the ECG is telling us regarding his heart?  If untreated what could happen to Bob?

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Betty is a 70y/o female who presents to the ER with complains of blurry vision. Although the deterioration of her eyesight has been progressing over the last several years, she became nervous that it means she was having a stroke. She states that her R eye is worse than her L and that objects "keep getting fuzzier" and worsened drastically over the past few weeks. She reports that her L eye is susceptible to glare and she sees "halos around lights". Pt has h/o TYPE 2 DM but no health issues. VS and BW were all WNL and no other signs of stroke were present.

What are some signs and symptoms of a stroke?  Why is this not considered a stroke?  How does diabetes mellitus cause vision issues? What are some of the other signs and symptoms associated with diabetes mellitus TYPE II?  If untreated what could happen to Betty and her vision?  What is Betty's prognosis?

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Jarvis is a 69 y/o male who presents to the ER complains of SOB. He states that he has a "dry, persistent, hacking cough, and a tight feeling in my chest." He is a retired construction contractor of 45 years whose main responsibility was installing insulation materials in office buildings. He began experiencing symptoms 6 mos ago. His initial CXR was (+) for "Shaggy Heart Border Sign."

Identify all medical terms and abbreviations.  Research "Shaggy Heart Border Sign" and identify what it is, what causes this condition, and what is the prognosis for those who get this condition.  Is there a treatment?

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Gladys is an 84 y/o female who presents to the ER with difficulty catching her breath. She states that she has gradually gotten worse and did not sleep the prior night due to fits of coughing, chills, and sharp chest p! She notes that she has been coughing up "thick, green" sputum. Her oral temperature was recorded at 103.6F and with an O2 sat of 86% on room air. Her lab reports show elevated neutrophils and WBC counts.

How does not having sleep affect a patient well-being?  What does the color and thickness of the mucus she is expelling tell us?  What types of diagnostic tests could be ordered to get a better understanding of her lung function?  What are her vital signs and lab results telling us?  Write your D-Dx and write a justification for your answers.