Question

You have two very ill patients this week, and each of them presents a very complicated case. First, you have a patient with an ongoing problem that has resisted diagnosis. He was enroute to an evaluation with a neurologist, but on the way to the hospital suddenly fell into a coma (a state of involuntary unconsciousness due to illness or injury) and had to be brought in to your medical facility by ambulance.

You will use at least 10 medical terms to describe this patient, and to refer to the original underlying problem the patient had in the first place. Use the nervous system medical word elements chart and the medical, surgical, and diagnostic terms chart on from your textbook to get you started on the medical terms you will need. You can include specific drugs used in neurological disease as you list at least 3 tests and procedures used.

Your second patient this week is also quite ill and is presenting a number of problems. This patient is diabetic, and also has another Endocrine System disorder (of your choice). Consult the endocrine medical word elements chart as you develop medical terms—include at least 10 that would be appropriate in this case. You should consult  medical, surgical, and diagnostic procedures in your textbook as you select at least 3 tests and procedures for this patient. .

Answer 1

Coma

means it is a state of unresponsiveness,patient cannot be aroused by stimuli even with vigorous stimulation.

1)Clouding of consciousness -mild form of altered mental status. Patient has reduced weakfulness or awareness.

2)confusion state -disorientation and difficulty to follow the comments.

3)obtundation-slow response to the stimulation and tend to sleep more than normal.

4)stupor-vigorous and repeated stimuli will arouse the individual and when left disturbed the patient will immediately lapse back to the unresponsive state.

5)delirious-disoriented,restless,marked attention deficit .

6)somnolent-sleepy,excessive drowsiness.

Drug of choice for neurological disorder -

Barbiturates -pentobarbital, thiopental

Benzodiazepines -Midazolam

Manitol and steroids for raised ICT

Investigation-

Glasgow coma scale -15 point scale used to detect the motor response(6) ,verbal response(5) eye response (4).score ranges from 3(deep coma or death) to 15(fully awake).

Categorize the patient in to severe (3-8) moderate(9-12),mild (13-15).

CT scan -used to diagnose coma(any tumour, haemorrhage, stroke)

MRI-to find out  the structural or functional problem.

Blood test -CBC (complete blood count)

LFT (liver function test)

ABGs (arterial blood gas analysis)

Amylase, calcium, lactate level.

RFT(renal function test) , CRP(C - reactive protein) ESR(erythrocyte sedimentation rate,TFT(thyroid function test) ,CSF(cerebro spinal fluid).

Diabetes mellites

A group of disease that result too much of sugar in blood .

1)gigantism-excessive growth due to hormonal imbalance

2)acromegaly-disorder of adult in which pituitary gland produce too much of hormone.

3)diabetes insipidus-It is caused by insufficient production of antidiuretic hormone.

4)hypopitutarism-decreased secretion of pituitary hormone.

4)Hyperpitutarism-Increased secretion of pituitary hormone.

5)cretinism- severely stunted physical and mental growth.

6)graves disease -It is a autoimmune disease, overactive thyroid gland. Excessive amount of thyroid hormone.

7)goitre-enlargement of thyroid gland.

Investigations

Blood test

Fasting blood sugar

Postprandial blood sugar

HbA1c

Lipid profile

Urine analysis-glycosuria, ketone  bodies.

Genetic testing -to find out the gene abnormalities.

Hormone testing -to find out the hormone level.

Management -diabetes mellites

oral hypoglycemic agents -metformin,glibenckamide.

Insulin therapy.

Management- endocrine disorder

Hormonal therapy

Medication.