Patient case study
The case study involves a seventy years old female patient who has controlled hypertension since 1985 with no complains, she smokes and takes clonidine, hctz and estrogen. The patient showed fatigue for one month which is associated with withdrawal from estrogen which can increase risk of cancer. The patient shows the following physical appearance; cough with minimal sputum, a low grade fever, five-pound weight loss. Additionally, after thirty days the patient showed ten-pound loss, cramp abdominal pain, max 101 which worsen at night, and appeared ill on examination, the laboratory test found out that; wbc and differential count normal, blood culture was negative, normal urine, alk phos 228 sed rate 101, colonoscopy was negative, and abdominal and chest negative. The patient was observed weeks later and appeared more ill and fungi shows a subtle abnormality and faint red spot in retina. The patient temporal artery biopsy shows inflammation which at consist giant cells.
The patient was put on high dose of oral prednisone and after three days her health improved. One week after the initial treatment she become primarily ill with cardiac symptoms, dyspnea and fatigue and the patient did not have acute MI enzymes, showed decrease perfusion and septal defects. Four months after the patient improves on prednisone ,isosorbide, hydralazine, metoprolol, the patient had rashes development and osteopenia as a result of prednisome treatment. The patient blood pressure and glucose became more complex to control as a result the prednisone dose was increased which led to recurrent fever, headache, fatigue, and increase in sed rate.
The patient health slowly improved after eighteen months and went back to normal and was put on prednisone for one year. The prednisone dose was adjusted to help introduce bisphosphonate to prevent osteoporosis. The patient was asymptomatic when on prednisone for twenty-four months following the initial treatment. The sed rate and CRP of the patient went back to normal after twenty-four months and blood pressure as well as diabetes was easy to control without us of prednisone. The death of patent husband resulted to depression which affected her blood pressure.
The symptoms began to reoccur after two years of discontinuing prednisone. The symptoms include fatigue and loss of appetite and her sedimentation rate increase as well as CRP. The patient medical history was complex and another biopsy was performed and was positive of giant cell arteritis (GCA) and was controlled within three weeks by resuming use of prednisone. The GCA illness was associated with coronary artery disease which increase the patient health risk.
The physicians should note that GCA is systematic illness with different manifestation since it emerges subtly in patent with typically other problems. Tsianakas et al (2009) state that The GCA is common illness with elderly with myriad manifestation, also GCA symptoms are recurrent even with effective treatment and use of prednisone as treatment to elderly may pose great risk. The use of prednisone as treatment drug for GCA should be recommended for younger patients since cause osteopenia which may be difficult for elderly patient to handle. The prednisone dose should be adjusted to help the patient body adjust to new medication
Word parts associated with bodily systems and medical terms
frequent iatrogenic; – these are diseases that requires powerful drugs which has undesirable side effects which are either predictable or not predictable and their dose is dependable on the patient health history. The administration of drug treatment should be monitored closely to avoid great side effects
Biopsy, – this is a procedure to remove a piece of tissue or cell sample from a body for analyses purposes it is mainly used to detect cancer and in bone marrow
chronic health problems; – this are illness that affect patient health for a long time and does not have cure for example arthritis, cancer, diabetes and epilepsy
sputum the is mucous substance secreted by cells in the lower airways different from saliva which comes out when someone cough it contains dead cells, foreign debris, bacteria and white blood cells that protect the lungs from infection
Crimpy abdominal pain; – this is muscle cramps perceived anywhere in the abdominal area with different causes for example food poisoning, gas, infection and lactose intolerance
Colonoscopy it is an examination used to detect changes and abnormalities in the large intestine and rectum. The procedure involves the use of long flexible tube (colonoscopy) inserted into the rectum. The tiny video camera is at the tip of the tube which allows the doctor to view the inside of the entire colon. Barker (1995) The process useful in removal of polyps or abnormal tissue also the samples can be used for laboratory analysis
multinucleated giant; – they are unique giant cell formed by the fusion of monocytes and macrophages found in human tissues. They may result to foreign body reaction resulting to material rejection. The giant cell affects the ectopic calcification of arteries leading to blood pressure.
cardiac symptoms; – this are symptoms related to heart disease which include; coronary artery disease, heart rhythm problems and heart defect. The heart disease involves the narrowed or blocked blood vessels which can result to heart attack, chest pain, or stroke. The most forms of heart disease can be prevented or treated by lifestyle choices
Osteopenia; – this is when the bone is weakened than normal and they break easily. The condition is common with the elderly and women since women has lower bone mass than men. Khosla et al (2007) state that medical treatment may trigger the condition for example too much treatment of thyroid may trigger the conditions. The condition can be treated by taking balanced diet and exercises which help in development of strong bones.
In conclusion the pathological condition of GCA is complex to the older patients since it may keep on reoccurring. The drug treatment of GCA results to side effect which may be threatening to patient health. The physician or clinical officer should be strategic when treating GCA patients and should be monitored to achieve effective treatment of GCA. The patient health record should be monitored to avoid reoccurrence of the GCA condition
References
Khosla, S., & Melton III, L. J. (2007). Osteopenia. New England Journal of Medicine, 356(22), 2293-2300.
Tsianakas, A., Ehrchen, J. M., Presser, D., Fischer, T., Kruse-Loesler, B., Luger, T. A., & Sunderkoetter, C. (2009). Scalp necrosis in giant cell arteritis: case report and review of the relevance of this cutaneous sign of large-vessel vasculitis. Journal of the American Academy of Dermatology, 61(4), 701-706.
Barker, D. J. (1995). Fetal origins of coronary heart disease. Bmj, 311(6998), 171-174.