Chief Complaint:
Clinical
Presentation
Severe pain in abdoman and
right leg throughout adolesence.
Frequently hospitalized for
pnemonia and other upper
respitory infection.
Weakness
(Patho)
Physiology Diagnose(s)
Sickle Cell diagnosed at birth due
to screenings. Initially the
screenings were only preformed
Defect in the gene encoding on patients in at rick AA
hemoglobin that causes. sickling communities, however the
of RBC, defect in in both treatment has now expanded to
maternal and paternal copy. include all babies born in the US.
 Epi/Ethics/Population
Treatment Health

Sickle Cell is overrepresented in the African

American community, since Sickle Cell Trait was
Pain therapy and symptom initially selected for in Africa as a way to resist
management. Ibeprofin malaria. Ethically Sickle Cell is a condition
recommended, with opioids who'se study has been underfunded relative to
used sparingly, as this is a lifelong conditions with high prevelance in the
condition. Caucasion community.
Resources Used Theme

https://www.sicklecelldisease.org/MCBG
Chief Complaint:
Clinical
Presentation
Cystic Fibrosis is now screened
for at birth, however, if you
immigrate to America you may
not have been screened. Hard
Coughign through the night, as
well as very thick mucus are both
symptoms of cystic Fibrosis.
A 23 year old woman comes into
the ER with shortness of beath,
nausea, and infrequent
vomitting. She statest that the
food she enjoys no longer tastes
good and that she has strange
cravings.
A 6 year old comes into Urgent
care with shortness of breath
after playing soccar at school and
being unable to stop wheezing
and having difficulty taking a full
breath in.
A patient comes in complaining
of a deep pain in his lungs that
started after a long plane trip
where he did not get up to drink
water or use the bathroom. The
pain is extreme and the patient
has never expereinced anything
this bad before.
(Patho)
Physiology
Cystic fibrosis, or CFTR is a
disease with five subcategories
that follows mendelian
inheritance patterns.
Pregnancy is a medical condition
where a patiet's child pushes up
agaisnt their diaphram,
preventing proper breathing and
focing them to breath more
rapidly.
Asthma is a constriction based
disease where a patient's lung
epithelium is narrowing and the
patient cannot take a deep
breath in. Without steroids or
gluccocorticoids administered
quickly, the patinet may die.
The patient has a deep vein
thrombosis that was thrown off
of his left or right leg during his
long flight. A DVT is a clot caused
by a blood clot occurring in the
veins of his leg due to pooling
blood.
Shor
Diagnose(s)
A diagnosis is typically made at
birth, but if you are in a rural
setting or in the developing
world, the sweat test is an
effective way to determine if a
patient has CF.
The patient is pregnant, and the
baby is acting like an O2 sink,
requiring extra O2 while also
providing a inpediment to the
mothers breathing.
The patient is suffering from an
asthma attack.
The patient was diagnosed with a
Deep Vein Thrombosis.
Fortunately the patient did not
have a patent Foramen Ovalle
and did not throw off an
embolism into his arteriole
supply.
 A paradoxical embolism is where
a patient has a embolus that
A patient is brought into the ER "switches sides" from the venous The patient is suffering from a
by a family friend after having circulating system, into the paradoxical embolism, and a CT
labored difficult breathing before arteriole circulating system. scan or an MRI would be needed
passing out. The patient has a These are the most dangerous to properly diagnose this disease.
history of hypertension of a type of embolism and can cause It's important to diagnose
family history of CAD. The family permenant brain damage and correctly because giving the
fears this is a heart attack. death if not rapidly treated. wrong medication could be fatal.
 Shortness of Breath
Treatment
The caughing and shortness of
breath can be treated with
DNAase that breaks up the
neutrophils' DNA that is released
when they necros. Chest
precausion and sometimes
exericse are also used to treat
caughing before DNAase is used.
Ivancaftor is a novel drug that
treats CF, however it doesn't
work for every type of CF.
The patient is unable to be
treated for this symptom as she
has decided to keep the child.
Her breathing will likely get
worse as goes further and further
along in her pregnancy.
A patient is treated for asthma by
giving them either a rescue
inhaler, or by giving them
glucocorticoid steroids to
suppress the body's response
that leads to an asthma attack.
The patient was diagnosed with a
DVT and was immediately given
an anticoagulent. The patient
was advised to wear compression
socks and raise his legs/walk
around when he travels.
Epi/Ethics/Population
Health
One in thirty caucasions are carriers for the CF
condition, and most do not know that they carry
the genes. Additionally, CF patients are now
living long enough to have children of their own,
menaing that the CF gene could theoretically
increase as a percentage of the population. CF is
a prohibively expensive disease to treat, and
many drugs designed for CF only work to
temporarily treat symptoms instead of treating
disease.
Millions of Women every year will decide to get
pregnant and give birth. The symptoms
associated with pregannacy are not signs that
"things are going wrong" but rather normal
conditions that are expect to occur alongside
pregnancy.
26 million Americans currently suffer from
Asthma. The most common causes are suffering
from Allergens or irritants entering the lung.
Currently, 1 in 13 americans have asmtha, or
about 8.3% of all Americans.
People with inhereted clotting disorders, people
who are on prolonged bed rest, or pregnant
women are all at increased risk for DVTs.
Additionally, women who are on birth control
pills or who are overweight/obese are also at an
increased risk for DVT.
A diagnosis for paradoxical
embolism is difficult to establish,
and required identifying a patent
foramen ovale, which can be
found in up to 35% of the healty
adult population. The patient is
again given a clot busting drug
and counceld on the same
lifestyle changes as before.
Up to 35% of all healthy adults are found to
have Patent Foramen Ovales upon autopsy.
Unfortuantely due to the mysterious nature of
strokes, with 45% not having a well defined
cause, I was unable to determine the number of
patients who are diagnosed with paradoxical
embolisms every year in the US.
 Resources Used Theme

https://www.mayoclinic.org/dise
ases-conditions/cystic-
fibrosis/symptoms-causes/syc-
20353700 MCBG

http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.StatisticsDetail&PageID=557
RESP unit

https://www.aafa.org/asthma-facts/RESP
https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653
unit

https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557
Cardio Unit https://medlineplus.
https://emedicine.medscape.com/article/460607-overview
Cardio Unit https://www.ncbi.nlm.nih.gov/books/NBK470196/
Chief Complaint:
Clinical
Presentation
a seven month old comes into
the office with a swollen belly
and is not alert. The child has
recently been weaned and has
been a fussy eater. The parents
have mostly given her amound
milk
A 19 year old patient presents
after noticing an insatable thirst
and general fatigue and
weakness. The BMI, weight, and
hight are all normal. The patient's
urine does not have glucose
present and has normal ketone
levels. The patient is also
suffering from worsoning vison.
(Patho)
Physiology
This is a classic case of Kwashikor.
The child is not alert, and the
disease is caused by adequate
caloric intake, but inadequate
protein intake.
His worsoning vision is the result
of bilateral heminopia (tunnel
vision) due to a pitutitary tumor
applying pressure to his optic
tract. Additionally blood tests
showed drastically elevate HCG,
suggesting the Tumor was
carrying a child
We
Diagnose(s)
The diagnosis is Kwashikor
disease.
A 2 cm anterior pitutiatry tumor
was identified after an MRI scan
was conducted. The patient also
was diagnosed with a buldging
optic disk due to to the excess
pressure the tumor was creating.
 Weight Loss/Gain
Treatment
Treatment would be a lengthy
discussion with the parents
about changing the diet of the
child. Explaining the dangers of
this disease, and the necessity
for protein in the child's diet.
The treatment is to remove the
tumor as carefully as possible so
as to not damage the patients
other sensory and or sense.
Epi/Ethics/Population
Health
This disease primarily occurs in developing
countries. However, this disease can effect
children whose parents are either neglectful, or
who don't understand proper pediactric
nutrition.
About 10k pitutitary tumors are diagnosed each
year in the united states. Within these 10,000
tumors, almost all of them are benign pitutiary
adenomas. Fortunately almost none are cancers
that spead to other body parts. It is estimated
that the number is actually higher and we are
just unable to diagnose them as is.
 Resources Used Theme

https://medlineplus.gov/ency/im
agepages/9563.htm MUSC

https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Pituitary-Gland-and-Pituitary-Tumors
Endo https://
Chief Complaint:
Clinical
Presentation
A 75 year old woman with a
history of type II diabetes on
netformin is admitted to the
hospital with fever, confusion,
and respiratory distress.
Tiny Tim is a crippled 9 year old
with asymmetric crippling and
intermittent spells of weakness.
(Patho)
Physiology Diagnose(s)
A lactic acidoses with partial
Her BP is 90/46, her HR is 120 respitory compensation caused
bpm. Her Temperature is 102.1, by metformin. Metformin is
and her RR is 32. She is lethargic known to cause a lactic acidosis.
and rapidly breathing She is additionally hyperkalemic.
A hyperchloremic metabolic
acidosis with a normal AG.
Because the Kidneys are unable
Na= 138 mEq/L K = 2.8 mEq/L Cl- to acidify the urine, a defect in
=113 mEq/L HCO3=14 mEq/L renal acidification is suspected. A
Atrial pH = 7.28 Urine pH =8 failure in Rental Tubular Acidsosis
(very high pH urine) is suspected as well.
 Fever

Epi/Ethics/Population
Treatment Health

The initial goal is to treat the

renal failure to promote
excretion of K+. Drugs that
reverse the underlying liver
failure would be ideal, however,
if that fails then a full liver
transplant would be needed.
Approx. 31,000 Americans die every year due to
liver failure. A lot of these deaths aren't caused
by medications, but rather by cirrhosis of the
liver.

Correction of metabolic acidosis

is done best when paired with a
alkali therapy such as sodium
bicarbonate or sodium citrate.
Correction of the metabolic
acidosis should fix the growth
issues tiny Tim is experiencing.
I was unable to determien the number of
americans that this diesease happens or or the
most likely populations. I apologize for this, the
information just isn't freely available.
 Resources Used Theme
https://www.hopkinsmedicine.or
g/healthlibrary/conditions/liver_
biliary_and_pancreatic_disorders
/liver_disease_statistics_85,p006
86https://www.mayoclinic.org/di
seases-conditions/acute-liver-
failure/diagnosis-treatment/drc-
20352868
https://www.ncbi.nlm.nih.gov/pu
bmed/14523675 RENAL

https://www.uptodate.com/contents/treatment-of-distal-type-1-and-proximal-type-2-renal-tubular-acidosishttps://www.hinda
RENAL
Chief Complaint: Ab

Clinical
Presentation
a 36 year old woman comes into
the clinic complaining of stomach
pains, loss of appetite, fatigue,
anorexia, frequent urination
followed by almost no urination.
She sufferend from hypertension
and we beginning to show signs
of pigmentation around her back
(Patho)
Physiology
Her patho physiology showed a
10 pound loss of weight without
effort. Fever, and a blood presure
of 95/65 when sitting. Her
dizziness prevented her from
working, however, her Thyroid
was normal sized.
Diagnose(s)
Her diagnoses was addisons
disease which was confirmed
with several labs that showed
drastically low Glucocorticoid
levels in her system.

The patient is found to have

A 30 year old woman comes into
the office complaining of sever
abdominal pain, fatigue, and
weight loss. She says that her
pain is always worse several
hosue after eating and that the
pain is worst after injesting a
ruben Sandwitch.
antibodies to gluten in her small
intestine. The antibodies are
attacking the lining of her
intesting and causing severe
damage to her intestine. It is
likely that her disease could
cause malabsorption,
contributing to her fatigue. Her diagnosis is Celiac Disease.
 Abdominal Pain
Treatment
Her treatment will invovled
gluccocorticoid replacement
therapy to make up for her
absent adrenal glands
(suprarenal.)
There is unfortuantely no cure for
Ciliac disease, however a strict
gluten free diet can help her to
manage her symptoms and
reduce the inflammation in her
intesting.
Epi/Ethics/Population
Health
Addisons disease is increidbly rare, with only 1
case per 60,000 adults. There are about 40-60
diagnoses cases per million Americans. The
exact cause of Addisons disease isn't entirely
known.
With 1% of America effected by Ciliac disease,
there are at least 3 million americans who are
currenlty suffering from Ciliac disease.
 Resources Used Theme
https://online.epocrates.com/dis
eases/5622/Addison-
disease/Common-Vignette
https://www.mayoclinic.org/dise
ases-conditions/addisons-
disease/symptoms-causes/syc-
20350293
https://rarediseases.org/rare-
diseases/addisons-disease/ ENDO/REPRO

https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220
GAS https://www.cureceliacdiseas
Chief Complaint:

Clinical (Patho)
Presentation Physiology Diagnose(s)

Gout, a disease caused by

Pain inbetween first and second
digit in left foot. Pain is often
made worse after heavy meat
filled meals.
buildup of Uric Acid in the body.
Can be caused by an
overabundance of Purines in the
blood stream, or by defects in
the enzymes that degrade
Purines Acute Gout Syndrome
 Joint Pain

Epi/Ethics/Population
Treatment Health

Gout is more common in men, although women

are not immune from contracting Gout as well.
Advise the patient to avoid eating Gout is more common in the african american
meat, additionally, could be community and is more common in elderly men
treated with Allipurol. than in young men.
Resources Used Theme

https://www.mayoclinic.org/dise
ases-conditions/gout/symptoms-
causes/syc-20372897 MUS
Chief Complaint:
Clinical
Presentation
a 32 year old man is admitted to
the ICU with acute renal
dysfuction and with a 2 month
history of weight loss and fatigue.
While The patient admits to light
drinking, it is unlikely that this is
causing the symptoms. The
patient is a homosexual man.
We
(Patho)
Physiology Diagnose(s)
The patient has a low blood
pressure of 112/65 and is
tachacardic. The patients WBC is
4.7*10^. His hematocrit is 34.5%. The patient is diagnosed with HIV
An antibody test for HIV came up but does not meet the low T cell
positivie. count required to diagnose AIDS.
 Weight Loss/Gain

Epi/Ethics/Population
Treatment Health

A treatment of PrEP is
recommended for the patient
The patient is also recommended HIV is a deadly disease effecting millinos of
a therapis to deal with the Amerians. It can be prevented with proper
mental anguish of having HIV. preperation and monitering durring pregnancy.
Resources Used Theme

https://www.accp.com/docs/stunet/StuNewsDecember2014Case.pdf
GAS
Chief Complaint:
Clinical
Presentation
A 65 year old man comes into the
clinic compaining of a history of
shaking hands and progressively
worse handwriting. He finds that
he is no longer able to knit, his
favorite pastime. He reports his
symptoms getting worse over a 2
year period. Blood results are
normal.
Mrs. Jones age 45 came into the
clinic after experiencing
uncontrolled jerky movements.
When asked about her medical
history she said that her mothers
side was healthy but that she did
not know her father. A full
genetic workup was done on her.
(Patho)
Physiology
He has tremor in both his hands
as well as in his legs when he
walks. He is unable to quickly
walk down the hall without
shaking. His tremor is worse
when he walks or ties to use his
hands.
Mrs. Jones has uncontrolled jerky
movements due to degradation
of the Caudate, and reduction of
the indirect "inhibitory" signaling
pathway. This causes and
overactive "active" pathway to
created uncontrolled jerky
movements.
Abnor
Diagnose(s)
Based on the symptoms and the
age, Parkinson disease is
suspected. The patient's
termmors can be explained by
degradation of the Substantia
Nigra-compacta, and the
decreased level of dopamine.
The diagnosis had to be made
with genetics tested because of
the absent father. The diagnosis
must be handled in a sensitive
manner because of the immense
social consequences associated
with huntington's disease.
 Abnormal movement
Treatment
There is no standard treatment
for Parkinson's disease.
Treatment usually involves
surgery and medication that
works on the side effects to help
manage symptoms.
There is no standard treatment
for Huntington's disease.
Currently, all we can do is
manage symptoms and
depending on the patient's more
specific symptoms, different
treatments will be
recommended.
Epi/Ethics/Population
Health
Approximately 60,000 americans are diagnosed
with Parkinsons disease every year. This number
does not reflect the undetected cases in the US.
Huntington's disease (HD) affects one person in
every 10,000. In the US this means around
30,000 people in the Unites States are effected
by Huntington's disease. There is currenlty no
cure for Huntington's disease and symptoms
begin around age 30-50.
Resources Used Theme

https://online.epocrates.com/diseases/14722/Parkinson-disease/Common-Vignette
Neuro https://parkinson.org/Understandi

https://www.mayoclinic.org/dise
ases-conditions/huntingtons-
disease/diagnosis-treatment/drc-
20356122
https://www.ncbi.nlm.nih.gov/pu
bmed/11651254 Neuro