Assignment task:
Monica is a 43-year-old African- American G3P2102. She is currently separated from her husband of 20 years and is working full-time as a legal secretary. About 8 months ago, Monica started having irregular periods with heavier than usual flow until she stopped having periods or any vaginal bleeding about 3 months ago. She is currently recovering from a "stomach flu" however, she reports daily nausea, vomiting, bloating and decreased appetite over the past 3 weeks. She is worried because she has gained 12 pounds over the last 3 months "due to menopause". Shecomes to the clinic today to discuss menopause symptoms and hormone replacement therapy. Physical exam is unremarkable with exception of a palpable 12- 14 weeks size uterus on bimanual. You check a for a fetal heartbeat and obtain a heart tone of 145 via doppler. The intake nurse reports that a urine pregnancy test came back positive. Monica is in disbelief.Prior medical history: Hypertension (2010)- well controlled on current antihypertensive
Prior surgical history: Cholecystectomy (2015)
Current medications: Lisinopril 10mg daily. Allergies: None
OB- GYN History: NSVD x 2 (2015, 2019) healthy female 6lb 8oz; healthy female 7lbs 6oz. First trimester
miscarriage (9 weeks) in 2014. Menarche age 15, cycle length-7 days- frequency every 28 days- 5-6 pads per day. No history of sexually transmitted infections (STDs). No history of abnormal pap (last pap 2 years ago).
LMP: Approximately 3 months ago. Contraception history: Condoms; past use of oral contraceptives.
Social history: Lives with her elderly father, 2 daughters. Separated from her husband for 6 months.
Family history: Mother deceased (age 60)- breast cancer. Father alive (age 70)- hypertension.
Review of Systems (ROS): Unremarkable with exception of as noted in HPI.
Physical Exam (PE)
VS: BP: 130/78, P: 78, RR: 18, T: 36.1 Weight: 152 lbs.
Physical exam is unremarkable with exception of a palpable 12- 14 weeks size uterus on bimanual. You check a for a fetal heartbeat and obtain a heart tone of 145 via doppler. The intake nurse reports that a urine pregnancy test came back positive.
Monica is in disbelief.
Identify diagnostic tests, procedures, laboratory work indicated, Distinguish at least three differential diagnoses, Identify appropriate medications, treatments or other interventions associated with each differential diagnosis, Explain key Social Determinants of Heath (SDoH) for your chosen case, Describe collaborative care referrals and patient education needs for your chosen case. Need Assignment Help?