Assignment Task: Gastrointestinal & Endocrine
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case Scenario:
Chief Complaint (CC): "neck swelling"
History of Present Illness (HPI) A 42-year-old African American female who refers that she has been noticing slow and progressive swelling on her neck for about a year. Also she stated she has lost weight without any food restriction
PMH Patient denies
PSH Surgical removal of benign left breast nodule 2 years ago
Drug Hx No medication at the time
Allergies NKA
Subjective Mild difficult to shallow, Neck feels tight, Pt states she feels Palpitations
PE B/P 158/90; Pulse 102; RR 20; Temp 99.2; Ht 5,4; wt 114; BMI 19.6
General 42-year-old female appears thin. She is anxious - pacing in the room and fidgeting, but in no acute distress.
HEENT Bulging eyes
Neck Diffuse enlargement of the thyroid gland
Lungs CTA AP&L
Card S1S2 without rub, Tachycardia
Abd benign, normoactive bowel sounds x 4
GU Non contributory
Ext no cyanosis, clubbing or edema
Integument Thin skin, Increase moisture
Neuro No obvious deficits and CN grossly intact II-XII
Once you received your case number, answer the following questions:
1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.
Submission Instructions:
- Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.