Patho Case Studies – Flashcards

56 y.o. male farmer- Mole on left side of his nose, skin has changed and looks shiny, cold feet & hands. Father had skin cancer, mole is malignant due to being unsymmetrical with a fuzzy border which changed in diameter- cancer of the epithelial tissue- correlated with excessive UV sunlight (farmer), gene mutations in p53, patched gene, and p16.

68 y.o. female (smoker) recently diagnosed with diabetes, PT compaining of severe upper abdominal pain with severe itching and subsequent weight loss. PT showed signs of obstructive jaundice from discoloration of skin and pruritus. Test results showed elevation in alkaline phosphatase and bilirubin with small tumors found in liver.

18 y.o. male muscle builder, complains of decreased appetite, unintentional weight loss, fatigue, stomach aches and tingling around his left thigh. Physician notices whitish substance behind patient's pupil and other signs related to having anemia and fever. Palpable swelling and lump on his thigh, blood test revealed elevation of the serum LDH (lactate dehydrogenase) level as well as red blood cell sedimentation rate

38 y.o. white male feeling weak and exhausted after daily activities and has dry itchy skin that won't go away, PT has a low platelet count as well as having low serum iron and iron-binding capacity. White blood cell count is found to be less than 15,000 and hemoglobin levels are found to be above 10.5, Reed-Sternberg (RS) cells are present.

62 y.o. male with flu-like symptoms, fever, chills and excessive sweating at night for ~1 week. The lymph nodes of the patient are swollen along with apparent swelling around the liver and the spleen. PT has visible bruises and tiny red dots on his skin. PT has very high white blood cell count, after bone marrow test, malignant neoplasm of the hematopoietic stem cells are found

36 y.o. red-headed female. History of skin cancer (mother and sister). Many freckles on her face, arms, and legs with dark moles on legs and back that are irregularly shaped, unsymmetrical, dark and raised. malignant tumor found originated from melanocytes.

36 y.o. female goes in for annual mammogram and is (+) for genetic BRCA1 mutation. She found unusual lump in upper outer quadrant of R breast. Results of biopsy came back positive for cancer and negative for estrogen, progesterone, and HER2 tests.

23 y.o. female (smoker) with vaginal bleeding between menstrual cycles and discomfort/bleeding after sexual intercourse. Routine exam was normal. Pap smear that shows cervical dysplasia & cervical lesions.

40 y.o. male truck driver with purplish-brown lesions and nodules rapidly spreading throughout body that are itchy and painful. Appears underweight and weak with signs of thrush on his tongue. Blood-work shows HIV antibodies and decreased CD4+T-cell numbers.

65 y.o. asian male who works as a lab technician analyzing blood; complains of vomiting and loss of appetite, PT has slight jaundice and has developed ascites with an elevated blood pressure. Since he has abdominal pain an ultrasound shows a mass on the liver, blood work shows elevated levels of alkaline phosphate, aspartate aminotransferate, alanine aminotransferase and alpha fetoprotein.

5 y.o. boy living in Africa complains of nausea, diarrhea, and night sweats with a mass growing in boys jaw. PT has edema of the face & neck, lymph nodes in neck are swollen. Biopsy on enlarged lymph node AND mass on jaw shows malignant B-cells. Blood work shows PT is anemic.

55 y.o. white female shows depression, resting tremor, bradykinesia, cogwheel rigidity, and postural instability. PT has unblinking wide-eyed stare, saliva at corner of mouth that is slightly open. Complains difficulty of concentrating, feels melancholy and loneliness. Has problems swallowing, chewing, articulating, and falls sideways. PT was given Levodopa to reduce symptoms.

51 y.o. female has weakness of both hands and both legs. Less coordinated than used too. Showed lack of response to different reflex tests and difficulty pronouncing words. Complains not able to do manual tasks, rest does not make her stronger. Fingernails are thicker, less hair on her body. Tests show abnormal neuron function.

8 y.o. male has a subacute infection that has become worse over a couple days. Suffers from headache, inflammation, confused/disoriented. Recently came to ER for upper respiratory infection. Upon examination, PT showed kerning signs and mild delirium. Dilated pupils and exhibiting cranial palsies. Lowered BP; elevated temp; and elevated heart rate. Lumbar puncture shows elevated level of white blood cells in cerebrospinal fluid as well as streptococcus pneumoniae bacteria

70 y.o. African Americal male has blurred vision, extreme dizziness, and severe headache. He has an elevated blood pressure, heart rate, body temperature, and his speech is partially slurred. PT claims numbness in the arm. Angiography was completed and found an infarct in the anterior cerebral artery.

25 y.o. male attends routine checkup with difficulty swallowing, chewing, and overall feels weak in the cheeks and face. Unable to fully smile, frown, and move basic facial muscles. Cerebral spinal fluid shows high protein level. Electromyography test shows abnormally small amount of innervation within facial muscles during test-- progressive loss of bulbar muscles and facial weakness

45 y.o. male with history of HIV complains of extreme tiredness and painful, burning sensation to hands and feet. PT shows decreased fxn of distal reflexes; with difficulty lifting heavy objects and daily tasks. Nerve conduction study and electromyogram show a decrease in electrical activity and effectiveness of the nerves.

10 y.o. boy shows a rash on his thigh and has a fever. He previously had a tick on his thigh which was removed right away but a reddish rash appeared ad has slowly spread. PT has muscle pain and headache.

30 y.o. female sees her physician for a repeating headache. Throbbing pain on one side of her head, and worsens when she is active and lasts for a day or 2. Typically occurs before menstrual cycle or when under more stress then usual.

30 y.o. white female shows impaired vision and hearing, vertigo, depressed and has been vomitting. Had a baby about 3 months ago. Shows decreased central visual activity, acquired red/green color deficit, and defective papillary rxn to light. Cognitive dysfunction: decreased short-term memory and decreased concentration. After an MRI: lesions are found and demyelinated plaques in the brain and brainstem. Spinal Tap: eleveated levels of oligoclonal bands of immunoglobukin G were found in the CSF.

22 y.o. active female who previously had a simple surgery complains of muscular fatigue and progressive weakness. PT shows signs of ptosis (drooping of lower portion of eye). Experiences double vision at inappropriate times. Tests include response to edrophonium chloride (Tenisilon): repetitive single-fiber EMG and detection of AChR and MuSK antibodies. Muscle strength declined during test.

21 y.o. college male began experiencing paranoia, fear, and acting in bizarre ways. PT says odd or irrational statements and easily overreacts to criticism. PT has disregard to personal hygiene. Physical findings are normal; feels anxiety and overwhelmed in public areas. MRI and CT show abnormalities of the brain.

young female PT has received many rejection letters from college- goes to the physician with decreased appetite and significant weight loss. Physical findings are normal. PT is speaking very quickly, scattered thoughts, feelings of grandeur, and long periods of euphoria. Gambling problem. between euphoric periods PT feels sadness and depression. Blood work shows increased basal TSH with normal thyroxine levels.

14 y.o. has decreased appetite, insomnia, irritability, and suicidal thoughts following a break-up with her BF. PT does not answer any questions from doctor; mother speaks for her. PT avoids interactions with friends and gets upset easily. Dexamethasone suppression test came back positive. Blood work shows elevated corticotropin-releasing hormone (CRH) in the plasma.

28 y.o. female complains of sleeping trouble and feels restless. Has been exposed to surface cleaners and sprays on a daily bases and has a fear of contamination. After PT examination, PT asks doctor to wash his hands and asks if she may wash her hands. Her cleaning ritual lasts up to 5 hours and cannot proceed to other tasks unless house is clean. Tests show her serotonin levels are decreased; with an increase in dopamine levels.

19 y.o. female complaining of panic attacks and is scared she may have another one and frequently worries about when her next one is going to occur. PT is very sweaty, SOB, and clutching her chest. Attacks come rapidly and unexpectedly- feels chest discomfort, dizziness, sweatiness, and feels like she is going to die.

23 y.o. male combat veteran experiences flashbacks, nightmares, and psychological distress following his return from war. PT avoids his smalls support system and describes himself as feeling emotionless, detached, irritable, numb and unable to concentrate. Structural imaging was done and it revealed the PT has a smaller than normal hippocampus.

Middle-aged man with pancreatic cancer had a convulsion and was rushed to the ER. He has felt very weak and nauseated lately. Frequent muscle twitching and headaches. Seems confused and has gained weight since last visit to doctor. BP was low. Blood work shows decreased levels of serum sodium concentrations and hematocrit. Urine samples showed a decreased in sodium. Both of these tests imply there's an excess amount of total body water. CT scan shows cerebral edema.

56 y.o. woman complains of increased urination and increased thirst (~30 days). PT also experiences nocturia. Urine was "not very yellow" and craved "very cold drinks"

28 y.o. female experiences pain and irritation in her eyes and swelling in her neck after she had a baby. The doctor also notes swelling in her neck that may be an enlargement of the thyroid gland (goiter). The patient complains that the itchiness in her eyes is often accompanied by blurry and double vision. She also noticed that her eyes appear larger than before she had a baby. Blood tests were performed and the results were positive for thyroid-stimulating immunoglobulins. Radioactive iodine uptake was observed as elevated.

32 y.o. female complains of a swollen face and large puffy bags under her eyes. She also notes cold intolerance, lethargy, tiredness, and a small mass over her thyroid bone. Her doctor notes bradycardia, hypoventilation, and slow movement, slow tendon jerk reflexes, myxedema (nonpitting, boggy edema around the eyes, hands, feet, and subclavicular fossae). The patient's thyroid seems to be smaller than normal, but of normal shape. The patient also complains of coarse brittle hair accompanied by hair loss, constipation, weight loss, joint stiffness and muscle weakness. She also notes having difficulty speaking and hoarseness due to thickening of the tongue. An EKG indicates sinus bradycardia and enlarged heart. Blood tests show abnormal readings associated with the heart failure along with decreased thyroid hormone (TH) levels and slightly elevated thyroid stimulating hormone (TSH) levels.

15 y.o. male has shows severe fatigue and dramatic weight loss. Interrupted sleep due to frequent urination. Physician notices heavy breathing, and mildly sweet scented breath. The blood glucose was critically elevated at greater than 500mg/dl. The urinalysis showed high levels of glucose and ketones in the urine. The doctor followed these tests with a hemoglobin A1c, which was also elevated.

60 y.o African American female presents to her doctor with fatigue, visual changes, pruritis and polyuria. She also has a history of hypertension and obesity.Her blood pressure is elevated at 140/100. All other physical findings are normal. The patient's blood work showed hyperlipidemia and hyperglycemia. Visual tests also showed retinopathy, or damage to the blood vessels in the retina

52 y.o. female admitted to the hospital for evaluation with complaints of fatigue, weakness and lethargy. Facial hair growth is displayed, thinning of the hair on her head, spontaneous bruising, and a recent diagnosis of diabetes. Patient also has a buffalo hump and exhibits signs of psychosis. Her physical examination showed a body weight of 211 lbs (gain of 40 lbs over the last two months with central distribution of weight gain and neck obesity), palmar erythema and hirsutism and an elevated blood pressure. Her face was moon-shaped with acne and pigmented knuckles and purple, livid striae on the abdomen and around the shoulder girdle. Test results indicated high cortisol level and presence of an adrenal adenoma.

Female patient presented with dehydration and frequent urination. Patient has elevated blood pressure, temperature is normal, some neuromuscular manifestations. She complains of constantly feeling thirsty and that her muscles seem weaker. Test shows low plasma renin activity and elevated urinary potassium. Serum aldosterone is greater than 15 ng/dl as measured by radioimmunoassay. CT scan is used to locate an aldosterone-secreting adenoma.

40 y.o. female feeling weak to the point where she can no longer function at her job and was fired. She also has been feeling nauseous, fatigued, and a loss of appetite. Her body weight decreased a lot since last year, and her blood pressure is low. She has not been out in the sun much, but her skin has gotten a lot darker. She also has been losing pubic hair and armpit hair. Tests show low level of corticosteroid and a high level of serum ACTH.