A 68-year old patient with Alzheimer disease was brought to the emergency room by the staff of a local nursing home. He presented as lethargic with a sallow complexion. He had an admission temperature of 102.4F and a respiratory rate of 33/minute. During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical. A sputum sample revealed blood and a greenish color. A chest x-ray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the room, combined with his fever. A smear of his sputum demonstrated no acid-fast bacteria. What is your presumptive diagnosis for this case? What evidence could the sputum give for this case? Is the reduced respiration rate and unequal chest movement indicative of the pathology? Is this a bacterial or viral disease?
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The evidence from the sputum sample that supports this diagnosis includes the presence of blood and a greenish color, which could indicate a bacterial infection. The chest x-ray showing consolidation of the left lung and formation of cavities in the lung tissue Show more…
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A 68-year-old patient with Alzheimer's disease was brought to the emergency room by the staff of a local nursing home. He presented as lethargic with a sallow complexion. He had an admission temperature of 102.4°F and a respiratory rate of 33/minute. During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical exam. A sputum sample revealed blood and a greenish color. A chest x-ray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the exam room, combined with his fever. A smear of his sputum demonstrated no acid-fast bacteria.
Supreeta N.
Case 6 A 75-year old patient with Alzheimer disease was brought to the emergency room of South shore hospital by the staff of a local nursing home. He presented as lethargic with a sallow complexion. He had an admission temperature of 102.4F and a respiratory rate of 33/minute. During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical exam. A sputum sample revealed blood and a greenish color. A chest x-ray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the exam room, combined with his fever. A smear of his sputum demonstrated no acid-fast bacteria. 1. What is your presumptive diagnosis for this case? 2. What evidence could the sputum give for this case? 3. Is the increased respiration rate and unequal chest movement indicative of the pathology? 4. Is this a bacterial or viral disease?
Madhur L.
Early-Onset Dementia. Dementia is a person's loss of intellectual and social abilities that is severe enough to interfere with judgment, behavior, and daily functioning. Alzheimer's disease is the most common type of dementia. In the article "Living with Early Onset Dementia: Exploring the Experience and Developing Evidence-Based Guidelines for Practice" (Alzheimer's Care Quarterly, Vol. 5, Issue 2, pp. 111-122), P. Harris and J. Keady explored the experience and struggles of people diagnosed with dementia and their families. A simple random sample of 21 people with early-onset dementia gave the following data on age, in years, at diagnosis. Use limit grouping with a first class of $40-44$ and a class width of 5. $$\begin{array}{ccccccc}\hline 60 & 58 & 52 & 58 & 59 & 58 & 51 \\61 & 54 & 59 & 55 & 53 & 44 & 46 \\47 & 42 & 56 & 57 & 49 & 41 & 43 \\\hline\end{array}$$
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