So I have a medical assignment, and there is one question that has stumped me:
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A 19 year old male comes to see a doctor with complaints of frequent blood noses, frequent and intense headaches, and shortness of breath. Upon further investigation, it is found that he also suffers from joint problems, and tender upper arms. Most worryingly, his upper arms appear to be bleeding through some pores, as his upper arms are covered in lots of tiny specks of blood.
Patient history:
Headaches 13+ years.
Had adenoids removed aged 7.
Joint issues 9 years.
Nose bleeds 5 years.
Arm bleeding 5 years.
Shortness of breath 4 years.
Patient file:
Age = 19
Height = 183cm
Weight = 90.5kg
Family history:
Grandmother and great aunt on mothers side both have diabetes.
Great grandfather on fathers side suffered from heart problems.
Other things to note:
Patient does not suffer from dizziness or frequent vomiting.
Patient does not suffer from haemophilia.
Patient suffers from depression.
Patient isn't on any medication, or drugs (illegal or legal).
Patient does drink alcohol, but rarely and not in large amounts.
Nasal and upper arm bleeding are not self inflicted.
Patient displays an abnormally high tolerance to cold, and a low tolerance to heat.
Patient gained 17kg in one year, aged 17. Claims to have since tried, and failed to lose weight, despite regular exercise and healthy diet. However patient is not gaining weight either.
Patient has been overseas twice. To Vanuatu aged 8, and to China aged 18.
Patient has curly hair.
Diagnose the patient, giving a detailed description of the potential disease(s) he may have, and suggest possible treatments for both the symptoms and underlying disease(s).
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So that's the question, it's the largest one in the assignment and worth the most marks by far. Usually I would be ok with this sort of thing, but the arm bleeding thing really threw me. My lecturer likes to throw in 'extra notes' as well as patient and family history that may be of no relevance to the disease at all. (I think the diabetes thing may be a trick. And apparently Vanuatu is a tropical island between Australia and Fiji.)
Any help would be most appreciated! Thankyou!
--------------------------------------…
A 19 year old male comes to see a doctor with complaints of frequent blood noses, frequent and intense headaches, and shortness of breath. Upon further investigation, it is found that he also suffers from joint problems, and tender upper arms. Most worryingly, his upper arms appear to be bleeding through some pores, as his upper arms are covered in lots of tiny specks of blood.
Patient history:
Headaches 13+ years.
Had adenoids removed aged 7.
Joint issues 9 years.
Nose bleeds 5 years.
Arm bleeding 5 years.
Shortness of breath 4 years.
Patient file:
Age = 19
Height = 183cm
Weight = 90.5kg
Family history:
Grandmother and great aunt on mothers side both have diabetes.
Great grandfather on fathers side suffered from heart problems.
Other things to note:
Patient does not suffer from dizziness or frequent vomiting.
Patient does not suffer from haemophilia.
Patient suffers from depression.
Patient isn't on any medication, or drugs (illegal or legal).
Patient does drink alcohol, but rarely and not in large amounts.
Nasal and upper arm bleeding are not self inflicted.
Patient displays an abnormally high tolerance to cold, and a low tolerance to heat.
Patient gained 17kg in one year, aged 17. Claims to have since tried, and failed to lose weight, despite regular exercise and healthy diet. However patient is not gaining weight either.
Patient has been overseas twice. To Vanuatu aged 8, and to China aged 18.
Patient has curly hair.
Diagnose the patient, giving a detailed description of the potential disease(s) he may have, and suggest possible treatments for both the symptoms and underlying disease(s).
--------------------------------------…
So that's the question, it's the largest one in the assignment and worth the most marks by far. Usually I would be ok with this sort of thing, but the arm bleeding thing really threw me. My lecturer likes to throw in 'extra notes' as well as patient and family history that may be of no relevance to the disease at all. (I think the diabetes thing may be a trick. And apparently Vanuatu is a tropical island between Australia and Fiji.)
Any help would be most appreciated! Thankyou!
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He picked up some type of fever causing joint symptoms then bleeding when he went overseas at age 8.dengue fever? He is bleeding internally from infection. I believe he has dic also. Other possibility is auto immune. But don't know if rheumatoid arthritis or other auto immune disease will cause internal bleeding. Suggest his liver be checked as its involved with clotting. He needs sedimentation rate checked. Wonder if it can be a form of bone marrow cancer. He needs cbc. He needs blood transfusion and possibly platelets. It could be leukemia,