Medical Discussion Questions Please answer the prompt in the picture. Does not have to be long GO DISCUSSION DUGU M https://learn.westcoastuniversity.edu/w

Medical Discussion Questions Please answer the prompt in the picture. Does not have to be long GO
DISCUSSION DUGU
M
https://learn.westcoastuniversity.edu/webapps/discussionboard/do/conference?toggle_mode=read&action=list_forums&course_id=_38676_1&nav=discu…
A 56-year-old male anatomy professor at a well-known university in North
Hollywood was brought to the emergency room at the UCLA Ronald Reagan
Medical Center. His chief complaint was right flank pain.
History of present Illness:
One day prior to admission, the patient developed a change in the color of his
urine from pale yellow to red in color. There was no associated fever, painful
urination, or penile discharge. He decided to consult with his primary physician
the following day.
One hour prior to admission, the patient developed severe right flank pain
associated with nausea. His wife was brought him to the UCLA Ronald Reagan
Medical Center. Upon admission, the patient was noted by the ER physician to be
in severe pain, with a pain scale of 9 from a visual analog pain scale from 1 to 10.
On physical exam, patient had the following findings:
• Vital Signs BP: 140/90
• Heart rate: 110/minute
• Respiration rate: 15/minute patient was afebrile
• All exam findings for the head, neck, heart, lungs, and abdomen
were normal.
• On examination of the back, patient had tenderness on the right flank upon
palpation.
• On examination of the genitalia, there was no penile discharge.
• Note of a 1 x 1 cm tophus on right big toe.
The following diagnostic exams were ordered:
• CBC with WBC differential count
• Urinalysis
• Serum uric acid
• KUB X-ray
• MRI Scan abdominopelvic area
He was immediately injected by IV with a strong analgesic to relieve the pain.
Past Medical History:
Diagnosed with gout one year prior to admission
• On medication with allopurinol
• No heart and lung disease
No diabetes ar hynertension
Past Medical History:
• Diagnosed with gout one year prior to admission
• On medication with allopurinol
• No heart and lung disease
• No diabetes or hypertension
Click here to review the results of the diagnostic exam.
Questions and topics for discussion:
1. What would be the clinical diagnosis in this patient? Please explain in detail the
pathogenesis of this disease.
2. What are the clinical manifestations: signs, symptoms of this particular disease?
3. Discuss and explain the results of the CBC, serum uric acid, and urinalysis.
4. What do you see in the plain KUB and the coronal MRI scan of the abdomen
where the 2 upper arrows are located? Identify this particular lesion, where is it
located, and the specific organs involved.
5. Review the patient’s medical history. With this in mind, what is the specific type
of lesion that you should expect to see and why?
6. On the axial scan of the abdomen, what is the organ pointed to by the three
arrows? Is there anything wrong with this organ? If you answered yes, please
explain in detail. What is a possible complication in this patient and the
possible effect on the function of this organ in the long term?
7. What are the possible treatment options both medical and surgical for this
particular patient?
8. Describe in detail the possible nursing intervention, especially with regards
to diet and fluid intake.
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Exams ordered
Results
CBC with WBC differential count
CBC within normal limits with no leukocytosis nor
anemia
RBCs too numerous to count
No pus cells (+) uric acid crystals
Slightly elevated
Urinalysis
Serum uric acid
KUB (kidney ureter bladder)
plain x-ray (radiograph)
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Abdominal Coronal MRI scan
R
Abdominal Axial MRI Scan
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