Patient Scenario (Upstream/Downstream) Assignment
knowledge of biological principles and the Scientific Method to ask and
answer relevant questions about human health and disease
information to distinguish between diseased and healthy structure and
how internal and external factors cause disruption of healthy body
function, leading to disease and disorders.
Mr. Smith is 60 years
old. He was diagnosed with prostate cancer five years ago. Over the past few
days, Mr. Smith has been feeling increasingly tired and has also been suffering
from a headache that did not respond to over-the-counter medications. He
scheduled an appointment with his physician.
performed a physical examination and recommendedabattery
of laboratory tests and imaging procedures.
His blood pressure is
165/100 mmHg. MRI reveals metastasis of prostate cancer to osseous
tissue. Abdominal CT shows obstruction of intestine due to nodular enlargement
of adrenal glands.
below shows Reference values in the right-hand column. These values
reflect the normal range of values for patients without disease or
illness. The center column reflects the resulting values for medical test
results obtained for Mr. Smith.
Take note whether Mr.
Smith’s values are within normal limits.
Laboratory results from Mr. Smith’s second hospital admission and
medical tests show following findings:
13.8 to 18.2 g/dL
70 mmol/L/24 hr
25-120 mmol/L/24 hr
24 hour Urinary Aldosterone
8.4 mcg/24 hr
2.3-21.0 mcg/24 hr
ACTH (Adrenocorticotropic Hormone)
MRI and CT confirmed metastatic prostate adenocarcinoma, hypertension and
refractory hypokalemia due to ectopic ACTH production. High levels of
circulating cortisol caused continuous activation of mineralocorticoid
receptors resulting in hypokalemia, metabolic alkalosis and hypertension.
provided scenario, answer the following questions:
are the components of physical examination? Describe each component. (See Module 1, Topic 8, Part B.2)
Smith’s blood pressure was 160/100 mmHg.
How does a medical provider take or measure blood pressure?
What do the top (numerator) and bottom (denominator) numbers mean in the
What is the significance the size of these two numbers?
Is Mr. Smith’s blood pressure within normal range? Explain how you
concluded whether Mr. Smith’s blood pressure is/is not within normal range.
Discuss the possible health issues anticipated for a person with a blood
pressure of 165/100 mm Hg.
on the data provided, what laboratory tests were performed and what samples
were taken from the patient? Select one of the laboratory tests ordered
for Mr. Smith and discuss why Mr. Smith’s physician might have ordered the test
and the information she might have expected to obtain from that particular
Analyze Mr. Smith’s values
Mr. Smith’s values with reference values and indicate whether Mr. Smith’s
values are below, above, or within normal range (compare Mr. Smith’s values with
the Reference values) for each laboratory tests in the table above from the
second set of tests.
Select one of the values outside of normal range from the table above and
discuss possible medical concerns related to the identified change in Mr. Smith’s
imaging procedures did Mr. Smith undergo? Discuss the distinctions and
similarities between the two different imaging approaches. What were the
results of imaging procedures in Mr. Smith’s case?
6. Select one of the medical terms from
the CONCLUSION and DIAGNOSIS section above and define what it means.
Also, discuss, in your own words and based on what you can gather about Mr.
Smith’s condition, how the laboratory or imaging tests helped with drawing a
conclusion or making the diagnosis. In your own words, discuss how medical
providers use the scientific method to come to work through the examination and
diagnosis of a patient.
You should write a short paper addressing all five questions
and submit it under “Assignments”. Your grade will
depend upon the content, clarity and originality of responses written in your
own words. Good writing practices, including the use of correct grammar,
sentence and paragraph structure, and punctuation, and presence of logical
reasoning, will account for a portion of your grade.
all sources in APA format within your answer text as well as full citations in
APA format at the end of the assignment.
Your grade for the short paper based on presented scenario
will be based on the following components:
all six questions and all sub-parts of each question and provides correct
or logical answers to each question—up to 60 points
provides original, detailed responses, written in student’s own words,
showing presence of logical reasoning – up to 24 points
incorporates terms and concepts learned from assigned materials – up to 8
correctly cites resources in APA format – up to 4 points
– grammar, spelling, style – up to 4 points