Write a comprehensive medical report on a disease we have studied up to this point. Be sure to include all relevant medical history, testing/diagnostics, treatment options, and recommended plan of action. Paper should be in APA format and 4 pages submitted to the Submissions Area.

Here is an example for assignment 2:
First you can introduce a patient report-case study.

“DATE OF CONSULTATION:  MM/DD/YYYY

REFERRING PHYSICIAN:  John Doe, MD  
CONSULTING PHYSICIAN:  Jane Doe, MD
REASON FOR CONSULTATION:  Surgical evaluation for coronary artery disease.
HISTORY OF PRESENT ILLNESS:  The patient is a (XX)-year-old female who has a known history of coronary artery disease.  She underwent previous PTCA and stenting procedures in December and most recently in August.  Since that time, she has been relatively stable with medical management.  However, in the past several weeks, she started to notice some exertional dyspnea with chest pain.  For the most part, the pain subsides with rest.  For this reason, she was re-evaluated with a cardiac catheterization.  This demonstrated 3-vessel coronary artery disease with a 70% lesion to the right coronary artery; this was a proximal lesion.  The left main had a 70% stenosis.  The circumflex also had a 99% stenosis.  Overall left ventricular function was mildly reduced with an ejection fraction of about 45%.  The left ventriculogram did note some apical hypokinesis.  In view of these findings, surgical consultation was requested and the patient was seen and evaluated by Dr. Doe.

PAST MEDICAL HISTORY:

1.  Coronary artery disease as described above with previous PTCA and stenting procedures.
2.  Dyslipidemia.
3.  Hypertension.
4.  Status post breast lumpectomy for cancer with followup radiation therapy to the chest.

ALLERGIES:  None.
MEDICATIONS:  Aspirin 81 mg daily, Plavix 75 mg daily, Altace 2.5 mg daily, metoprolol 50 mg b.i.d. and Lipitor 10 mg q.h.s.
SOCIAL HISTORY:  She quit smoking approximately 8 months ago.  Prior to that time, she had about a 35- to 40-pack-year history.  She does not abuse alcohol.

FAMILY MEDICAL HISTORY:  Mother died prematurely of breast cancer.  Her father died prematurely of gastric carcinoma.

REVIEW OF SYSTEMS:  There is no history of any CVAs, TIAs or seizures.  No chronic headaches.  No asthma, TB, hemoptysis or productive cough.  There is no congenital heart abnormality or rheumatic fever history.  She has no palpitations.  She notes no nausea, vomiting, constipation, diarrhea, but immediately prior to admission, she did develop some diffuse abdominal discomfort.  She says that since then, this has resolved.  No diabetes or thyroid problem.  There is no depression or psychiatric problems.  There is no musculoskeletal disorders or history of gout. There are no hematologic problems or blood dyscrasias.  No bleeding tendencies.  Again, she had a history of breast cancer and underwent lumpectomy procedures for this with followup radiation therapy.  She has been followed in the past 10 years and mammography shows no evidence of any recurrent problems.  There is no recent fevers, malaise, changes in appetite or changes in weight.

PHYSICAL EXAMINATION:  Her blood pressure is 120/70, pulse is 80.  She is in a sinus rhythm on the EKG monitor.  Respirations are 18 and unlabored. Temperature is 98.2 degrees Fahrenheit.  She weighs 160 pounds, she is 5 feet 4 inches.  In general, this was an elderly-appearing, pleasant female who currently is not in acute distress.  Skin color and turgor are good.  Pupils were equal and reactive to light.  Conjunctivae clear.  Throat is benign. Mucosa was moist and noncyanotic.  Neck veins not distended at 90 degrees.  Carotids had 2+ upstrokes bilaterally without bruits.  No lymphadenopathy was appreciated.  Chest had a normal AP diameter. The lungs were clear in the apices and bases, no wheezing or egophony appreciated.  The heart had a normal S1, S2.  No murmurs, clicks or gallops.  The abdomen was soft, nontender, nondistended.  Good bowel sounds present.  No hepatosplenomegaly was appreciated.  No pulsatile masses were felt.  No abdominal bruits were heard.  Her pulses are 2+ and equal bilaterally in the upper and lower extremities.  No clubbing is appreciated.  She is oriented x3.  Demonstrated a good amount of strength in the upper and lower extremities.  Face was symmetrical.  She had a normal gait.

IMPRESSION:  This is a (XX)-year-old female with significant multivessel coronary artery disease.  The patient also has a left main lesion.  She has undergone several PTCA and stenting procedures within the last year to year and a half.  At this point, in order to reduce the risk of any possible ischemia in the future, surgical myocardial revascularization is recommended.    
PLAN:  We will plan to proceed with surgical myocardial revascularization.  The risks and benefits of this procedure were explained to the patient.  All questions pertaining to this procedure were answered.”

References:  Cardiology Consultation Transcribed Medical Transcription Sample Reports. (n.d.). Retrieved from Medical Transcription Samples

Note: Add the diagnostic tests before impression in your paper.

Take time to write about the disease. It can be described in more details  after your case study or integrated within it. Add more details regarding pathophysiology, differential diagnoses, explanation of testing methods, Add prognosis/potential outcome as well.

Your paper will look like a history and physical but with emphasis on discussing the disease, diagnostic tests, diagnosis(differential diagnoses) and treatments

You need to create a story about a patient with an illness we have looked at so far.

For your paper, you need to follow APA Style guidelines and must include the following standardized elements:

· Title page

· Main body

· In-text citations for paraphrased and quoted material

· References page

· Minimum number of credible, academic sources

· Running head

· Page numbers

· Double spaced on standard sized paper (8.5” x 11”)

· 1” margins

· 12 pt. Times New Roman

· Indent each new paragraph (tab ½” or 5 spaces)

AFTER ASSIGNMENT IS COMPLETED PLEASE ATTACH A TURNITIN REPORT. THIS ASSIGNMENT HAS TO BE SUBMITTED THROUGH TURNITIN! ALSO, CHECK YOUR GRAMMAR, SPELLING, AND PROUNCIATION ONCE EVERYTHING IS DONE!

 

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Purpose: 

To integrate scientific articles that cover a similar topic and assess the placement and impact of H. naledi within the hominin lineage.

Learning Objectives:

• Locate and describe a relevant scientific article that describesHomo naledi
• Construct an outline of the Homo naledi fossil finds and assess whether the characteristics of this hominin are derived or primitive
• Compare the findings of scientific articles that cover a similar topic
• Determine the impact of the new hominin fossil find on the trend of hominin evolution

 

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Individual Assignment 3 Instructions

The global community is plagued by increasing incidence of leukemia; non-Hodgkin lymphoma; lung, colorectal, breast, pancreatic, prostate, liver, ovarian, and esophageal cancers. Other types of cancer exist but are less frequent. What is the scientific community doing to attempt to eliminate the most common forms of cancer that are ravaging society?

1. Read the course textbook’s chapter on cell division, specifically the last section on how cells become cancerous. This is context for completing Individual Assignment 3.

2. Watch the Presentation in Module/Week 4 entitled “Ways to Fight Cancer.” Notice that the presentation outlines essentially 3 approaches to fighting cancer: a) reduction of cancer risks, b) correction of cancer genes, and c) destruction of cancerous tissue.

3. Open the “10 Discoveries in the War on Cancer” document in the Assignment Instructions folder. Scan the discoveries briefly. Then, open the assignment submission link in Module/Week 9. In the text box, number from 1 to 10 for the 10 discoveries.

4. Reflect carefully on discovery 1. Would this discovery be more useful for a) reducing cancer risks, b) correcting/restoring cancer cells to normal, or c) destroying cancerous tissue? After number 1 in your list, place in parentheses the letter representing the approach to fighting cancer that will best be served by this new discovery. (More than 1 approach may be served, but which is most likely to be helped most significantly?)

5. Repeat this analysis for each of the remaining 9 discoveries. Return to the “Ways to Fight Cancer” presentation as needed for additional perspective. When finished, your entire text box must be simple: a numbered (1–10) list of letters (a), (b) or (c). The assignment is now complete.

6. Each correct association up to 8 correct answers is granted 7 points. If you get 9 or 10 out of 10, you get a perfect score (60 pts.) on the assignment.

Submit this assignment by 11:59 p.m. (ET) on Monday of Module/Week 4.

Individual Assignment 3 – 10 Discoveries in the War on Cancer

1. Virologists are modifying lentiviruses as vectors for carrying proto-oncogenes into cancer-transformed cells in culture. They are developing this virus for inserting the ras proto-oncogene directly into its correct location in the genome. The correct ras gene will already be linked to human DNA on either side of it and complexed with a recombination enzyme that will insert it into its correct location within the human genome. At the same time, the recombination enzyme will excise the defective oncogenic form of ras. The cells in culture should again come under normal hormonal control and require extra-cellular signals in order to continue dividing.

2. Malignant brain tumors in adults are fast-growing cancers with median survival rates of 15 months, even with aggressive treatment. Researchers have been searching for genetic “signatures” (characteristic groups of cancer-causing genes) that could help in defining the kind of brain tumor the patient has. They hope to be better able to predict the course of the disease and more accurately design the patient’s course of treatment.

3. Tobacco smoking is the leading cause of preventable deaths worldwide. It is a risk factor for lung cancer and several other types of cancer. Results of analysis of the entire human gene collection (the “genome”) support some previous findings that a region of human chromosome number 15 contains one or more genes that are associated with smoking intensity (the number of cigarettes smoked per day) and the closely related trait of nicotine dependency. Scanning people’s genomes for these genes will help them to determine their risk of addiction should they begin smoking tobacco.

4. Immunologists are working with a mutation (HER2) that is expressed on the surface of many breast, bladder, pancreatic, and ovarian cancer cells. They have made antibodies against this mutant surface protein. These antibodies have been covalently bonded to a “gene expression vector” that makes cells light up when incubated with luciferin from fire flies. The vector takes the gene for luciferin into the cancer cells. The researchers have shown that their antibody can accurately find and “light up” cancer cells. Their next step is to bond the antibody to an expression vector that carries the normal HER2 gene into mutant cancer cells.

5. Immunologists are investigating ways to destroy lymphocytes (white blood cells of the immune system) that have become cancerous (lymphomas). A current drug Rituximab contains antibodies that bind to the surfaces of these lymphocytes setting them up for destruction by the cancer patient’s own immune system. They are currently seeking ways to modify the antibody’s structure so that it will attract the cancer patient’s “natural killer” (NK) cells to the lymphocytes. Success of this project will bring a multi-faceted immune response against lymphomas and hasten destruction.

6. Biochemists have discovered a protein kinase enzyme named BRAF that is an important link in a molecular pathway that causes a cell to divide. Normally, BRAF responds to signals coming from outside the cell—signals calling for the cell to divide normally under normal conditions. But there is a mutation in BRAF enzymes that causes it activate the cell toward division continually. In this way it gives rise to melanomas and thyroid or ovarian cancers. Biochemists have also found a drug, vemurafenib, which binds selectively to mutant BRAF totally inactivating it. Cells that have inactivated BRAF undergo apoptosis—a process that leads to cell death.

7. Molecular biologists have taken nanoparticle-sized spheres and used them to deliver a cell-killing toxin from bee venom to tumors in mice, substantially reducing tumor growth without harming normal body tissues. Nanoparticles are known to concentrate in solid tumors because blood vessels in tumors show “enhanced permeability and retention effect” or EPR. Hence substances such as nanoparticles escape more readily from the bloodstream into tumors and the generally poor drainage of lymph from tumors further helps trap the particles in tumor tissue.

8. Organic chemists are exploring structural variations of the organic compound avobenzone (1-[4-Methoxyphenyl]-3-[4-tert-butylphenyl] propane-1,3-dione) for inclusion in sunblock products. Avobenzone is known for its ability to absorb a broad spectrum of ultra-violet radiations including UVB light (known to enhance the frequency of basal cell and squamous cell carcinomas [skin cancers]); and UVA rays thought to increase the frequency of melanoma cancers. New variations in the structure of avobenzone are hoped to retain the ability to absorb harmful UV radiation while having an increased stability in the presence of that radiation.

9. Biochemists are analyzing the many, many components of red meat (beef and pork) to determine which component, if any, will cause increased colorectal cancer rates in mice when the component is administered orally. Studies have shown that higher colorectal cancer rates in humans are associated with higher consumption rates of red meat.

10. Molecular biologists have developed a new sequence of human genes called an ankyrin insulator sequence. A new corrected or therapeutic gene is placed within this sequence. Its role is to create an active area on a human chromosome where the new gene can work efficiently no matter what chromosome it lands on.

 

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1.  What do YOU think about Zicam?

• -If Zicam had  detrimental side effects, how did it get approved to be sold?  
• -Why do you think the makers of Zicam switched their active ingredients in the nasal spray to one already used in Afrin and other OTC medicines?
• -What biases might exist to keep pharmaceuticals on the market after they are approved by the FDA?

2.  Your Uncle Billy calls you saying he is thinking about moving to Los Angeles, but is worried about the air quality because he saw the following report. Air pollution in the Los Angeles area is characterized by a decrease in visibility, crop damage, eye irritation, objectionable odor, and rubber deterioration. These effects are attributed to the release of large quantities of hydrocarbons and nitrogen oxides to the atmosphere. The photochemical action of nitrogen oxides oxidizes the hydrocarbons and thereby forms ozone, responsible for rubber cracking. Under experimental conditions, organic peroxides formed in the vapor phase oxidation of hydrocarbons have been shown to give eye irritation and crop damage resembling closely that observed on smog days.

• -Explain the above description to your Uncle Billie in your own words, in a way that he (a barber from Okemos) would understand.  Connect the concepts to at least a couple of ideas that Uncle Billy could reasonably know about.
• Compare and contrast the accuracy of your explanation with that of the original.

3.  Find a visual about a topic you find interesting.  Use the three-step process to understand the image (1. Interpret a point, 2. Identify as many trends as possible, 3. Interpret the overall message of the visual), regardless of whether or not it is a scatter plot.  Did this system work for your visual, why or why not? 

 

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