Patient Case Study on Constipation and Sinusitis

Patient Case Study 1

• A 65-year-old woman presented with constipation lasting two weeks.
• Stool was hard and bullet-shaped.
• No significant medical history; social alcohol use only.
• Blood pressure: 110/70 mmHg; Pulse rate: 70/min; Temperature: 37.5°C.
• Used over-the-counter medication for constipation.
• Docusate sodium is a stool softener.

Teaching Points

• Docusate sodium is often recommended for mild constipation.
• It's available orally and as a suppository.
• It acts as a surfactant, inhibiting fluid secretion in the small intestine.
• Demulcents are mucilaginous or oleaginous preparations, soothing mucous membranes for less than 30 minutes

Patient Case Study 2

• A patient with right maxillary sinus pain, nasal congestion, thick yellow secretions, and worsening pain around the second maxillary molar.
• Had used nasal decongestant spray, saline spray, and anti-inflammatory drugs for several days.
• The patient is experiencing persistent thick drainage, low-grade fever.
• High dose amoxicillin or amoxicillin/clavulanate is the first-line antibiotic choice for sinusitis if no allergies present.

Patient Case Study 3

• A 72-year-old female with lower-risk myelodysplastic neoplasms (MDS) and transfusion-dependent anemia.
• EPO level: 200 mU/mL
• Cytogenetic analysis shows a deletion on the long arm of chromosome 5 (5q deletion).
• Platelets and neutrophil counts are normal.
• Lenalidomide is the preferred treatment in this case.

Patient Case Study 4

• A 34-year-old woman seeking contraceptive advice.
• Recently gave birth via vaginal delivery a month ago.
• Current use of condoms for contraception.
• Past medical history of pulmonary embolism, chronic liver disease, migraine without aura, coronary artery disease, and polycystic ovary syndrome (PCOS).
• Occasional smoker.
• Previous history of DVT 4 years ago.
• History of smoking, liver disease, previous venous thromboembolism is a contraindication for oral contraceptive pills.

Patient Case Study 5

• A 65-year-old man with fatigue and weight loss, positive fecal occult blood test, and a mass in the sigmoid colon with liver metastasis.
• Monoclonal Antibody therapy against VEGF-A (Vascular Endothelial Growth Factor A) is used to manage the cancer.

Patient Case Study 6

• A 27-year-old male with shortness of breath during exercise, no chest pain, loss of consciousness, palpitations, history of breast cancer in mother, and sudden death in paternal uncle.
• Systolic ejection murmur, increased with Valsalva maneuver.
• Clear lungs on auscultation.
• Echocardiography showed thickened interventricular septum and systolic anterior motion of mitral valve.
• The ejection fraction was 76%.
• Metoprolol is a useful treatment for this type of condition

Patient Case Study 7

• A 23-year-old woman with a left eye infection that gradually worsened over a few days without affecting vision.
• Blood Pressure: 122/80 mmHg; Pulse: 90/min; Respiratory rate: 14/min, Temperature: 99.5°F (37.5°C).
• Past Medical History: cystic fibrosis, type 2 diabetes mellitus, and IgA nephropathy.
• Tobramycin ophthalmic solution is prescribed.
• Renal function needs close monitoring before prescribing Tobramycin.

Patient Case Study 8

• A 84-year-old man with community-acquired pneumonia caused by Streptococcus pneumoniae.
• Previous history of atrial fibrillation controlled using Class III antiarrhythmic sotalol therapy for 10 years.
• Doxycycline is likely the best choice for antibiotic therapy.

Patient Case Study 9

• A 30-year-old woman with a history of unprotected sexual intercourse.
• Was taking combined oral contraceptives (COCs) and missed several pills.
• Seeking emergency contraception option.
• Copper intrauterine device (IUD) is the most effective method of emergency contraception, even if ovulation has occurred.

Patient Case Study 10

• A 65-year-old woman who is being treated for osteoporosis.
• Has not responded adequately to bisphosphonate agents.
• Prescribed an anabolic agent (PTHrP analog) to reduce fracture risk, but comes with a black box warning of increased risk of osteosarcoma.
• Abaloparatide is prescribed as an anabolic agent to treat osteoporosis.

Miscellaneous

• Key drug classes include HMG-Coa reductase inhibitors.
• Various medications, including digoxin, may interact with each other, depending on the specific patient and medications.
• The specific drug to treat any disease is up to the discretion of healthcare professionals.

Explore two detailed patient case studies focusing on a 65-year-old woman with constipation and a patient suffering from sinus pain. The quiz highlights the recommended treatments and medications, specifically docusate sodium for constipation and the impact of nasal decongestants for sinus issues. Test your understanding of the clinical approaches and pharmacology involved in these conditions.