Patient 1001 is a 42-year-old female that is experiencing severe heartburn, abdominal pain, bloating, nausea, and vomiting. Ulcers Bleeding sores in the stomach or intestine Gallbladder Disease Gallstones Gastric Reflux Stomach acid burning the esophagus Table 1. Possible Diagnoses Symptoms Slide Abnormalities Fecal Occult Test Results Abdominal pain especially after eating, bloody stool, heartburn, back pain, vomiting, nausea, bloating Portions of the stomach lining will have been eaten away by acid; pits or gaps in the stomach lining will be visible Positive; blood will be found in stool if the patient has a bleeding ulcer Abdominal pain, back and shoulder pain, fever, chills, vomiting, nausea, jaundice, bloating, heartburn Heartburn, nausea, vomiting, regurgitation, abdominal pain, bloating No change will be visible in the stomach lining No change will be visible in the stomach lining Negative; no blood will be present in the stool Positive; blood from the wearing of the esophagus can be found in the stool THE FECAL OCCULT TEST: There are many different types of diagnostic tests that can be used to identify possible digestive disorders. One of the most common tests is the fecal occult blood test to search for trace amounts of blood in the stool. A healthy individual will normally have a small amount of blood loss into the stool daily, but a primary symptom of many digestive disorders is chronic bleeding in the gastrointestinal (GI) tract. Blood in the stool may be indicative of ulcers, polyps, cancer, anal fissures, infection, hemorrhoids, diverticulitis, colitis, and esophageal bleeding just as a few examples. Normal stomach image Patient 1001 stool sample Cotton swabs Patient stomach image Fecal occult test sheet Paper towels 1 Compare/contrast the normal stomach and Patient 1001 stomach images. Record your results on the answer sheet. 2 Obtain a Q-tip and a fecal occult test sheet. DO NOT TOUCH the circle test area with your fingers to avoid contamination! 3 Open the stool sample container and remove a very small amount of the sample with the Q-tip. Replace the lid on the sample. 4 Rub the sample from the Q-tip on the test area of the fecal occult test sheet. Spread the stool sample out as thinly as possible. If the test is positive, the fecal occult test sheet will turn pink/purple. Even a small change indicates a positive test result 5 indicating the presence of blood in the stool sample. 6 Record the results on your answer sheet. Discard the Q-tip and test sheet in the trash. 7 Using your results and the table above, diagnose your patient. 137
Patient 2002 is a 15-year-old male that is experiencing a high fever, cough, excess mucus, shortness of breath, chest pain, and severe fatigue. The patient has been admitted to the emergency room. Influenza Viral infection Pneumonia Respiratory infection Tuberculosis Caused by Mycobacterium tuberculosis bacteria Body aches, muscle aches, cough, chills, fever, headache, sore throat, fatigue, mucus Table 2. Possible Diagnoses Symptoms Slide Abnormalities Infectious Disease Test Results Alveoli sacs may appear No color change damaged and/or torn Muscle aches, cough, fever, rapid breathing, chest pain, abdominal pain, fatigue, sore throat Cough, excess mucus, fatigue, shortness of breath, fever, chest pain, weight loss, night sweats Air sacs in alveoli will appear filled with mucus, bacteria, and/or blood Large round collections of tuberculosis bacteria will be visible in lung tissue Normal lung image Patient fluid sample Test tube Patient lung image Infectious disease test Paper towels Pink to red color change Orange or dark blue color change 1 Compare/contrast the normal lung and Patient 2002 lung images. Record your results on the answer sheet. 2 Measure out 3 ml of the Patient 2002 Fluid Sample and pour it into the test tube. 3 Add 10-20 drops of the Infectious Disease Test fluid to the test tube. 4 Swirl the test tube to mix the fluids. Observe any color change that occurs in the test tube. No color change would indicate influenza, a pink to red color change 5 would indicate pneumonia, and an orange or dark blue color change would indicate tuberculosis. Record the results on your answer sheet. 6 Rinse out your test tube and dry it with a paper towel. 7 Using your results and the table above, diagnose your patient. 138
Patient 3003 is a 4-year-old male that is experiencing bone and joint pain, lack of appetite, infections, headaches, fever, swollen lymph nodes, and fatigue. Leukemia Cancer of blood cells Aplastic Anemia Lack of red blood cell production Metabolic Bone Disease Disease causing a lack of bone development Headaches, nigh sweats, fever, bruises easily, bone pain, enlarged spleen, swollen lymph nodes, weakness, weight loss Weakness, paleness, fatigue, dizziness, rapid pulse, abnormal bleeding, infections, swollen Table 3. Possible Diagnoses Symptoms Slide Abnormalities CBC Results An excess of blood cells will be visible in the bone marrow lymph nodes Weak teeth, bone pain, fractures, anemia, bruises easily, deafness, infections, headaches, fatigue A lack of blood cells will be visible in the bone marrow No change will be seen in the bone marrow of those affected Normal bone marrow image Patient bone marrow image Patient CBC image Red blood cells HIGH White blood cells HIGH Platelets HIGH Red blood cells LOW White blood cells LOW Platelets - NORMAL Red blood cells LOW White blood cells HIGH Platelets HIGH 1 Compare/contrast the normal bone marrow and Patient 3003 bone marrow images. Record your results on the answer sheet. Examine the patient hemocytometer results on the CBC Count sheet. They show what would be seen through a microscope when 2 counting blood cells. The lines of the hemocytometer grid are used to make counting easier. 3 Count the red blood cells for each patient. Start at the top left box and move box by box to the right, row by row. 4 To determine the total number of red blood cells (RBC) per mm 3, multiply the counted red blood cells by 100,000. 5 Determine whether the patient has normal, high, or low RBC values. Record the results on your answer sheet. Count the white blood cells for each patient. To determine the total number of white blood cells (WBC) per mm 6 3, multiply the counted white blood cells by 1,000. 7 Determine whether the patient has normal, high, or low WBC values. Record the results on your answer sheet. 8 Count the platelets for each patient. To determine the total number of platelets per mm 3, multiply the counted platelets by 10,000. 9 Determine whether the patient has normal, high, or low Platelet values. Record the results on your answer sheet. 10 Using your results and the table above, diagnose your patient. 139
Patient 4004 is a 22-year-old female that is experiencing a severe headache, fever, vomiting, neck stiffness, confusion, weakness, and eye pain. Stroke Blockage of arteries in the brain Encephalitis Viral infection Meningitis Viral or bacterial infection Severe headache, limb weakness, fatigue, vision change, confusion, eye pain, nausea, vomiting Table 4. Possible Diagnoses Symptoms Slide Abnormalities Bacteria Test Results Large amounts of red blood No color change cells will be present in the brain tissue Severe headache, fatigue, fever, confusion, limb weakness, seizures, nausea, vomiting Severe headache, fatigue, fever, neck pain, nausea, vomiting, confusion, pain in various parts of the body Large collections of infected cells will appear as darker masses within the brain tissue Large spaces in brain tissue will be visible indicating areas where bacteria has destroyed brain tissue Red to orange color change Black or dark blue color change Normal brain image Patient CSF sample Test tube Patient brain image Bacteria test Paper towels 1 Compare/contrast the normal brain and Patient 4004 brain images. Record your results on the answer sheet. 2 Measure out 3 ml of the Patient 4004 CSF Sample and pour it into the test tube. 3 Add 10 drops of the Bacteria Test fluid to the test tube. 4 Swirl the test tube to mix the fluids. Observe any color change that occurs in the test tube. No color change would indicate a stroke, a red to orange color change 5 would indicate encephalitis, and a black to dark blue color change would indicate meningitis. Record the results on your answer sheet. 6 Rinse out your test tube and dry it with a paper towel. 7 Using your results and the table above, diagnose your patient. 140
Patient 5005 is a 17-year-old female that has just joined a running club and has started experiencing worsening pain, headaches, fatigue, and paleness especially with exercise. Sickle Cell Anemia Genetic disease Malaria Infection caused by a protist Thalassemia Genetic disease Anemia, body pain, joint pain, swollen limbs, frequent infections, delayed growth, paleness, vision problems Muscle pain, fatigue, chills, fever, sweating, headache, nausea, vomiting Fatigue, weakness, body pain, abdominal swelling, delayed growth, jaundice, paleness Table 5. Possible Diagnoses Symptoms Slide Abnormalities Oxygen Saturation Levels Red blood cells will look LOW to NORMAL oxygen abnormal, and may be flat saturation levels that or curved into a sickle DECREASE drastically with shape exercise The worm-like Plasmodium protist will be visible microscopically in the blood Very few blood cells that are all abnormally shaped NORMAL oxygen saturation levels that DECREASE drastically with exercise NORMAL oxygen saturation levels that remain NORMAL with exercise Normal blood image Patient blood image Patient oxygen saturation test results 1 Compare/contrast the normal blood and Patient 5005 blood images. Record your results on the answer sheet. 2 Look at the Oxygen Saturation Test results for Patient 5005. A healthy oxygen saturation level will remain above 90%, even with heavy exercise. Compare the normal oxygen saturation 3 results and the results for Patient 5005. Compare the oxygen saturation levels to the levels listed in Table 5 above. Record your interpretation of the results on the 4 answer sheet. 5 Using your results and the table above, diagnose your patient. 141
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