Week 2: COPD Case Study Part 1 (Initial post due Tuesday, faculty and peer responses due Sunday)
A 62 year-old Caucasian male presents to the oﬃce with persistent cough and recent onset of shortness of breath. Upon further questioning you discover the following subjective information regarding the chief complaint.
Nares patent. Nasal turbinates clear without redness or edema. Nasaldrainage is clear.
Oropharynx moist, no lesions or exudate. Tonsils ¼ bilaterally.Teeth in good repair, no cavities noted.
Neck supple. No lymphadenopathy. Thyroid midline, small andﬁrm without palpable masses. No JVD
Heart S1 and S2 with no murmurs, noted. Lungs clear to auscultationbilaterally with faint forced expiratory wheezes in bilateral bases.Respirations unlabored. Legs without edema.
Soft, non-tender. No organomegaly
Application of Course Knowledge
● A brief AND concise summary of the history and physical (H&P) ﬁndings is presented without redundancy orirrelevant information; AND ● Three (3) appropriate diagnoses in the differential are presented which canexplain the patient’s chief complaint; AND ● A brief statement of pathophysiology is included for each diagnosis; AND● Each diagnosis in the differential is analyzed using pertinent positive and negative subjective and objective ﬁndings as support; AND● The differential is ranked in order from most likely to least likely; AND● Clinical reasoning skills are demonstrated by linking testing to diagnoses as applicable; AND● Testing decisions are well supported with EBP arguments that are in-line with the clinical scenario and appropriate for the primary care setting
(7 critical elements)
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