Case Studies for Problem-Based Research Project (PBRP)
Anatomy & Physiology II (34 BIOL 2002C)
Spring Semester 2013
Nestor T. Hilvano, M.D., M.P.H.
Focus Questions (Learning Outcomes for discussion and understanding of the
main problem):
1. Correlate the structure(s) and function(s) of the organ system affected.
Discuss pathways to show understanding of the pathophysiology of the main
problem (condition, disease, injury or malfunction) and other related issues.
2. Explain signs and symptoms and other associated conditions of the patient
(establish the basis for physiological symptoms).
3. Describe the causes and risk factors you think are essential to the problems.
4. What pertinent lab work- up(s) will help you correlate your diagnosis?
5. Understand and correlate possible complications that might arise if not given
proper care and management.
6. Explore common preventive measures, treatments and suggestions to help
him alleviate, recover or limit disability.
The problems (conditions, diseases, or injuries) and their complaints (signs
and symptoms) listed below are case studies of Problem-Based Research
Project (PBRP):
Problems (Clinical Diagnosis)
Endocrine System:
45 y/o, male, Type 2 Diabetes Mellitus
17 y/0, female, Type 1 Diabetes Mellitus
50 y/o, male, Grave’s disease
6 y/o, female, Cretinism
36 y/o, male, Cushing syndrome
48 y/o, female, Addison’s disease
Lymphatic & Immune System
20 y/o, female, Systemic Lupus
Erythematosus (SLE)
32 y/o, male, Multiple sclerosis
63 y/o, male, Myasthenia gravis
59 y/o, female, Lymphoma
Complaints (Sign and Symptoms)
Polyuria and polydipsia; with 45 BMI and high
triglycerides
Ketoacidosis and hyperglycemia; noted extreme
hunger for the 6 days
Swelling of anterior neck and palpitations;
associated with reddish, skin rash on extremities
Delayed epiphyseal development; had choking
episodes, poor feeding and poor weight gain
Hump at back; with fat accumulation at back,
hyperglycemia, high blood pressure, and episodes of
irritability or anxiety reactions
Weakness and weight loss; associated with muscle
aches and severe intolerance to cold
Tachycardia and joints pain; noted cervical lymph
nodes enlargement
Sensitivity to heat and tingling sensation on
admission; had weakness on limbs, tremor, and
unsteady gait on walking
Drooping of eyelid on right and difficulty of
swallowing; weakness of arm and leg
Swelling of right arm; had history of weight loss,
lethargy, and feeling of being full.
1
47 y/o, male, Scleroderma
12 y/o, female, Acute lymphocytic leukemia
Cardiovascular System
60 y/o, male, Congestive heart failure
10 y/o female, Sickle cell disease
50 y/o, female, Myocardial infarction
21 y/o, male, Rheumatic heart disease
70 y/o, female, Deep vein thrombosis
68, y/o, male, Aortic aneurysm
Respiratory System
17 y/o, male, Bronchial asthma
58 y/o, male, Bronchogenic carcinoma
39 y/o, female, Bronchitis
32 y/o, male, Pulmonary tuberculosis
48 y/o, female, Emphysema
50 y/o, male, Pulmonary sarcoidosis
Digestive System, Metabolism/Nutrition
20 y/o, male, Crohn’s disease
24 y/o, female, Peptic ulcer
18 y/o, male, Irritable bowel syndrome
(ulcerative colitis)
56 y/o, male, Acute Pancreatitis
48 y/o, female, Hepatitis C
Stiff and puffy fingers and hands; noted fingers very
sensitive to cold, difficulty of swallowing
Gum bleeding and lumps in neck and underarm;
with shortness of breath and complains of fatigue
Breathlessness and had to sleep with 3 pillows,
swelling of lower extremities from ankles to knees,
distended neck veins, grade 3/6 systolic murmur,
nail beds mildly cyanotic
Fever, episodes of pain in chest and bones,
abdominal swelling, and pale skin
Chest pain radiated to left arm and neck, nausea,
sweating, body malaise, and shortness of breath
Fatigue, breathlessness, and fainting attack
Swelling associated with pain in ankle and foot, pale
skin color, dizziness, and rapid pulse
Tearing pain at chest and back, hoarseness,
coughing, and shortness of breath
Tachypnea, audible wheezing and restlessness; had
tightness of chest at night or early morning and
associated rhinitis
Blood-streaked sputum and dyspnea of 3 days
duration; with fever and develop pneumonia, had
60 pack-year smoking history
Shortness of breath and coughing with increase
mucus for 3 months in 2 consecutive years, change
in phlegm color, increasing tiredness
Fever, night sweat and increase productive cough of
2 months duration; had weight loss and body
malaise
Shortness of breath and tachycardia; history of
smoking since 18 years old
Shortness of breath and dry cough; with chest pain,
swelling of cervical lymph nodes, and fatigue
Abdominal pain and diarrhea of 5 weeks; associated
with nausea, joints pain, and weight loss
Epigastric pain relieved by food intake; associated
with fullness, nausea, and chest discomfort; history
of smoking and intake of NSAIDs
Bowel cramps, nausea, bloating, diarrhea
alternating with constipation; noted mucus in stool
Sudden onset of abdominal pain, nausea and
vomiting; later had loss of consciousness and
muscle weakness; history of alcohol drinking since
19 years old
Loss of appetite, myalgia and yellowish skin; noted
2
44 y/o, female, Gallstone (cholelithiasis)
Urinary System, Fluid/Acid-Base Balance
12 y/o, female, Urinary tract infection (UTI)
30 y/o, male, Polycystic kidney disease
62 y/o, male, Chronic renal disease
35 y/o, female, Painful bladder syndrome
(interstitial cystitis)
46 y/o, female, Kidney stone
(nephrolithiasis)
68 y/o, male, Acute renal failure
Reproductive System, Genetics/Heredity
36 y/o, female, Endometriosis
39 y/o, female, Cervical cancer
27, y/o, female, Breast cancer
68 y/o, male, Benign prostatic hypertrophy
(BPH)
19 y/o, male, Testicular cancer
7 y/o, boy, Trisomy 21 (Down syndrome)
spider-like blood vessels on abdominal skin
Sharp, cramping epigastric pain and nausea; noted
clay-colored stool; history of diabetes mellitus, and
intake of instant/fast-food meals
Pain in lower abdomen, painful to urinate at times,
and cloudy urine.
Back pain, frequency of urination and hematuria;
history of recurrent urinary tract infection 4 years
ago
Changes in urine output, loss of appetite, and
muscle cramps; history of hypertension and
diabetes mellitus
Frequency and painful urination; had tenderness at
pelvic region, symptoms get worse during
menstruation
Severe flank pain and hematuria; had fever and
chills, and history of inflammatory bowel disease
Flank pain, decreased appetite, and changes in
mental status; had history of car accident and
undergone surgery of perforated small intestine
Irregular menses, pre-menstrual spotting,
attempting to conceive for 6 years
Abnormal intermenstrual and post-coital bleeding;
had no pap’s smear since completing HPV
vaccination
Breast lump on right & redness around nipple;
smoking history since 18 years old
Urgency and difficulty in starting to urinate;
dribbling urine and feeling of bladder fullness
Swelling and pain in scrotum; associated with pain
in lower abdomen and breast enlargement
Small head and flattened facial features; with poor
muscle tone and small fingers
3