Case 39 Part 1

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Physical exam




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Discussion Questions

   

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1. Summarize the history.
 
 
2. What causes of death was the patient at risk for based on the history?
 
 
3. How do you interpret information from a health professional who is also a family member? When do you consider this reliable? When might you have questions about the reliability? Do you believe the patient was bradycardic at home?
 
 
4. What is the differential diagnosis of dizziness with bradycardia? With tachycardia?
 
 
5. What is the differential diagnosis of increasing abdominal girth when it occurs chronically over time? Acutely (prior to presentation)? During resuscitation? Specifically, during CPR? Specifically, during intubation?
 
 
6. Is there a scenario where the size of the abdomen could have started to increase before resuscitation, but was only noticed at the time of resuscitation? What scenario might that be? Revisit this question after viewing the videos. Decide if it’s still relevant. State what data in the history and videos support your answer.
 
 
7. What is the purpose of mentioning slurred speech?
 
 
8. The patient appears to have scars on the lower legs surrounded by brown pigment. What is hemosiderin? How do you interpret this finding?
 
 
9. Based on the physical exam, what surgeries might the patient have had?
 
 
10. What findings suggest CPR?
 
 
11. What findings indicate the patient received medical care?
 
 
12. Is there livor mortis?
 
 
13. Is the patient obese? How does this change your analysis of the case, if at all?





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