Patient Scenario Metastatic Prostate Adenocarcinoma Assessment

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Patient Scenario

1.   What are the components of physical examination? Describe each component. (See Module 1, Commentary, Topic 8. Disease Categories, Part B. Steps in Diagnosis attached)

As per the course module, there are several components of a physical examination. To begin with, we have the observation of the diseases’ physical signs as well as assessment of a few factors such as skin color changes, stimuli responsiveness, alertness, mobility, facial expression, posture, etc. Next, there is the taking of the vital signs of the patient which could in this case be inclusive of the patient’s breathing rate, heart rate, blood pressure, etc. Third, yet another key component of physical examination is auscultation. In this case, a physician makes use of a stethoscope to listen a patient’s bowel movements as well as well as heart and lungs for abnormalities. Fourth is a procedure referred to as percussion. It is important to note that under standard or normal conditions, specific sounds are produced following the tapping of an individual’s abdomen and chest. Thus, thanks to this particular procedure, the course module points out that it is possible for a physician to make a determination as to the disease area, excess air or fluid in the lungs, etc. The last procedure in as far as physical examination is concerned is palpation. On this front, a physician applies pressure using his or her fingers with the intention of feeling certain regions of the body and nearby organs. As per the course module, this particular procedure “provides information about the size of an organ and changes in its consistency, shape, and tenderness, and can help determine the presence of a foreign mass.”

2.   Mr. Smith’s blood pressure was 160/100 mmHg. How does a medical provider take or measure blood pressure? What do the top (numerator) and bottom (denominator) numbers mean in the biological sense? What is the significance the size of these two numbers? Is Mr. Smith’s blood pressure within normal range? Explain how you concluded whether Mr. Smith’s blood pressure is/is not within normal range.

It is important to note, from the onset, that blood pressure could be conceptualized as a range between two numbers - with the said range presented as a numerator and denominator. The numerator and denominator are referred to as systolic and diastolic blood pressures respectively (Palmer, 2005). In essence, systolic blood pressure is representative of pressure in an individual’s arteries following heart muscle contraction.

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On the other hand, diastolic blood pressure is representative of pressure in an individual’ arteries after his or her heart rests, i.e. in between heart beats. To a large extent, these two numbers come in handy in the assessment of an individual’s heart health as well as general wellbeing. It therefore follows that when the said numbers are above the normal range, an individual is said to be having high blood pressure. On the other hand, when numbers are below the normal range, a person is said to have low blood pressure. According to the American Heart Association (2020), the normal range for the upper number (systolic) is less than 120. On the other hand, as the American Heart Association (2020) further points out, the normal range for the lower number (diastolic) is below 80. With a blood pressure of 160/100 mmHg, Mr. Smith’s blood pressure is obviously out of the normal range. His blood pressure could, thus, be deemed high. As a matter of fact, as per the definitions offered by the American Heart Association, his blood pressure could be categorized under ‘high blood pressure (hypertension) stage 2, i.e. upper number (systolic) of 140 or higher; and lower number (diastolic) of 90 or higher.

3.   Based on the data provided, what laboratory tests were performed and what samples were taken from the patient?  Select one of the laboratory tests ordered for Mr. Smith and discuss why Mr. Smith’s physician might have ordered the test and the information she might have expected to obtain from that particular test.

The laboratory tests that were performed in this case on the basis of the data provided are: K (potassium test), Hb (Hemoglobin test), hct (hematocrit test), platelet count (platelet blood count), HCO3 (bicarbonate test), urinary K (potassium urine test), blood glucose, serum aldosterone, and 24 hour urinary Aldosterone. In the potassium test, a small sample of blood was collected. This was also the case for the hemoglobin test, hematocrit test, the platelet count test, the bicarbonate test, blood glucose, and serum aldosterone. On the other hand, urine samples were taken in both the….....

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