Requirements

For Week 5 of the course the faculty will not be providing a case study. Instead you will choose from an area that you have an opportunity for improvement that was identified on your APEA predictor exam. You will research that area of content in relation to complaints and disorders that commonly occur in family practice. Please work up a case study that begins with a chief complaint commonly seen in primary care based on that body system. The case should be clear and include all elements of a normal case that might be presented in class (subjective, objective, assessment, diagnostic testing and 5 point plan in part 2.The clinical logs will be helpful for this process, or notes you have taken in clinical regarding cases. The case should be clear, organized, and meet the following guidelines: 

Week 5 Part 1: Due by Tuesday 11:59 p.m. MT

Step 1. Review your Week 4 APEA Predictor Exam Results and focus on the “Percent Correct by Knowledge Area” Choose a knowledge area on which you scored the lowest to work on this week.

Step 2. Once you’ve chosen the subject, research and work up a common chief complaint from that system that you haven’t learned already in the program and present your findings in the discussion threads. Push yourself to explore diagnoses in this area that are still common to primary care, but not a repeat of content learned in this or other courses.

Step 3. Respond to at least one other student’s CC work up as well as any questions posed to you by faculty.

Work up includes:

Chief complaint, PMHx, Demographics, PSHx, allergies, lifestyle, HPI

Associated risk factors/demographics that contribute to the chief complaint and differential diagnoses

Three common differential diagnoses represented by the CC including pathophysiology and rationale in the identified body system i.e., if pulmonary was your body system than a chief complaint could be persistent cough and three pulmonary differentials; 

Discuss how the three differential diagnoses differ from each other in: occurrence, pathophysiology and presentation (NOTE: Simply listing the diagnoses and their occurrence, pathophysiology and presentations separately does not confer an understanding of how they differ. Your discussion should compare and contrast these items against each other among the three differentials chosen); 

Relevant testing required to diagnose/evaluate severity of the three differential diagnoses; and 

Review of relevant National Guidelines related to the Diagnosis and Diagnostic testing for these diagnoses 

Solution:

CC: ” I have been having excessive thirst and polyuria for the past 3 months”

HP1: A 54 y/o old African American  male presented to the clinic complaining of increased urination at night and excessive hunger. He is worried about the symptoms because his father and mother died of diabetes complications. He states that symptoms started 3 months and they have been worsening over time. Other symptoms that he has been experiencing include decreased visuals and slow healing wounds. He has not been taking any medication.

PMHx: HTN, Cholecystectomy