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Biology Medical Case Study

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by

Ana Dzepina

on 22 May 2013

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Transcript of Biology Medical Case Study

By Meram Riad, Ana Dzepina, Kate Raymond and Jean Wang Biology Medical Detectives Project The Case Study: Ivana Gohome Differential Diagnosis Disease Causes 38 year old
female
severe right flank pain
nausea, chills,high fever
in pain for past five hours
not had a menstrual period for 2 months
no change in weight and appetite
has a two-year old son
has no chronic problems
non- smoker Treatment Test Results Comparison Blood Tests Leukocyte Count Hematocrit HCG (Human Chorionic Gonadotropin) Normal:5,000 to 10,000/mm3
Patient's: 12 000/mm3 higher then normal Hemoglobin Normal: 7.4—9.9 mmol/L
Patient's: 8mmol/L normal levels(a bit lower) Focusing mainly on the two most rare symptoms... Possible diseases Most likely diseases... Final Decision: Urinary calculi
Hydronephrosis
Hypernephroma (Kidney cancer)
rH incompatibility
Pyelonephritis
Choriocarcinoma
Fertility drugs
Pregnancy and miscarriage
Secondary amenorrhea
Emotional Stress
Ovarian Cancer (hCG levels and blood in urine) Normal: normal(38%-46%)
Patient's: 0.40 or 40% Normal: 4 weeks pregnant ( 5 – 426 mIU/ml)
Patient's: 500mIU/ml Urine Tests Erythrocytes HCG Patient's: Trace
Note: Different STDs, kidney infections Choriocarcinoma Pregnancy After normal pregnancy
complete hydatidform mole
mass inside
miscarriage
genetic damage to germ cell
abortion
ectopic pregnancy Pregnancy and miscarriage

Pyelonephritis

Urinary calculi

Choriocarcinoma - Doesn't cause high HCG and lack of period - Required HCG levels too high and no other pregnancy symptoms - Same as pyelonephritis and pain occurs in cycles of 20-60 min 40-year-old women are more likely than 20-year-old nausea, chills, fever, flank pain occurs months/years after pregnancy Raises HCG levels and results in no menstrual cycle Slightly lowers hemoglobin level Patient's: Positive
Note: Pregnant After diagnosis a check is done to make sure the cancer has not spread to other parts of the body
Brain and liver are particularly dangerous organs to develop cancer and usually result in fatality
If HCG levels are more than 40,000 mIU/ml then it is more difficult to cure the cancer
Cancer may return within several months to three years after being cured
More difficult to cure if a baby is delivered normally prior to formation of cancer
70% of women with high risk situations will be cured
Women with this disease can go on to have normal pregnancies
Infection of the uterus is most easily treated Chemotherapy Chemotherapy is the most common treatment
90-95% of those who are given chemotherapy are cured
Chemotherapy is highly effective when metastases (secondary malignant cells) has not formed
The most commonly used drug for this type of chemotherapy is methotrexate, for low risk cases
EMACO is used for high risk cases (etoposide, methotrexate, actinomycin D, cyclosphosphamide and Oncovin) Removal of the uterus (hysterectomy) is used for women above the age of 40, who have extreme infection or bleeding
The Hydatidiform mole is the leading cause of this type of cancer, it is a grape like structure that should normally form the embryo and forms malignant cells
This mole can be removed with surgical procedures such as dilatation and curettage Surgical Procedures Although rare radiation therapy is used if the cancer is spread to other parts of the body
Minor treatments such as relaxation and mild exercise can reduce stress and decrease side effects of chemotherapy such as rapid weight loss and depression Other Treatments It is important to have frequent check ups after pregnancy (especially miscarriages or abortion) to ensure you are healing properly and that the hydatidifporm mole has not formed, so cancer will not form
Early diagnosis will make for a more positive outcome
Good nutrition, especially during pregnancy will make it less likely to cause the formation of the hydatidifporm mole Prevention
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