Mr. XYZ is a 57 year old Caucasian male

Mr. XYZ is a 57 year old Caucasian male who you recently saw in the clinic for the first time for evaluation of generalized abdominal pain and fullness, urinary frequency, urgency, and nocturia for 2 months. Labs were completed and have partially resulted. You recall he has liver masses shown on CT which are consistent with metastatic disease of unknown primary. 

Currently, he is complaining of shortness of breath which started 24 hours ago and increased lower extremity swelling. He has mild, intermittent, left sided substernal chest pain which does not radiate. 

Review of symptoms is positive for: weight loss of 40lbs over the last 6 months, fatigue, malaise, general body aches, polydipsia, polyuria, chest pain, shortness of breath, abdominal fullness, lower extremity swelling. 

Social History: Quit smoking 5 years ago but smoked 4 packs a day for 8 years. Denies ETOH and drug use

Mother: Had some type of cancer but does not know what kind, parkinson’s disease, pneumonia

Father: Diabetes, chronic kidney disease, hypertension

Vitals: 98.6-100-26-158/96, 92% on 2L NC

Constitutional: Alert and Oriented x 3. Obese. Is mildly dyspneic.

Head: Normocephalic and atraumatic

Eyes: pupils are equal, round, and reactive to light. No nystagmus. No scleral icterus.

Neck: Neck supple. 3 cm JVD present. No tracheal deviation present. No Thyromegaly or thyroid modules noted.
Cardiovascular: Normal rate, S1 Normal, S2 present, S3 is present, +2 edema in lower extremities bilaterally.
Pulses: Brachial, Radial, Dorsalis pedis, and posterior tibial pulses 2+/4+ bilaterally 
Pulmonary/Chest: Dyspneic, not using accessory muscles. Respirations regular and even. Lungs with rales in the anterior and posterior lung fields bilaterally. 
Abdominal: Obese, Soft. Bowel Sounds are active. Generalized tenderness. no masses noted. No CVA tenderness. Unable to palpate liver due to body habitus. There is no rigidity, rebound or guarding.
Lymph: No cervical lymphadenopathy
Neurological: CN II-XII intact
Skin: Skin warm, dry and intact. No rashes. Lesions and abrasions.
Psychiatric: Mood and affect normal. Calm and cooperative behavior. Judgment intact.

Medications: None

AST                60 units/L

ALT                58 units/L

Cholesterol       250 mg/dL

LDL                180 mg/dL

HDL                15 mg/dL

Triglycerides      275 mg/dL       

Troponin I         0.6 ng/ml

Chest xray: shows cardiomegaly and kerley lines

Echocardiogram: left ventricle ejection fraction of 35%, impaired left ventricular relaxation, left and right atrial hypertrophy, right ventricular hypertrophy, and pulmonary hypertension.

Explain Mr. XYZ’s diagnoses. Must integrate the answers to the questions below into your discussion. 

1. Based on the current information available, what diagnoses do you believe Mr. XYZ has?
2. What labs and/or diagnostic tests do you believe are needed at this time?
3. Describe the pathogenesis which explains Mr. XYZ’s condition, his physical symtoms and diagnostic test results?
4. What education is important for Mr. XYZ to receive?

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – Mr. XYZ is a 57 year old Caucasian male

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

• Guarantee

  

• Zero Plagiarism
• On-time delivery
• A-Grade Papers
• Free Revision
• 24/7 Support
• 100% Confidentiality
• Professional Writers

• Services Offered

• Custom paper writing
• Question and answers
• Essay paper writing
• Editing and proofreading
• Plagiarism removal services
• Multiple answer questions

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper