Dermatologic Disease or Condition Medical Report

From the long tube of the gastrointestinal system and the lungs of the respiratory system last week, we move on to that very sensitive system of the body—the skin, and to that miraculous system of the body—the heart and the related circulatory system. You will add words related to the integumentary system and the cardiovascular system to your vocabulary of medical terms.

Start this week by reading the online lectures. Use the textbook to learn medical terms related to these two systems. Read the medical reports carefully to see some of these terms in context. When you think you have understood the report, answer the comprehension questions.When you are ready, take the vocabulary self assessments. Throughout the week post your responses to the discussion questions and reply to the contribution of others. Also, share with other students any mnemonic devices you create.You will end this week by completing the writing assignment and reading it to your facilitator’s voicemail Integumentary System (1 of 2)

An IntroductionThe word integumentary is derived from the Latin word integumentum, which means “to cover.” What covers the body? The skin. The integumentary system consists of the skin, which is the largest organ of the body and covers a surface area of 2 meters. The skin makes up 12–15% of body weight.Of the integumentary system, what you can see are the skin, the hair, and the nails. What you do not see are the hair follicles, the glands, the nerve fibers, the layers of the skin, and the cells in these layers.The outer layer of the skin is the epidermis. This layer has keratinocytes which produce keratin. This is the protein that goes to make nails and hair. The inner layer is the dermis. This layer has sensory receptors that let us feel touch and temperature.

In this layer, hemoglobin (red), melanin (brown), and carotene (orange-yellow) make up the color palette that determines the color of the skin.The functions of the skin include thermoregulation, excretion of salt water and wastes, physical protection, and synthesis of vitamin D3. You can easily guess the meaning of thermoregulation because you know the meanings of the two parts of the word thermo and regulation.Here are some more words to break down: dermatitis, psoriasis, and scleroderma. These are names of skin diseases. A dermatologist would treat these diseases. That’s another word for you, and it is easy to guess its meaning.The graphic on this screen shows how to decode two of the medical terms you have just read. Words in Context

In your reading, you often come across new words. You can usually make a guess about the meanings of such words from the context in which they appear. This is also true of medical terms. Your knowledge of these terms will grow as you see them in context. Read this consultation report about a skin rash. You will find that you can make sense of it with occasional help for meanings of medical terms. On reading the report, you will take a self assessment. VAMS General Hospital

San Diego, California

Consultation Report

Patient Name: Jane Bond
Patient Number: 2004-007
Patient Room: 007
Birth Date: 07/07/50
Report Date: 07/07/04
Consulting Physician: Dr. E. Schar

The patient is a 54-year-old white female, admitted to the hospital for a skin rash of unknown etiology. I reviewed the chart and examined the patient. None of her immediate family members (husband and two children) have developed a facial rash, lesions, or any other similar infection. She denies contacts with any animals recently, and has no pets. The patient reports that the onset of this lesion started three weeks ago when she first noticed a few diffuse papular lesions on her forehead that slowly increased in number, over the first week, spreading to her nose and periorbital region. In the course of the next two weeks the lesion rapidly spread to encompass her whole face, and anterior nares, becoming more edematous, with an obvious diffuse pustular exudate.

Initially, the patient self-treated her rash with topical bacitracin to no avail. She consulted Dr. Know, who initially placed her on Duricef, then Erythromycin, as the Duricef had no effect on the rash. Dr. Know admitted Jane for IV antibiotics, as her face had become swollen and as she was hardly able to open her eyes or sleep. She was placed on Cleocin, and over the course of three days, the spread of the lesion remitted, but didn’t resolve. She eventually developed a mild, diffuse pruritus, with accompanying erythema on the anterior and posterior aspects distal to olecranon area, which was assumed to be an allergic histamine response. I was called in yesterday and changed her medication to Unasyn 500mg IV q.8h.

Physical exam revealed a slender woman, with cellulitis-like lesions containing purulent yellow discharge over her entire face. There is evidence of an extensive edema that has apparently resolved. Palpation revealed lymphadenopathy and tenderness of the submental and submandibular lymph nodes. The patient was slightly febrile at 99.2oF. Lab results from the cultures obtained by Dr. Know and myself were negative for bacteria, which would be expected as she was on a course of antibiotics. Impression: Impetigo. Etiological pathogen is expected to be a resistant strain of Staphylococcus as it didn’t respond to the antibiotics administered. I would continue her therapy Unasyn 500mg IV q.8h., and if there is no response, I would include vancomycin as well. Thank you very much for this consultation, and I will continue to provide you with additional recommendations as they become necessary. Dr. E. Schar, M.D

Cardiovascular System (1 of 2)

IntroductionFitness experts often talk about a cardiovascular workout. The word workout makes you think of pumping iron. But pumping iron is for building muscles. To keep the heart in good shape, you need another kind of exercise. First, let us find out what cardiovascular means.By now, you are quite the expert at decoding. So you know that cardio refers to the heart. What does vascular mean? Vascular refers to the blood vessels—the arteries, capillaries, and veins. This is the blood circulation system. The heart is a muscular organ and pumps oxygenated blood out into the arteries.Arteries carry this oxygenated blood to all parts of the body. The blood does its job around the body, but becomes impure in the process. Veins carry impure blood back to the heart. The blood is oxygenated in the lungs and brought back to the heart by the pulmonary veins. Capillaries are thin-walled blood vessels that form a bridge between the arteries and veins allowing oxygen and nutrients to pass from the blood into tissues and waste products to pass from tissues into the blood.The heart is a vital organ of the body. Damage to the heart could be potentially life threatening. Heart trouble is usually indicated by pain in the chest.

There could be many causes for the pain. Some acute causes include myocardial infarction, angina, pulmonary embolus, and spontaneous pneumothorax. There are other less serious causes of chest pain. Click the link on the page to know more about chest pain.Some of the diagnostic imaging procedures used to visualize the heart and its functions include the echocardiogram, the transesophageal echocardiogram, aortography, and angiogram. Before recommending any of these procedures a cardiologist usually asks for lab tests to be done. The most common lab test is the lipid profile, which measures the fatty substances in your blood.To avoid all these troubles, physicians recommend cardiovascular workouts. Good cardiovascular exercises are aerobics, jogging, and swimming. These exercises increase the rate of heartbeats, and so strengthen this vital organ. But before heading out for the gym, take your textbook and learn terms related to the cardiovascular system Cardiovascular System (2 of 2) Cardiology ReportPatient Name: David Smith

12 lead EKG (attached) showed elongated QRS complex, transient atrial fibrillations with associated tachycardia. Cardiac enzymes drawn, patient placed on telemetry, with a dopamine drip at 12mcg. Echocardiogram showed moderate to severe hypokinesis of the anterior wall. Ejection fraction was 30%. Patient scheduled for emergency cardiac catheterization. Cardiac catheterization showed significant single vessel CAD with mild LV dysfunction. The left main coronary artery was totally occluded just beyond the origin. There were no irregularities of the other vessels noted.

The associated perfused anterior wall was moderately hypokinetic, with a calculated ejection fraction of 30%. Immediately following that cardiac catheterization procedure, the left main was successfully stented with a 2.5mm NIR leaving an optimal result. Subsequent EKG’s showed marked shortening of the QRS complex. He is expected to make a full recovery. He will require three weeks of Clopidogrel bisulfate and aspirin therapy. He was advised to refrain from vigorous activity for 3-4 weeks to allow the ventricular myocardium to repair.