Case Studies

### Case 1: Bodychecked!

At my hockey game I was skating near the boards and got hit from the opposing player. I fell and landed on my hand awkwardly. I returned to the bench and took off my glove just above my wrist my hand was a dark purple and very swollen. I could move my fingers slightly but not very much. I am feeling a lot of pain and I am a little bit dizzy. What happened?

### Case 2: A Real Pain in the Knee

A healthy 60 year old male went to his doctors with the following complaint. He explained he was feeling pain, stiffness, and swelling to his knee. He then continued to tell his doctor that he has been feeling this pain for approximately two months. He described it by saying that he felt pain when he was running, but his knee felt good when he was lying down. He also mentioned the joint would at times become very red and hot. The doctor then examined the man and noted that there was some inflammation around the knee. When the patient bent his knee there was limitation of movement. To confirm his diagnosis the doctor ordered an X-ray. The doctor also order a series of blood tests to rule out any other disease or infection.  Upon receiving the results of the X – ray the results confirmed there was no fracture just inflammation around the knee and the doctor was correct with his diagnosis.

### Case 3: A Bad Cough?

I’ve been smoking for about 25 years and
recently I’ve been feeling pains and weaknesses in my body. I have never felt this before but I had a feeling that smoking was one of the main reason why I’m feeling sick. I have been feeling some chest discomfort and pain in my chest. Also I’ve been feeling a lot of shortness of breath and been coughing a lot of yellowish mucus colour out. I have also been feeling really tired and getting chills and fevers off and on.

### Case 4: Smoking is Bad

Andrea is 40 years old and has been
smoking for close to 22 years now. She tried her first cigarette when she was 18 at a party with all of her friends, and has been smoking ever since. Before she used to only smoke 2-3 times a week, but now she smokes at least 2-3 time every day. For the past 22 years she hasn’t had any physical problems with her body, only the usual ‘smoker’s cough’ that is caused when someone smokes frequently. One morning, Andrea woke up and felt weird about something, she had a sudden burning sensation in her chest. Andrea didn’t think much of the sensation in her chest because she blamed it on the Mexican food she had the
night before, and then went to work. Throughout the whole day she felt that sensation, but didn’t do anything about it. The next morning she woke up and felt good again, so she decided to go on a run with her friend Margret. Margret and Andrea go on runs at least 1-2 times a week, but this time was different. Andrea wasn’t able to keep up with Margret because she had a shortness of
breath, felt very dizzy, and was sweating abnormally. Andrea said that it was nothing because she has been very stressed at work, and that she was just tired. Margret was still concerned for Andrea, because she never acts that way, so she took her to the doctor’s office to see if there was anything wrong.

### Case 5: 3rd Period

Yesterday night, I was
playing hockey and in the 3rd period of the game, I got hit into the boards and felt a snap in my arm. I got off the ice and my trainer told me to see if I could move my arm. I could not lift my arm above my head, put it behind my back, and turn it upside-down. I did not go back on the ice, and after the game I, got help taking off my equipment because I could not apply any pressure on the arm. When I finally got my equipment off my arm was swollen, bruised, and deformed. My parents then took me to the hospital to get it checked out.

### Case 6: Out of Breath

Today, Selena walks into the doctor’s office complaining somethings wrong with her. She’s been noticing that she hasn’t been able to sleep because of her intense coughing at night. Selena is known to be really athletic as she runs every morning and has been noticing that she shortness of breath easier and isn’t able to run anymore. Though, she later notices that by walking around the office or walking down the stairs of her home cause her to have shortness of breath.  Selena, has also been complaining to her husband about her constant chest pain, she says that it hurts too much to even breathe.  Now she suffers lack of sleep because of this problem she’s been having, which causes her to have lots of stress in her day to day life. Today, she hasn’t been able to stop wheezing, and she is now super concerned. When she begins telling her doctor all her symptoms, Selena explains to the doctor that her father had similar symptoms when he was a kid.

### Case 7: Itchy Hands

Over the past few weeks, I have been experiencing itchiness on my hands. I usually have dry skin at times during the year on my hands, but it has never been this itchy or red. I usually get my dry skin in the winter. My hands start sting as I play hockey, the sweat and cold together causes my hands to have an irritated itchiness and stinging. My room is quite cold as well and at night my hands start to become more irritated. Overall my hands at the moment feel rough and I notice some redness or rashes starting to appear and this is not my normal dry skin and am wondering what this could possibly be?

### Case 8: Trouble in the Deep End

I was at a public pool swimming with my sister and suddenly I lost the ability to hold my body above the water. I continuously bobbed my head above and below the surface of the water. It seemed as if my right arm and leg stopped working completely. I panicked because I had never experienced this before and I did not know how to react. At first I pretended I was fine, but when I got extremely weak I swam to the wall to take a break. My sister asked me how I was feeling. She said I was speaking strangely. She mentioned that my mouth looked uneven and was slurring my speech. I mentioned that I felt very weak on the right side of my body. She immediately called the lifeguard who removed me from the water and began asking me questions. The lifeguard asked me my name and how I was feeling. I explained my symptoms. She told my sister to call 911.  She asked me to hold her hands and squeeze them as tight as I could. She checked my breathing and my heart rate as well. She also asked me if I have any family members with high blood pressure or diabetes. I explained my father has high blood pressure. She continuously told me that everything was going to be fine and comforted me until the paramedics arrived.

### Case 9: Cramping My Style

A 30 year old woman visits her family doctor as she had been having abdominal cramping and pains for the past two weeks constantly. She has been bloated constantly as well for the past two weeks. She is constipated on and off but when she is able to release her waste, her stool has been appearing soft with mucus in it.

### Case 10: A Splitting Headache

A 60 year old man who smokes walks into the hospital and waits to see a doctor. He continues to complain about his headache to his wife. Once he is taken in he explains to the doctor that he has been feeling very weak lately. Then the man continues I have had splitting headaches since last night which feel like migraines. The doctor then asks are you experiencing anything else. The man goes it feels like I am almost drunk I have a very hard time walking and it’s been very difficult to see out of one of my eyes and half of my face has been numb ever since I woke up there is something wrong doctor please help.

### Case 11: Coming Out Both Ends

Over the past few weeks I’ve been feeling a lot of discomfort and pain in my abdominal area and I’m unsure as to what the source of the problem is.  I’ve been experiencing reoccuring cramping and nausea almost every day which is causing me to vomit repeatedly.  Due to my consistant vomitting I’ve been feeling incredibly fatigue, I’ve been loosing a lot of energy, and I’ve also noticed that I’ve lost a considerable amount of weight.  Even though I’ve been loosing weight and energy as I have not been eating, I fail to have any source of appetite.  To also mention, when I do try to eat certain types of food my symptoms become worse when they are foods high in both spice and salt.  The abdominal pain I’ve been experiencing has also caused me to have diahrea up to eleven times a day, and occasionally I notice that there is blood within it. During the physical examination, the Doctor notices that the patient also complains of pain and soreness in their joints, has red and tender bumps located on the skin of their left arm and leg, and also has small tears on their anus.

### Case 12: Sick and Tired

Bianca is an active 15 year old girl
that enjoys playing hockey, and is always active in gym class. Recently, Bianca has been experiencing trouble sleeping and has had a rapid heartrate. She has had to sit out in hockey as well as gym class. Bianca is a fairly healthy eater but since her heartrate has begun to rise, she has been eating many healthy foods in thought of the reason. Each night, Bianca goes to bed fairly late and thinks this is a symptom of always being tired. As a result of the healthy eating, Bianca has lost a lot of weight but has not been on a diet, she also is experiencing hand tremors, increased sweating and muscle weakness. Bianca does not know what is happening to her and is becoming very nervous. Bianca’s mother has had this disease in the past but has had her thyroid gland surgically removed to prevent the disease from happening again. Bianca’s parents would like to gather more information about it before they decide to take action. Bianca and her parents booked a visit with their family doctor to find out what was the problem.

### Case 13: A Rough Night

Amelia Riley is a patient at the King City Medical Clinic. She is 1 year old and has a breathing problem. One night Amelia had a very bad cough, so her parents took her to the doctors. The doctors found that, instead of Amelia taking nice long breaths her breaths are very short. Amelia’s parents said that every night Amelia has been coughing a lot, and wouldn’t stop, and since her cough was so bad one night her parents thought it best to take her to the doctors.

### Case 14: Dazed and Confused

You have been recently experiencing memory loss and
having difficulty figuring out the time and place where you live. Just yesterday, you were having language problems when you talk. You come to the conclusion that something is wrong with you, but you don’t know what. You have misplaced your car keys and can’t retrace your steps to figure out where it is, but you found it twelve minutes later. You decide you are not well enough to dive so you call your sibling to pick you up and go to the doctor. You start to get angry with your sibling for no reason. Your sibling notices your mood change, and all your other symptoms. Your sibling tells you he/she might know what is wrong with you, but your sibling wasn’t sure so they don’t want to worry you for nothing. You finally get to the doctor’s office after what felt like half an hour, but was really ten minutes. Your sibling takes notice of your confusion of the time. You get into the doctor’s office and your sibling talks to the doctor in privacy, probably about what he/she thinks you have. The doctor then checks your symptoms. You said you were experiencing confusion with time, not being able to retrace your steps after you misplaced something, changes in mood, language difficulties, and your sibling adds memory loss. The doctor has diagnosed you. What was the diagnosis that the doctor gave you?

### Case 15: Cough, Cough

Mr. John is a 60 year old auto mechanic who presents with progressive shortness of breath for the past several days. His problem began four days ago when he got a cold. His job forces him to work in the cold and damp air. His cold consisted of a sore throat, fatigue, and chills. At first, he just felt tired but later he developed a cough and shortness of breath. Initially, the cough was dry but within 24 hours, it produced abundant yellow-green sputum. He states, "I cough up a cup of this stuff every day." He didn't think much of a cough because he continually coughs during the winter of each year. The shortness of breath has worsened so that he can hardly speak now. Hence, he also has pain in the left side of his chest when he coughs. He becomes very tired after walking up a flight of stairs. In addition, he has been treated for similar episodes of coughing and shortness of breath during the past three years. Once he was hospitalized because he was drinking too much and for smoking 1-2 packs of cigarettes per day and has done this for the past 35 years. What disease does Mr. John have?

### Case 16: Bike Ride Gone Bad

**Patient Initials: MR**

**Initial date of patient consultant/treatment: February 11th, 2016**

**Patient Age: 23                Gender: Female            Occupation: Student**

**Patient Complaints:** Excruciating pain in the shin, leg looks deformed, swelling and bruising is beginning to form and pain deepens once pressure is applied

**History before accident:** Riding on the bike for half an hour and then lost control and fell off. A bit of pain was present at first but gradually the pain has been getting worse. It has currently been 14 hours since the accident.

**Medications taken up to this point:** acetaminophen and ibuprofen

### Case 17: Mr. Larkin's Legs

Many of my patients have harsh jobs that make them feel uncomfortable and serious pain which make them come see me once a month. One particular patient of mine is a professional athlete Mr. Larkin who is in his first year of playing professional hockey came to me saying that he is experiencing pain in his thigh. The first check that I did was for the serious injuries such as torn muscles and blood clots in the injured area. I found no symptoms or bruising that would lead to the conclusion of those injuries so my final diagnosis check would be for muscle strains. I told the patient to move his leg in different ways that way I can see where it hurts the most. The next thing that I did was ask the patient if I could put pressure on the injured thigh and see how the patient would react depending on where I put pressure. When I put some pressure with my fist on the patient’s thigh he reacted in a hurting way, this is when I came to my conclusion of the diagnosis.

### Case 18: All Red-Faced

Hi, I am coming in to talk to you about some skin issues I have been experiencing. My name is Ashely, and I am a 16 year old teen. I have noticed that throughout the past 2 years I have had painful, red pimples on my oily skin that look similar to boils.  I also have pimples that are very firm bumps and are extremely painful to the touch. They feel as though they are deep within my skin, and when popped create major scarring. The ones that appear as a boil, are filled with a puss substance. My mother also experienced this when she was around my age. I have tried many topical treatments including salicylic acid, and benzoyl peroxide. The systems include face washes, toners, and topical creams. However, although I consistently use systems properly, I feel as though they are not working well with my skin. I am still continuously getting these painful pimples and scars on my face. I wanted to know some background information on what may have caused it, what type of pimples these are, and ways to treat this issue as well as my scars.

### Case 19: Downhill Disaster

I went snowboarding the other day and the front edge of the board caught the snow and I fell forward on my hands and immediately I felt pain I my left wrist. I noticed swelling and bruising after a few minutes. I tried to apply pressure to see if I was ok but I could not move it and when I put pressure it got worse. I went to the infirmary and they told me that it was a sprain so they gave me a bag of ice and I put it on but I was still in deep pain. For the next two days I wore a sprain bandage and I did not notice an improvement. I finally went to the hospital and got an x-ray and they noticed swelling.

### Case 20: All I Want is a Coffee

One morning a 55 year old man was in his house about to leave for work. He has been feeling really tired for the past two weeks, but ignores the exhaustion, and instead believes he did not sleep long enough. He pours the last cup of coffee left in the pot into his coffee cup. As he grabs his mug and was about to pour his coffee, his hands start to shake and drop the cup, which causes it to shatter on the floor. Oblivious to what might be more at hand, he cleans the shattered cup off the floor, gets into the car, and drives to a local coffee shop to get his morning coffee, as he did not have one this morning. The man gives the barista his order, but he slurred his words. He gets his coffee and walks to his car. He notices that he is very dizzy and his hands are cramping. The man finally admits that something is not right, therefore, call his boss saying he is sick, and drives to his doctor's office.

### Case 21: No More Knitting

Hello, my name is Veronica Smith and I am 67 years old. Recently I have been noticing that my hands have been quite swollen especially in the thumb area. Also, specifically in the morning, my hands are extremely stiff and it is very painful for me to move them. I have been knitting a blanket for my grandson, and the pain in my hands has been affecting my knitting skills. I was hoping that the stiffness would go away after a couple days, but it has been 3 weeks of swelling and stiffness, so I thought it was time for me to contact a doctor.

### Case 22: "A Very Uncomfortable Interaction"

John is a 35 year old man who has had abdominal pain and cramping for just over a week now and cannot classify what disease he is facing. John has been cramping, vomiting, bad diarrhea and a lack of energy for a week while he has been at home and at work this week. John did not think much of these symptoms, he just thought that these symptoms were caused because of the unhealthy meal choices he had eaten because of his wife going away on a work trip. John woke up at 3am and had a very uncomfortable interaction with the toilet and could not go back to sleep all day because of the countless times he had used the washroom. At this point it is 8am and john still hasn’t slept. John decides to check himself into the washroom because of the fatigue, vomiting, diarrhea, and lack of energy.

### Case 23: Skate Park Mayhem

I am an 18 year old boy named Chris Leo and one day ago I went to the skate park. I was skating and fell off my skate board and landed on my right arm. My arm is now in a lot of pain. It is bruised on my lower half and is very swollen. If I apply pressure to my arm a pain shocks through my whole arm. I cannot move my arm since it would be too painful and I can’t even feel anything, it feels like my arm in num. My arm is interfering with me doing my homework. I also cannot skate board since whenever I do my flips my arm would hurt too much.

### Case 24: Sick in Bed

Michelle, is a healthy 15 year old girl, who went to her doctor to tell him some symptoms she was having. She said she was having the chills, headaches, and body aches. She told him that she woke up yesterday and just started throwing up uncontrollably. The doctor asks if Michelle has been eating, she says that she has had a loss of appetite and can’t seem to hold down any food. Michelle has been lying in bed due to weakness and nausea. She says that whenever she tries to get up and do stuff, everything just rushes through her and she can’t keep up right. What is the doctor’s diagnosis?

### Case 25: Uncomfortably Numb

Mr. Andrews is a 42 year old male has always been a hardworking, fit individual.  He often complains to his wife that he is constantly having blurry or double vision. These issues with sight has gotten steadily worse throughout the month. He also explained that he felt a lot of tingling and numbness, and fatigue throughout the day. He has had to take time off of work because he has troubles concentrating and remembering things. Thinking for a little amount of time is a great struggle for him.  He says he finds his everyday life to be a struggle. He has lost control over his bladder and ha has often been in need of supports for walking and this morning he collapsed to the ground because he had a muscle spasm in his leg.  His wife immediately took him to the doctors to see what was wrong with him. Finally, he has difficulty controlling his bladder.

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