12/1/14

Tonight's homework is to continue researching your dietary malady and hopefully draw conclusions about what is affecting your patient. Then you can begin writing it up according to the parameters discussed in class.

Diagnosing a Dietary Disaster!

Introduction

You have just graduated medical school and are now beginning your residency. You and your team of other residents will be working together to help Dr. House (who is back from the “dead,” but can’t practice medicine) with some of his more straightforward cases (sorry, no Exploding Head Syndrome or hypertrichosis to solve this time). Your task is as follows:

1. Based on the reporting patient’s symptoms, make a claim and diagnose the dietary deficiency to the best of your ability. Support your conclusion with logical reasoning.

2. Recommend a treatment for the patient with an explanation of why you think this will work.

3. Produce a write-up for the patient’s medical files as well as a report to your supervisor. Your individual write-up will include the following:

a. The patient’s symptoms

b. Your diagnosis of the dietary deficiency and the reasoning/evidence behind it

c. Your recommendation for treatment supported by reasoning and evidence

d. A prognosis for the patient – Do you expect the patient to survive? Will he or she live a normal life? Explain.

e. An MLA or APA formatted bibliography

Criteria	4 (Mastery)	3 (Proficient)	2 (Approaching)	1 (Needs Revision)
Draws conclusion and makes diagnosis	Correctly diagnoses disorder/disease	Correctly diagnoses disorder/disease	Incorrectly diagnoses disorder/disease, but diagnosis is close to actual condition	Incorrectly diagnoses disorder/disease
Supports conclusions with specific evidence	Correctly and clearly uses several pieces of evidence and reasoning to support diagnosis	Correctly uses multiple pieces of evidence and reasoning to support diagnosis	Correctly uses evidence but relies heavily on one/few pieces of evidence OR misinterprets and/or misuses a piece of evidence	Misinterprets and/or misuses multiple pieces of evidence
Demonstrates detailed knowledge of content	Consistently and correctly uses detailed explanations (to discuss condition, affected body system(s), etc.)	Correctly uses detailed explanations	Uses details and explains, but with minor errors	Avoids details OR does not explain thoroughly
Written work acknowledges sources	Always writes in student friendly language without information directly lifted from sources AND contains an APA formatted bibliography	Consistently writes in student friendly language without information directly lifted from sources AND contains an APA formatted bibliography	Consistently writes in student friendly language without information directly lifted from sources OR contains an APA formatted bibliography	Does not consistently write in student friendly language OR lifts information directly from sources OR does not submit a bibliography
Written work is professional	Writes elegantly and in a sophisticated manner while very consistently adhering to spelling and grammar conventions.	Very consistently adheres to spelling and grammar conventions.	Consistently adheres to spelling and grammar conventions.	Mostly adheres to spelling and grammar conventions.

SAMPLE

Patient: James Johns

Symptoms: Constant thirst, fatigue, frequent urination, sweet breath

Diagnosis: The constant thirst and frequent urination seemed to obviously be connected. They also point to kidney issue. The presence of glucose in James’ urine and the smell of fruit on his breath indicated that there was more to the condition rather than just kidney problems. Glucose‘s presence in the bloodstream indicates that he is likely diabetic (to be confirmed with a blood test). It is more likely that James is suffering from Type 1 diabetes as opposed to Type 2 diabetes, because of his young age and athletic lifestyle. Additionally, it is obvious that he does not have gestational diabetes because he is neither pregnant nor a woman.

Explanation: All tissues in the human body rely upon glucose as an energy source. Glucose is obtained from chemical digestion by enzymes in saliva and the small intestine and then it is absorbed into the bloodstream by the villi in the small intestine. The hormone insulin is responsible in part for maintaining blood glucose levels. Its release by the pancreas aids the diffusion of glucose into the cell so that its energy can be released and stored or used in the cell. These actions allow the cell to have a constant supply of glucose in order to function most effectively. James’ diabetes prevents his pancreas from producing more insulin and as a result, his blood glucose levels stay very high because insulin cannot help to diffuse glucose into the cell. As a result, James and his cells lack energy.

Recommendations: James should continue to eat healthy and exercise regularly. He will also need insulin in order to balance his blood glucose levels. Daily injections of insulin will helpful for managing his diabetes. He will also need a blood glucose meter in order to keep track of his blood glucose levels and keep it under 110 mg per 100 mL of blood .

Prognosis: If James carefully monitors his blood glucose levels, maintains his insulin injections and continues his otherwise healthy lifestyle, then he should live a normal life for a long time to come. If he does not, then he may suffer from complications such as hypoglycemia, which could cause short-term problems such as a lack of energy, fainting or even a diabetic coma that could result in death. Without proper management of his condition, James is at a much higher risk of complications such as heart disease, blindness, neuropathy, amputations, and kidney disease.

Bibliography:

Eckman, A. (2010, May 10). Diabetes - symptoms, diagnosis, treatment of diabetes. Retrieved from http://health.nytimes.com/health/guides/disease/diabetes/overview.html

Zieve, D., & Eltz, D. (2011, August 31). Diabetes. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/