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Charogat
Charogat, Doctor
Category: Health
Satisfied Customers: 1588
Experience:  Licensed in both NYS and NJ with experience in surgery and medicine.
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Write a medical report describing the history, symptoms, and

Customer Question

Write a medical report describing the history, symptoms, and physical examination findings of a patient with pancreatitis. Make sure to include the following terms in your report.

1.Acute
2.Chronic
3.Gallstones
4.Furosemide
5.Azathioprine
6.CT Scan
7.Stethoscope
8.Amylase
9.Lipase
10.Prognosis
11.Endoscopy
12.Pseudocyst
13.Cystic Fibrosis
14.Hypercalcemia
15.Hyperlipidemia
16.Hypertriglyceridemia
17.ERCP
18.Insulin
19.Diagnosis
20.Pancreas divisum
Submitted: 3 years ago.
Category: Health
Expert:  Chris12 replied 3 years ago.

Please read carefully and answer completely for faster service. Due date and time of assignment? # XX refs? Word/page length? APA? Is additional info needed to complete?

Customer: replied 3 years ago.
due tomorrow and this is all the info i posted that is required. thank you
Expert:  Chris12 replied 3 years ago.
What time tomorrow?
Customer: replied 3 years ago.
800am
Expert:  Chris12 replied 3 years ago.

My apologies, I won't have the assignment done by 8am. I will opt-out so another expert can assist you.

Customer: replied 3 years ago.
what tim can you have it done by
Expert:  Charogat replied 3 years ago.
hi,
If you still need help (as it seems this was due this morning) please let me know.
I also see that you've only accepted 4/8 of the answers that other experts have given you. I want to make sure you are serious about this before I spend a couple hours of my time.
Thank You
G-d Bless
Customer: replied 3 years ago.

I'm very thisserious about this I need this asap before tomorrow morning i got any ext. on

Expert:  Charogat replied 3 years ago.
Ok.
I am working on it.
Customer: replied 3 years ago.
Thank you ever much for doing this.
Expert:  Charogat replied 3 years ago.
Your welcome.
Please make sure to click ACCEPT as I have spent a few hours trying to make this as good as possible for you.
G-d Bless

If you have any follow-up questions for me please feel free to ask them.

________________________
If you are satisfied with the doctor's answer please click 'accept' so that she can be paid. BONUSES and POSITIVE FEEDBACK are not expected, but are always appreciated.


CC: My stomach has been hurting for the last week but got much worse last night, when I also developed a fever.

HPI: Patient is a 43yowm with a history of cystic fibrosis and renal failure, s/p cadaveric transplant. He reports that he has had abdominal pain for the last week which has suddenly worsened. He reports that he has developed a fever and chills overnight. Patient denies any bloody bowel movements or black tarry stools. Patient reports no change in his urinary volume. He also denies any recent history of alcohol..

PMHx:
Cystic Fibrosis
ESRD s/p cadaveric transplant
Chronic Pancreatitis

PSHx:
Cadaveric renal transplant

Medications:
Azathiprine
Furosemide
Pancreatic Enzymes
Tori
Pulmozyme
Anti Inflammatory medication
Hypertonic Saline

Allergies: NKDA

SocHx: No smoking/drugs/alcohol

ROS:
General: No complaints of insomnia, generalized fatigue, night sweats, or unintentional weight loss.
HEENT: Denies any headaches, dizziness, syncope, changes in his vision, photophobia, hearing loss, tinnitus or vertigo. Also denies nosebleeds, PND, or sinus pressure. Denies any mouth sores, bleeding or other oral ulcers.
Respiration: Wheezing daily, exercise intolerance, +chronic cough, and sputum production. Denies hemoptysis.
CV: Denies any chest pain or pressure, palpitations, PND or edema of the lower extremities.
Abdomen:+epigastric pain radiating to the back, +N/V without hematemesis, no D/C
Musculoskeletal: Denies any joint stiffness, pain or swelling. Reports chronic clubbing of fingernails.

PE:
Vitals: T=101.4 HR=100 BP = 135/85 O2Sats 92% on RA
A&O*3, appears ill
HEENT: NCAT, EOMI, PERRL, No erythema or edema of ENT, Oral Mucosa is pink w/o any lesions or ulcers.
Neck: Supple, trachea midline, no thyroid enlargements, no carotid bruits
Chest: on auscultation with a stethoscope there are diffuse W/R/R. No egophany was appreciated.
Heart: PMI was not palpable, RRR no MRG.
Pulses: 2+ throughout
Abdomen: Severe pain apparent in upper abdomen, decreased bowel sounds throughout. + scar from heterotopic cadaveric implant. No jaundice apparent. + tenderness and guarding on palpation. No organomegally palpated.
Musculoskeletal: Good tone and reflexes throughout, complete passive ROM in all joints. Strength 5/5 throughout.

Labs:
CBC: Hemoconcentration and Leukocytosis
CMP: Significant for hypercalcemia, hyperlipidemia, and hypertrigliceridemia. Elevated BUN/Cr ratio, elevated glucose levels. Grossly elevated Amylase and Lipase levels.

Imaging studies:
CXR shows hyperinflation of the lungs with bronchiectasis
Abdominal CT is significant for heterotopic kidney, and small native kidneys. No free air is seen in the abdomen, +inflammatory changes around the pancreas, +calcifications in the pancreas. No pancreatic necrosis noted. No pancreatic pseudocyst seen.
Abdominal U/S: Shows no gallstones, no pericholic thickening or inflammation.
MRCP: Shows no biliary or pancreatic duct obstruction, and no pancreatic divisum.
Write a medical report describing the history, symptoms, and physical examination findings of a patient with pancreatitis. Make sure to include the following terms in your report.

ERCP: No indicated at this time as the patient has apparent severe pancreatitis. There is no suspicion of choledocholithiasis as the patient shows no evidence of gallstones (cholelithiasis).and he does not have biliary pancreatitis.
Endoscopy is not indicated in this patient for the same reasons mentioned above.

Diagnosis:
Patient with acute on chronic pancreatitis likely secondary to history of CF and of azathioprine.
Patient not in need of insulin at this time as the endocrine function of the pancreas has continued working for now.

Prognosis: Commiserate with degree of pancreatitis.
Facts that must be taken into effect to determine the prognosis for this patient include Ranson’s criteria, as well as complications from CF and renal transplantation.
Expert:  Charogat replied 3 years ago.
I was wondering if you were going to pay. I did ask you in the beginning if you were serious about this.

G-d Bless

If you have any follow-up questions for me please feel free to ask them.

________________________
If you are satisfied with the doctor's answer please click 'accept' so that she can be paid. BONUSES and POSITIVE FEEDBACK are not expected, but are always appreciated.
Customer: replied 3 years ago.

I did accept answer it took money off my balance

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