History of Present Illness: The patient states that she has been having vaginal bleeding more like spotting over the past month. She denies the chance of pregnancy; although she states that she is sexually active and using no birth control.…
A 22 year old married female comes to endocrinologist for evaluation, she want to have kids but has not attained her menarche (primary amenorrhea). She also noticed a mass in the right groin (undescended testis), not associated with pain. No c/o vomiting, abdominal pain or any other associated complication. She also have frequent back pain and knee joint pains (osteoporosis).…
Jacqueline Mallett will be out on leave until Monday of next week. Therefore, should I feel out her leave sheet for her, or wait until she gets back? Annie usually makes the decisions whether to fill leave sheets out for employees who are on LWP. Jacqueline showed me how much leave she has accrued, and she will definitely go into LWP by being off.…
9/18/2009 CASE PRESENTATION #1 URINARY INCONTINENCE Clinical Clerkship Lecture Series Mrs. V.M. 44 year old female GTPAL 44004 referred by her family doctor with urinary by her family doctor with urinary incontinence. What questions would assist you in making a diagnosis?…
HISTORY OF PRESENT ILLNESS: The patient states she has been having vaginal bleeding more like spotting over the past month. She denies the chance of pregnancy although she states that she is sexually active and using no birth control.…
A case of 23 year old female presented with primary amenorrhea, poor pubertal development and with absent sense of smell. She was overweight, her breast development was Tanner stage 2, pubic and axillary hair Tanner stage 3 with normal external genitalia . laboratory work up done which revealed low normal LH and FSH as well as estradiol, serum cortisol, and testosterone level. Prolactin was slightly elevated. TSH and FT4 were also normal as well as OGTT, electrolytes, and hematology results. SGPT revealed to be elevated an ultrasound of liver revealed fatty liver. Patient had 46 XX karyotype. Pelvic ultrasound revealed small atrophic uterus and atrophic ovaries. Cranial CT scan shows negative CT scan of the sellar region and brain, non specific tentorial calcification. MRI of the head revealed essentially normal MRI of the brain, polysinusitis with retention cyst in the right maxilla…
“I hear and I forget. I see and I believe. I do and I understand.” --Confucius (551-479 BC)…
4. RADIOLOGIST- PERFORM DIFFERENT PROCESDURES USING IMAGING TECHNOLOGY TO TREAT DISORDERS SUCH AS UTERINE FIBROIDS…
What are the latest views on materiality in financial accounting? How have standards for measuring materiality changed since passage of the Sarbanes-Oxley Act? And what new approaches are being taken to better assess the materiality of financial information? In the aftermath of the Enron scandal, corporate financial statements are under greater scrutiny than ever, forcing auditors to pay closer attention to many transactions previously considered immaterial. This paper reviews the basis of materiality in financial reporting and the methods commonly used to assess what is – and what is not – material.…
Henry Sy and John Gokongwei introduce their heirs to already solid and full founded dynasty of business. Both tycoons share their ideas and decisions to their children. even they make decision , a big part of it , which influence them very much , are still their fathers who made thousands of critical decision before. Such great tycoons knows exactly what to do, Henry Sy and John Gokongwei introduce their children to the world of business , but not to the world of nothingness, there children is the smallest worker of the big dynasty of the company , but they already have something to start up with.…
She has taken oral contraceptive pill for her family planning. The couple wishes to have children every four years. Apart from that, She also had pap smear done in 2004 and 2008. There were no abnormalities detected. There are also no history of surgical procedure , infertility and STI.…
The Mother Tongue-Based Multilingual Education refers to “first-language-first” education that is, schooling which begins in the mother tongue and transitions to additional languages particularly Filipino and English. It is meant to address the high functional illiteracy of Filipinos where language plays a significant factor. Since the child’s own language enables her/ him to express him/herself easily, then, there is no fear of making mistakes. It encourages active participation by children in the learning process because they understand what is being discussed and what is being asked of them. They can immediately use their mother tongue to construct and explain their world, articulate their thoughts and add new concepts to what they already know.…
1. Problem Statement: Identify the problem(s) concisely, using whatever case facts are necessary to show significance and/or priority.…
A case study is a description of an actual administrative situation involving a decision to be made…
PHYSICAL EXAMINATION: Vital signs show temperature 97 degrees. Pulse 53 respirations 22. Blood pressure 108/60. GENERAL: physical exam revels a well-developed, well-nourished 35-year-old white female is the moderate amount of distress at the time of the examination, HEENT are all remarkable except poor indentation. Neck is soft and supple. CHEST: Lungs are clear in both fields. HEART: Regular rate and rhythm. ABDOMEN: soft but positive tenderness of her lower abdominal area. Fundus was not palpable above the pubic area. Left adnexal are more than tender than the right. VAGINAL EXAM: The cervix is close. A moderate amount of motherapulient vaginal discharge is noted. The patient wouldn’t allow me to perform a bimanual examination due to her pain so the speculum was withdrawn. EXTERMITIES: No clot or edema. NUEROLOGIC EXAM: Intact urea x3, no neurologic deficits. DIAGNOSTIC Dr.: admission hemoglobin 12.8 grams, hematocrit is 36.6%. Urinalysis is essentially negative. Beta hcg is positive with the WBC count of 23,278. RADIOLOGY: pelvic ultrasounds shows a 7 week, 4 day off viable ectopic pregnancy per radiologist. The patient was given Demerol 25 mg and Phenergan 25mg IV for the pain after her report was obtained. She was also given Claforan 1 gram IV. I paged the South Miami office and reached Dr. Gerard’s office at approximately 10:15 am. His office personal advised me that he is not on call, Dr. Vonbeck is on call. I spoke with Dr. Vonbeck at approximately 10:25 am and she will be here to take the patient to the operating room.…