What is a risk-benefit analysis of cultural, socioeconomic, developmental, and physical factors with some examples?
What type of information should be in the presenters notes for a PowerPoint presentation?
Ms. Hernandez is a 34 year old female who presented to your office today with complaints of right upper quadrant pain. Patient reports that her pain started a few days ago and has been getting progressively worse and today is accompanied by nausea and dry heaving. Ms. Hernandez reports that the pain is worse shortly after eating and she has had a poor appetite for the past few days due to the pain and nausea. Patient denies any vomiting or diarrhea and denies any bloody emesis or stools. Patient has tenderness in the RUQ on palpation.
1b. What are the differential diagnosis choices for the patient’s symptoms? What diagnostic labs or tests might you order to confirm your diagnosis?
1c. What is your treatment plan/recommendation for the diagnosis? For acute, for non-acute?
Acute
Non-acute
Mr. Marx is a 58 year old male with a past medical history of occasional heartburn and osteoarthritis presented to the clinic with complaints of mid epigastric pain. The patient states that pain is better with food and when he takes his Tums but is worse when he has an empty stomach or is hungry. In the ROS, the patient also reports that his stools have been a little darker lately, but he denies any vomiting, or diarrhea. Patient does admit to taking Ibuprofen daily to help with his arthritis pain.
2b. The physical exam was significant for mildly tender epigastric area, fecal occult blood test was positive for blood in the stool. What other tests might you recommend?
2c. What are your treatment recommendations?
PATIENT CASE
Patient’s Chief Complaints and History of Present Illness
M.L. is a 50-year-old white female who has been working in the front office of a medical clinic for the past five years. She has made an appointment to see her primary care provider because she has been feeling very tired for the past month and has also been suffering from stiffness, pain, and swelling in multiple joints. “I ache all over,” she told her PCP, “and I have pain in different places all the time. One day it is in my right shoulder, the next day in my right wrist, and the following day in my left wrist. I’m stiff everywhere when I get up in the morning or if I sit for any length of time. And I feel so tired, like I have a case of the flu that won’t go away.” The patient is allergic to IV iron dextran from which she has developed shortness of breath. She rarely uses alcohol and does not smoke. She is taking an over-the-counter calcium supplement, levothyroxine sodium, and venlafaxine. There is no family history of rheumatoid arthritis.
Physical Examination and Laboratory Tests
The patient is pleasant and alert, but appears very tired. She is in moderate acute distress from joint pain.
Vital Signs BP 125/80 left arm, sitting; P 80; RR 15; T 100.0°F; Ht 54; Wt 140 lbs
HEENT
• Head atraumatic
• PERRLA
• Normal funduscopic examination
• EOMI
• TMs intact
Skin
• Intact, warm, pink, and dry • No rashes • Normal turgor
Neck
• Supple with no jugular vein distention or thyromegaly
• No bruits
• Mild lymphadenopathy bilaterally
Lungs
• Clear to auscultation and percussion
Heart
• RRR • Normal S1, S2; no S3 or S4 • No murmurs, rubs, or gallops
Abdomen
• Soft, non-tender, and non-distended • Positive bowel sounds throughout • No superficial veins or organomegaly
Breasts No lumps, dimpling, discharge, or discoloration
Genitourinary
• Last menstrual period 16 months ago • Normal pelvic exam and Pap smear
Neurologic
• Alert and oriented 3 • Cranial nerves II-XII intact • Muscle strength: 5/5 upper extremities, 4/5 lower extremities • DTRs 2 in biceps, triceps, and patella
Rectal Heme-negative stool
Musculoskeletal, Extremities • No clubbing or ankle edema • Hands: Swelling of the 3rd, 4th, and 5th PIP joints bilaterally; pain in the 4th and 5th MCP joints bilaterally; poor grip strength bilaterally • Wrists: Good range of motion, fixed nodule at pressure point on left side • Elbows: Good range of motion, fixed nodule at pressure point on right side • Shoulders: Pain and decreased range of motion bilaterally • Hips: Good range of motion • Knees: Pain, significant edema, and decreased range of motion bilaterally • Feet: No edema, full plantar flexion and dorsiflexion and full pedal pulse bilaterally
Laboratory Blood Test Result
s Na 140 meq/L ANA Negative Hct 43% Uric acid 2.9 mg/dL K 3.7 meq/L ESR 38 mm/hr WBC 15,100/mm3 Cholesterol 189 mg/dL Cl 104 meq/L Cr 1.0 mg/dL Plt 270,000/mm3 Albumin 4.0 g/dL HCO3 23 meq/L Glucose, fasting 94 mg/dL RBC 4.7 million/mm3 TSH 1.7 µU/mL BUN 18 mg/dL Hb 14.9 g/dL Ca2 8.8 mg/dL RF Positive
Urinalysis Normal with no RBC, WBC, or protein Bruyere
Chest X-Ray No fluid, masses, infection, or cardiomegaly
Hand X-Ray Soft tissue swelling and bone demineralization; no erosions
Synovial Fluid Analysis (Left Knee) • 7.4 mL volume • Cloudy and yellow in appearance • 14,000 WBC/mm3, primarily neutrophils • Glucose: 60 mg/dL
Questions:
1. Which of the vital signs above is consistent with a diagnosis of rheumatoid arthritis and why?
2. List two conditions for which the drug venlafaxine is often prescribed.
3. Identify two abnormal findings from the physical exam above that are consistent with rheumatoid arthritis.
4. What is the association between the “fixed nodule(s) at pressure point(s)” on the left wrist/right elbow and a diagnosis of rheumatoid arthritis?
5. Why is it reasonable that this patient has no stiffness, pain, or swelling in the DIP joints of the fingers?
6. Identify three abnormal laboratory tests that are consistent with a diagnosis of rheumatoid arthritis.
7. Why is it entirely appropriate that the PCP has ordered a TSH test for this patient?
8. Provide a reasonable explanation for the serum uric acid test result?
9. What is probably the first class of drugs that the PCP will prescribe for this patient?
After the Lehman Brothers collapse, the federal Reserve stood ready to lend financial institutions
funds. When the Federal reserve did this, it was acting in its role as a lender of last resort. Which type of
group has this role?
Informal institution
Nongovernmental organization
Formal institution
Government agency
2 evidence based strategies to promote interprofessional collaboration
SCENARIO:
Soleil Panel Distribution, a solar panel company, has been in business for 25 years. For the first two decades, they focused primarily on distributing small panels used in personal electronic devices, such as calculators and watches. As solar-powered technology has developed, the company is seeing unprecedented growth. They have gone from 15 to well over 150 employees in three years. They are expanding on multiple fronts and seeing growth in residential rooftop solar panel sales, largescale commercial applications, and product distribution.
While growth has increased both sales and profits, this rapid growth has presented various challenges for a company so accustomed to small-scale operations. One of the most pressing challenges is the onboarding of new employees. In the first 12 years, the organization hired one or two employees every few years. An administrator easily handled this process, and each department handled tasks pertaining to the new-hire’s various roles. More recently, the company has experienced monthly increases in personnel of as many as 20, making their current onboarding process obsolete. The administrator who previously handled employee onboarding had been trying to improve the process, but it has become clear that the company no longer has the time or processes in place to surmount this challenge.
In addition, analysis of the solar industry competition implies that a quick growth of the employee workforce could position Soleil Panel Distribution to improve its market share.
Over the years, Soleil Panel Distribution has grown and developed a seasoned software team as part of the IT department, and they feel confident a new software application called SolDistHR can meet their needs while addressing concerns. While anticipating rapid growth and additional software vulnerabilities, their other concerns include security and customer support.
QUESTION: How does the above scenario represent Porter’s models, including five forces industry, generic strategies, and the value chain, applied to the scenario?
What is an IT SWOT analysis of a company?
Based on this Scenario Can you help me to :
A. Discuss how you would plan the catered lunch project by completing each of the following 5 distinct project management phases:
1. Project initiation
a. Describe the project and the need for the project. Include information from the provided scenario for support.
b. Identify three relevant stakeholders and discuss how the project impacts each stakeholder.
c. Discuss whether the project is feasible by addressing each of the three triple constraint components: scope, cost, and timeline.
2. Project planning
a. List three milestones for the project plan and provide a timeline for each milestone.
b. Write a SMART goal for the project.
c. Identify two different potential risks to this project’s success and describe how each risk could be managed.
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