Pathophysiology Case Studies
Case Study 1
Ms. J., a 26-year-old female, presents with symptoms, which could possibly indicate urinary tract infections. It is widely known that dysuria and urgency to urinate coupled with frequent urination are among the most common complaints from patients with diseases of lower urinary tract. Several laboratory tests were performed to understand the cause of afore mentioned symptoms.Urinalysis showed the presence of inflammatory process in urinary tract. To be exact, dark yellow color of the urine, bacteriuria (presence of bacteria in urine), pyuria (presence of WBC in urine) and absence of casts coupled with pubic and lower aches discomfort could be considered as potential signs of cystitis.
Noteworthy, that cystitis is a rather common disease of lower urinary tract in women due to anatomic features of female urogenital system.Differential diagnosis for infectious cause of bacteriuria and pyuria include cystitis and pyelonephritis. To make an accurate diagnosis, physician should understand the difference between cystitis and pyelonephritis (Dulczak and Kirk). Contrary to cystitis’ clinical picture, clinical presentation and symptoms of pyelonephritis develop rapidly including fever, chills and flank pain. The onset of pyelonephritis is usually sudden and acute. Judging from the patient’s history and the localization of pain, cystitis is more likely to be final diagnosis in given situation.Treatment of cystitis depends on the type of bacterial cystitis (complicated or uncomplicated) and above all involves antibiotic treatment. First-choice antibiotics agents include nitrofurantoin monohydrate/macrocrystals, trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin (Brusch et al.). It is important to remember that effective antibiotic treatment is impossible without taking into consideration the evidence of antibiotic resistance.
Case Study 2
Mr. S., a 69 years-old male, cigarette smoker, presents with symptoms that can be perceived as signs of chronic lung disease. Moreover, history of patient shows recurrent episodes of cough, especially in the morning on arising, and shortness of breath occurring even at rest. As can be seen, physical exercises intensify existing symptoms. Patient’s history and his objective assessment revealed that he could possibly suffer chronic obstructive pulmonary disease (CORD). CORD is known to be a group of chronic respiratory disorders, which causes irreversible and progressive damage to lungs. Although chronic obstructive pulmonary disease has slowly progressive clinical course, repeated episodes of its acutization could be also present. In following case, physician can observe symptoms of both chronic bronchitis and emphysema. Furthermore, fresh air of the mountains combined with physical activity trigged asthma episode, which is also included into classic triad of CORD (Kleinschmidt).
Results of patient’s instrumental and functional investigation showed flat and low diaphragm with lung hyperinflation, decreased tidal volume and vital capacity, increased total lung capacity, and prolonged forced expiratory volume. The results of pulmonary test indicated reduced lung function as the consequence of chronic inflammation of bronchi complicated by thickening of mucous membranes, enlargement and destruction of the alveoli and loss of alveoli’s elasticity (Gozhenko et al.). It is important to realize that further progression of CORD could be a risk …
