Medical and dental history
Below are elements of the medical history on two patients. You are given answer choices after each question. On a separate piece of paper, write your answer and your reason for choosing that answer. Check your answer and your reason by clicking on the Answer and Reason pull downs below each case. Be certain you understand the reason before you leave the quiz.
Your patient, Mr. Simmons, presents with a bilateral white plaque on the buccal mucosa that rubs off. You scrape some of the material off and smear it on a slide, fix it and send it to a laboratory for diagnosis. The report with the diagnosis comes back Candida, albicans. Which of the following elements in the patient history would you connect with this patient's problem and the diagnosis?
- heart attack, 1987
- stomach ulcer last year treated with Tagumet
- long term Cyclosporine therapy for kidney transplant
- appendix removed 1963
c. long term Cyclosporine therapy for kidney transplant.
Patients on long term antibiotic therapy often destroy the ecology of the normal flora of their GI tract, their mouth and/or their genital area (particularly women). Candida albicans is an "opportunistic organism." This means it will take any opportunity it can to proliferate and grow. If the organisms with which it competes are not in abundance, this is a window of opportunity for Candida to thrive. In this patient, another factor is at work. Because Mr. Simmons is a kidney transplant patient, he is taking immunosuppressive medications. This means his immune system is not as effective in fighting infection as a person not on these medications. Thus Mr. Simmons has two reasons to be susceptible to Candida infection.
Your patient, Maria Garcia, lists the medication Methyldopa and Hydrochlorothiazide in the Medical History under "Current Medications." She has not listed any diseases for which she is under a physician's care. Which of the following questions should you ask her? (If you don't know the medications, look them up in a drug reference book. You should have one as part of your library, and keep it current.)
- Considering the medications you listed, do you have an infection?
- Considering the medications you listed, do you have hypertension?
- Considering the medications you listed, do you have seizures?
- Considering the medications you listed, are you being treated for a venereal disease?
b. Considering the medications you listed, do you have hypertension?
Both Methyldopa and Hydrochlorothiazide are medications used to treat high blood pressure.