|
Symptoms & History
Physical Findings
Stop & Think
Lab and X-Ray
Differential Diagnosis
The Disease
Treatment
Conclusions
Quiz & Evaluation
|
|
Mr. Harvey had a rather complicated problem. Obviously, his clinical course
sure didn't work out too well.
-
History and physical is where it all starts.
-
His diabetes resulted from high cortisol levels.
-
The increasing cortisol led to changes in his insulin requirement.
-
His adrenals were hyperactive because they were caught up in a
paraneoplastic syndrome secondary to ACTH secretion by a small
cell carcinoma.
-
Small cell carcinomas arise from neuroendocrine cells, unlike the common
variety of lung cancer, squamous cell carcinoma.
-
The overall picture undoubtedly contributed to an increased susceptibility
to infections.
-
Focal bronchial obstruction by his tumor created the right local circumstances
for the pneumonia to start.
-
Unfortunately, the bug happened to be a methycillin resistant Staphylococcus
aureus.
He died.
Did we do a lousy job
?
Back
|
|