A 25 year-old male reports a life-long history of upper respiratory tract infections which occur about twice a year. Three weeks ago, he came down with the “flu,” with coughing of yellowish-green and difficult to expectorate sputum, fever and chills, shortness of breath, and slight chest pain. He saw a biomedical physician who diagnosed acute asthmatic bronchitis and prescribed a course of Amoxicillin for 10 days and a metered dose Albuterol inhaler, 2 puffs every 4 hours for a week. He stopped taking the inhaler after 4 days because he seemed to be getting palpitations, nervousness, and sleeplessness from taking it; besides, he was no longer short of breath. He did complete the course of Amoxicillin. He smokes marijuana daily and consumes about 3-4 beers nightly. He denies tobacco use. He has a steady diet of fast food and particularly enjoys very spicy Mexican food.
The cough has decreased gradually and the sputum has gradually become lighter in color; however he is still coughing. The cough is most prominent in the morning and after meals. Although there is no longer any yellow sputum, there is now a copious amount of whitish-grey sputum throughout the day. He also reports fatigue and loose stools since taking the antibiotic, as well as slight nausea and decreased appetite. His tongue is pale, tooth marked, and coated with a thick slimy white fur. His pulse is soft (Ru Mai).
Biomedical Examination
Upon auscultation, there are some slight wheezes and faint crackles. He does not appear short of breath at rest. His blood pressure is 115/62 and his pulse rate is 70. His respiratory rate is 15/min. His temperature is 98.1F.
1. TCM name. Explain (etiology, general facts, prognosis)
Based on the signs, symptoms and his history,...
... middle of paper ...
...toger, E. (2004). Chinese Herbal Medicine: Materia Medica. Seattle, WA: Eastland Press.
Bensky, D., Barolet, R. (1990). Chinese Herbal Medicine: Formula & Strategies. Seattle, WA: Eastland Press
Damone, B. (2011). Pacific Collage of Oriental Medicine DTD 1 course notes. San Diego, CA: Pacific College of Oriental Meidicine.
Deadman, P., & Al-Khafaji M. (2009). A Manual of Acupuncture. East Sessex, England: Journal of Chinese Medicine Publications
Liangyue, D., Yijun, G., Shuhui, H., Xiaoping, X., Hengze, X., Xinling, X., … Jingling, Y. (2010). Chinese Acupuncture and Moxibustion. C. Xinnong (Ed.). Beijing, China: Foreign Languages Press.
Wiseman, N., & Ellis, A. (1996). Fundamentals of Chinese Medicine. Brookline, Mass: Paradigm Publications.
Wu, Y., & Fischer, W. (2009). Practical Therapeutics of Traditional Chinese Medicine. Taos, NM: Paradigm Publications.
The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow.
Examination revealed an oxygen saturation of 98% and blood pressure of 145/90. Oropharyngeal inspection revealed significant crowding (Mallampati class 3) with macroglossia. Chest auscultation was clear and two heart sounds were audible with nil else.
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
Mathews, Holly F. "Introduction: A Regional Approach and Multidisciplinary Persepctive." Herbal and Magical Medicine: Traditional Healing Today. Ed. James Kirkland, Holly F. Mathews, C. W. Sullivan, III, and Karen Baldwin. Durham: Duke UP, 1992. 1-13. Print.
The EB’s case study said the female patient is 50 years old with symptoms of fever, chills, congestion, three weeks of coughing, shortness of breath when walking. The study implies that the patient is now seeking medical advice due to vital signs recording and the noting of decreased breath sounds and wheezing. She denies smoking and not taking any chronic medication.
Public Health Reports (Interagency Team at NIMH and NIDA Studies How Acupuncture Works.) (1974-) , Vol. 95, No. 5 (Sep. - Oct., 1980), pp. 503-504
Traditional Chinese Medicine: An Introduction [NCCAM Backgrounder]. (n.d.).National Center for Complementary and Alternative Medicine [NCCAM] - nccam.nih.gov Home Page. Retrieved December 11, 2011, from http://nccam.nih.gov/health/whatiscam/chinesemed.htm
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
Acupuncture originated in China and it has been practice for more than 2000 years now. This modality is considered the main treatment within the traditional Chinese medicine. Its main concept is the conviction that the body possesses hidden channels identified as meridians. These channels allows for the flow of energy which is considered a vital life force through all the body. Acupuncture modality believes that when this energy becomes obstructed or imbalanced, sickness and symptoms can build up. It is only when this energy becomes unblocked by stimulating focal points in the meridians that health can be achieved again (Cherry & Jacob, 2010).
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
Medicine presents a myriad of complex puzzles waiting to be solved. Though not for the faint of heart, Internal Medicine allows for a daily dose of these complex diagnostic and treatment problems. During my Internal Medicine rotation, one of my most memorable cases was a 44-year-old who presented with shortness of breath, cough, night sweats, fever, focal neurological
Herbal remedies’ qualities are widespread availability, lower cost, effective for chronic conditions. Herbal remedies are the use of plants or plant extract to treat a person’ overall health. Herbal treatments are prominent for developing countries for instance, “in Africa up to 90% and in India 70% of the population depend on traditional medicine to help meet their health care needs” (Wachtel-Galor & Benzie, 2011), due to their low cost and availability. Herbal remedies have gained attention in the past decades, and expanding their uses due to the increased interest of natural therapies (Wachtel-Galor & Benzie, 2011). Herbs used on the remedies grow in the wild throughout the world, therefore making it easy to