Unit 3 Case Studies
MODULE 7
T.J. is a 14-year-old female who just immigrated to the United States from Guatemala.
T.J. is emaciated, pale, and complains of shortness of breath. T.J.'s nutritional status is
poor, as her diet had consisted primarily of rice and corn. Microscopic examination of
T.J.'s blood indicated that she is severely anemic.
1. What type of anemia would T.J. most likely have?
T.J. likely has iron-de ciency anemia. Based on her mostly vegetarian diet of
corn and rice which are poor sources of iron. However, considering her age and
sex, T.J. may be experiencing blood loss related anemia and should be further
evaluated.
2. What is the best treatment for this?
In this case, T.J. has advanced signs of anemia and should be prescribed oral
iron supplementation like ferrous sulfate for 120 days and be reevaluated at that
point. She should be instructed on dietary modi cation and adding red meat, sh,
beans to her diet. Cream of wheat, spinach and raspberries are also good
sources of iron. It may take 3 months for T.J. to feel back to health. Adding stool
softeners with the iron supplements can help prevent constipation with may
hinder T.J. from taking the medication.
MODULE 8
Linda, a thin 4th grader, experienced a signi cant weight gain within two weeks' time.
Just before holiday break, she had a bad sore throat, but after a visit to the doctor, those
symptoms subsided. Her abdomen was distended and she had edema to the
extremities. She complained of abdominal discomfort and general aches. Urinalysis
indicated proteinuria and hematuria. A follow-up blood screen found antibodies to
streptococci.
1. How do you explain Linda's signs and symptoms? (1 point)
Based on the case scenario, Linda likely has Acute Post-streptococcal
glomerulonephritis (PSGN). Linda had symptoms of strep throat and we do not
know if she was tested or treated following the doctor visit. However the only way
for streptococci antibodies to be found in her blood is if she had a prior infection of
the bacteria. Following a streptococcal infection of the throat, antibodies from the
bloodstream may become trapped in the glomeruli of the kidney. This explains
Lindas distended abdomen, peripheral edema, hematuria and proteinuria.
Glomerulonephritis is a common disease that effects children following a strep
infection.
2. What is the treatment for her condition? (1 point)
Blood tests, urine studies, ultrasound, and or biopsy are done for de nitive
diagnosis. Treatment for Linda may include IV and oral hydrations with or with out
diuretics to ush the kidneys. Anti-in ammatory and immunosuppressive drugs may
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MODULE 7
T.J. is a 14-year-old female who just immigrated to the United States from Guatemala.
T.J. is emaciated, pale, and complains of shortness of breath. T.J.'s nutritional status is
poor, as her diet had consisted primarily of rice and corn. Microscopic examination of
T.J.'s blood indicated that she is severely anemic.
1. What type of anemia would T.J. most likely have?
T.J. likely has iron-de ciency anemia. Based on her mostly vegetarian diet of
corn and rice which are poor sources of iron. However, considering her age and
sex, T.J. may be experiencing blood loss related anemia and should be further
evaluated.
2. What is the best treatment for this?
In this case, T.J. has advanced signs of anemia and should be prescribed oral
iron supplementation like ferrous sulfate for 120 days and be reevaluated at that
point. She should be instructed on dietary modi cation and adding red meat, sh,
beans to her diet. Cream of wheat, spinach and raspberries are also good
sources of iron. It may take 3 months for T.J. to feel back to health. Adding stool
softeners with the iron supplements can help prevent constipation with may
hinder T.J. from taking the medication.
MODULE 8
Linda, a thin 4th grader, experienced a signi cant weight gain within two weeks' time.
Just before holiday break, she had a bad sore throat, but after a visit to the doctor, those
symptoms subsided. Her abdomen was distended and she had edema to the
extremities. She complained of abdominal discomfort and general aches. Urinalysis
indicated proteinuria and hematuria. A follow-up blood screen found antibodies to
streptococci.
1. How do you explain Linda's signs and symptoms? (1 point)
Based on the case scenario, Linda likely has Acute Post-streptococcal
glomerulonephritis (PSGN). Linda had symptoms of strep throat and we do not
know if she was tested or treated following the doctor visit. However the only way
for streptococci antibodies to be found in her blood is if she had a prior infection of
the bacteria. Following a streptococcal infection of the throat, antibodies from the
bloodstream may become trapped in the glomeruli of the kidney. This explains
Lindas distended abdomen, peripheral edema, hematuria and proteinuria.
Glomerulonephritis is a common disease that effects children following a strep
infection.
2. What is the treatment for her condition? (1 point)
Blood tests, urine studies, ultrasound, and or biopsy are done for de nitive
diagnosis. Treatment for Linda may include IV and oral hydrations with or with out
diuretics to ush the kidneys. Anti-in ammatory and immunosuppressive drugs may
fl fi fl fi fi fi fi
