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Smoking and COPD: Case Study of Patrick

Presentation Requirements for the Clinical Case Presentation

How to Prepare your Presentation 

1) Plan your verbal answers to your questions; do not include or read out the question, and do not undertake “introductory” conversation.  The answers to questions are to be in a style to demonstrate your understanding of relevant concepts to your assessor; this assessment does not involve you having a conversation directly with Patrick.  

2)  Prepare a Powerpoint Presentation, make a voice-over Powerpoint recording, and save as a movie:

Slide 1:  All names and student members of your group members

Slides 2-7: 1 slide (or 2 slides if preferred) for each of the 6 questions listed below for Patrick.  Prepare visual material to accompany each question, whilst you verbally speak and record your oral answers to each question.  The visual material should not be the same as the words you are saying, but should be supportive material such as dot points, flow diagrams, and key concepts.  Images may be included but are not essential.  References are not required, but it is very important that you do not copy information directly from a source in order to promote Academic Integrity; you must re-frame the information into your own words, and personalise that information to the case on Patrick.

We recommend using the narrated PowerPoint function to audio-record your presentation.  This is then saved as a movie (.mov, .mp4 or .wmv format).  Mac users will need to use a QUT on-campus computer to save this in the appropriate format.

Please be aware that it can take extended time to export your narrated Powerpoint as a video.  Ensure that you allow PLENTY of time to create this file and complete the submission steps by the due date and time.  You are reminded of QUT’s late assignment policy.   

The assessor must be able to open your file and clearly hear your presentation, otherwise it will not be marked and you will receive a grade of 1.  

3)  Go to your personal YouTube channel to upload your movie.  

Many students will already have created a YouTube channel through assessments for NSB104, NSB105 and/or NSB202.  If you do not already have a YouTube channel, this box shows you how to do this.   

When you upload your movie, YouTube will create a URL for your file.

Please do not attempt to directly upload your video to Blackboard – there are strict limitations on file size that students can upload, and the uploading process can take several hours or more.  

4)  Using the URL that you have obtained that links to your movie on your YouTube channel, please type this URL into the relevant box in the Assessment Coversheet.

5)  Submit the Assessment Coversheet (relevant to Assessment 1) through the Turnitin site prior to the due date and time.  

Important notes:

The presentation must be submitted through the above steps.  

Do not include the YouTube link on your assessment coversheet, as these links are de-activated through the Turnitin process.  

Please be aware that it can take a considerable amount of time to create and save a Powerpoint file as a movie; ensure that you allow PLENTY of time to complete this well before the due date/time.  You are reminded of QUT’s late assignment policy.   

There is no “live” oral presentation within class time (ie students do not stand in front of the class and present). 

Answer

Case Study of Patrick

Q1. 

Patrick is suffering from severe cough and signs of dyspena. He has difficulties in breathing along with wheezing, shallow breathing and noisy breathing. The previous medical history of Patrick stated that he was a smoker from his 20’s and he quit it at his early 60’s. Therefore, a study conducted by the Centers for Disease Control and Prevention (CDC), suggested that 90% of the lung cancer and COPD death is directly caused by smoking (Urmc.rochester, 2018). Therefore, COPD can precipitate cough and different features of dyspena. Studies suggested that smoking can create irritation of the larynx and trachea. Therefore, it can reduce functional capacity of the lungs by swelling and narrowing the lung airways and increasing the mucus in the passage and result shortness of breath. In this condition impairment of the lungs clearance system can increase the poisonous substances which can damage the lungs gradually. In case of Patrick prolong habits of smoking can cause permanent damage of air sacs present in the lung and the increase the chances of lung infections and COPD.

 Q2. 

It has been observed that habits of smoking can raise the blood pressure and heart rate. In patients with COPD it has been recognised that lack of oxygen in blood reduced the blood flow to extremities and damaging the arteries lining. This can be caused in elevating the blood pressure and heart rate (Jensen et al., 2012). COPD can over stress the heart due to lack of oxygen in blood. In case of Patrick, his age, previous history of smoking and COPD can accelerate his heart rate. In addition, Patrick is an obese which also plays an important role in increasing his heart rate. However, increasing heart rate in COPD patients can indicate the severity of the illness and amplify the chances of mortality. 

Q3. 

The prime cause of COPD is smoking. Long smoking history can be considered for reducing the lung functions.  In addition airways obstructions due to emphysema and chronic bronchitis can be responsible for COPD (Mayo Clinic, 2018). 

Left side heart failure is mostly caused by high blood pressure and coronary heart disease. However, in COPD can influence the onset of the incident by lowering the blood oxygen and pressuring the heart. 

Therefore, studies recommended that left side of human heart receives oxygenated blood from the lung and circulated the fresh blood throughout the body. Hence, in COPD , abnormal immune response can cause inflammation which can adversely affect the airways. This condition can precipitate coronary heart disease in which narrowing of the blood vessels can create burden. In COPD, the chances of hypoxemia, pulmonary hypertension is also increased which can hypertrophied the left heart and develop left heart failure (Bottrell, 2017). 

At last it can be concluded that the disease of left- sided heart failure can be precipitate by different reasons, however, COPD is not directly responsible for the disease. Thus, it can adversely the affect the whole scenario and increase the chances of disease onset. In addition, left- sided heart failure can precipitate fluid deposition in lungs and aggravated the symptoms of COPD. 

Q4.  

In this scenario it can be predicted that the persons with lungs diseases are vulnerable to develop right- sided heart failure. The right side of the human heart receives un-oxygented blood from the body and carries out it towards the lungs for purification purpose. In COPD lack of oxygen in lungs due to obstructive airways can alter the function of the lungs.  As a result the body is unable to solve the problems. Therefore, the body is sending more blood to the disease area of the lungs by constricting the blood vessels. In progression of COPD, when the number of disease area in lungs increases can cause the heart works stressfully to pump the blood through the diseased lungs (WebMD, 2018). Therefore, it can increase the pulmonary blood pressure and cause hypertrophy heart muscles which unfavourably change the whole situations.

 In addition, the incident of left sided heart failure can elevate the chances of right sided heart failure in COPD patients. Therefore, in case of Patricks the chances of right sided heart failure is much higher compared to others. 

Q5. 

The fasting blood report of Patrick suggested that he has suffering from calcium ions deficiency. In COPD, it is a common phenomenon; therefore, it has been isolated that the COPD patients are suffering from calcium, magnesium, and vitamin D deficiency.  Thus a poor lung functions is responsible for electrolyte imbalance in the body. 

Patrick has low haemoglobin count which is also symptoms anaemia. In COPD increase level of inflammatory cytokines can reduce the life expectancy of RBC which increases the production demands. However, the bone marrow cannot able to response properly by increasing the RBC production. This condition can lead erythropoietin resistance and precipitate anaemia (Toft-Petersen, Torp-Pedersen, Weinreich & Rasmussen, 2016).     

LDL is considered as bad cholesterol and HDL is considered as good cholesterol. Therefore, the blood report of Patrick indicating that he has low level of good cholesterol and high level of bad cholesterol. This scenario can increase the onset of stroke and heart failures. However, the use of oral steroid during the treatment process of COPD can raise the blood cholesterol level (Mayo Clinic, 2018).

High glucose level is indicating that the chances of diabetes are elevated by COPD. Studies suggested that inflammatory chemical in COPD can get into the blood stream and damage the other vital organs like pancreas and liver. This can increase the chances of diabetes. COPD is caused by smoking. Therefore, habits of smoking can enhance the depositions of free radicals in human body and reduce the effectiveness of antioxidants. Thus, this condition can cause high blood glucose. In COPD, lack of oxygen can injure the vital organs and cause diabetes. At last the use of corticosteroid medicines can increase the blood glucose level and develop diabetes.  

In neurological aspect, the high cholesterol level can lead to dementia in affected individual. However, the high blood glucose level can damage the blood vessels in the brain and develop vascular cognitive impairment. Therefore, COPD causes memory loss and disorderly thinking problems (Rushlow, 2018). Lack of oxygen in blood can cause scarcity of oxygen in brain cells and develops neural damage.  

 Q6. 

Troponin T level : 

Normal- <0.01 ng/dl 

Patrick’s -0.06ng/dl

Serum troponins T value can increase in chronic COPD as it can exhibit the severity of the exacerbation. It can be identified that in COPD troponin level can significantly elevate due to tachycardia, renal impairment, and anaemia (Harvey & Hancox, 2004). In case of Patrick, he is suffering from COPD for long period of time. Hence, elevated tropinin level can damage his cell by necrosis and increase the chances of ischemia and cardiac failure. Thus, it can increase the rate of mortality among COPD patients.        

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