PBL Sessions: Vascular Diseases 1

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Case Introduction and Chief Complaint:

Your medical practice includes the Smith family:

Robert comes to see you because of a 4 day history of pain and burning on urination. He has had increased frequency of urination for the past 3 months. He has had no major medical illnesses. He had a right inguinal hernia repair at age 31. Family History: His mother Doris lives with the family and helps with caring for the two children. His father died at age 65 of a stroke. Social History: He works as an insurance claims adjuster. He does not smoke. He occasionally drinks alcoholic beverages.

Valerie comes to see you because of a month-long history of occasional right upper quadrant pain. She says the pain can be intense for about 20 minutes and then subside. She has had one or two episodes per week, but has had one per day in the past week. These episodes seem to occur in mid-afternoon or early evening. She has had no major medical illnesses. She is G2 P2, with menstrual periods averaging 29 days, but she missed her last period. She has had no major surgeries. Family History: Her father died at age 59 of a heart attack. Her mother died at age 70 of breast cancer. Social History: She has a part-time job as a sales clerk. She does not smoke. She does not drink alcoholic beverages.

Tasks

• What problems can you identify for these family members?

• What hypotheses can you suggest that might be causing their problems?

• Explain your reasoning for the hypotheses you choose.

• What learning issues are being identified?

• What additional information might you request?

Stop !! Complete discussions and tasks before moving to the next page.