HPB Assignment

Patient Case Study

Mr Bob Jackson is a 55 year old man admitted to ED with a presenting complaint of

diarrhoea, nausea and malaise. His Subjective and Objective examinations are as follows:

History of presenting complaint:

1 week history of increasing Left Lower Quadrant (LLQ) abdominal pain and diarrhoea

Medical History:

Obesity Seasonal rhinitis

Osteoarthritis Right knee Depression
Hypertension AF

Surgical History:

Appendicectomy as a child
Knee arthroscopy 2005

Allergies

NKA

Medications

Celebrex Metoprolol
Ramipril

Review of Systems
CNS

Currently not on antidepressants, describes normal mood in last year

No dizziness, headache, vision change noted, except some headache during last few days

Resp

Recurrent bronchitis and colds over last year

CXR NAD 12 months ago
Recent haemoptysis and persistent cough with mild pleuritic pain over 1/12

CVS

Regular antihypertensives (Ramipril)

No central chest pain/ palpitations/dizziness reported

GIT

3/12 Hx of occasional loose stools and frank blood in bowl.

States that over the years that he has often had runs of watery diarrhoea that he treats with
gastro-stop
 States a history of piles

UGS

No retention/hesitancy/pain

MKS

Nocturnal bone pain in hips and back noted last 2/12 - treated with OTC Ibuprofen
Hx of knee and lumbar pain

Social History

Sheep farmer at Patersons Plains, a rural community 100 km Northwest of Melbourne. Married
with 2 adult children.

Lifestyle

Currently smokes pack a day for the last 35 years

Alcohol: 6 stubbies of heavy beer a week
Denies illicit drug use

On examination:
Vital signs: T-37, HR -96 Sinus Rhythm, RR 20, BP 165/110, SpO2 98% on RA

CNS

Alert and orientated

Resp

Chest clear on auscultation

CVS

Warm and well perfused, cap refill < 3 sec, slight pallor

GIT

Pain Left lower Quadrant abdo soft and tender in LLQ

6/10 at rest 8/10 on movement Lower abdominal distension noted
Mildly obese

UGS

Urinalysis shows SG 1.05, otherwise NAD

MKS

NAD
Assignment question

Answer the following questions in regards to Mr Jacksons presentation.

1. Hypothesise the most likely chronic disease process that fits Mr Jacksons symptoms and
history. Your hypothesis must be justified by aetiology and pathophysiology relevant to Mr
Jacksons presentation.

2. Name one other chronic disease that explains Mr Jacksons symptoms. Justify what
further data, such as diagnostic tests and/or further history, which would enable a clinician
to discriminate between these two diseases.

Guidelines

Part 1 is asking you to find the most likely disease that fits these symptoms not
the most obscure disease to fit these symptoms. There are many diseases that fit but
select one that is most likely i.e. fits the symptoms but also is common.

Marks in this assignment are not attained for regurgitating facts you must use
the facts (aetiology and pathophysiology) to justify your proposed disease that is,
how well does the proposed aetiology and pathophysiology fit the symptom profile,
how realistic is it, why do you think that this is the most likely disease? It might be
useful to look at epidemiology and the risk factors that increase the chances of one
disease being more likely than another

Read the rubric half the marks are for analysis and the rest split evenly between
logical construction and use of evidence. This assignment is heavily weighted
towards how you use your facts and how you structure your argument there are no
marks for piling facts up randomly.

The marker do not have a list of diseases that you must satisfy to get marks. If you
justify your selected physiology with a rational argument as to its likelihood you will
have marks accorded.

The first sentence in part 2 is a statement. You do not need to provide a rationale
at this stage.

In the rest of part 2 you will need to provide examples of diagnostic tests and/or
further information from Mr Jackson that the collaborative care team might employ
to differentiate between the two diseases that you have selected. It might be
appropriate to compare and contrast the two pathophysiologies at this point.

How many references do you need? If you use three or less, then you are in
danger of having a very restricted information base to make an effective argument.
Assignment Instructions

Format:
The assignment will be read on-screen by markers so use a web-friendly font and
spacing: UseGeorgia, Arial or Verdana size 12 font with 1.15-1.5 spacing.
Dot point format not acceptable
References used should be acknowledged in-text using APA version 6 formatting
Provide a full list of end-text references using APA Version 6 formatting.

Construction:

No introduction or conclusion required

Use headings for Part 1 and part 2 to partition the assignment but do not use the
assignment questions in the heading.

The discussion must be presented using academic assignment format with

attention to good paragraph structure, grammar, Australian spelling and formal
academic expression.

Submission:
Assignments must be submitted electronically by 0900 hours 4th September 2017
via Turnitin on LMS.

Extensions
Students must seek a formal extension to submit after the deadline where there
are extenuating circumstances. The extension must be sought at least three (3)
days prior to the submission date.
The central LTU Request for Extension process must be used; the link for this can
be accessed via the Essentials tab on LMS or at
http://www.latrobe.edu.au/students/request-an-extension

If you have a personal issue or illness that has affected your capacity to complete
the assignment you may be eligible to apply for special consideration.
http://www.latrobe.edu.au/special-consideration

Late Submissions
An assignment submitted after the due date without an extension will incur a
penalty of 5% per working day of the total possible mark for the assessment in
question.
 Assessment tasks will not be accepted after the earlier of the following occurrences:
The fifth (5th) working day after the due date; or
Feedback on the assessment task has been returned to any student by a
teaching team member.

Academic Integrity

Please makes yourselves familiar with the university policy on academic

misconduct which can be found below.

https://policies.latrobe.edu.au/document/view.php?id=221

See the student guidelines on Academic Integrity, including definitions and tips to
avoid plagiarism and how to reference:

http://www.latrobe.edu.au/students/academic-integrity
https://latrobe.libguides.com/referencing
Assessment Excellent 80- Above expectation Meets Pass 50-60% Marginal 30-50% Needs Mark
criteria 100% 70-80% expectation - Improvement 0-
60-70% 30%
Analysis of Very good application Compares and contrasts Comprehensive Critical analysis Completely descriptive with Data not interpreted or
and analysis of patient evidence effectively with descriptive limited and some critical elements missing. applied to patient case.
patient case
data to support critical thinking and discussion with pertinent data Hypothesis not supported by Implausible hypothesis or
study. hypotheses. analysis evident. evidence of critical missing. data or pathophysiology aetiology. /50
Interprets and judges Hypothesis well supported examination. Some Hypothesis is not discussed and/or irrelevant or
*Q: 1 - Justifies patient data well and by data. data missed and well supported by unclear discussion.
aetiology makes sound inferences some analysis data or
*Q:-2 - Justifies of aetiology. absent or unclear. pathophysiology.
differentiation Hypothesis largely
supported.
Logical Logically argued and Minor errors in logic or Errors in logic that Errors of logic that Deficiencies in logic that Absent in logic or /25
constructed. Clear clarity. hamper argument. detract from makes the piece lack haphazard construction.
construction and
progression of ideas. Unclear passages or readability or sense. coherency. Nonsensical.
clarity. errors of Inarticulate style that Inarticulate style that creates
. construction that hampers clarity. ambiguity or has internal
obscure the contradictions.
argument.
Use of evidence Well selected sources Well selected sources used Evidence is Some evidence is of
used to support argument to support argument generally well poor quality, less Singular source or poor Evidence absent, irrelevant
based sources.
convincingly. effectively. selected but is than three quality of information used. or non-academic in nature
limited or does not references. Very limited support of /25
always support References provide argument provided.
argument limited support for
effectively. argument.
Subtotal
/100
Referencing/citations APA 6 style not consistently used for citations
(up to 4 marks deducted) APA 6 style not consistently used for reference list

Presentation Specified format not used (font, double spacing)

(up to 3 marks deducted) Spelling, typing and/ or grammatical errors

Word limit Word limit - (more than or less than 10% of the prescribed limit)
(up to 3 marks deducted) Subtract Subtotal
/10

Total /4
= /25