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Religious Studies 2140 Chapter Notes - Chapter 8: Médecins Sans Frontières, Survival Kit, Stethoscope

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carminewalrus808
18 Jul 2015
School
Western University
Department
Religious Studies
Course
Religious Studies 2140
Professor
perierra

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Document Summary

This moral map represents my life and my future. In the near future i plan on graduating high school and going to university to study medicine, which are represented by the graduation cap and by the university symbol on my moral map. Becoming a doctor has been a dream of mine ever since i was 6 years old, and it is still my dream to become a doctor. The caduceus sign on my moral map represents my future of becoming a doctor. I plan on going back to my home country. Syria to help and take care of all the victims of the war that is going on there. I have learned so much and grown from the people my home country and it is my time to pay them back by doing my best to help the victims of the war.

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Related Questions

Please help answer 4 questions:

1. Using the information provided thus far by both Parts I and II, answer the following questions.

What problems both stated and unstated does Phyllis seem to be experiencing? What pieces of background information (patient environment and social/family history) have been provided by the family?

2. Distinguish between the relevant and non relevant symptoms/lab results needed to form a diagnosis. Of the relevant symptoms/lab results, rank them in priority and defend your answer.

3. Given what you know about the role of myelin in action potential propagation and the key information previously identified in questions 1 and 2, explain why multiple sclerosis is the appropriate diagnosis.

4. Consider you are the physician, what would be your strategy to slow progression of the disease and compensate for reduced neuronal function? What is the long-term prognosis with treatment?

The Soccer Mom:

A Case Study on the Nervous System

by

Jennifer Bolognese, Misti Coronel, Anita Intorre, and

Phil Stephens Biology Department Villanova University

Part I—At the Soccer Game

Thirty-two-year-old Phyllis Jackson was sitting on the bench at the side of the soccer ?eld, sipping a bottle of

Gatorade. Her husband, Steven, sat next to her with a concerned expression. “I’m really worried about you, honey,” he said.

“I’m just a little dehydrated; I’ll be ?ne.”

“If this were the ?rst incident, then maybe I’d agree with you. But your boss has been on your case about your lack of concentration at work, you forgot to pick up the kids from school last week, and quite frankly, you haven’t exactly been yourself with me lately. Now you’re having fainting spells during games? Something doesn’t seem right.”

“I know things haven’t been going well for me lately, but I don’t know why. I try so hard at work, at home, with the kids, to be a good wife. So maybe all this stress has made me a little unfocused and disoriented. What do you want me to do about it?” Phyllis said, blinking back tears.

“I think you should see a doctor,” Steven replied, putting his arm around her and drawing her close. “The kids are getting worried, too.”

Phyllis sighed. “Alright, if it will make you feel better. I really just think I need some time to relax, though.” “Well… I could drop the kids of at my sister’s tonight; that would give us a little free time…”

“That’s really thoughtful of you. I could de?nitely use a quiet night at home, maybe even go to bed early.” Steven seemed disappointed.

Part II—The Doctor Visit

“So, what seems to be the problem, Mrs. Jackson?” Dr. Warner asked Phyllis.

“My husband wanted me to come in and see you after I fainted during my soccer game Saturday. I’ve also been having some problems at work, but I think I’m just stressed.”

“What kinds of problems have you been having at work?”

“It’s been hard to concentrate on tasks. I’ve also had some problems typing—I’ve been making more errors than usual, and oftentimes my ?ngers will go numb.”

“I see,” said Dr. Warner, taking a few notes on his clipboard. “According to my records you are not on any long term medication. Have you noticed any problems outside of work?”

“Well, my husband has been complaining about our personal life lately. And last week, I completely forgot that I was supposed to pick up our two daughters after school. I’ve been feeling really tired lately; even my coordination seems of.”

“How long has this been going on for?”

“A few weeks, but this isn’t the ?rst time. These problems seem to come and go, but it’s getting to the point where I can’t just ignore them anymore. I don’t know, maybe I’m just depressed.”

“Why do you say that?”

“My mother suffered from depression throughout my childhood.”

“Well, depression certainly could cause some of the symptoms you’re experiencing,” Dr. Warner said thoughtfully. “Is there a history in your family of any neurological disorders?” “I don’t think so. I have some vague recollection of my grandfather in a wheelchair when I was really young, but I don’t know what was wrong with him.”

“Okay,” said the doctor, nodding. “Well, the few preliminary tests we’ve run show that you are not pregnant, and that you are not going through menopause. I’d like to send you to see Dr. Thrush, a friend and colleague of mine. She is a neurologist at the local hospital and she will run a few tests to explore your symptoms a little further.”

Questions: Analyze

1. Using the information provided thus far by both Parts I and II, answer the following questions.

What problems both stated and unstated does Phyllis seem to be experiencing? What pieces of background information (patient environment and social/family history) have been provided by the family?

Part III—Diagnostic Tests

Dr. Thrush looked over the results of Phyllis’s Magnetic Resonance Imaging (mri) and evoked potential tests. She was thinking how glad she was that Steven had accompanied Phyllis on this visit as she showed them the MR images of Phyllis’ brain.

“The machine took pictures of Phyllis’ brain in slices. The dark areas are the brain tissue, Phyllis, and the white areas in the middle and around the outside are the cerebrospinal ?uid.”

“Is that normal? Am I ok?” Phyllis asked. “And what are those little white dots in the tissue?”

“The white dots are what concerned me,” replied the doctor. “So we did another type of mri, called dark ?uid, so that your cerebrospinal ?uid would not show up white.”

“But I still see the white dots in my brain tissue. What does that mean?”

The doctor looked down, knowing that this was never an easy thing to tell a patient.

“I am afraid that this indicates that there are plaques or scars in your brain, and that you may have multiple sclerosis.”

Tears began to form in her eyes as Phyllis squeezed her husband’s hand.

“I am afraid that the evoked potential test and the elevated levels of myelin basic protein in you cerebrospinal ?uid indicate the same thing.”

Questions: Evaluate and Apply

2. Distinguish between the relevant and non relevant symptoms/lab results needed to form a diagnosis. Of the relevant symptoms/lab results, rank them in priority and defend your answer.

3. Given what you know about the role of myelin in action potential propagation and the key information previously identified in questions 1 and 2, explain why multiple sclerosis is the appropriate diagnosis.

Part IV—The Diagnosis

Dr. Thrush informed Phyllis that she was probably suffering from the relapsing-remitting form of multiple sclerosis (ms), in which relapses of symptoms are separated by periods of remission. ms is a disorder in which the myelination of axons is degraded due to unknown factors. The most commonly accepted explanation is that ms is an autoimmune disorder in which myelin in the central nervous system is attacked by the body’s own immune system. There is no known cure for multiple sclerosis. During remission, axons affected by the disorder regain their function. Voltage-gated sodium channels are concentrated in the nodes of Ranvier and the distribution changes at disease onset.

Questions: Create

4. Consider you are the physician, what would be your strategy to slow progression of the disease and compensate for reduced neuronal function? What is the long-term prognosis with treatment?

Thank you for your time with this

proof read please

Society is changing constantly and families has different point of view of how to live their life or raise their kids. I think what we know so far as a family will change in the near future. Furthermore for my own personal experience I have seen great thing from the changes that have come over the past years to now and it was acceptable by the society however, People and society in general like good changes. My grandma at age of 13 yrs. old had kids and spouse and they used to stay home raising their kids and taking care the house, while spouse were working to bring food to their tablet and older kids in the household used to work to support their parent home too Versus now in 2016 that family are disintegrating, kids are isolating themselves from their family due to the technology and you see more divorce. I could imagine how family will be 100 year from now. I have seen that woman wants to be more independently and having kids is not their priority anymore because I feel that it won’t be no family 50 to 100 year from now. It will be a law that marriage couple are going to have 1 year marriage contract. I can say that many values come from our parents and most are very worthwhile and I pass those values to my kids and I would like to retain them, but Family values are different from culture to culture and tradition and there will be change by the time, based on these I could say that it won’t be moral and immoral activities 50 year from now. We are goings lose moral value and ethic and I will see population decrease causing higher dead and less birth because government will soon controlling family life by limit how many kids a marriage couple could have. Since technology offer a good and effectively way to keep in touch with family around the world, but I also think technology will also affect family in the household. However, technology is taking control when the one on one communication is falling apart. The social media preventing family from communicating and less interaction with family and the society won’t have too much talking. I probably happy to say that the only positive thing that I will see 50 to 100 year from now will be major diseases like Heart attack , diabetes and cancer will largely preventing by the time with new scientist and good technologies. As a family we need to know and stay focus of who we are, in what we personally think values stand for because our action won’t always stay of our deepest belief. There is gab between our life values, action and behavior and if we retain those values chances are that even though 50 year from now won’t matter how great the external rewards.

Mary, a 23 year old female was involved in a head on collision that lead to massive head trauma and neurological injuries. She is not defined as brain dead, however, after 3 weeks in the Medical Intensive Care Unit and neurological consultations there is grave concern for the patient. The medial team has come back with a prognosis that “meaningful recovery” is estimated to be less than 1%. At this point it appears that Mary would remain in a non-responsive (vegetative) state.

During this entire ordeal, Mary’s religious parents have been by her side and keeping track of everything going on. After consultation with Mary’s doctor and their priest, who is currently present for support, they decide it is time to remove Mary from tube feedings and off the ventilator. The parents feel that it is now “God’s will.” Later that day, while the priest is present and with family surrounding, they remove life support.

In preparation, the Medical Intensive Care Unit nurse notified the Organ Procurement Organization (OPO) to be on standby, with the expectation that soon after extubation, death would soon follow. Mary was always thinking of others and even though she never signed up with the online stated done registry, her driver’s license showed she was an organ donor represented by a “heart” on the front. Mary was carefree and did not have any healthcare directives but her driver’s license was enough to be considered a “first person consent.”

However, there is an issue. When the OPO rep arrives to discuss this with the family and explain that Mary had wishes to donate her organs, the parents are taken aback and upset at the suggestion. They explain that this was never discussed as a family and that they would not allow this to occur.

Even though Mary is not brain dead she qualifies as a donor under the hospital’s “Donation after Cardiac Death” protocol. In addition, this would be in accordance with the state’s newly revised “Uniform Anatomical Gift Act” which states that, “in the absence of an express, contrary indication by the donor, a person other than the donor is barred from making, amending, or revoking an anatomical gift of a donor’s body or a part if the donor made an anatomical gift.

The OPO rep goes to the attending physician and explains the interaction with Mary’s parents. They discuss hospital policies and state law, which is on their side. They also begin examination of Mary for preparation for possible donation. Soon after Mary’s parents come looking for the doctor and an explanation as to why Mary has not been removed from the machines and “let God take over.”

Question 1) What should happen next? On what ethical and moral grounds? What about the law?